bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary cardiac lymphoma: a clinicopathological study of 121 cases
Authors: Zhuang Shuhui , Chang Liudi , Feng Xiaoxi , Hu Weiwen , Yang Zhaobo , Zhang Yuanyuan 
Published: January 2025

BackgroundPrimary cardiac lymphoma (PCL) is an exceedingly uncommon type of lymphoma that primarily affects the heart and/or pericardium, or manifests through cardiac symptoms due to myocardial infiltration. The infrequency of PCL, coupled with its non-specific clinical presentations, often complicates early diagnosis. This study aims to fill the existing gap in clinical knowledge regarding PCL by detailing a case of PCL and examining its clinical features, auxiliary examinations, treatment approaches, and prognostic outcomes, thereby facilitating early detection and enhancing patient care.MethodsA thorough search of the PubMed and Chinese National Knowledge Infrastructure (CNKI) database was performed using keywords “heart” and “lymphoma” or “primary cardiac lymphoma”. This search encompassed publications from January 1, 2014, to November 1, 2024.ResultsThe review included 121 cases. These cases usually present with atypical symptoms, mainly circulatory and respiratory, including chest tightness, dyspnea, and edema, along with occasional neurological and gastrointestinal symptoms. Echocardiography served as the primary diagnostic method in 92.6% of cases, while a definitive diagnosis was achieved through pathological examination in all cases (100%). Treatment strategies predominantly included surgical intervention (44.6%) and chemotherapy (76.0%). Although surgery did not have a significant effect on survival rates, chemotherapy proved to be critical in improving patient survival.ConclusionsPCL, which arises in the cardiac or pericardial areas, is generally associated with a poor prognosis. It is essential for clinicians to develop a greater awareness and understanding of the characteristics of PCL to enhance early diagnosis. The timely initiation of chemotherapy is vital for improving survival rates and the overall quality of life for patients with PCL.
Consonant aspiration in Mandarin-speaking children: a developmental perspective from perception and production
Authors: Li Yani , Li Qun , Du Yihang , Wang Lili , Li Lin , Wen Jian , Zheng Yun 
Published: January 2025

IntroductionThis study investigates Mandarin-speaking children's acquisition of aspirated/unaspirated voiceless consonants in terms of perception and production, to track children's developmental profile and explore the factors that may affect their acquisition, as well as the possible association between perception and production.MethodsMandarin-speaking children (N = 95) aged 3–5 and adults (N = 20) participated in (1) a perception test designed based on the minimal pairs of unaspirated/aspirated consonants in the quiet and noisy conditions respectively; (2) a production test where participants produced the target words, with syllable-initial consonants focusing on aspiration and non-aspiration. Six pairs of unaspirated/aspirated consonants in Mandarin were included.Results(1) Children's perception and production accuracy of aspirated and unaspirated consonants increased with age. Five-year-olds achieved high accuracy in the perception under the quiet condition and in the production (over 90%), though not yet adult-like. (2) Noise adversely affected children's perception, with all child groups showing poor performance in the noisy condition. In terms of perception, stops were more challenging to children than affricates, but in terms of production, children performed better on stops. Furthermore, the presence of noise had a greater detrimental effect on the perception of aspirated consonants compared to unaspirated ones. (3) A weak positive correlation was found between children's perception of consonant aspiration in the quiet condition and their production.DiscussionThe findings indicate that age, aspiration state, and manner of articulation (MOA) would affect children's acquisition of consonant aspiration. Although 5-year-olds have almost acquired aspirated/unaspirated consonants, compared to adults, the perception of consonant aspiration in noise remains a challenge for children.
Appropriateness and inappropriate medication predictors of stress ulcer prophylaxis in the intensive care unit
Authors: Zhang Pan , Wang Siyang , Zhi Tingting , Ye Naobei , Sun Haonan , Qin Xingyu , Xu Shuhan , Zhang Ruiqin 
Published: January 2025

IntroductionPreventive drugs for stress ulcers are widely and unreasonably used in the Intensive Care Unit (ICU). This study aims to examine the appropriate utilization of medications for stress ulcer prophylaxis (SUP) and identify factors that contribute to the inappropriate use of these medications in the ICU of the Second Hospital of Shanxi Medical University.MethodsPatient cases admitted to the ICU during the period from May 2022 to May 2023 were extracted from the hospital’s information management system. Single-factor analysis and multivariate logistic regression model analysis were performed using the SPSS to identify factors associated with inappropriate medication for prophylaxis. The efficacy of this predictive model was assessed through the use of the Receiver Operating Characteristic Curve (ROC), while the Hosmer test was utilized to evaluate the model fit.ResultsThis study included a total of 651 patient cases that met the inclusion criteria. Among these cases, 48.39% were found to have received inappropriate medication of SUP. The analysis revealed a significant association between inappropriate medication and partial transfer to departments (P &lt; 0.05), as well as the use of anticoagulants (P = 0.009) in the prophylaxis group. In the non-prophylaxis group, the multifactorial logistic analysis indicated a significant correlation between inadequate prescriptions and partial transfer to departments (P &lt; 0.05), as well as the presence of artificial airways (P &lt; 0.01).ConclusionThere is a notable prevalence of inappropriate SUP in the ICU of this hospital. Attention should be paid to the SUP of some patients transferred to the department, the use of anticoagulants and the presence of artificial airway.
Cost-effectiveness analysis of pembrolizumab plus chemotherapy versus chemotherapy in untreated advanced pleural mesothelioma in the Chinese healthcare system
Authors: Lang Wenwang , He Yulong , Hou Changchun , Li Hua , Jiang Qinling , Mei Liuyong 
Published: January 2025

ObjectiveThe combination of pembrolizumab and chemotherapy has demonstrated notable clinical advantages in improving overall survival than chemotherapy alone for patients with untreated advanced pleural mesothelioma. The purpose of this study was to assess its cost-effectiveness.Materials and methodsA Markov state-transition model was constructed using data from the IND227 phase 3 randomized clinical trial. Utility values for health states were taken from the IND227 trial, and direct medical costs were from the pertinent literature and local pricing data. Outcomes measured included quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), incremental net health benefit (INHB), and incremental net monetary benefit (INMB). To manage the uncertainty in the model, both probabilistic sensitivity analysis (PSA) and one-way sensitivity analysis (OWSA) were used.ResultsIn the base-case analysis, pembrolizumab plus chemotherapy resulted in an incremental gain of 0.23 QALYs at an additional cost of $18,199.63, resulting in an ICER of $80,557.23/QALY. This was not favorable compared to China’s willingness-to-pay (WTP) threshold of $38,042.49/QALY, with an INHB of −0.25 QALYs and an INMB of $-9,605.00. Subgroup analyses showed ICERs for pembrolizumab plus chemotherapy versus chemotherapy of $33,917.61 and $99,536.73 in non-epithelioid and epithelioid patients, respectively. PSA indicated probabilities of cost-effectiveness for pembrolizumab plus chemotherapy at 0.55%, 69.41%, and 0.14% for the entire population and the non-epithelioid and epithelioid subgroups, respectively.ConclusionIn the Chinese healthcare system, the combination of pembrolizumab and chemotherapy did not prove to be more cost-effective than chemotherapy alone as an initial treatment for untreated advanced pleural mesothelioma, with the exception of patients who have non-epithelioid histology.
Portulaca oleracea L. (purslane) extract ameliorates intestinal inflammation in diet-induced obese mice by inhibiting the TLR4/NF-κB signaling pathway
Authors: Miao Lingchao , Cheong Meng Sam , Zhang Haolin , Khan Haroon , Tao Hongxun , Wang Yuxiao , Cheang Wai San 
Published: January 2025

BackgroundPortulaca oleracea L. (purslane) is a dietary plant and a botanical drug with antioxidant, antidiabetic, and anti-inflammatory activities. However, the effects of purslane against intestinal-inflammation-associated obesity are yet to be studied. In the present study, we hypothesized that purslane extract could reduce intestinal inflammation associated with metabolic disorder.ResultsMale C57BL/6J mice were fed a high-fat diet (HFD, 60% kcal% of fat) for a total duration of 14 weeks to establish an obesity model; further, the treatment group was orally administered purslane extract (200 mg/kg/day) during the last 4 weeks. Then, intestinal tissues were detached from the mice for detecting protein expressions through Western blot and immunohistochemical analyses. Pro-inflammatory cytokines were determined using ELISA kits, whereas the components of purslane extract were detected by ultra performance liquid chromatography/electrospray ionization quadrupole time-of-flight mass spectrometry. Chronic oral administration of purslane extract ameliorated colon shortening syndrome and reduced bowel inflammation in HFD-induced obese mice through suppression of the toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) signaling pathway to downregulate TLR4, myeloid differentiation factor 88 (MyD88), Ser32 phosphorylation of NF-κB inhibitor alpha (IκBα), and Ser536 phosphorylation of NF-κB p65 expression levels, thereby inhibiting the pro-inflammatory cytokines, tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels.ConclusionThe present study supports the anti-inflammatory potential of purslane extract for modulating bowel inflammation under obesity through inhibition of the TLR4/NF-κB signaling pathway.
Pharmacogenetic and pharmacokinetic factors for dexmedetomidine-associated hemodynamic instability in pediatric patients
Authors: Guan Yanping , Li Bilian , Zhang Yiyu , Luo Hao , Wang Xueding , Bai Xue , Zheng Zhuoling , Huang Yaying , Wei Wei , Huang Min , Song Xingrong , Zhong Guoping 
Published: January 2025

PurposeThe incidence of hemodynamic instability associated with dexmedetomidine (DEX) sedation has been reported to exceed 50%, with substantial inter-individual variability in response. Genetic factors have been suggested to contribute significantly to such variation. The aim of this study was to identify the clinical, pharmacokinetic, and genetic factors associated with DEX-induced hemodynamic instability in pediatric anesthesia patients.MethodsA cohort of 270 pediatric patients scheduled for elective interventional surgery received an intranasal dose of 3 mcg·kg-1 of dexmedetomidine, and subsequent propofol induction was conducted when patients had a UMSS of 2–4. The primary endpoint was hemodynamic instability—defined as a composite of hypotension and/or bradycardia, which is characterized by a 20% reduction from age-specific baseline values. Plasma concentrations of dexmedetomidine were determined, and single-nucleotide polymorphisms (SNPs) were genotyped. A validated population pharmacokinetic model was used to estimate pharmacokinetic parameters. LASSO regression was used to identify significant factors, and a Cox’s proportional hazards model-derived nomogram for hemodynamic instability was developed.ResultsHemodynamic instability was observed in 52 out of 270 patients (209 events), resulting in a cumulative incidence of 16.30% at 90 min, as estimated by Kaplan–Meier estimation, and it was associated with a median time to event of 35 min. The interval time between DEX initiation and propofol induction was 16 min (IQR: 12–22 min). The cumulative incidence was 8.2% within 22 min after DEX initiation. The identified significant risk factors for DEX-associated hemodynamic instability included weight, DEX clearance, concomitant propofol use, and the following gene variants UGT2B10 rs1841042 (hazard ratio (HR):1.41, 95% confidence interval (CI): 1.12–1.79), CYP2A6 rs8192733 (HR:0.28, 95%CI:0.09–0.88), ADRA2B rs3813662 (HR:1.39,95%CI:1.02–1.89), CACNA2D2 rs2236957 (HR:1.46, 95%CI:1.09–1.96), NR1I2 rs3814057 (HR:0.64, 95%CI:0.43–0.95), and CACNB2 rs10764319 (HR:1.40,95%CI:1.05–1.87). The areas under the curve for the training and test cohorts were 0.881 and 0.762, respectively. The calibration curve indicated excellent agreement.ConclusionThe predictive nomogram, which incorporates genetic variants (UGT2B10, CYP2A6, ADRA2B, CACNA2D2, NR1I2, and CACNB2) along with clinical factors such as weight, DEX clearance, and propofol use, may help prevent DEX-associated hemodynamic instability. Delayed hemodynamic instability is likely to occur after 35-min DEX initiation in patients with lower DEX clearance after propofol induction.
The effects of clinical and pharmacological factors on the ratio of clozapine to norclozapine in psychiatric patients
Authors: Mach Anna , Wnorowska Anna , Siwek Marcin , Wojnar Marcin , Radziwoń-Zaleska Maria 
Published: January 2025

BackgroundDue to its exceptional effectiveness, clozapine (CLO), whose metabolite is norclozapine (NCLO), is a drug of choice in the management of treatment-resistant schizophrenia. The purpose of this study was to assess the factors modifying the CLO/NCLO ratio (CNR).MethodsA total of 446 blood samples (233 of which were drawn from females and 213 from males, aged from 18 to 77 years) were analyzed in this study. The patients were treated at a psychiatric hospital in the period 2016–2021. Serum CLO and NCLO levels were determined with high-performance liquid chromatography coupled with a UV detector.ResultsThe median CNR was 2.38 (minimum 0.30, maximum 14.36). Our analysis showed that neither sex (p= 0.135) nor smoking (p = 0.774) had any significant effect on the CNR. However, increased doses of CLO resulted in lower CNR values (p = 0.005). Concomitant use of other psychotropic drugs increased the CNR (p = 0.001).DiscussionThe results of our study indicate a need for personalized CLO treatment. Assessing the CNR may be useful in identifying CLO interaction with other psychotropic drugs.
Therapeutic effects of composite probiotics derived from fermented camel milk on metabolic dysregulation and intestinal barrier integrity in type 2 diabetes rats
Authors: Manaer Tabusi , Sailike Jialehasibieke , Sun Xin , Yeerjiang Baheban , Nabi Xinhua 
Published: January 2025

BackgroundIn the Kazakh community of Xinjiang, China, fermented camel milk has been traditionally used to manage diabetes. This study evaluates the effects of composite probiotics derived from fermented camel milk (CPCM) on metabolic disturbances in a rat model of Type 2 diabetes (T2DM).MethodsT2DM was induced in Wistar rats using streptozotocin. Experimental groups included a diabetic control, Metformin, and low- and high-dose CPCM. Measurements over 6 weeks included body weight (BW), fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c), C-peptide (CP), lipid profiles, inflammatory markers, fecal short-chain fatty acids (SCFAs), and tight junction protein expression in colonic tissues.ResultsHigh-dose CPCM significantly increased BW by 22.2% (p &lt; 0.05) and reduced FBG by 6.5 mmol/L (p &lt; 0.001). The OGTT AUC decreased by 40.1% (p &lt; 0.001), and HbA1c levels fell by 22.9% (p &lt; 0.01). CP levels rose by 21.8% (p &lt; 0.05). Lipid profiles improved: TC decreased by 40.0%, TG by 17.1%, and LDL-C by 30.4% (all p &lt; 0.001). Fecal SCFAs, including acetate (75.4%, p &lt; 0.001), methyl acetate (18.9%, p &lt; 0.05), and butyrate (289.9%, p &lt; 0.001), increased, with total SCFAs rising by 89.7% (p &lt; 0.001). Inflammatory markers IL-1β (12.7%, p &lt; 0.01), TNF-α (16.7%, p &lt; 0.05), and IL-6 (17.3%, p &lt; 0.01) were significantly reduced. Tight junction protein expression (ZO-1, occludin, claudin-1) and mucin (MUC2) in colonic tissues increased (p &lt; 0.05). CPCM treatment also reduced serum total bile acids by 24.9%, while hepatic and fecal bile acids increased by 114.0% and 37.8% (all p &lt; 0.001). CPCM lowered serum DAO, D-lactate, and LPS levels (all p &lt; 0.001). mRNA levels of TGR5 and CYP7A1 in the liver, and TGR5 and FXR in the colon, were markedly elevated (all p &lt; 0.001). Histological examinations revealed reduced pancreatic inflammation and hepatic steatosis, with restored colonic structure.ConclusionCPCM treatment significantly improved metabolic dysregulation in the T2DM rat model, reducing blood glucose and lipid levels, enhancing intestinal barrier function, and increasing insulin secretion. These findings highlight the therapeutic potential of CPCM in T2DM management and probiotics’ role in metabolic health.
Correlation between the white blood cell/platelet ratio and 28-day all-cause mortality in cardiac arrest patients: a retrospective cohort study based on machine learning
Authors: Huang Huai , Ren Guangqin , Sun Shanghui , Li Zhi , Zheng Yongtian , Dong Lijuan , Zhu Shaoliang , Zhu Xiaosheng , Jiang Wenyu 
Published: January 2025

ObjectiveThis study aims to evaluate the association between the white blood cell-to-platelet ratio (WPR) and 28-day all-cause mortality among patients experiencing cardiac arrest.MethodsUtilizing data from 748 cardiac arrest patients in the Medical Information Mart for Intensive Care-IV (MIMIC-IV) 2.2 database, machine learning algorithms, including the Boruta feature selection method, random forest modeling, and SHAP value analysis, were applied to identify significant prognostic biomarkers. Key patient characteristics, encompassing demographic data, comorbidities, hematological and biochemical indices, and vital signs, were extracted using PostgreSQL Administration Tool (pgAdmin) software. The Cox proportional hazards model assessed the impact of WPR on mortality outcomes, while Kaplan-Meier survival curves and restricted cubic spline (RCS) analysis further validated the findings. Subgroup analyses stratified the prognostic value of WPR by demographic and clinical factors.ResultsWPR demonstrated the highest prognostic significance among the variables studied, showing a strong association with 28-day all-cause mortality. In the unadjusted Model 1, hazard ratios (HRs) for WPR quartiles ranged from 1.88 (95% CI: 1.22–2.90) in Q2 to 3.02 (95% CI: 2.04–4.47) in Q4 (Ptrend &lt;0.05). Adjusted models (Models 2–4) confirmed the robustness of these associations, even after accounting for demographic and clinical covariates. Kaplan-Meier and RCS analyses revealed a significant U-shaped relationship between WPR and mortality risk. Subgroup analyses indicated that elevated WPR was particularly associated with increased mortality in males, elderly patients, married individuals, and those with chronic pulmonary disease.ConclusionWPR serves as an independent and reliable prognostic biomarker for 28-day mortality in cardiac arrest patients. Its integration into clinical decision-making may enhance the early identification of high-risk patients and guide tailored therapeutic interventions.
Doctor, what is my risk of bleeding after cardiac surgery while on combined anticoagulant with antiplatelet therapy? A validated nomogram for risk assessment
Authors: Han Haolong , Xu Hang , Zhang Jifan , Zhang Weihui , Yang Yi , Wang Xia , Wang Li , Wang Dongjin , Ge Weihong 
Published: January 2025

BackgroundPatients with comorbid coronary artery disease and valvular heart disease usually undergo coronary artery bypass grafting alongside valve replacement or ring repair surgeries. Following these procedures, they typically receive a combination of anticoagulation and antiplatelet therapy, which notably heightens their bleeding risk. However, Current scoring systems provide limited predictive capability.MethodsA total of 500 adult patients treated with anticoagulation plus antiplatelet therapy after cardiac surgery were randomly divided into the training set and the validation set at a ratio of 7:3. Predictive factors were identified using univariate logistic regression, LASSO regression and multivariable analysis. Various models were developed, validated and evaluated by using methods including ROC curves, calibration curves, the Hosmer-Lemeshow test, net reclassification improvement (NRI), integrated discrimination improvement (IDI) index, decision curve analysis (DCA) and clinical impact curves (CIC).ResultsMod2 showed the best performance (AUC of validation set = 0.863) which consists of 8 independent predictive factors (gender, age &gt; 65 years, diabetes, anemia, atrial fibrillation, cardiopulmonary bypass time, intraoperative bleeding and postoperative drainage), with a significantly higher AUC compared to Mod1 (only preoperative factors) and Mod3 (the HAS-BLED scoring model). NRI and IDI analyses further confirmed the superior predictive ability of Mod2 (NRI &lt; 0.05, IDI &lt; 0.05). Both DCA and CIC indicated that Mod2 exhibited good clinical applicability.ConclusionThis research established and validated a nomogram model incorporating eight predictive factors to evaluate the bleeding risk in patients who receive anticoagulation combined with antiplatelet therapy following cardiac surgery. The model holds significant potential for clinical applications in bleeding risk assessment, decision-making and personalized treatment strategies.
The effects of strength and conditioning interventions on serve speed in tennis players: a systematic review and meta-analysis
Authors: Deng Nuannuan , Soh Kim Geok , Xu Fan , Yang Xinggang 
Published: January 2025

BackgroundTennis performance is highly influenced by serve speed. This review aimed to evaluate and quantitatively compare the efficacy of popular strength and conditioning (S&amp;C) training methods in enhancing the speed of the ball in the serves of tennis players.MethodsFollowing PRISMA guidelines, a systematic search was conducted in the Scopus, Web of Science, SportsDiscuss, and PubMed databases without date constraints, up to July 2024. Studies included in this meta-analysis met PICOS criteria: a) randomized controlled trials with healthy tennis players, b) isolated or combined S&amp;C training programs, c) evaluation of tennis serve speed, and d) adequate data to compute effect sizes (ESs). The PEDro scale was used to assess methodological quality.ResultsOut of 271 identified papers, 16 studies of moderate to high quality were included in the meta-analysis. Resistance training demonstrated a small but significant effect on serve speed (ES = 0.53; p &lt; 0.001), while multimodal training exhibited a moderate and significant effect (ES = 0.79; p = 0.001). However, core training did not have a significant effect on serve speed (ES = 0.32, p = 0.231).ConclusionThe findings suggested that S&amp;C interventions, including resistance and multimodal training, were beneficial for increasing serve speed in tennis players. Further high-quality research is recommended to confirm this conclusion.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_ record.php?RecordID=519790, identifier CRD42024519790.