bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-flow nasal cannula oxygen therapy versus non-invasive ventilation in healthy respiratory physicians: a non-randomized study
Authors: Ye Hong , Xiang Dandan , Zhu Xiangyu , Du Xiuwei , Shang Shengyun , Xu Jing , Li Yu , Cheng Yunyun , Yang Zhongfei 
Published: January 2025

BackgroundHigh-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) are commonly used for respiratory support. This study aims to first establish whether to use HFNC or NIV based on comfort levels, and subsequently evaluate diaphragmatic function under equivalent comfort levels to determine the optimal modality for clinical application.MethodsA self-controlled, non-randomized study was conducted with 10 healthy respiratory physicians as participants. Each subject was exposed to different HFNC settings, including flow rates of 20, 40, and 60 L/min at both 33 and 37°C. Additionally, participants were assessed under NIV mode. Comfort levels as the primary outcome were evaluated using the Visual Numerical Scale (VNS). Meanwhile, vital signs and diaphragmatic mobility were monitored through an electrocardiograph and ultrasound.ResultsHFNC at a flow rate of 20 L/min provided greater comfort than NIV. However, as the flow rate increased, this comfort benefit decreased. At 40 L/min, comfort levels were similar between HFNC and NIV, while at 60 L/min, HFNC was less comfortable than NIV. Notably, temperature variations between 33 and 37°C had no significant effect on comfort. In addition, under conditions of similar comfort, HFNC demonstrated slightly greater diaphragmatic mobility compared to NIV.ConclusionOur study indicated HFNC was the preferred choice for providing respiratory support at low to moderate flow rates in healthy volunteers not requiring respiratory support. By contrast, at higher flow rates, NIV discomfort was lower than HFNC discomfort.
Case report: Trauma-induced Klebsiella pneumoniae invasive syndrome presenting with liver abscess, lung abscess, endophthalmitis, and purulent meningitis
Authors: Chen Hong-qiao , Mo Zhen-hua , Wei Wu-xiao 
Published: January 2025

PurposeThis study aims to explore the underlying causes, diagnostic strategies, and treatment approaches of trauma-induced Klebsiella pneumoniae invasive syndrome (KPIS) through a rare case report. By highlighting the role of trauma as a potential trigger for KPIS, particularly in high-risk populations such as individuals with diabetes, this study seeks to provide valuable insights for improving clinical outcomes and promoting public health awareness.BackgroundKlebsiella pneumoniae invasive syndrome is a multi-organ infectious disease commonly associated with complications such as liver abscess, lung abscess, endophthalmitis, and purulent meningitis, with high mortality and disability rates. In recent years, the incidence of KPIS has been increasing, particularly in the Asia-Pacific region, and is closely linked to hypervirulent Klebsiella pneumoniae (hvKp) infections. While extensive research has focused on the risk of KPIS in patients with underlying conditions such as diabetes, trauma-induced KPIS remains exceedingly rare, with limited understanding of its pathophysiology and clinical management. Trauma may facilitate invasive infections by disrupting immune barriers and compromising local tissue integrity, creating entry points for pathogens.Case presentationThis study reports a case of a 72-year-old male who developed multiple infections, including liver abscess, lung abscess, left endophthalmitis, and purulent meningitis, following a traumatic fall. The patient had a history of poorly controlled diabetes mellitus. A diagnosis of KPIS caused by hvKp was confirmed through bacterial cultures and a positive string test. Imaging studies revealed multi-organ involvement. Given the complexity of the patient’s condition, a comprehensive treatment regimen, including broad-spectrum antibiotics, was implemented with significant therapeutic success. The patient showed marked improvement and continued follow-up after discharge, with a notable resolution of the infections.ConclusionThis case highlights the significance of trauma as a potential trigger for KPIS, particularly in patients with high-risk underlying conditions such as diabetes. Early recognition and the implementation of individualized anti-infective treatment are crucial for reducing mortality and improving prognosis in KPIS patients. Future research should further investigate the relationship between trauma and hvKp infections and develop more comprehensive diagnostic and therapeutic guidelines.
Endoscopic surgery affects the gut microbiota and its metabolism in breast cancer patients
Authors: Li Jingtai , Gao Fangfang , Li Runwei , Chen Zhilin , Chen Guoping , Fan Pingming , Du Guankui 
Published: January 2025

BackgroundDespite the advantages of endoscopic surgery in reducing trauma and enhancing recovery for breast cancer patients, its impact on gut microbiota, which is crucial for health and estrogen metabolism, remains unclear. Further investigation is necessary to fully understand this impact and its implications.Materials and methodsBetween June and December 2022, fecal samples were collected from 20 patients who underwent endoscopic surgery. The gut microbiota composition was determined using 16S rRNA sequencing, while the metabolites were analyzed through liquid chromatography-tandem mass spectrometry (LC-MS/MS). Bioinformatics and statistical analyses were employed to identify significant alterations in microbial taxa abundance and to assess intergroup differences. These analyses included t-tests for pairwise comparisons, one-way ANOVA for multiple group comparisons, and chi-square tests for categorical data analysis.ResultsEndoscopic surgery in breast cancer patients subtly changed gut microbiota diversity and composition. Post-surgery, there was a reduction in Lachnospiraceae, Monoglobaceae and Firmicutes to Bacteroides ratios. Shifts in metabolites were also observed, the changed metabolites impacted pathways such as primary bile biosynthesis and Ascorbate and aldarate metabolism, with PE(PGD1/18:1(9Z)) identified as a key differential metabolite that increased post-surgery. Azasetron, tyramine glucuronide, DL-DOPA, phthalide, acetophenazine, aciclovir, creatinine bicarbonate, and 4-oxo-L-proline being associated with distinct bacterial taxa.ConclusionBreast cancer patients undergoing endoscopic surgery experience a shift in their gut microbiota and metabolic profiles. Therefore, postoperative management, with a particular focus on the adjustment of the gut microbiota, is crucial for enhancing patient recovery and health outcomes.
Exploring the alleviating effects of Bifidobacterium metabolite lactic acid on non-alcoholic steatohepatitis through the gut-liver axis
Authors: Zhao Hongmei , Zhou Juan , Yuan Lingzhi , Sun Zhiyi , Liu Yi , Zhao Xinyu , Ye Feng 
Published: January 2025

ObjectiveThis study investigates the protective effects of lactic acid, a metabolite of Bifidobacterium, on non-alcoholic fatty liver disease (NAFLD) induced by a high-sugar, high-fat diet (HFD) in mice, in the context of the gut-liver axis.MethodsA NAFLD mouse model was established using a HFD, and different intervention groups were set up to study the protective effects of Bifidobacterium and its metabolite lactic acid. The groups included a control group, NAFLD group, Bifidobacterium treatment group, Glyceraldehyde-3-P (G-3P) co-treatment group, and NOD-like receptor family pyrin domain containing 3 (NLRP3) overexpression group. The evaluation of liver function and lipid metabolism was conducted using the liver-to-body weight ratio, histological staining, and biochemical assays. Enzyme-linked immunosorbent assay (ELISA) was performed to measure inflammatory cytokines, and western blotting was used to analyze the expression of NLRP3 inflammasome and autophagy-related molecules. In vitro, an NAFLD cell model was established using oleic acid, with cells treated with lactic acid and NLRP3 overexpression to assess lipid droplet accumulation and inflammation.ResultsIn vivo findings indicated that, in comparison to CBX group (Control group without antibiotic treatment), NAFLD/CBX group (NAFLD group without antibiotic administration) and NAFLD/ABX group (NAFLD group with antibiotic administration) exhibited increased liver-to-body weight ratio, higher lipid droplet accumulation, aggravated liver histopathological damage, and elevated levels of AST (Aspartate Aminotransferase), ALT (Alanine Aminotransferase), TC (Total Cholesterol), TG (Triglycerides), LDL-C (Low-Density Lipoprotein Cholesterol), IL-6 (Interleukin-6), TNF-α (Tumor Necrosis Factor-alpha), IL-1β (Interleukin-1 beta), and NLRP3-related molecules, while HDL-C (High-Density Lipoprotein Cholesterol) levels significantly decreased. Intervention with Bifidobacterium significantly reversed these adverse changes. Further addition of G-3P led to more pronounced improvement in NAFLD symptoms, while overexpression of NLRP3 weakened the protective effects of Bifidobacterium. In vitro results indicated that Ole group exhibited heightened lipid droplet accumulation and expression of NLRP3 inflammasome-related molecules relative to the control group. Treatment with lactic acid effectively reversed these changes; however, the protective effect of lactic acid was significantly weakened with NLRP3 overexpression.ConclusionLactic acid can alleviate lipid metabolism disorders in NAFLD induced by diet through the inhibition of inflammation mediated by the NLRP3 inflammasome and the regulation of the autophagy process.
ASFV infection induces lipid metabolic disturbances and promotes viral replication
Authors: Chu Xuefei , Ge Shengqiang , Li Yingchao , Zhang Qin , Cui Xinyu , Zuo Yuanyuan , Li Ruihong , Sun Hongtao , Yin Lei , Wang Zhenzhong , Li Jinming , Xiao Yihong , Wang Zhiliang 
Published: January 2025

IntroductionAfrican swine fever is a highly transmissible and lethal infectious disease caused by the African swine fever virus (ASFV), which has considerably impacted the global swine industry. Lipid metabolism plays a vital role in sustaining lipid and energy homeostasis within cells and influences the viral life cycle.Methods and resultsIn this study, we found that ASFV infection disrupts lipid metabolism in the host. Transcriptomic analysis of cells infected with ASFV revealed that the levels of lipid metabolism significantly changed as the duration of the infection progressed. The intracellular cholesterol levels of the host exhibited a pattern similar to the viral growth curve during the course of infection. Notably, increased cholesterol levels promoted ASFV replication in host cells, whereas inhibition of the cholesterol biosynthesis pathway markedly reduced intracellular ASFV replication.DiscussionThe findings of this study showed that ASFV led to lipid metabolism disturbances to facilitate its replication, which is useful for revealing the mechanism underlying ASFV infection.
Irisin reshapes bone metabolic homeostasis to delay age-related osteoporosis by regulating the multipotent differentiation of BMSCs via Wnt pathway
Authors: Xing Shangman , Ma Yifan , Song Bing , Bai Min , Wang Kexin , Song Wenjing , Cao Tingting , Guo Chao , Zhang Yanying , Wang Zhandong , Wang Yongfeng 
Published: January 2025

IntroductionBone aging is linked to changes in the lineage differentiation of bone marrow stem cells (BMSCs), which show a heightened tendency to differentiate into adipocytes instead of osteoblasts. The therapeutic potential of irisin in addressing age-related diseases has garnered significant attention. More significantly, irisin has the capacity to enhance bone mass recovery and sustain overall bone health. Its mechanism of action in preventing osteoporosis has generated considerable interest within the research community. Nonetheless, the targeting effect of irisin on age-related osteoporosis and its underlying molecular biological mechanisms remain unclear.MethodsThe specific role of irisin in osteogenic-adipogenic differentiation in young or aging BMSCs was evaluated by multiple cells staining and quantitative real-time PCR (RT-qPCR) analysis. RNA-seq and protein Western blotting excavated and validated the key pathway by which irisin influences the fate determination of aging BMSCs. The macroscopic and microscopic changes of bone tissue in aging mice were examined using Micro-computed tomography (Micro-CT) and morphological staining.ResultsIt was noted that irisin affected the multilineage differentiation of BMSCs in a manner dependent on the dosage. Simultaneously, the Wnt signaling pathway might be a crucial mechanism through which irisin sustains the bone-fat balance in aging BMSCs and mitigates the decline in pluripotency. In vivo, irisin reduced bone marrow fat deposition in aging mice and effectively alleviating the occurrence of bone loss.ConclusionIrisin mediates the Wnt signaling pathway, thereby influencing the fate determination of BMSCs. In addition, it is essential for preserving metabolic equilibrium in the bone marrow microenvironment and significantly contributes to overall bone health. The findings provide new evidence for the use of iris extract in the treatment of age-related osteoporosis.
Association between hypertension and hearing loss: a systemic review and meta-analysis
Authors: Jin Xiaohua , Xu Xianpeng , Wang Jingjing , Liu Xinghong , Deng Xinxing , Xie Hui 
Published: January 2025

ObjectiveTo systematically evaluate the association between hypertension and hearing loss.MethodsA standardized search for studies on hypertension and hearing loss in PubMed, Embase, Scopus, and Web of Science was performed using subject terms, free terms, and keyword combinations for the period of library construction to March 2024. Meta-analysis was performed using RevMan 5.4 and STATA 18.0.ResultsA total of 12 studies were included, assessing 594,676 participants. The combined OR using the random effects model was 1.849 (95% CI: 1.549, 2.208). Heterogeneity in this analysis was high (I2 = 98%, p &lt; 0.1), and by sensitivity analysis we found that the heterogeneity may have originated from 3 studies, the removal of which significantly reduced the heterogeneity and had a small effect on the effect size [OR (95%CI): 1.893 (1.834, 1.953), I2 = 0.0%, p = 0.465].ConclusionHypertension may be one of the risk factors for hearing loss. Identification of hypertension can help in early assessment and management of hearing loss risk.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023460001.
Impact of in-hospital COVID-19 quarantine policy changes on quality of acute stroke care: a single center experience
Authors: Kim Minkyung , Lee Keon-Joo , Kim Seong-Eun , Kim Hokyu , Han Jung Hoon , Kim Han Jun , Oh Kyungmi , Park Sung-Jun , Kim Chi Kyung , Cho Young-Duck 
Published: January 2025

IntroductionThe COVID-19 pandemic is known to impact in-hospital processes for acute stroke patients, potentially resulting in delays due to quarantine and screening measures. The purpose of this study was to determine effects of changes in in-hospital quarantine policies on quality of care for acute stroke patients.MethodsHyperacute ischemic stroke patients who were admitted to Korea University Guro Hospital between January 2019 and February 2021 via the emergency department were included in this study. All had neurological symptoms within 6 h before arrival. As a mandatory COVID-19 real-time PCR screening test was implemented in March 2020, changes in quality indicators according to the progress of COVID-19 pandemic and changes in in-hospital quarantine policy, including door-to-image time (DIT), door-to-referral time, door-to-needle time (DNT), door-to-puncture time (DPT), and functional outcomes (discharge and 3-month modified Rankin’s scale) were determined.ResultsA total of 268 hyperacute stroke patients were analyzed. The number of hyperacute stroke patients gradually decreased as the pandemic progressed. Time indicators, including door-to-referral time, DIT, and DPT during the pandemic were increased. When pre-and post-COVID-19 screening epochs were compared, DIT, door-to-neurologist referral time, and DPT showed numerical increases. However, after accounting for potential confounders, a significant delay in DIT was found to be associated with the in-hospital COVID-19 quarantine policy.DiscussionOur study showed that enhancing in-hospital COVID-19 quarantine measures might increase the response time for hyperacute stroke care, suggesting an impact on the quality of care.
Ancillary tests for brain death
Authors: Duvuru Shyam , Sanker Vivek , Mishra Rajeeb Kumar , Sharma Arvind K. , Lim Shir Lynn , Baskar Nisha , Sharma Vijay K. 
Published: January 2025

BackgroundAncillary tests are often used in the determination of death by neurologic criteria (DNC), especially when the clinical examination is inconclusive. DNC is widely accepted, as defined by the comprehensive report of the World Brain Death Project. However, there are several medical, legal, religious, ethical, and social controversies. Accordingly, “premature” and “delayed” diagnoses of brain death attract these issues.MethodsDepending upon the availability and experience of the managing medical teams, various ancillary tests are employed for an early and supplementary diagnosis of brain death.ResultsWe describe the practicality, test performance, and utility of some of the commonly employed ancillary tests for the diagnosis of brain death in clinical practice, along with their case examples.ConclusionBrain death is a clinical diagnosis determined by history, physical examination, and adherence to recommended criteria. All ancillary investigations are used as supplementary tests with variable accuracy parameters. These ancillary tests often facilitate an early and “timely” diagnosis of brain death.
Efficacy and safety of intravenous ferric carboxymaltose in the treatment of Restless Legs Syndrome: a systematic review and meta-analysis
Authors: Khan Ayesha , Kumar Harsh , Rai Kuldeep Dalpat , Saeed Anzel , Ishtiaq Jawad , Tanveer Alam Muhammad , Chawla Sakshi , Haque Md Ariful 
Published: January 2025

IntroductionRestless Legs Syndrome (RLS), also known as Willis-Ekbom Disease (WED), is a sensorimotor disorder characterized by an uncontrollable urge to move the legs, typically accompanied by discomfort. Low iron levels, pregnancy, and age are some identified risk factors. RLS is treated using various pharmacological options, including dopamine agonists, benzodiazepines, anticonvulsants, opioids, and bupropion. Iron supplementation, particularly with intravenous Ferric carboxymaltose (FCM), has gained attention due to the role of iron deficiency in RLS pathophysiology. This meta-analysis evaluates the efficacy and safety of FCM in treating RLS symptoms.Materials and methodsA systematic review and meta-analysis were conducted following the PRISMA guidelines, using databases such as PubMed, Google Scholar, and Cochrane. Studies involving intravenous FCM in patients diagnosed with RLS were included. Statistical analysis was performed using Review Manager 5.4.ResultsSeven studies involving 539 participants were analyzed. FCM significantly reduced IRLS scores (WMD = −5.77; 95% CI = [−8.85, −2.70]; p = 0.0002) and improved VAS and SF-36 scores compared to placebo. However, FCM did not significantly improve RLS quality of life scores. Adverse events were more common in the FCM group, particularly nausea, but no significant differences were found for severe adverse events.ConclusionIn conclusion, intravenous ferric carboxymaltose significantly reduces Restless Legs Syndrome symptoms, especially in patients with confirmed iron deficiency. The treatment appears generally well-tolerated, with adverse effects being manageable. However, further long-term studies are needed to fully assess the safety profile and confirm sustained symptom improvement in a broader population.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42024585233.
Suprasternal aortic arch echocardioscopy as a potential tool in detection and follow-up of mobile thrombi in patients with ischemic stroke
Authors: Esnaola Barriola Inhar , Escriche Gorospe Elena , Miguel Navas Paula , Martínez Campos Elisa , Molina Goicoechea María , Capell Pascual Ferran , Jiménez Delgado Adrián , Muñoz Arrondo Roberto 
Published: January 2025

IntroductionSevere or complicated atheromatosis of the aortic arch represents an important and often underdiagnosed embolic source in patients with ischemic stroke. The presence of a floating thrombus has significant clinical relevance, as it is associated with a high risk of early recurrence. The aim of this study was to analyze the potential of echocardiographic examination through the suprasternal window in both the detection of embolic sources and the monitoring of the response to anticoagulant treatment in patients with mobile thrombi.MethodsThis case series study included ten consecutive patients with a mobile floating aortic arch thrombus associated with an atheromatous plaque, detected by focused echocardiography and confirmed by Computed Tomography Angiography (CTA). Epidemiological, clinical, radiological, and ultrasound characteristics were analyzed. Clinical and ultrasound follow-up was performed after initiation of anticoagulation as secondary prevention to assess the efficacy and safety of this treatment.ResultsTen patients (seven female) with a mean age of 76 years were identified. After anticoagulation, a complete resolution of the mobile thrombus was observed in eight of them during ultrasound follow-up. One patient suffered an ischemic recurrence. Two patients receiving associated antiplatelet therapy presented severe hemorrhagic complications, one of which was fatal. Once the disappearance of the mobile thrombus was detected, anticoagulation was discontinued, and no further ischemic recurrences were observed.DiscussionFloating thrombus of the aortic arch is an underdiagnosed but clinically relevant condition. The study of the aortic arch with echocardiography through the suprasternal window is a highly available and harmless technique, that may be highly useful for the detection and monitoring of response to treatment of this pathology. Furthermore, early anticoagulation could be an effective and safe treatment in these patients.
Linear incrementality in focus and accentuation processing during sentence production: evidence from eye movements
Authors: Zhang Zhenghua , Zhang Qingfang 
Published: January 2025

IntroductionWhile considerable research in language production has focused on incremental processing during conceptual and grammatical encoding, prosodic encoding remains less investigated. This study examines whether focus and accentuation processing in speech production follows linear or hierarchical incrementality.MethodsWe employed visual world eye-tracking to investigate how focus and accentuation are processed during sentence production. Participants were asked to complete a scenario description task where they were prompted to use a predetermined sentence structure to accurately convey the scenario, thereby spontaneously accentuate the corresponding entity. We manipulated the positions of focus with accentuation (initial vs. medial) by changing the scenarios. The initial and medial positions correspond to the first and second nouns in sentences like “N1 is above N2, not N3.”ResultsOur findings revealed that speech latencies were significantly shorter in the sentences with initial focus accentuation than those with medial focus accentuation. Furthermore, eye-tracking data demonstrated that speakers quickly displayed a preference for fixating on initial information after scenarios onset. Crucially, the time-course analysis revealed that the onset of the initial focus accentuation effect (around 460 ms) preceded that of the medial focus accentuation effect (around 920 ms).DiscussionThese results support that focus and accentuation processing during speech production prior to articulation follows linear incrementality rather than hierarchical incrementality.