bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-dose esketamine with sufentanil for postcesarean analgesia in women with gestational diabetes mellitus: a prospective, randomized, double-blind study
Authors: Han Tao , Chen Qin , Huang Jie , Zhang Jie , Li Aiyuan , Xu Wei , Peng Zheming , Li Zhen , Chen Liang 
Published: August 2023

BackgroundPregnant women with gestational diabetes mellitus (GDM) require more analgesics after cesarean delivery than those who do not have GDM. Uncontrolled pain following cesarean delivery is a major problem in women with GDM. We investigate the efficacy of low-dose esketamine combined with sufentanil intravenous patient-controlled analgesia (PCA)for postcesarean analgesia in women with GDM.MethodsOne hundred forty pregnant women with GDM were enrolled participate in this randomized controlled trial and were randomized into two groups (70 in each group). The esketamine (S) group was given esketamine +sufentanil + ondansetron, and the control (C) group was given sufentanil +ondansetron. The primary outcome is sufentanil consumption at 24 hours postoperatively, the secondary outcomes are sufentanil consumption at 6 hours postoperatively, pain scores at 6, 24 and 48 hours postoperatively.ResultsCompared with group C, group S had significantly lower sufentanil consumption at 6 and 24 hours postoperatively (P= 0.049 and P&lt;0.001), significantly lower activities VAS(pain during activities)scores at 6 hours postoperatively, rest and activities VAS (pain at rest and pain during activities)scores at 24 hours postoperatively, and activities VAS scores at 48 hours postoperatively(P=0.022, P =0.002, P=0.001 and P=0.007). Compared to group C, the time to bowel function return was significantly shorter in group S. There was no significant difference in rest VAS (pain at rest) scores at 6 and 48 hours postoperatively (P&gt;0.05). The time to first lactation was not significantly different between the two groups (P&gt;0.05). There was no significant difference in neonatal neurobehavioral scores between the two groups (P&gt;0.05).ConclusionCompared to sufentanil PCA, adding low dose of esketamine significantly reduced the consumption of sufentanil while providing equally effective post cesarean analgesia in the patients with gestational diabetes.
Increased sLRP1 and decreased atrial natriuretic peptide plasma levels in newly diagnosed T2DM patients are normalized after optimization of glycemic control
Authors: García Eduardo , Gil Pedro , Miñambres Inka , Benitez-Amaro Aleyda , Rodríguez Claudia , Claudi Lene , Julve Josep , Benitez Sonia , Sánchez-Quesada Jose Luís , Rives Jose , Garcia-Moll Xavier , Vilades David , Perez Antonio , Llorente-Cortes Vicenta 
Published: August 2023

BackgroundLow-density lipoprotein receptor-related protein 1 (LRP1) negatively modulates circulating atrial natriuretic peptide (ANP) levels. Both molecules are involved in the regulation of cardiometabolism.ObjectivesTo evaluate soluble LRP1 (sLRP1) and ANP levels in people with newly diagnosed type 2 diabetes mellitus (T2DM) and determine the effects of metabolic optimization.MethodsThis single-center longitudinal observational study recruited patients with newly diagnosed T2DM (n = 29, HbA1c &gt; 8.5%), and 12 healthy control, age- and sex-matched volunteers. sLRP1 and ANP levels were measured by immunoassays at T2DM onset and at one year after optimization of glycemic control (HbA1c ≤ 6.5%).ResultsT2DM had higher sLRP1 levels than the control group (p = 0.014) and lower ANP levels (p =0.002). At 12 months, 23 T2DM patients reached the target of HbA1c ≤ 6.5%. These patients significantly reduced sLRP1 and increased ANP levels. Patients who did not achieve HbA1c &lt; 6.5% failed to normalize sLRP1 and ANP levels. There was an inverse correlation in the changes in sLRP1 and ANP (p = 0.031). The extent of sLRP1 changes over 12 months of metabolic control positively correlated with those of total cholesterol, LDL cholesterol, TG, TG/HDLc, and apolipoprotein B.ConclusionsNewly diagnosed T2DM patients have an increased sLRP1/ANP ratio, and increased sLRP1 and decreased ANP levels are normalized in the T2DM patients that reached an strict glycemic and metabolic control. sLRP1/ANP ratio could be a reliable marker of cardiometabolic function.
Distributed dynamic modelling of suspended sediment mobilization and transport from small agricultural catchments
Authors: Sandström Sara , Markensten Hampus , Futter Martyn N. , Kyllmar Katarina , O’Connell David W. , Bishop Kevin , Djodjic Faruk 
Published: August 2023

Erosion, soil loss and consequent nutrient fluxes impair water quality and can degrade arable soils. Erosion rates in Sweden are generally low but episodic losses of suspended solids (SS) can affect water quality. Identifying critical source areas (CSAs) and “hot moments” is essential to reduce erosive losses from arable land. Here we use a distributed, dynamic high-resolution erosion model that simulates the sum of all transported material, i.e., erosion within the soil profile, on the soil surface and transport through drainage systems. We simulate monthly SS transport in six small agricultural catchments with varying soil texture over 8 years. Kling-Gupta Efficiency (KGE) was used as model performance statistics, and calibration (KGE = 0.45–0.78) and validation (KGE = 0.64–0.83) showed acceptable model performance for all catchments, with mean annual SS losses between 2.1 and 31.5 t km-2yr-1. Equifinality could be minimised by using more precise initial parameter values. We suggest that the model can be applied to comparable unmonitored catchments to identify erosion-sensitive periods and CSAs.
Microbial gene expression during hibernation in arctic ground squirrels: greater differences across gut sections than in response to pre-hibernation dietary protein content
Authors: Grond Kirsten , Buck C. Loren , Duddleston Khrystyne N. 
Published: August 2023

Obligate seasonal hibernators fast for 5–9 months depending on species yet resist muscle atrophy and emerge with little lean mass loss. The role of the gut microbiome in host nitrogen metabolism during hibernation is therefore of considerable interest, and recent studies support a role for urea nitrogen salvage (UNS) in host-protein conservation. We were interested in the effect of pre-hibernation diet on UNS and the microbial provision of essential amino acids (EAAs) during hibernation; therefore, we conducted a study whereby we fed arctic ground squirrels (Urocitellus parryii) pre-hibernation diets containing 9% vs. 18% protein and compared the expression of gut bacterial urease and amino acid (AA) metabolism genes in 4 gut sections (cecum mucosa, cecum lumen, small intestine [SI] mucosa, and SI lumen) during hibernation. We found that pre-hibernation dietary protein content did not affect expression of complete bacterial AA pathway genes during hibernation; however, several individual genes within EAA pathways were differentially expressed in squirrels fed 18% pre-hibernation dietary protein. Expression of genes associated with AA pathways was highest in the SI and lowest in the cecum mucosa. Additionally, the SI was the dominant expression site of AA and urease genes and was distinct from other sections in its overall microbial functional and taxonomic composition. Urease expression in the gut microbiome of hibernating squirrels significantly differed by gut section, but not by pre-hibernation dietary protein content. We identified two individual genes that are part of the urea cycle and involved in arginine biosynthesis, which were significantly more highly expressed in the cecum lumen and SI mucosa of squirrels fed a pre-hibernation diet containing 18% protein. Six bacterial genera were responsible for 99% of urease gene expression: Cupriavidus, Burkholderia, Laribacter, Bradhyrizobium, Helicobacter, and Yersinia. Although we did not find a strong effect of pre-hibernation dietary protein content on urease or AA metabolism gene expression during hibernation, our data do suggest the potential for pre-hibernation diet to modulate gut microbiota function during hibernation, and further investigations are warranted.
Epidemiological profile and effectiveness of immediate postpartum contraception in Brazilian women
Authors: Steiner Marcelo Luis , Mendes Julia Lorenzini , Strufaldi Rodolfo , Carneiro Monica , Giovanelli Silvana Aparecida , da Silva Mariliza Henrique 
Published: August 2023

PurposeTo determine the epidemiological profile of women who inserted copper intrauterine device (Cu-IUD), subdermal etonogestrel implant (ENG), tubal ligation (TL), depot medroxyprogesterone acetate (DMPA) or did not choose a contraceptive method (NCM) in the immediate postpartum period and compare the contraceptive effectiveness of Cu-IUD and DPMA with non-MAC.MethodsWe analyzed the epidemiological profile of women who inserted copper intrauterine device (Cu-IUD), subdermal etonogestrel implant (ENG), tubal ligation (TL), depot medroxyprogesterone acetate (DMPA) or did not choose a contraceptive method (NCM) in the immediate postpartum. The data was collected by electronic medical records of postpartum women assisted at the University Hospital of São Bernardo do Campo (HMU-SBC) from January 2016 to December 2020. Also, we compared the contraceptive effectiveness of Cu-IUD and DPMA with non-MAC by identifying women who returned for second delivery during the study period and analyzing the contraceptive method chosen in the first hospitalization. Then the pregnancies interval and the sociodemographic characteristics were analyzed according to contraceptive method type.ResultsData from 20,896 women were collected, of which 8,183 (39%) opted for Cu-IUD, 559 (2.5%) DPMA, and 10,989 (52.5%) chose not to use contraception at the time of hospital discharge. When comparing these groups, women in the DPMA were younger (26.5 ± 7.3, p &lt; 0.05), and NCM showed women with a lower number of pregnancies (2.2 ± 1.3, p &lt; 0.05). Subjects in the TL group (4.6%) had the higher number of pregnancies (3.8 ± 1.2, p &lt; 0.05), and ENG group, the highest number of miscarriages (1.6 ± 1.3, p &lt; 0.05). Of those women who returned pregnant, 5.5% belonged to the DPMA group, 6% to the NCM group, and 2.3% to the Cu-IUD.ConclusionsWomen who opted for Cu-IUD insertion were younger, had more pregnancies and vaginal delivery when compared to those who did not choose a method. Of those women who returned, the minority opted for Cu-IUD compared to those that opted for DPMA or no method.
Klebsiella pneumoniae manipulates human macrophages to acquire iron
Authors: Grubwieser Philipp , Hilbe Richard , Gehrer Clemens Michael , Grander Manuel , Brigo Natascha , Hoffmann Alexander , Seifert Markus , Berger Sylvia , Theurl Igor , Nairz Manfred , Weiss Günter 
Published: August 2023

BackgroundKlebsiella pneumoniae (KP) is a major cause of hospital-acquired infections, such as pneumonia. Moreover, it is classified as a pathogen of concern due to sprawling anti-microbial resistance. During infection, the gram-negative pathogen is capable of establishing an intracellular niche in macrophages by altering cellular metabolism. One factor critically affecting the host-pathogen interaction is the availability of essential nutrients, like iron, which is required for KP to proliferate but which also modulates anti-microbial immune effector pathways. We hypothesized, that KP manipulates macrophage iron homeostasis to acquire this crucial nutrient for sustained proliferation.MethodsWe applied an in-vitro infection model, in which human macrophage-like PMA-differentiated THP1 cells were infected with KP (strain ATCC 43816). During a 24-h course of infection, we quantified the number of intracellular bacteria via serial plating of cell lysates and evaluated the effects of different stimuli on intracellular bacterial numbers and iron acquisition. Furthermore, we analyzed host and pathogen specific gene and protein expression of key iron metabolism molecules.ResultsViable bacteria are recovered from macrophage cell lysates during the course of infection, indicative of persistence of bacteria within host cells and inefficient pathogen clearing by macrophages. Strikingly, following KP infection macrophages strongly induce the expression of the main cellular iron importer transferrin-receptor-1 (TFR1). Accordingly, intracellular KP proliferation is further augmented by the addition of iron loaded transferrin. The induction of TFR1 is mediated via the STAT-6-IL-10 axis, and pharmacological inhibition of this pathway reduces macrophage iron uptake, elicits bacterial iron starvation, and decreases bacterial survival.ConclusionOur results suggest, that KP manipulates macrophage iron metabolism to acquire iron once confined inside the host cell and enforces intracellular bacterial persistence. This is facilitated by microbial mediated induction of TFR1 via the STAT-6-IL-10 axis. Mechanistic insights into immune metabolism will provide opportunities for the development of novel antimicrobial therapies.
Honokiol decreases alpha-synuclein mRNA levels and reveals novel targets for modulating alpha-synuclein expression
Authors: Fagen Sara J. , Burgess Jeremy D. , Lim Melina J. , Amerna Danilyn , Kaya Zeynep B. , Faroqi Ayman H. , Perisetla Priyanka , DeMeo Natasha N. , Stojkovska Iva , Quiriconi Drew J. , Mazzulli Joseph R. , Delenclos Marion , Boschen Suelen L. , McLean Pamela J. 
Published: August 2023

BackgroundIntracytoplasmic inclusions comprised of aggregated alpha-synuclein (αsyn) represent a key histopathological feature of neurological disorders collectively termed “synucleinopathies,” which includes Parkinson’s disease (PD). Mutations and multiplications in the SNCA gene encoding αsyn cause familial forms of PD and a large body of evidence indicate a correlation between αsyn accumulation and disease. Decreasing αsyn expression is recognized as a valid target for PD therapeutics, with down-regulation of SNCA expression potentially attenuating downstream cascades of pathologic events. Here, we evaluated if Honokiol (HKL), a polyphenolic compound derived from magnolia tree bark with demonstrated neuroprotective properties, can modulate αsyn levels in multiple experimental models.MethodsHuman neuroglioma cells stably overexpressing αsyn, mouse primary neurons, and human iPSC-derived neurons were exposed to HKL and αsyn protein and SNCA messenger RNA levels were assessed. The effect of HKL on rotenone-induced overexpression of αsyn levels was further assessed and transcriptional profiling of mouse cortical neurons treated with HKL was performed to identify potential targets of HKL.ResultsWe demonstrate that HKL can successfully reduce αsyn protein levels and SNCA expression in multiple in vitro models of PD with our data supporting a mechanism whereby HKL acts by post-transcriptional modulation of SNCA rather than modulating αsyn protein degradation. Transcriptional profiling of mouse cortical neurons treated with HKL identifies several differentially expressed genes (DEG) as potential targets to modulate SNCA expression.ConclusionThis study supports a HKL-mediated downregulation of SNCA as a viable strategy to modify disease progression in PD and other synucleinopathies. HKL has potential as a powerful tool for investigating SNCA gene modulation and its downstream effects.
Case report: 3D intracranial vessel wall MRI in Susac syndrome: potential relevance for diagnosis and therapeutic management
Authors: Lotti Antonio , Barilaro Alessandro , Mariottini Alice , Vannozzi Lorenzo , Piergentili Marco , Fainardi Enrico , Massacesi Luca 
Published: August 2023

BackgroundSusac syndrome (SS) is a rare immune-mediated vasculitis affecting retina, inner ear and brain. Assessment of central nervous system (CNS) involvement is currently based on standard brain magnetic resonance imaging (MRI) sequences. Accuracy of three dimensional (3D)-vessel wall imaging (VWI) was compared to standard sequences and contrast-enhanced-3D T2-fluid attenuated inversion recovery (CE-FLAIR) to assess CNS disease activity in two cases of definite SS.MethodsBrain MRI scan and retinal fluorescein angiogram (RFA) were performed at disease onset and at 1, 3, and 6 months after induction therapy start. CE-FLAIR and VWI based on 3D black-blood proton density weighted (PDW) with and without gadolinium were added to standard sequences on a 3 Tesla MRI scanner.ResultsContrast enhanced-VWI (CE-VWI) detected an abnormal diffuse leptomeningeal enhancement (LME) in both cases at onset and during follow-up. Pathological enhancement on CE-VWI persisted at 6-month brain MRI, despite absence of new lesions and disappearance of LME on CE-FLAIR. Follow-up RFA revealed new arterial wall hyperfluorescence in both cases.ConclusionsVWI may represent a useful tool for diagnosing and monitoring CNS disease activity in SS patients, as confirmed by concordance with RFA, leading treatment's choice and timing. Moreover, CE-VWI seemed at least as sensitive as CE-FLAIR in detecting LME, possibly being superior to the latter in posterior fossa. LME remission might be not accurate in predicting suppression of CNS inflammation in SS.
Pediatric hypnic headache: a systematic review
Authors: Ferretti Alessandro , Velardi Margherita , Fanfoni Claudia , Di Nardo Giovanni , Evangelisti Melania , Foiadelli Thomas , Orsini Alessandro , Del Pozzo Marco , Terrin Gianluca , Raucci Umberto , Striano Pasquale , Parisi Pasquale 
Published: August 2023

IntroductionHypnic headache (HH) is a primary headache, and it is considered a rare condition in children. The underlying mechanisms of HH are not yet fully understood. This systematic review aims to provide a comprehensive description of the clinical features of all published cases of pediatric HH. It will also discuss the differences in headache features between children and adults, the increased diagnostic sensitivity of the new diagnostic criteria (ICHD-3), potential pathophysiological hypotheses explaining the higher incidence in adults, differential diagnoses, and therapeutic options for children.MethodsA systematic search was conducted to identify and analyze articles reporting cases of HH in patients under the age of 18. The search was performed in major medical databases including Cochrane Library, EBSCO, Embase, Medline, PubMed, Science Direct, Scopus, and Web of Science. The search covered the period from 1988 to April 2023. Relevant studies were screened for eligibility, and data extraction was performed using a standardized approach.ResultsSeven children with HH were included in the analysis. The mean age of onset for headache attacks was 10 ± 4.3 years (range 3–15 years). The average time from the start of headaches to diagnosis was 15.8 ± 25.0 months (range 1–60 months). Headache features in children differed from those observed in adult HH patients. Children experienced throbbing/pulsating pain, while adults reported dull/pressure-like pain. Children also had lower frequency and shorter duration of attacks compared to adults. The use of ICHD-3 criteria appeared to be more sensitive and inclusive for diagnosing HH in children compared to the previous ICHD-2 criteria. The association of headache attacks with sleep suggests that HH may be a primary disorder with a chronobiological origin. Hypothalamic dysfunction and melatonin dysregulation, which are more prevalent in older individuals, could potentially explain the higher incidence of HH in adults. Other primary headaches and secondary causes should be ruled out. Melatonin prophylactic therapy may be considered for pediatric patients.DiscussionFurther evaluation of the clinical features of HH in children is needed. The development of specific diagnostic criteria for pediatric cases could improve diagnostic rates and enhance the management of children with HH.
Decreased GABA levels of the anterior and posterior cingulate cortex are associated with executive dysfunction in mild cognitive impairment
Authors: Fu Xiaona , Qin Mengting , Liu Xiaoming , Cheng Lan , Zhang Lan , Zhang Xinli , Lei Yu , Zhou Qidong , Sun Peng , Lin Liangjie , Su Ying , Wang Jing 
Published: August 2023

Background and purposeExecutive function impairment, a slight but noticeable cognitive deficit in mild cognitive impairment (MCI) patients, is influenced by gamma-aminobutyric acid (GABA) levels. Reduced cognitive function is accompanied by thinning of the cerebral cortex, which has higher GABA levels than white matter. However, the relationships among GABA levels, cortical thickness, and executive function in MCI patients have not yet been elucidated. We investigated the relationships among GABA levels, cortical thickness, and executive function in MCI patients.MethodsIn this study, a total of 36 MCI patients and 36 sex-, age-, and education-matched healthy controls (HC) were recruited. But 33 MCI patients and 35 HC were included because of head motion or poor data quality for three MCI patients and one HC. The levels of gamma-aminobutyric acid plus relative to creatine (GABA+/Cr) and glutamate-glutamine relative to creatine (Glx/Cr) in the anterior cingulate cortex (ACC) and posterior cingulate cortex (PCC) were measured using the Meshcher-Garwood point resolved spectroscopy (MEGA-PRESS) sequence. Metabolite ratios, cortical thickness, and executive function and their interrelationships were determined in the MCI and HC groups.ResultsPatients with MCI showed lower GABA+/Cr levels in the ACC and PCC. Combined levels of GABA+ and Glx in the ACC and GABA+ in the PCC showed good diagnostic efficacy for MCI (AUC: 0.82). But no differences in cortical thickness were found between the two groups. In the MCI group, lower GABA+/Cr level was correlated to worse performance on the digit span test backward, and the shape trail test-B. The cortical thickness was not associated with GABA+ levels and executive function in patients.ConclusionThese results implied that decreased GABA levels in the ACC and PCC had a critical role in the early diagnosis of impaired executive function of MCI. Therefore, GABA in the ACC and PCC could be a potential diagnostic marker of the executive function decline of MCI.
Unraveling the link: exploring the causal relationship between diabetes, multiple sclerosis, migraine, and Alzheimer’s disease through Mendelian randomization
Authors: Xue Hua , Zeng Li , Liu Shuangjuan 
Published: August 2023

IntroductionObservational studies suggested that diabetes mellitus [type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM)], multiple sclerosis (MS), and migraine are associated with Alzheimer’s disease (AD). However, the causal link has not been fully elucidated. Thus, we aim to assess the causal link between T1DM, T2DM, MS, and migraine with the risk of AD using a two-sample Mendelian randomization (MR) study.MethodsGenetic instruments were identified for AD, T1DM, T2DM, MS, and migraine respectively from genome-wide association study. MR analysis was conducted mainly using the inverse-variance weighted (IVW) method.ResultsThe result of IVW method demonstrated that T2DM is causally associated with risk of AD (OR: 1.237, 95% CI: 1.099–1.391, P: 0.0003). According to the IVW method, there is no causal association between TIDM, MS, migraine, and the risk of AD (all p value &gt; 0.05). Here we show, there is a causal link between T2DM and the risk of AD.ConclusionThese findings highlight the significance of active monitoring and prevention of AD in T2DM patients. Further studies are required to actively search for the risk factors of T2DM combined with AD, explore the markers that can predict T2DM combined with AD, and intervene and treat early.