bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial
Authors: Ibarra-Estrada Miguel , Kattan Eduardo , Aguilera-González Pavel , Sandoval-Plascencia Laura , Rico-Jauregui Uriel , Gómez-Partida Carlos A. , Ortiz-Macías Iris X. , López-Pulgarín José A. , Chávez-Peña Quetzalcóatl , Mijangos-Méndez Julio C. , Aguirre-Avalos Guadalupe , Hernández Glenn 
Published: March 2023

Abstract
Purpose
Methylene blue (MB) has been tested as a rescue therapy for patients with refractory septic shock. However, there is a lack of evidence on MB as an adjuvant therapy, its’ optimal timing, dosing and safety profile. We aimed to assess whether early adjunctive MB can reduce time to vasopressor discontinuation in patients with septic shock.

Methods
In this single-center randomized controlled trial, we assigned patients with septic shock according to Sepsis-3 criteria to MB or placebo. Primary outcome was time to vasopressor discontinuation at 28 days. Secondary outcomes included vasopressor-free days at 28 days, days on mechanical ventilator, length of stay in ICU and hospital, and mortality at 28 days.

Results
Among 91 randomized patients, forty-five were assigned to MB and 46 to placebo. The MB group had a shorter time to vasopressor discontinuation (69 h [IQR 59–83] vs 94 h [IQR 74–141]; p < 0.001), one more day of vasopressor-free days at day 28 (p = 0.008), a shorter ICU length of stay by 1.5 days (p = 0.039) and shorter hospital length of stay by 2.7 days (p = 0.027) compared to patients in the control group. Days on mechanical ventilator and mortality were similar. There were no serious adverse effects related to MB administration.

Conclusion
In patients with septic shock, MB initiated within 24 h reduced time to vasopressor discontinuation and increased vasopressor-free days at 28 days. It also reduced length of stay in ICU and hospital without adverse effects. Our study supports further research regarding MB in larger randomized clinical trials.
Trial registration ClinicalTrials.gov registration number NCT04446871, June 25, 2020, retrospectively registered.
Three developed spectrophotometric methods for determination of a mixture of ofloxacin and ornidazole; application of greenness assessment tools
Authors: Kelani Khadiga M. , Gad Asmaa G. , Fayez Yasmin M. , Mahmoud Amr M. , Abdel-Raoof Ahmed M. 
Published: March 2023

AbstractThis work is dedicated to the greenness estimation of three proposed spectrophotometric techniques [e.g., ratio difference (RD), mean centering of ratio spectra (MCR) and continuous wavelet transform of ratio spectra (CWT)] for the determination of a binary combination named Ofloxacin (OFL) and Ornidazole (ORN). Applying the green analytical chemistry methods to assess the proposed methods has widely attained the analytical community care. The greenness assessment was performed via three evaluation approaches; the “Analytical Eco-Scale”, the “National Environmental Method Index” (NEMI) and “Green Analytical Procedure Index” (GAPI). Following the examination of the zero spectrum of OFL and ORN, it is observed that OFL and ORN spectra are overlapped, so they can be detected by the methods mentioned previously. The ratio difference method was carried out at wavelengths of 294.6 nm and 265.6 nm for OFL, 292 nm and 315 nm for ORN. The linear range was (2–15 µg/mL) for OFL and (3–30 µg/mL) for ORN. The MCR method based on the use of mean centered ratio spectra in dual steps and calculating the second ratio spectra mean centered values at 294.6 nm for OFL and 315 nm for ORN. The continuous wavelet transformation which carried out using MATLAB at wavelengths of 265 nm for OFL and 306 for ORN. These techniques were intended for the binary mixture analysis in bulk powder and pharmaceutical formulations with high recoveries. The developed methods were validated according to ICH guidelines. All techniques were statistically compared to either an official method for OFL or a reported method for ORN and the results indicate that there were not any significant differences.
Long-term effects of aromatase inhibitors on body mass index among postmenopausal breast cancer survivors in Africa: observational cohort study
Authors: Milambo Jean Paul Muambangu , Nyasulu Peter S , Akudugu John M , Ndirangu James 
Published: March 2023

Abstract
Purpose
this study was conducted to assess the impact of AIs on body mass index and high sensitivity as prognostic predictors to be incorporated into point of care technology (POCT) testing in postmenopausal breast cancer women after a 24 month follow up in Africa. An observational cohort study was conducted; including 126 female BC patients with stages ranging from 0-III initially subjected to AIs and subsequently followed up for 24 months. Multiple imputation model was conducted to predict missing data.

Results
Random effects model was used to monitor the changes over the time. The study revealed stronger statistically association between BMI and homocysteine (p = 0.021, 95%CI: 0.0083 to 0.1029). Weight and total body fat were strongly associated after 24 months follow up. Hs-CRP was associated with BMI (p = 0.0001), and hs-CRP was associated with other biomedical markers such as calcium (p = 0.021, 95% CI: 0.01 to 0.10), phosphate (p = 0.039, 95%CI: 0.01 to 0.10), and ferritin (p = 0.002, 95%CI: 0.02 to 0.08) and calcium. The patients subjected to AIs are likely to develop cardiovascular adverse events. POCT of care strategy which include clinical, biomedical and genetic predictor’s measurement is required to improve BC survivorship.
Medical ID use by international patients with Aspirin-Exacerbated Respiratory Disease
Authors: Alqabasani Mohammed , Lasso Andrea , Kilty Shaun 
Published: March 2023

Abstract
Background
Patients widely use medical identification (ID) to indicate their food and drug allergies, and chronic medical conditions. One chronic condition for which patients are recommended to use a form of medical ID is Aspirin-Exacerbated Respiratory Disease (AERD), a disease characterized by the presence of asthma, chronic rhinosinusitis with nasal polyps and sensitivity to aspirin and other COX-1 inhibitors, including nonsteroidal anti-inflammatory drugs (NSAIDs). The uptake of medical ID use in AERD is unknown and has not been widely studied in this population.

Methods
We conducted a cross-sectional survey study to measure the perception of the need to use a medical ID and its use by patients with AERD internationally.

Results
245 members of an online AERD support group completed an online survey. The majority (80%, n = 198) of the participants did not use any form of medical ID. The participants reported that the lack of knowledge and awareness about the importance of using a medical ID was the most common reason for not using it.

Conclusion
This international survey found that the majority of the AERD patient respondents did not use a medical ID. The most common reasons for nonuse were not knowing that it is recommended for their condition and that the patients did not consider it necessary. The results highlight the need for further patient and health care provider education.
Isolated medial antebrachial cutaneous nerve injury after blunt trauma: a case report
Authors: Babaeian Zahra , Ashraf Alireza , Erfani Fariba 
Published: March 2023

Abstract
Background
The medial antebrachial cutaneous nerve is a branch of the brachial plexus that contains C8–T1 segments. Injury of this nerve by various mechanisms has been reported in the literature; however, currently, there is no reported case of medial antebrachial cutaneous nerve injury in the setting of acute blunt trauma.

Case presentation
This case report presents the case of a 34-year-old Persian female with dysesthesia and pain in the medial side of the forearm immediately following a blunt trauma by mechanism of elbow external rotation. On electrodiagnostic evaluation, the medial antebrachial cutaneous nerve sensory nerve action potential of the symptomatic side had a significant amplitude drop (more than 50%), compared with the other side. On follow-up electrodiagnosis, after several sessions of physical therapy, the medial antebrachial cutaneous nerve sensory nerve action potential still had a significant amplitude difference.

Conclusion
Blunt trauma can be one of the causes of medial antebrachial cutaneous nerve involvement. An electrodiagnostic study can be helpful in the diagnosis of this nerve injury after blunt trauma.
Long-term outcomes after severe acute kidney injury in critically ill patients: the SALTO study
Authors: Chaïbi Khalil , Ehooman Franck , Pons Bertrand , Martin-Lefevre Laurent , Boulet Eric , Boyer Alexandre , Chevrel Guillaume , Lerolle Nicolas , Carpentier Dorothée , de Prost Nicolas , Lautrette Alexandre , Bretagnol Anne , Mayaux Julien , Nseir Saad , Megarbane Bruno , Thirion Marina , Forel Jean-Marie , Maizel Julien , Yonis Hodane , Markowicz Philippe , Thiery Guillaume , Schortgen Frédérique , Couchoud Cécile , Dreyfuss Didier , Gaudry Stephane 
Published: March 2023

Abstract
Background
The extent of the consequences of an episode of severe acute kidney injury (AKI) on long-term outcome of critically ill patients remain debated. We conducted a prospective follow-up of patients included in a large multicenter clinical trial of renal replacement therapy (RRT) initiation strategy during severe AKI (the Artificial Kidney Initiation in Kidney Injury, AKIKI) to investigate long-term survival, renal outcome and health related quality of life (HRQOL). We also assessed the influence of RRT initiation strategy on these outcomes.

Results
Follow-up of patients extended from 60 days to a median of 3.35 years [interquartile range (IQR), 1.89 to 4.09] after the end of initial study. Of the 619 patients included in the AKIKI trial, 316 survived after 60 days. The overall survival rate at 3 years from inclusion was 39.4% (95% CI 35.4 to 43.4). A total of 46 patients (on the 175 with available data on long-term kidney function) experienced worsening of renal function (WRF) at the time of follow-up [overall incidence of 26%, cumulative incidence at 4 years: 20.6% (CI 95% 13.0 to 28.3)]. Fifteen patients required chronic dialysis (5% of patients who survived after day 90). Among the 226 long-term survivors, 80 (35%) answered the EQ-5D questionnaire. The median index value reported was 0.67 (IQR 0.40 to 1.00) indicating a noticeable alteration of quality of life. Initiation strategy for RRT had no effect on any long-term outcome.

Conclusion
Severe AKI in critically ill patients was associated with a high proportion of death within the first 2 months but less so during long-term follow-up. A quarter of long-term survivors experienced a WRF and suffered from a noticeable impairment of quality of life. Renal replacement therapy initiation strategy was not associated with mortality outcome.

Graphical Abstract
Evidence-based health policy in Germany: lack of communication and coordination between academia and health authorities?
Authors: Kugler Charlotte Mareike , Perleth Matthias , Mathes Tim , Goossen Kaethe , Pieper Dawid 
Published: March 2023

AbstractHealth-care decision making should consider the best available evidence, often in the form of systematic reviews (SRs). The number of existing SRs and their overlap make their identification and use difficult. Decision makers often rely on de novo SRs instead of using existing SRs. We describe two cases of duplicate reviews (minimum volume threshold of total knee arthroplasties and lung cancer screening) and one case of duplicate primary data analysis (transcatheter aortic valve implantation). All cases have in common that unintended duplication of research occurred between health authorities and academia, demonstrating a lack of communication and coordination between them.It is important to note that academia and health authorities have different incentives. Academics are often measured by the number of peer-reviewed publications and grants awarded. In contrast, health authorities must comply with laws and are commissioned to deliver a specific report within a defined period of time. Most replication is currently unintended. A solution may be the collaboration of stakeholders commonly referred to as integrated knowledge translation (IKT). The IKT approach means that research is conducted in collaboration with the end users of the research. It requires active collaborations between researchers and decision-makers or knowledge users (clinicians, managers, policy makers) throughout the research process. Wherever cooperation is possible in spite of requirements for independence or confidentiality, legal regulations should facilitate and support collaborative approaches between academia and health authorities.
Supplemental Clostridium butyricum modulates lipid metabolism by reshaping the gut microbiota composition and bile acid profile in IUGR suckling piglets
Authors: Zhang Xin , Yun Yang , Lai Zheng , Ji Shuli , Yu Ge , Xie Zechen , Zhang Hao , Zhong Xiang , Wang Tian , Zhang Lili 
Published: March 2023

Abstract
Background
Intrauterine growth restriction (IUGR) can cause lipid disorders in infants and have long-term adverse effects on their growth and development. Clostridium butyricum (C. butyricum), a kind of emerging probiotics, has been reported to effectively attenuate lipid metabolism dysfunctions. Therefore, the objective of this study was to investigate the effects of C. butyricum supplementation on hepatic lipid disorders in IUGR suckling piglets.

Methods
Sixteen IUGR and eight normal birth weight (NBW) neonatal male piglets were used in this study. From d 3 to d 24, in addition to drinking milk, the eight NBW piglets (NBW-CON group, n = 8) and eight IUGR piglets (IUGR-CON group, n = 8) were given 10 mL sterile saline once a day, while the remaining IUGR piglets (IUGR-CB group, n = 8) were orally administered C. butyricum at a dose of 2 × 108 colony-forming units (CFU)/kg body weight (suspended in 10 mL sterile saline) at the same frequency.

Results
The IUGR-CON piglets exhibited restricted growth, impaired hepatic morphology, disordered lipid metabolism, increased abundance of opportunistic pathogens and altered ileum and liver bile acid (BA) profiles. However, C. butyricum supplementation reshaped the gut microbiota of the IUGR-CB piglets, characterized by a decreased abundance of opportunistic pathogens in the ileum, including Streptococcus and Enterococcus. The decrease in these bile salt hydrolase (BSH)-producing microbes increased the content of conjugated BAs, which could be transported to the liver and function as signaling molecules to activate liver X receptor α (LXRα) and farnesoid X receptor (FXR). This activation effectively accelerated the synthesis and oxidation of fatty acids and down-regulated the total cholesterol level by decreasing the synthesis and promoting the efflux of cholesterol. As a result, the growth performance and morphological structure of the liver improved in the IUGR piglets.

Conclusion
These results indicate that C. butyricum supplementation in IUGR suckling piglets could decrease the abundance of BSH-producing microbes (Streptococcus and Enterococcus). This decrease altered the ileum and liver BA profiles and consequently activated the expression of hepatic LXRα and FXR. The activation of these two signaling molecules could effectively normalize the lipid metabolism and improve the growth performance of IUGR suckling piglets.
Immunological and tumor-intrinsic mechanisms mediate the synergistic growth suppression of experimental glioblastoma by radiotherapy and MET inhibition
Authors: Silginer Manuela , Papa Eleanna , Szabó Emese , Vasella Flavio , Pruschy Martin , Stroh Christopher , Roth Patrick , Weiss Tobias , Weller Michael 
Published: March 2023

AbstractThe hepatocyte growth factor (HGF)/MET signaling pathway has been proposed to be involved in the resistance to radiotherapy of glioblastoma via proinvasive and DNA damage response pathways.Here we assessed the role of the MET pathway in the response to radiotherapy in vitro and in vivo in syngeneic mouse glioma models. We find that the murine glioma cell lines GL-261, SMA-497, SMA-540 and SMA-560 express HGF and its receptor MET and respond to exogenous HGF with MET phosphorylation. Glioma cell viability or proliferation are unaffected by genetic or pharmacological MET inhibition using tepotinib or CRISPR/Cas9-engineered Met gene knockout and MET inhibition fails to sensitize glioma cells to irradiation in vitro. In contrast, the combination of tepotinib with radiotherapy prolongs survival of orthotopic SMA-560 or GL-261 glioma-bearing mice compared with radiotherapy or tepotinib treatment alone. Synergy is lost when such experiments are conducted in immunodeficient Rag1−/− mice, and, importantly, also when Met gene expression is disrupted in the tumor cells. Combination therapy suppresses a set of pro-inflammatory mediators including matrix metalloproteases that are upregulated by radiotherapy alone and that have been linked to poor outcome in glioblastoma. Several of these mediators are positively regulated by transforming growth factor (TGF)-β, and pSMAD2 levels as a surrogate marker of TGF-β pathway activity are suppressed by combination treatment. We conclude that synergistic suppression of experimental syngeneic glioma growth by irradiation and MET inhibition requires MET expression in the tumor as well as an intact immune system. Clinical evaluation of this combined strategy in newly diagnosed glioblastoma is warranted.
Effects of IPR by mechanical oscillating strips system on biological structures: a quantitative and qualitative evaluation
Authors: Gazzani Francesca , Bellisario Denise , Fazi Laura , Balboni Alessia , Licoccia Silvia , Pavoni Chiara , Cozza Paola , Lione Roberta 
Published: March 2023

Abstract
Background
To evaluate by means of profilometric analysis and scanning electronic microscope (SEM) the effects on enamel surfaces of oscillating mechanical systems for interproximal enamel reduction (IPR). Fifteen complete (Group 1) oscillating IPR sequence and 15 single metallic strips (Group 2) for active IPR phase of 0.2 mm were selected and tested on 30 freshly extracted teeth by means of tribological tests with alternative dry-sliding motion (Linear Reciprocating Tribometer, C.S.M. Instruments, Peseaux, Switzerland). Enamel surface roughness and waviness measurements were assessed by contact probe surface profiler (TalySurf CLI 2000; Taylor Hobson, Leicester, UK) and a TayMap software for the 3D analysis. Statistical analysis was performed with independent samples t-test. Significance was established at the P < .05 level. SEM analysis of enamel surfaces was conducted with a FEI Quanta 200 (Hillsboro, USA) in high vacuum at 30.00 kV. Images were acquired at 30X, 100X, and 300X of magnification.

Results
Teeth undergone Group 1 showed lower values of surface roughness (Ra − 0.34 µm, Rt − 1.55 µm) and significant increase of waviness parameters (Wa 0.25 µm, Wt 4.02 µm) when compared with those treated with Group 2. SEM evaluation showed smoothers and more regular surfaces when IPR was performed by complete IPR sequence. Single metallic strip determined more irregular surfaces characterized by extended grooves, alternated with enamel ridges and irregular fragments.

Conclusion
The adoption of a standardized oscillating IPR sequence determines more regular and harmonious enamel surfaces at the end of the procedure. An adequate polishing after IPR plays a crucial role to guarantee a good long-term prognosis and a good respect of biological structures.
Your neighborhood matters: an ecological social determinant study of the relationship between residential racial segregation and the risk of firearm fatalities
Authors: Shour Abdul R. , Anguzu Ronald , Zhou Yuhong , Muehlbauer Alice , Joseph Adedayo , Oladebo Tinuola , Puthoff David , Onitilo Adedayo A. 
Published: March 2023

Abstract
Background
Firearm fatalities are a major public health concern, claiming the lives of 40,000 Americans each year. While firearm fatalities have pervasive effects, it is unclear how social determinants of health (SDOH) such as residential racial segregation, income inequality, and community resilience impact firearm fatalities. This study investigates the relationships between these SDOH and the likelihood of firearm fatalities.

Methods
County-level SDOH data from the Agency for Health Care Research and Quality for 2019 were analyzed, covering 72 Wisconsin counties. The dependent variable was the number of firearm fatalities in each county, used as a continuous variable. The independent variable was residential racial segregation (Dissimilarity Index), defined as the degree to which non-White and White residents were distributed across counties, ranging from 0 (complete integration) to 100 (complete segregation), and higher values indicate greater residential segregation (categorized as low, moderate, and high). Covariates were income inequality ranging from zero (perfect equality) to one (perfect inequality) categorized as low, moderate, and high, community resilience risk factors (low, moderate, and high risks), and rural-urban classifications. Descriptive/summary statistics, unadjusted and adjusted negative binomial regression adjusting for population weight, were performed using STATA/MPv.17.0; P-values ≤ 0.05 were considered statistically significant. ArcMap was used for Geographic Information System analysis.

Results
In 2019, there were 802 firearm fatalities. The adjusted model demonstrates that the risk of firearm fatalities was higher in areas with high residential racial segregation compared to low-segregated areas (IRR.:1.26, 95% CI:1.04–1.52) and higher in areas with high-income inequality compared to areas with low-income inequality (IRR.:1.18, 95% CI:1.00–1.40). Compared to areas with low-risk community resilience, the risk of firearm fatalities was higher in areas with moderate (IRR.:0.61, 95% CI:0.48–0.78), and in areas with high risk (IRR.:0.53, 95% CI:0.41–0.68). GIS analysis demonstrated that areas with high racial segregation also have high rates of firearm fatalities.

Conclusion
Areas with high residential racial segregation have a high rate of firearm fatalities. With high income inequality and low community resilience, the likelihood of firearm fatalities increases.