bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of renal function on the clinical outcomes and management of patients hospitalized with hyperglycemic crises
Authors: Almohareb Sumaya N. , Aljammaz Norah , Yousif Nada , Sunbul Mayar , Alsemary Raghad , Alkhathran Lama , Aldhaeefi Mohammed , Almohammed Omar A. , Alshaya Abdulrahman I. 
Published: January 2025

BackgroundThe global prevalence of diabetes has been rising rapidly in recent years, leading to an increase in patients experiencing hyperglycemic crises like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Patients with impaired renal function experience a delay in insulin clearance, complicating the adjustment of insulin dosing and elevating hypoglycemia risk. Accordingly, this study aims to evaluate the impact of renal function on the safety and efficacy of insulin use in patients with isolated DKA or combined DKA/HHS.MethodsA retrospective observational study was conducted at King Abdulaziz Medical City, Saudi Arabia, from January 2016 to December 2021. Eligible patients were ≥18 years, had a confirmed diagnosis of isolated DKA or combined DKA/HHS, presented with an anion gap (AG) of ≥ 16 mmol/L, and received insulin either via continuous infusion or as bolus doses. Patients were categorized into normal kidney function and patients with chronic kidney disease (CKD). The primary outcome was to determine the difference in time to close the AG between the two groups. Statistical analyses were performed using SAS® software.ResultsOut of 319 screened patients, 183 patients met the inclusion criteria. The patients were divided into normal kidney function (43.2%) and CKD (56.8%) groups. The average eGFR for patients with normal kidney function was 93.7 ± 32.5 mL/min/1.73m2 compared to 33.4 ± 14.3 mL/min/1.73m2 for patients with CKD. The time to close AG was similar between patients in the normal kidney function and CKD groups (22.6 ± 16.0 hours vs. 24.5 ± 17.5 hours, p=0.4475). However, the patients’ length of stay in hospital (3.4 ± 2.5 days vs. 5.2 ± 4.0 days; p=0.0004) and ICU (2.5 ± 1.8 days vs. 4.0 ± 2.8 days; p=0.0453) were both significantly longer for patients with CKD. Hypoglycemic events were low in our study with only four documented cases among patients with CKD.ConclusionThis study provides insights into DKA management and outcomes in patients with normal and impaired renal function. The time required to close AG was comparable between the two groups. Larger, multi-center studies are needed to validate these findings and explore additional factors that may impact the management of DKA in patients with CKD.
Combined oven/freeze drying as a cost and energy-efficient drying method for preserving quality attributes and volatile compounds of carrot slices
Authors: Mina Zobabalo Progress , Kaseke Tafadzwa , Fadiji Tobi , Silue Yardjouma , Fawole Olaniyi Amos 
Published: January 2025

IntroductionAn effective and efficient drying method for preserving fresh carrots is essential in food processing. Combined drying represents a novel approach that addresses the shortcomings of conventional methods by balancing energy consumption, cost, and product quality.MethodsThis study evaluated the impact of combining oven drying (OD) with freeze-drying (FD) on drying behavior, energy requirements, costs, enzyme activity, and the physicochemical and sensory properties of dried carrots. Drying conditions included 36 hours of FD, OD, and combinations of OD and FD at 1 h of OD + 21 h of FD (OD1-FD21), 2 h of OD + 18 h of FD (OD2-FD18), 3 h of OD + 15 h of FD (OD3-FD15), and 9 h of OD.Results and discussionCompared to FD alone, the OD-FD combination reduced drying time by 39–50% and decreased energy consumption and costs by 40–56%. FD and OD-FD reduced polyphenol oxidase activity by 71–85% and peroxidase activity by 29–52% compared to OD alone. FD carrot slices retained significantly higher levels of β-carotene (11.67–25.96 mg/100 g DM), lycopene (9.91–21.85 mg/100 g DM), total phenolic content (7.12–10.24 mg GAE/100 g DM), and DPPH radical scavenging activity (16.44–19.38 mM AAE/100 g DM) than OD and OD-FD slices. OD-FD slices exhibited the highest levels of volatile compounds, including aldehydes, terpenes, esters, alcohols, ketones, and acids, indicating superior flavor preservation.ConclusionThe OD2-FD18 combination emerged as the optimal method, significantly reducing energy consumption and costs while maintaining better β-carotene, total phenolic content, DPPH radical scavenging activity, and volatile compound profiles. This study highlights the potential of combined drying methods to enhance drying efficiency and product quality.
Immunotherapy combined with chemotherapy without locoregional radiotherapy in de novo metastatic nasopharyngeal carcinoma: two case reports and a literature review
Authors: Gao Yingna , Shi Xiaoqiong , He Jianqiao , Yao Hui , Yu Guoning , Zhao Lin , Ma Yi , Zheng Hongliang , Zhu Minhui , Zhang Caiyun 
Published: January 2025

BackgroundThere is no consensus regarding the optimal regimen for de novo metastatic nasopharyngeal carcinoma (dmNPC). Locoregional intensity modulated radiotherapy (LRRT) following palliative chemotherapy (PCT) has been shown to prolong the overall survival (OS) and improve the progression-free survival (PFS) of patients with dmNPC, compared with PCT alone. However, patients with a high tumor burden do not benefit from additional LRRT, which inevitably results in toxicity. Recently, immunotherapy has made great progress in the treatment of recurrent or metastatic NPC (RM-NPC). Compared with PCT alone, programmed death-1(PD-1) inhibitors combined with PCT have shown a promising survival outcome and an acceptable safety profile. Therefore, this treatment strategy is recommended as a first-line therapy for RM-NPC. However, whether dmNPC can be treated with immunochemotherapy alone (without LRRT) remains controversial.Case presentationWe report two cases of dmNPC, both in middle-aged men who mainly presented with epistaxis and systemic pain. Radiological examination with positron emission tomography–computed tomography (PET-CT) and contrast-enhanced magnetic resonance imaging (MRI) showed NPC with multiple systemic lymph node metastases, multiple bone metastases, and liver metastases. Both patients were diagnosed with dmNPC and received pabolizumab in combination with six courses of platinum-based chemotherapy treatment. After complete remission (CR) was achieved, the patients were maintained on pabolizumab alone. No LRRT was used throughout the course of the disease. Pre- and post-treatment levels of plasma Epstein-Barr virus (EBV) DNA were measured, and radiological imaging was performed before and after treatment.ResultsWe achieved good efficacy in these two cases of dmNPC. Both patients exhibited survival benefits (PFS has reached 31 months since diagnosis), and no serious chemotherapy- or immune-related adverse reactions occurred. Treatment-related toxicity from radiotherapy was avoided. Levels of plasma EBV DNA decreased and remained below the minimum detection level consistently after four or five cycles of treatment, with no obvious symptoms of neck muscle fibrosis, throat mucosa dryness, ear congestion, or nasal congestion.ConclusionOur findings suggested that chemotherapy combined with a PD-1 inhibitor without LRRT, followed by sequential immunotherapy as maintenance, can achieve good results in some dmNPC patients. Further validation of our results may be required in large, high-quality prospective clinical studies.
Electroacupuncture may protect pulmonary dysplasia in offspring with perinatal nicotine exposure by altering maternal gut microbiota and metabolites
Authors: Xie Yana , Fang Yang , Liu Yitian , Ji Bo , Sakurai Reiko , Wang Yifei , Li Hewen , Zhang Ling , Wu Le , Guo Tingting , Quan Ye , Rehan Virender K. 
Published: January 2025

BackgroundPerinatal nicotine exposure (PNE) induces pulmonary dysplasia in offspring and it increases the risk of respiratory diseases both in offspring and across generations. The maternal gut microbiota and its metabolites, such as short-chain fatty acids (SCFAs), can regulate fetal lung development and are susceptible to nicotine exposure. Therefore, modulation of PNE-induced changes in maternal gut microbiota and SCFAs may prevent the occurrence of pulmonary dysplasia in offspring.ObjectiveOur previous studies demonstrated that electroacupuncture (EA) ameliorated PNE-induced impairment in offspring lung development. To further our study, we aimed to determine whether the protective effect of EA is associated with the modulation of changes in maternal gut microbiota and SCFAs.MethodsWe observed changes in maternal gut microbiota and serum SCFA levels in both mother and offspring after EA treatment using a PNE rat model. Furthermore, using broad-spectrum antibiotics, we established a pseudo-germ-free PNE rat model to explore whether EA can protect offspring’s pulmonary function and lung morphology in the presence of depleted maternal gut microbiota.ResultsOur study revealed that EA increased the community richness (Sobs index) of perinatal nicotine-exposed maternal gut microbiota and the abundance of beneficial bacteria (RF39, Clostridia, Oscillospirales, etc.). This was accompanied by an upregulated serum levels of acetate, butyrate, and total SCFAs in both mother and offspring rats, as well as stimulated expression of SCFA receptors (GPR41 and GPR43) in the lung tissue of offspring rats. However, the beneficial effects of EA on offspring pulmonary function (FVC, PEF, PIF, and Cdyn) and lung morphology (alveolar number and MLI) were lost after maternal gut microbiota depletion.ConclusionThese findings suggest that EA may exert its therapeutic effects on PNE-induced lung phenotype by altering maternal gut microbiota. The likely mechanism involves the associated improvement in serum SCFA levels in both mother and offspring, as well as the upregulation of SCFA receptors in the lung tissue of offspring.
Characterization and pathogenicity of a novel avian orthoreovirus in China
Authors: Chen Shunyan , Yang Jialin , Li Li , Guo Yawei , Yang Shenghua , Su Zetao , Zhao Sucan , Li Xuesong , Lin Wencheng , Du Yunping , Yin Lijuan , Wang Lianxiang , Chen Feng 
Published: January 2025

IntroductionAvian orthoreovirus (ARV) is a significant pathogen causing viral arthritis, leading to substantial economic losses in the poultry industry worldwide.MethodsA novel ARV strain, designated FJ202311, was isolated from a broiler farm in Fujian Province, China. Whole-genome sequencing was conducted using next-generation sequencing with MGI technology, and phylogenetic analysis of the sigma C amino acid sequence was performed. Comparative sequence analysis identified unique genetic features of FJ202311. Pathogenicity studies were carried out by inoculating broilers with the isolated strain and monitoring clinical signs, weight gain, and histopathological changes.ResultsThe complete genome of FJ202311 was determined to be 23,495 base pairs in length, encoding 12 major proteins. Phylogenetic analysis revealed that FJ202311 forms a distinct genotypic cluster, exhibiting only 47.1% to 59.3% sequence identity to 16 reference ARV strains. Notably, 50 unique amino acid substitutions were identified in the sigma C protein. Pathogenicity tests demonstrated that FJ202311 caused severe arthritis and tenosynovitis in broilers. Infected birds exhibited significant weight loss compared to controls, with reductions of 11.78% and 8.93% at 14 and 21 days post-infection, respectively.DiscussionThis study highlights the unique molecular and pathogenic characteristics of the novel ARV strain FJ202311, contributing to our understanding of ARV diversity and epidemiology in China. These findings underscore the importance of continuous monitoring and provide insights for developing improved prevention and control strategies against ARV.
Association of individual-based morphological brain network alterations with cognitive impairment in type 2 diabetes mellitus
Authors: Shen Die , Huang Xuan , Diao Ziyu , Wang Jiahe , Wang Kun , Lu Weiye , Qiu Shijun 
Published: January 2025

ObjectiveTo investigate the altered characteristics of cortical morphology and individual-based morphological brain networks in type 2 diabetes mellitus (T2DM), as well as the neural network mechanisms underlying cognitive impairment in T2DM.MethodsA total of 150 T2DM patients and 130 healthy controls (HCs) were recruited in this study. The study used voxel- and surface-based morphometric analyses to investigate morphological alterations (including gray matter volume, cortical thickness, cortical surface area, and localized gyrus index) in the brains of T2DM patients. Then two methods, Jensen-Shannon divergence-based similarities (JSDs) and Kullback–Leibler divergence-based similarities (KLDs), were used to construct individual morphometric brain networks based on gray matter volume, to discover altered features of the topological network and extract abnormal key brain regions. Subsequently, partial correlation analyses were performed to explore the relationship between clinical biochemical indices, neuropsychological test scores, and altered cortical morphology and network indices.ResultsBrain regions with reduced gray matter volume and cortical thickness in T2DM patients were mainly concentrated in the frontal lobe, temporal lobe, parietal lobe, anterior cingulate gyrus, insula, lingual gyrus, and cerebellar hemispheres. The global attributes of the Individual-based morphological brain network were significantly reduced (Cp, Eloc, σ), with an increase in the nodal efficiency of the hippocampus and the nodal local efficiency of the anterior cingulate gyrus, and the nodal local efficiency of the parahippocampal gyrus and transverse temporal gyrus were reduced. There was a correlation between these node attributes and cognitive scale scores.ConclusionThis study demonstrated that patients with T2DM exhibit generalized cortical atrophy and damage to individual morphologic brain networks. It also identified overlapping and cognitively relevant key brain regions, primarily within the limbic/paralimbic network (especially the hippocampus and cingulate gyrus), which may serve as imaging markers for identifying cognitive deficits in T2DM. These findings offer new insights into the neural network mechanisms underlying T2DM-associated brain damage and cognitive impairment.
Prediction of delirium occurrence using machine learning in acute stroke patients in intensive care unit
Authors: Kim Hyungjun , Kim Min , Kim Da Young , Seo Dong Gi , Hong Ji Man , Yoon Dukyong 
Published: January 2025

IntroductionDelirium, frequently experienced by ischemic stroke patients, is one of the most common neuropsychiatric syndromes reported in the Intensive Care Unit (ICU). Stroke patients with delirium have a high mortality rate and lengthy hospitalization. For these reasons, early diagnosis of delirium in the ICU is critical for better patient prognosis. Therefore, we developed and validated prediction models to classify the real-time delirium status in patients admitted to the ICU or Stroke Unit (SU) with ischemic stroke.MethodsA total of 84 delirium patients and 336 non-delirium patients in the ICU of Ajou University Hospital were included. The 8 fixed features [Age, Sex, Alcohol Intake, National Institute of Health Stroke Scale (NIHSS), HbA1c, Prothrombin time, D-dimer, and Hemoglobin] identified at admission and 12 dynamic features [Mean or Variability indexes calculated from Body Temperature (BT), Heart Rate (HR), Respiratory Rate (RR), Oxygen saturation (SpO2), Systolic Blood Pressure (SBP), and Diastolic Blood Pressure (DBP)] based on vital signs were used for developing prediction models using the ensemble method.ResultsThe Area Under the Receiver Operating Characteristic curve (AUROC) for delirium-state classification was 0.80. In simulation-based evaluation, AUROC was 0.71, and the predicted probability increased closer to the time of delirium occurrence. We observed that the patterns of dynamic features, including BT, SpO2, RR, and Heart Rate Variability (HRV) kept changing as the time points were getting closer to the delirium occurrence time. Therefore, the model that employed these patterns showed increasing prediction performance.ConclusionOur model can predict the real-time possibility of delirium in patients with ischemic stroke and will be helpful to monitor high-risk patients.
Sleep patterns and cardiovascular disease risk in US participants: a comprehensive analysis
Authors: Wu Yue , Li Zhizheng , Zhao Peng , Xu Jiajing , Yuan Min 
Published: January 2025

Background and purposeTo evaluate the association between sleep-related factors, including sleep duration, self-reported sleep disturbances, and diagnosed sleep disorders, and the risk of cardiovascular disease (CVD) in US participants.MethodsThe data of this study from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2014. Sleep factors were assessed using a standardized questionnaire, and overall sleep scores were calculated on a scale of 0 to 3. The participants were classified into three sleep pattern groups: poor sleep pattern (overall sleep score ≤ 1), intermediate sleep pattern (overall sleep score = 2), and healthy sleep pattern (overall sleep score = 3). CVD was defined based on self-reported questionnaire responses. Logistic regression models were used to investigate the association between sleep factors and CVD.ResultsAmong 21,115 participants, 2,245 (10.6%) were diagnosed with CVD. Participants with poor sleep patterns had a significantly higher risk of CVD (OR = 1.82, 95% CI: 1.52–2.16, p &lt; 0.001). Self-reported trouble sleeping (OR = 1.53, 95% CI: 1.32–1.78, p &lt; 0.001), and sleep disorder (OR = 2.09, 95% CI: 1.75–2.50, p &lt; 0.001) were related to an increased risk of CVD. However, no such association was observed for either short (OR = 1.12, 95% CI: 0.95–1.33, p = 0.174) or long sleep durations (OR = 1.14, 95% CI: 0.90–1.45, p = 0.266). Our study also suggested an interaction between sleep patterns and age (P for interaction = 0.002).ConclusionThis study highlights the significant association between poor sleep patterns and an increased risk of CVD in US participants.
LC-MS based analysis reveal antimicrobial compounds from Gabonese pharmacopoeia: chemical characterisation and cytotoxicity evaluation
Authors: Otogo N’nang Elvis , Essone Paulin N. , Ella Ndong Judicael , Boueya Augustin , Kokou Kossiwa , Kriz Richard , N’nengué Marie Andrée , Ovono Abessolo Félix , Lell Bertrand , Kremsner Peter G. , Agnandji Selidji T. 
Published: January 2025

Plants used in traditional medicine represent an important source of new compounds. Hallea ledermannii (H. ledermannii) (Krause) Verdc. (Rubiaceae), Gossypium barbadense (G. barbadense) (Malvaceae), Pycnanthus angolensis (P. angolensis) (Myristicaceae), Drypetes gossweileri (D. gossweileri) S. Moore (Euphorbiaceae) and Scyphocephalium ochocoa (S. ochocoa) Warb (Myristicaceae) are five plants widely used in traditional Gabonese medicine as antimicrobials. However, little is known about the active compounds associated with their biological activities. Based on botanical studies and the claims of traditional healers regarding the antimicrobial effects of these plants, a study to evaluate the antimicrobial activity and phyto-chemical profile of aqueous extracts of three plants (bark of H. ledermannii, G. barbadense root bark and P. angolensis bark) and methanolic extracts of two plants (S. ochocoa stem bark and D. gossweileri root bark). Under the guidance of LC-MS detection, identified twenty seven (27) potentially active compounds. Eight (8) of these belong to the quinovic acid-type triterpenoid sap-onins identified in the aqueous extract of H. ledermannii, eleven (11) are dibenzofurans, chroman and stigmasterol detected in the methanolic extract of S. ochocoa and eight (8) compounds in the methanolic extract of D. gossweileri are friedelin, drypemolundein B and gossweilone, to name but a few. In parallel, the five extracts were tested on reference bacterial strains: Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 278533, Salmonella thyphi ATCC 13311, Klebsiella pneumoniae ATCC 700603, Shigella flexneri ATCC 24570. Three of these extracts (aqueous extract of H. ledermannii and two methanolic extracts of S. ochocoa stem bark and D. gossweileri root bark) showed moderate activity against Staphylococcus aureus ATCC 25923, with inhibition zones of 12.3 ± 0.5 mm, 10.1 ± 0.5 mm and 7,6 ± 0 mm respectively. In addition, we assessed the toxicity of the three extracts that showed antimicrobial activity using an invertebrate model, Galleria mellonella (GM). We found that the LD varied according to the concentration of the plant material. The aqueous extract of H. ledermannii and the methanolic extracts of S. ochocoa and D. gossweileri were not toxic to G. mellonella. The LD50s (mg/mL) obtained were 93.2 mg/mL [717.2 g/kg body weight (bw)] and 100 mg/mL (762.3 g/kg bw), 95.4 mg/mL [721.1 g/kg body weight (bw)].
Key considerations based on pharmacokinetic/pharmacodynamic in the design of antibody-drug conjugates
Authors: Gao Yangyang , Xia Yuwei , Chen Yixin , Zhou Shiqi , Fang Yingying , Yu Jieru , Zhang Leyin , Sun Leitao 
Published: January 2025

BackgroundAntibody-drug conjugate (ADC) is an anticancer drug that links toxins to specifically targeted antibodies via linkers, offering the advantages of high target specificity and high cytotoxicity. However, complexity of its structural composition poses a greater difficulty for drug design studies.ObjectivesPharmacokinetic/pharmacodynamic (PK/PD) based consideration of ADCs has increasingly become a hot research topic for optimal drug design in recent years, providing possible ideas for obtaining ADCs with desirable properties.MethodsFrom the assessment of the ADC action process based on PK/PD, we introduce the main research strategies of ADCs. In addition, we investigated the strategies to solve the prominent problems of ADC in the clinic in recent years, and summarized and evaluated the specific ways to optimize various problems of ADC based on the PK/PD model from two perspectives of optimizing the structure and properties of the drugs themselves. Through the selection of target antigen, the optimization of the linker, the optimization of novel small molecule toxins as payload, the optimization of ADC, overcoming the multi-drug resistance of ADC, improving the ADC tumor penetration of ADC, surface modification of ADC and surface bystander effect of ADC provide a more comprehensive and accurate framework for designing new ADCs.ResultsWe’ve expounded comprehensively on applying pharmacokinetics or pharmacodynamics while designing ADC to obtain higher efficacy and fewer side effects. From the ADC’s PK/PD property while coming into play in vivo and the PK/PD study strategy, to specific ADC optimization methods and recommendations based on PK/PD, it has been study-approved that the PK/PD properties exert a subtle role in the development of ADC, whether in preclinical trials or clinical promotion.ConclusionThe study of PK/PD unfolds the detailed mechanism of ADC action, making it easier to control related parameters in the process of designing ADC, limited efficacy and inevitable off-target toxicity remain a challenging bottleneck.