bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin combined with spironolactone vs. metformin alone in polycystic ovary syndrome: a meta-analysis
Authors: Zeng Huamin , Zhang Ying , Huang Sikai , Wu Jinghua , Ren Wenrui , Zhou Lingru , Huang Leneng , Ye Yuyin 
Published: August 2023

AimsDue to its high heterogenicity and unclear etiology, there is currently no specific treatment for polycystic ovary syndrome (PCOS). Metformin, as an insulin sensitizer, combined with spironolactone, an antiandrogen medication, may exert complementary effects on PCOS. We therefore performed a meta-analysis of trials in which metformin combined with spironolactone was applied to treat PCOS to evaluate the efficacy and safety of the combination therapy.MethodsWe retrieved the PubMed, Embase, Scopus, Cochrane Library, CNKI, CBM, Wangfang, and VIP databases for literatures published from their inception to December 16, 2022 on the effects of metformin combined with spironolactone in the treatment of PCOS. Inclusion criteria according to P.I.C.O.S criteria were: PCOS patients, metformin combined with spironolactone interventions, metformin alone control group, and randomized controlled trials with the following outcome data: body mass index (BMI), hirsutism score, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), fasting blood glucose (FBG), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and side effects including nausea, vomiting, diarrhea and drug withdrawal.ResultsOur results revealed that metformin combined with spironolactone significantly reduced BMI and TT, but that it exerted no significant effects on hirsutism score, or on FSH or LH concentrations. Combined treatment also resulted in a significant diminution in FBG and insulin resistance using the HOMA-IR when the interventional time was greater than 6 months. In addition, the combination did not have a higher occurrence of adverse reactions than metformin alone.ConclusionCompared with metformin alone, metformin combined with spironolactone therapy may be more effective in reducing BMI and serum androgen levels, but the combination showed no significant effect on the hirsutism score or gonadotropin hormone levels, and was not associated with an elevation in side-effects. Moreover, when the treatment course was greater than 6 months, combination therapy reduced FBG and improved insulin resistance more effectively than metformin alone. However, more research is needed to determine the most effective course of treatment.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022355515.
Uneven vulnerability: characterizing population composition and change in the low elevation coastal zone in the United States with a climate justice lens, 1990–2020
Authors: Tagtachian Daniela , Balk Deborah 
Published: August 2023

Fine scale data collection on vulnerability metrics is necessary for just policy outcomes. Those most likely to be disproportionately affected by specific climate risks should be identified early so that the needs of vulnerable communities (especially historically marginalized communities) can be addressed and mitigated in accordance with climate justice principles. While there is a growing body of event-specific and place-based studies, systematic studies on coastal populations at risk have typically not applied equity principles and have often ignored attributes such as race and ethnic composition, age structure, urban/rural classification, and housing tenure. Additionally, assumptions about future population trends depend on understanding past spatial patterns of change, as well as demographic and socioeconomic characteristics of the populations at risk, especially considering increasing coastal hazards. Yet, with few exceptions, research on coastal vulnerability has not analyzed changes in exposure over time and has not systematically addressed implications for communities of color over time. This paper seeks to fill these gaps. In this paper, using an equity lens and spatial demographic methods with the finest-resolution data available (census blocks), we estimate the extent of exposure and population change from 1990 to 2020 in the low elevation coastal zone in the continental United States. We find that the population of the LECZ has increased during this period, primarily by the growth of the urban population which has risen from about 22 million to 31 million persons. From 2000 to 2020, the urban population consistently grew at higher rates inside the LECZ than outside of it, reversing the pattern from the decade prior. We also examine changes in the population by race and Hispanic origin, urban and rural status, and a set of more expansive vulnerability themes. Our estimates, tabulated by counties and states, reveal the concentration and characteristics of exposure and changes to it over the past 30 years. Key findings include: residents of the LECZ are much older than average; Black residents are overrepresented in renter-occupied housing units in the urban LECZ; and from 2000 to 2020, Hispanic population growth was much higher in urban LECZ areas than urban areas elsewhere. These systematic insights into the demographic attributes of the populations most at risk of sea-level rise and associated coastal hazards can be used to ensure adaptation, mitigation, and disaster-related policies are tailored to the specific needs of these communities and actors at local, regional, and national scales. It also showcases how spatial methods can be used to understand demographic change and be put in place for future estimates of population in non-traditional units (e.g., coastal zones or other environmentally-vulnerable areas).
Fast degradation of carbamazepine in water by electric discharge plasma
Authors: Gao Shuzhan , Lu Fu , Abid Abid Ali , Yang Xiyao , Wu Zhengwei 
Published: August 2023

The proliferation of pharmaceuticals in the aqueous environment has adversely impact on human health and ecosystem balance. Pharmaceutical contaminations are difficult to remove effectively by conventional treatment technologies. In order to degrade carbamazepine (CBZ) efficiently, a common antiepileptic drug, three plasma discharge modes were studied, including liquid-phase discharge, air gas-liquid jet and dielectric barrier discharge. It is noteworthy that the degradation efficiency and energy yield reached to highest levels (0.11 g/kWh) when operating at 225 W input power under liquid phase discharge, compared with the other discharge modes. The parameters of concentration, electrode distance, volume, input power and frequency of the discharge were also evaluated and optimized. Plasma emission spectroscopy revealed the degradation process is mainly attributed to reactive oxygen species (ROS), while the role of reactive nitrogen species was not significant. The contributions of diverse ROS were assessed by radical quenching experiments, including p-benzoquinone, p-phthalic acid and tert-butanol. The possible degradation intermediates and pathways of CBZ were tested and analyzed by liquid chromatography-mass spectrometry (LC-MS). Comprehensively consideration of cleanliness, degradation efficiency and application difficulty, liquid-phase discharge treatment is a promising technology for water treatment.
Prognostic effect of lncRNA BBOX1-AS1 in malignancies: a meta-analysis
Authors: Lin Guangyao , Wang Yongzhou , Deng Li , Ye Tao 
Published: August 2023

Background: With the increasing number of new cancer cases and mortality rates, cancer has become a serious global health problem, but there are no ideal cancer biomarkers for effective diagnosis. Currently, mounting evidence demonstrates that lncRNAs play a fundamental role in cancer progression. BBOX1 anti-sense RNA 1 (BBOX1-AS1) is a recently clarified lncRNA and has been identified as dysregulated in various carcinomas, and it contributes to poor survival in cancer patients.Methods: We thoroughly searched six databases for eligible articles published as of 27, April 2023. The association of BBOX1-AS1 expression levels with prognostic and clinicopathological parameters was assessed by odds ratios (OR) and hazard ratios with 95% CIs. Additionally, we further validated our results utilizing the GEPIA online database.Results: Eight studies comprising 602 patients were included in this analysis. High BBOX1-AS1 expression indicated poor overall survival (OS) (hazard ratios = 2.30, 95% Cl [1.99, 2.67], p &lt; 0.00001) when compared with low BBOX1-AS1 expression. Furthermore, BBOX1-AS1 expression was positively correlated with lymph node metastasis (OR = 3.00, 95% CI [1.71–5.28], p = 0.0001) and advanced tumor stage (OR = 3.74, 95% CI [2.63–5.32], p &lt; 0.00001) for cancer patients. Moreover, BBOX1-AS1 was remarkably upregulated in 12 malignancies, and the elevated BBOX1-AS1 expression predicted poorer OS and worse disease-free survival (DFS) confirmed through the GEPIA online gene analysis tool.Conclusion: The findings highlight that BBOX1-AS1 was significantly associated with detrimental overall survival, disease-free survival, lymph node metastasis and tumor stage; thus, it could act as a novel promising biomarker to predict the clinicopathological characteristics and prognosis for various cancers.
Comparison of platelet-and endothelial-associated biomarkers of disease activity in people hospitalized with Covid-19 with and without HIV co-infection
Authors: van der Mescht Mieke A. , Steel Helen C. , de Beer Zelda , Abdullah Fareed , Ueckermann Veronica , Anderson Ronald , Rossouw Theresa M. 
Published: August 2023

IntroductionSARS-CoV-2 elicits a hyper-inflammatory response that contributes to increased morbidity and mortality in patients with COVID-19. In the case of HIV infection, despite effective anti-retroviral therapy, people living with HIV (PLWH) experience chronic systemic immune activation, which renders them particularly vulnerable to the life-threatening pulmonary, cardiovascular and other complications of SARS-CoV-2 co-infection. The focus of the study was a comparison of the concentrations of systemic indicators o\f innate immune dysfunction in SARS-CoV-2-PCR-positive patients (n=174) admitted with COVID-19, 37 of whom were co-infected with HIV.MethodsParticipants were recruited from May 2020 to November 2021. Biomarkers included platelet-associated cytokines, chemokines, and growth factors (IL-1β, IL-6, IL-8, MIP-1α, RANTES, PDGF-BB, TGF-β1 and TNF-α) and endothelial associated markers (IL-1β, IL-1Ra, ICAM-1 and VEGF).ResultsPLWH were significantly younger (p=0.002) and more likely to be female (p=0.001); median CD4+ T-cell count was 256 (IQR 115 -388) cells/μL and the median HIV viral load (VL) was 20 (IQR 20 -12,980) copies/mL. Fractional inspired oxygen (FiO2) was high in both groups, but higher in patients without HIV infection (p=0.0165), reflecting a greater need for oxygen supplementation. With the exception of PDGF-BB, the levels of all the biomarkers of innate immune activation were increased in SARS-CoV-2/HIV-co-infected and SARS-CoV-2/HIV-uninfected sub-groups relative to those of a control group of healthy participants. The magnitudes of the increases in the levels of these biomarkers were comparable between the SARS-CoV-2 -infected sub-groups, the one exception being RANTES, which was significantly higher in the sub-group without HIV. After adjusting for age, sex, and diabetes in the multivariable model, only the association between HIV status and VEGF was statistically significant (p=0.034). VEGF was significantly higher in PLWH with a CD4+ T-cell count &gt;200 cells/μL (p=0.040) and those with a suppressed VL (p=0.0077).DiscussionThese findings suggest that HIV co-infection is not associated with increased intensity of the systemic innate inflammatory response during SARS-CoV-2 co-infection, which may underpin the equivalent durations of hospital stay, outcome and mortality rates in the SARS-CoV-2/HIV-infected and -uninfected sub-groups investigated in the current study. The apparent association of increased levels of plasma VEGF with SARS-CoV-2/HIV co-infection does, however, merit further investigation.
Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study
Authors: Wang Zonghua , Fan Jiangshan , Chen Ling , Xie Langlang , Huang Lingfang , Ruan Yang , Xu Xia , Liang Zeping 
Published: August 2023

BackgroundAlthough the incidence of pressure injury in the prone position is high for the mechanically ventilated patients in the intensive care unit, evidence-based strategies are still lacking.ProposeTo conduct a systematic review of current evidence, and to propose a series of strategies to prevent pressure injuries among mechanically ventilated patients with prone position in the intensive care unit.MethodsThe study was guided by the Medical Research Council framework. After a systematic review of current evidence of original articles, guidelines, expert consensus and theories, a strategy draft was developed. Then we invited 20 experts to modify and refine these strategies through two rounds of Delphi consensus method.ResultsAfter two rounds of Delphi process, the importance of coefficient of variation (Cv) and Kendall’s coefficient of concordance in the strategies repository were 0.067 and 0.311, respectively. And the operability of Cv and Kendall’s coefficient of concordance in the strategy draft was 0.055 and 0.294, respectively. Ultimately, we established 31 strategies for including 7 themes (assess risk factors, assess skin and tissue, body position management, skin care, nutrition, preventing medical device-related pressure injuries, education and supervision). In addition, we also developed a strategy framework to clarify our strategies.ConclusionAccording to the Medical Research Council framework, we developed 7 themes and 31 strategies to prevention prone-position pressure injuries among the intensive care unit mechanically ventilated patients. This study was considered to improve the clinical management of pressure injuries among prone position patients in the intensive care unit settings.
Validity and reliability of the Berlin questionnaire for the detection of moderate or severe obstructive sleep apnea in patients aged 40 years or older detected from primary care
Authors: Navarrete-Martínez Esther , Muñoz-Gómez Rafaela , Serrano-Merino Jesús , Perula-de Torres Luis Angel , Vaquero-Abellán Manuel , Silva-Gil Fátima , Roldán-Villalobos Ana , Martín-Rioboó Enrique , Ruiz-Moruno Javier , Romero-Rodríguez Esperanza , González-Lama Jesús , Montes-Redondo Gertrudis 
Published: August 2023

BackgroundThe obstructive sleep apnea syndrome (OSA) is a highly prevalent condition. In Spain and other countries, only 5%–9% of patients with OSA have been diagnosed and treated. The lack of accessibility to diagnosis is considered the main cause of this situation through easy-to-use screening instruments, it is necessary to check their validity and reliability in the context where they are to be used.ObjectiveTo validate the Spanish translation of the Berlin questionnaire for screening for moderate or severe OSA in patients aged 40 years or more detected in primary care.MethodsA descriptive observational study, with a first qualitative phase of transcultural adaptation to Spanish using the translation-back-translation method. Setting: primary care level of the Spanish National Health System. A total of 255 patients recruited from 7 healthcare centers completed the study. The Berlin questionnaire was administered to the recruited patients, and subsequently, a respiratory polygraphy was performed to confirm the diagnosis of OSA. The concurrent criterion validity of the questionnaire and its reliability in terms of internal consistency and reproducibility (intra-observer agreement) were analyzed.ResultsThe patients’ mean age was 54.76 years (SD: 6.57; 95% CI: 53.53–54.99), and 54.12% were men (95% CI: 47.96–60.27). We found that 61.57% (95% CI: 55.57–67.57) presented OSA (apnea-hypopnea index-AHI &gt;5), and 45.5% (95% CI: 17.05–57.92) presented moderate or severe (AHI &gt;15) OSA. The Berlin questionnaire, with a cut-off point of 4.5, showed a sensitivity of 76.77% (95% CI: 67.94–85.59), a specificity of 74.49% (95% CI: 65.35–83.63), a positive predictive value of 75.25% (95% CI: 66.34–84.16), a negative predictive value of 76.04% (95% CI: 66.98–85.10), and an area under the curve of 0.786 (95% CI: 0.721–0.851). Cronbach’s alpha coefficient was 0.730 (95% CI: 0.668–0.784), and the Kappa index was 0.739 (95% CI, 0.384–1.000).ConclusionThe Spanish adaptation of the Berlin questionnaire has good validity and reliability as a test for the diagnostic screening of moderate or severe OSA in patients aged 40 years or older. The findings of our study confirm that primary care physicians should use such screening tools to predict OSA.
Comparison of the pathological outcome and disease progression of two Mycobacterium caprae experimental challenge models in goats: endobronchial inoculation vs. intranasal nebulization
Authors: Melgarejo Cristian , Cobos Alex , Planas Carles , Fondevila Jaume , Martín Maite , Cervera Zoraida , Cantero Guillermo , Moll Xavier , Espada Yvonne , Domingo Mariano , Vidal Enric , Pérez de Val Bernat 
Published: August 2023

BackgroundGoats are natural hosts of tuberculosis (TB) and are a valid animal model to test new vaccines and treatments to control this disease. In this study, a new experimental model of TB in goats based on the intranasal nebulization of Mycobacterium caprae was assessed in comparison with the endobronchial route of infection.MethodsFourteen animals were divided into two groups of seven and challenged through the endobronchial (EB) and intranasal (IN) routes, respectively. Clinical signs, rectal temperature, body weight, and immunological responses from blood samples were followed up throughout the experiment. All goats were euthanized at 9 weeks post-challenge. Gross pathological examination, analysis of lung lesions using computed tomography, and bacterial load quantification in pulmonary lymph nodes (LNs) by qPCR were carried out.ResultsThe IN-challenged group showed a slower progression of the infection: delayed clinical signs (body weight gain reduction, peak of temperature, and apparition of other TB signs) and delayed immunological responses (IFN-γ peak response and seroconversion). At the end of the experiment, the IN group also showed significantly lower severity and dissemination of lung lesions, lower mycobacterial DNA load and volume of lesions in pulmonary LN, and higher involvement of the nasopharyngeal cavity and volume of the lesions in the retropharyngeal LN.ConclusionThe results indicated that the IN challenge with M. caprae induced pathological features of natural TB in the lungs, respiratory LN, and extrapulmonary organs but extremely exaggerating the nasopharyngeal TB pathological features. On the other hand, the EB route oversized and accelerated the pulmonary TB lesion progression. Our results highlight the need to refine the inoculation routes in the interest of faithfully reproducing the natural TB infection when evaluating new vaccines or treatments against the disease.
Tunneled antibiotic-impregnated vs. bolt-connected, non-coated external ventricular drainage: a comparison of complications
Authors: Ortega-Angulo Celia , Royuela Ana , Kalantari Teresa , Rodríguez-Boto Gregorio , Gutierrez-Gonzalez Raquel 
Published: August 2023

BackgroundExternal ventricular drainage (EVD) is a common emergency neurosurgical procedure, but it is not free of adverse events. The aim of this study is to compare the complication rate of two frequently used EVD types, namely, tunneled antibiotic-impregnated catheters (Bactiseal©) and bolt-connected non-coated devices (Camino©).MethodsAll EVDs placed between 1 March 2015 and 31 December 2017 were registered. Procedures performed with any catheter different from Bactiseal© or Camino© EVD with incomplete follow-up and those EVDs placed due to infectious disease were excluded. Demographic and clinical variables, as well as the overall complication rate (infection, hemorrhage, obstruction, malposition of the catheter, and involuntary pull-out of the device) and the need for replacement of the EVD, were collected.ResultsA total of 77 EVDs were finally considered for analysis (40 Bactiseal® and 37 Camino®). There was a statistically significant difference in diagnosis and also in the location of the procedure, as more bolt-connected EVD was placed outside the operating room (97.3 vs. 23.5%, p &lt; 0.001) due to emergent pathologies such as vascular diseases and spontaneous hemorrhages. In the univariate analysis, a statistically significantly higher rate of catheter involuntary pull-out (29.7 vs. 7.5%, p = 0.012) and the need for EVD replacement (32.4 vs. 12.5%, p = 0.035) was found in the Camino cohort. However, those differences could not be confirmed with multivariable analysis, which showed no association between the type of catheter and any of the studied complications. Ventriculostomy duration was identified as a risk factor for infection (OR 1.09, 95% CI 1.02–1.18).ConclusionNo significant differences were observed regarding infection, hemorrhage, obstruction, malposition, involuntary catheter pull-out, and the need for EVD replacement when comparing non-impregnated bolt-connected EVDs (Camino®) with tunneled antibiotic-impregnated catheters (Bactiseal®). The duration of EVD was associated with an increased risk of infection.
The MOG antibody associated encephalitis preceded by COVID-19 infection; a case study and systematic review of the literature
Authors: Borończyk Michał , Węgrzynek Julia , Borończyk Agnieszka , Siuda Joanna 
Published: August 2023

BackgroundNew neurological complications of COVID-19 infection have been reported in recent research. Among them, the spectrum of anti-MOG positive diseases, defined as anti-MOG antibody associated disease (MOGAD), is distinguished, which can manifest as optic neuritis, myelitis, or various forms of encephalitis (MOGAE).Materials and methodsThis study reports a new case of MOGAE following SARS-CoV-2 infection. A literature review of other MOGAE cases associated with COVID-19 infection was conducted and summarized.ResultsA 60-year-old male patient, who had previously been infected with COVID-19, was admitted to the Neurology Department with a rapidly progressive deterioration of his cognitive functions that lasted for about 3 months. On neurological examination, the Mini-Mental State Examination (MMSE) score was 17, which further deteriorated to 13. In addition, central paresis of the right VIIth nerve and pyramidal hemiparesis on the right side were noted. The MRI of the brain showed multiple hyperintense lesions. The CSF examination revealed an elevated total protein level with a normal cell count, and serum showed a positive finding of anti-MOG antibodies. Taking into account all the information, the diagnosis of MOGAE, following COVID-19 infection, was made. A total of 9 similar cases of MOGAE associated with SARS-CoV-2 infection were identified in the available literature. Among them 2 cases presented progressive cognitive dysfunction and another 5 altered mental status. The most frequently described MRI changes were hyperintense lesions located cortically and/or subcortically. Anti-MOG antibodies were positive in all patients. In 5 cases they were detected only in serum, in 2 cases in serum and CSF, and in 2 cases the origin was not reported.ConclusionThe reported cases of MOGAE following COVID-19 infection suggest an increasing new clinical problem, and show an association between COVID-19 and MOGADs.