bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Nutrition on the Gut Microbiota: Implications for Parkinson’s Disease
Authors: Sobral Joana , Empadinhas Nuno , Esteves Ana Raquel , Cardoso Sandra Morais 
Published: January 2025

Abstract
Parkinson’s disease (PD) is a multifactorial neurodegenerative disease that is characterized by the degeneration of dopaminergic neurons in the substantia nigra pars compacta and by the anomalous accumulation of α-synuclein aggregates into Lewy bodies and Lewy neurites. Research suggests 2 distinct subtypes of PD: the brain-first subtype if the pathology arises from the brain and then spreads to the peripheral nervous system (PNS) and the body-first subtype, where the pathological process begins in the PNS and then spreads to the central nervous system. This review primarily focuses on the body-first subtype. The influence of the gut microbiota on the development of PD has been the subject of growing interest among researchers. It has been suggested that gut inflammation may be closely associated with pathogenesis in PD, therefore leading to the hypothesis that gut microbiota modulation could play a significant role in this process. Nutrition can influence gut health and alter the risk and progression of PD by altering inflammatory markers. This review provides an overview of recent research that correlates variations in gut microbiota composition between patients with PD and healthy individuals with the impact of certain nutrients and dietary patterns, including the Mediterranean diet, the Western diet, and the ketogenic diet. It explores how these diets influence gut microbiota composition and, consequently, the risk of PD. Last, it examines fecal transplantation and the use of prebiotics, probiotics, or synbiotics as potential therapeutic strategies to balance the gut microbiome, aiming to reduce the risk or delay the progression of PD.
Insights into Chronic Low Back Pain Etiology
Authors: Martinsen Amy Elise , Børte Sigrid , Spildrejorde Mari , Brumpton Ben Michael , Heuch Ingrid , Zwart John-Anker , Winsvold Bendik Slagsvold 
Published: January 2025

Study Design.
Genome-wide association study (GWAS) meta-analysis with downstream analyses.

Objective.
To explore the genetic architecture of chronic low back pain (cLBP) and identify underlying biological mechanisms that contribute to its development.

Summary of Background Data.
Chronic low back pain is prevalent and debilitating, with many cases having no identifiable biological cause. Current treatment options provide only limited relief, highlighting the need for a deeper understanding of the genetic and molecular factors involved in cLBP pathogenesis. Identifying these factors may lead to more effective, targeted therapies.

Methods.
We conducted a GWAS meta-analysis involving 325,078 participants from the UK Biobank and the HUNT population studies. This was followed by downstream analyses, including gene prioritization, tissue enrichment analysis, and functional gene set analysis. Genetic loci were examined for their association with cLBP, and gene sets were assessed for functional relevance.

Results.
Eighteen genetic loci associated with cLBP were identified corresponding to as many prioritized genes, including eight novel genes not previously linked to the condition. Tissue enrichment analysis highlighted significant involvement of hippocampal brain tissue, suggesting central memory processes may contribute to cLBP. Functional gene set analysis identified 37 gene sets, many related to transcription factors involved in bone and cartilage maintenance. Literature on the prioritized genes suggested a potential role for neurological, cartilaginous, and inflammatory mechanisms, including genes implicated in the innervation of intervertebral discs, inflammatory cell death, and central sensitization. Comparison with previous GWASs indicated potential differences between individuals who seek medical care and those who do not.

Conclusion.
This study enhances our understanding of the genetic basis of cLBP, revealing distinct biological mechanisms and suggesting the existence of patient subgroups with differing treatment needs. These insights may pave the way for more tailored and effective treatment approaches in the future.

Level of Evidence.
Level 3 (observational study)
A Retrospective, Single-Center Assessment of Changes in Pain, Agitation, and Delirium Management Before and During the COVID-19 Pandemic
Authors: Winner Rachel L. , Ware Lydia R. , Dube Kevin M. , Kovacevic Mary P. , Lupi Kenneth E. , Szumita Paul M. , DeGrado Jeremy R. 
Published: January 2025

IMPORTANCE:
Recent studies have found an association between COVID-19 infection and deeper sedation in mechanically ventilated patients, raising concerns about the impact of the COVID-19 pandemic on pain, agitation, and delirium (PAD) management practices overall.

OBJECTIVES:
This study aimed to assess differences in PAD management in patients without COVID-19 infection in pre- and peri-COVID-19 pandemic timeframes.

DESIGN, SETTING, AND PARTICIPANTS:
This was a single-center, retrospective, pre-/post-cohort analysis of mechanically ventilated adult patients without COVID-19 infection admitted to an ICU in Boston, MA. The “pre” and “post” groups enrolled patients in 2019 and 2021, respectively. All PAD data during the first 7 days of mechanical ventilation (MV) were collected.

MAIN OUTCOMES AND MEASURES:
The primary outcome was ventilator-free days (VFDs) during the first 28 days. A multivariable linear regression analysis was performed to assess VFD while controlling for confounders. Secondary outcomes included depth of sedation, total dose of sedatives, and in-hospital mortality.

RESULTS:
There were 339 patients included in the final analysis. There was no difference in VFD between the pre- and post-groups (22.2 vs. 22.6 d; p = 0.92); this was confirmed by multivariable linear regression (p = 0.91). Patients in the post-group experienced significantly deeper levels of sedation compared with the pre-group (58% vs. 53%; p < 0.01) within the first 48 hours of MV. The median number of Richmond Agitation-Sedation Scale assessments per 24-hour period was greater in the pre-group (13 vs. 12 assessments; p = 0.02) within the first 48 hours of MV. There were no significant differences in total cumulative dose of sedatives or in-hospital mortality between the two groups.

CONCLUSIONS AND RELEVANCE:
This study suggests that PAD practices, including depth of sedation and frequency of assessment, differed between pre- and post-COVID-19 groups in patients without COVID-19. Outcomes including VFD, mortality, and hospital length of stay were not affected. Further studies are needed to understand the broader impact of the COVID-19 pandemic on PAD management practices.
Women’s health and climate change: an urgent call for leadership among obstetricians and gynecologists in developing countries: a perspective
Authors: Sajjad Waseem , Mushtaq Iqra , Kalsoom Umme , Gargab Nada Kamaleldin , Khan Mishaim , Akhtar Zareen , Nasrallah Jamil 
Published: January 2025

Climate change, considered as the most serious health hazard to humanity, has a disproportionate impact on women’s health, particularly in poor nations. Women alongside their developing fetuses are facing growing risks from environmental factors such as pollution, natural disasters and heat when it comes to their health. Even though the contribution to climate change is very limited, obstetricians and gynecologists (OBGYNs) can lead and help resolve or at least acknowledge these issues by going for systemic solutions as well as helping patients understand all the negative outcomes climate change can have on their health.
OBGYNs are ethically responsible for understanding, monitoring, and balancing the environmental impact their practices cause as well as regulating policies that counter such effects from climate change. Known names such as the International Federation of Gynaecology and Obstetrics (FIGO) talk about the important role of their lead when it comes to solving such issues.
The aim of highlighting this perspective is to sensitize the OBGYNs of their urgent responsibility and remind them of the inevitability of their roles in the combat against climate change. This awareness not only empowers OBGYNs to advocate for their patients but also encourages collaboration with other healthcare professionals to implement sustainable practices. By fostering an environment of innovation and resilience, they can significantly contribute to a healthier future for both individuals and the planet.
Duodenal-jejunal bypass ameliorates MASLD in rats by regulating gut microbiota and bile acid metabolism through FXR pathways
Authors: Ren Mengting , Xia Yi , Pan Hanghai , Zhou Xinxin , Yu Mosang , Ji Feng 
Published: January 2025

Background:
Although bariatric and metabolic surgical methods, including duodenal-jejunal bypass (DJB), were shown to improve metabolic dysfunction–associated steatotic liver disease (MASLD) in clinical trials and experimental rodent models, their underlying mechanisms remain unclear. The present study therefore evaluated the therapeutic effects and mechanisms of action of DJB in rats with MASLD.

Methods:
Rats with MASLD were randomly assigned to undergo DJB or sham surgery. Rats were orally administered a broad-spectrum antibiotic cocktail (Abx) or underwent fecal microbiota transplantation to assess the role of gut microbiota in DJB-induced improvement of MASLD. Gut microbiota were profiled by 16S rRNA gene sequencing and metagenomic sequencing, and bile acids (BAs) were analyzed by BA-targeted metabolomics.

Results:
DJB alleviated hepatic steatosis and insulin resistance in rats with diet-induced MASLD. Abx depletion of bacteria abrogated the ameliorating effects of DJB on MASLD. Fecal microbiota transplantation from rats that underwent DJB improved MASLD in high-fat diet–fed recipients by reshaping the gut microbiota, especially by significantly reducing the abundance of Clostridium. This, in turn, suppressed secondary BA biosynthesis and activated the hepatic BA receptor, farnesoid X receptor. Inhibition of farnesoid X receptor attenuated the ameliorative effects of post-DJB microbiota on MASLD.

Conclusions:
DJB ameliorates MASLD by regulating gut microbiota and BA metabolism through hepatic farnesoid X receptor pathways.
A combination regimen of Intravitreal clindamycin with dexamethasone, systemic co-trimoxazole and steroids for macular Toxoplasma retinochoroiditis in immunocompetent cases.
Authors: Satavasia Sushree , Mishra Akshay , Jadhav Vishal , Abhishek Talluri Ronnie , Kelgaonkar Anup , Patel Anamika , Basu Soumyava , Pathengay Avinash 
Published: January 2025

Purpose:
To study the role of intravitreal clindamycin with dexamethasone as an adjuvant to systemic co-trimoxazole and steroids in macular Toxoplasma retinochoroiditis.

Methods:
Retrospective study of Toxoplasma retinochoroiditis cases from January 2014 to December 2021 treated with a combination of oral and intravitreal therapy in immunocompetent patients.

Results:

39 eyes of 39 patients were included in this study after meeting the inclusion criteria with the mean age of presentation being 25.25 years (± 9.30; range 4–52 years). Male preponderance with 61.53 % of males (n = 24) and 38.47% of females (n = 15) was observed. Active retinitis was unilateral in all eyes (20 right eyes; 19 left eyes). Five lines of improvement in vision acuity on ETDRS chart were noted at final visit. The location of retinitis was either foveal (n=24) or extrafoveal (n=15). The mean size of retinitis was 1.24 ± 0.70-disc diameter. The mean number of injections given was 1.79 with a mean interval of 1.39 weeks.

Conclusions:
Intravitreal clindamycin with dexamethasone when used as an adjunct to systemic therapy showed resolution of retinitis in all cases with visual improvement.
Vascular Density and Retinal Structure Relationships Across Sectors and Regions of the Optic Nerve in Patients with Primary Open Angle Glaucoma
Authors: Ritzer Lukas , Harris Alon , Arciero Julia , Siesky Brent , Fry Brendan , Januleviciene Ingrida , Oddone Francesco , Carnevale Carmela , Eckert George , Verticchio Vercellin Alice 
Published: January 2025

Précis:
The relationship between structural and hemodynamic parameters in patients with primary open angle glaucoma is strongest in the temporal region of the optic nerve.

Purpose:
To investigate the relationship between radial peripapillary capillary (RPC) vessel density (VD) and retinal nerve fiber layer (RNFL) thickness in quadrants and sectors of the optic nerve head (ONH) in patients with and without primary open angle glaucoma (POAG).

Methods:
In a cross-sectional prospective analysis, 191 subjects (80 early-stage POAG; 111 non-glaucomatous controls) were assessed for RNFL thickness and RPC VD in each quadrant [superior (S), inferior (I), nasal (N) and temporal (T)] and sector [inferior-temporal (IT), temporo-inferior (TI), temporo-superior (TS), superior-temporal (ST), inferior-nasal (IN), naso-inferior (NI), naso-superior (NS), and superior-nasal (SN) sectors] of the ONH via optical coherence tomography angiography (OCTA, Avanti, Optovue). Pearson correlations were used to test for associations between measurements, with P<0.05 considered statistically significant.

Results:
Significantly stronger positive correlations were found between RPC VD and RNFL thickness in the S, I, and T quadrants in POAG patients compared to non-glaucomatous controls (all P<0.05). The temporal quadrant in POAG patients displayed the largest difference in correlation compared to controls. A stronger positive correlation was also found between RPC VD and RNFL thickness in the temporal sectors of the ONH in POAG patients compared to controls, with the largest difference in the TS sector (all P<0.05).

Conclusion:
Early-stage POAG patients have a stronger relationship between RPC VD and RNFL in the temporal regions of the ONH compared to non-glaucomatous controls, with the TS sector demonstrating the largest difference between groups. Temporal sector VD loss may represent an early-stage biomarker for vascular-linked POAG disease.
Aqueous Angiography Guided Bent Ab Interno Needle Goniectomy in High versus Low Aqueous Humor Outflow Regions in POAG: A Pilot RCT
Authors: Dada Tanuj , Gupta Ashi , Beri Nitika , Huang Alex S. , Sharma Namrata , Angmo Dewang , Maharana Prafulla K. , Pujari Amar 
Published: January 2025

Précis:
Trabecular cutting minimally invasive glaucoma surgery like bent ab interno needle goniectomy (BANG) when performed in baseline aqueous angiography identified low aqueous humor outflow regions, results in greater success of intraocular pressure reduction.

Purpose:
To study the efficacy of Bent Ab Interno Needle Goniectomy (BANG) in high versus low aqueous humor outflow (AHO) regions as determined by Aqueous Angiography(AA) in patients with primary open angle glaucoma (POAG).

Methods:
A prospective, single-centre, pilot, randomized control trial recruited 30 eyes of 30 patients of POAG and visually significant cataract (45-80 y) and were randomised into two groups (“A”: BANG performed in the high-flow regions and “B”: BANG performed in the low-flow regions) of 15 each. AA was performed using indocyanine green dye (0.1%) to identify baseline high- and low-flow regions of the AHO pathways followed by BANG in these respective regions as per randomisation. Preoperative and postoperative data on IOP, number of antiglaucoma medications (AGMs) and any complications were noted over 6 months. Overall success was defined as achieving an IOP ≤15 mm Hg and ≥6 mm Hg at 6 months of follow-up with AGMs (qualified success) or without AGMs (complete success).

Results:
AA revealed high-flow regions of AHO pathways in the nasal quadrant and low-flow regions of AHO pathways in the temporal quadrant in all 30 patients. Both groups had comparable demographic composition [group A age: 65.3±6.48 y and male: female (14:1) and group B age: 64.6±7.08 y and male: female (13:2)]. The mean preoperative IOPs [group A (17.27±3.43 mm Hg); group B (17.60±5.42 mm Hg)] (P=0.842) and mean postoperative IOP at 6 months [group A (15.6±4.98 mm Hg); group B (13.13±2.29 mm Hg)] (P=0.09) were similar. However, lower qualified success was seen in group A (40.00%) compared to group B (86.67%; P=0.021). Survival in Kaplan-Meier analysis was higher in group B (P=0.021). Complications were comparable in both groups.

Conclusion:
Short-term results of BANG in low-flow AHO regions show enhanced success compared to those in high-flow AHO regions. This study suggests that trabecular cutting minimally invasive glaucoma surgeries (like BANG) may be performed in baseline low-flow AHO regions (temporal quadrant) instead of the high-flow AHO (nasal quadrant) regions.
Multidrug Resistant Gram-negative Bacteria in Surgical Site Infections: Antimicrobial Resistance and Preventive Measures
Authors: Kumar Sunil , Sharma Anil Kumar , Yadav Mukesh , Sehrawat Nirmala , Jaiswal Durgesh Kumar 
Published: January 2025

Abstract
Multidrug resistant (MDR) gram-negative bacteria (GNB) are responsible for high mortality and morbidity in healthcare settings worldwide. They have been declared as priority pathogens by the WHO for their continuously escalating antimicrobial resistance. Nevertheless, data associated with MDR GNB in healthcare-associated infections are insufficient. Surgical site infections (SSIs) are among the most commonly occurring healthcare-associated infections. Such infections are particularly common when bacteria from the patient's normal microflora are transferred to the surgical sites during surgical procedures. SSIs affect approximately 0.5%-3% of patients undergoing surgery, resulting in prolonged hospital stay compared with patients without SSIs. SSIs result in severe problems and lead to a heavy economic burden. Most SSIs can be avoided if suitable preventive measures are employed. Novel findings support the dedicated usage of oral preoperative surgical antimicrobial prophylaxis for specific surgeries based on sites/organs. Immediate interventions are sought to control the transmission of MDR GNB typically found in hospital settings. The present narrative review aims to describe MDR GNB in SSIs in different sites. Antimicrobial resistance epidemiology and preventive measures for SSIs are also discussed. Different intrinsic and extrinsic factors and control measures are elaborated for curbing SSIs.
Lower-Limb Orthoses in Duchenne Muscular Dystrophy
Authors: Peken Avcı Gizem , İpek Dongaz Özge , Bayar Banu 
Published: January 2025

ABSTRACT

Introduction
Duchenne muscular dystrophy (DMD) is associated with a mutation in the DMD gene. It is a progressive disorder characterized by deficiency or absence of the production of dystrophin protein. The mechanical stress increased by muscle contractions causes damage to the muscle cell. Delayed ambulation, frequent falls, incompetence during climbing stairs, Gower’s sign, pseudohypertrophy of the calf, and proximal muscle weakness may be seen in children. Loss of ambulation, pulmonary failure, cardiomyopathy, and early mortality are expected in the natural process of the disease. The life expectancy is 30 years with the treatments and care applied nowadays.

Materials and Methods
Physiotherapy has a substantial place during aging. Physiotherapy approaches, orthoses, and self-help devices are utilized to prevent the development of contractures and deformities characterized by long-term fixed joint position, muscle imbalance, loss of joint range of motion, and fibrotic changes.

Results
It is observed that stretching exercises are noneffective in contracture and deformity management. It should be considered that the development of lower-limb contractures may occur in the early period. Orthotic approaches can be utilized to delay the loss of ambulation.

Conclusions
Lower-limb orthoses can be recommended for controlling contracture occurrence, providing postural control, ensuring and maintaining the correct position, continuity of function, ensuring ambulation or vertical position, and preserving surgical success. The use of personalized orthoses will enhance the success of rehabilitation. Orthoses should be used with other treatments to maintain functional mobility in accordance with the patient’s condition and should be reproduced according to the course of the disease.

Clinical Relevance
Ambulation level is important in choosing a lower-limb orthosis for patients with DMD. It is recommended that ankle-foot orthoses (AFOs) be preferred during the ambulatory period and knee-ankle-foot orthoses (KAFOs) or hip-knee-ankle-foot orthoses (HKAFOs) be preferred during the nonambulatory period.
Comparison the Cosmetic Outcome of the Triangular Flap Insertion Versus Direct Linear Resection in Correction of Dog Ear Deformities on the Face—A Prospective and Randomized Controlled Trial
Authors: Song Jipeng , Cui Xiwei , Fan Jincai , Jiao Hu 
Published: January 2025

Background:
Compared with direct linear resection, the triangular flap insertion method is a correction method that purportedly reduces the incision tension of dog ears deformity. Randomized clinical trials comparing these 2 methods seem to be limited or absent.

Objective:
A randomized study was planned to compare the cosmetic effect and scar in the defect area between the triangular flap insertion method and direct linear resection in the repair of dog ear deformities after the suture of the facial circular defect.

Methods:
The authors' study was prospective, 2-arm, randomized, evaluator-blinded clinical trial in a single-center outpatient academic plastic surgery center. Patients were eligible if they or their parents were able to provide informed consent and had dog ear deformity higher than 8 mm at both ends of the incision after suture of a circular or oval facial defect. Each dog ear deformity at the ends of the incision, half accept direct linear random resection, the other half to accept triangular flap insert. At 3-month and 6-month follow-up, each patient and 2 blinded observers evaluated the wound using the Patient Observer Scar Assessment Scale (POSAS).

Results:
In all, 52 subjects completed the study. At the 3-month follow-up, there was a statistically significant difference in the mean total POSAS scores for both the blinded observer and patients, indicating a preference for the side with the triangular flap insertion method. However, at the 6-month follow-up, this difference was lost.

Conclusion:
Three months after surgery, the triangular flap insertion method resulted in a better scar outcome than direct linear resection in correction of dog ear deformities on the face. At 6 months’ follow-up, this difference diminished, with scars for both sides appearing similar.

Level of Evidence:
Level II