bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oxygen Saturation Sub-analyses Errors in the Dominant Meta-analysis Used to Deimplement Albuterol as a Therapeutic Option for Bronchiolitis
Authors: Mellick Larry , Weston Gabriella , Walsh Paul , McKinney Shane , Xu Hongyan 
Published: February 2025

Objective:
Clinical experience and patient-level physiological studies indicate that albuterol transiently reduces oxygen saturation, irrespective of the underlying respiratory condition causing the wheezing. Three revisions of the Cochrane review, Bronchodilators for Bronchiolitis (Review), have found that albuterol temporarily increases oxygen saturation. Rarely, these findings were even statistically significant, but the direction of effect is consistently opposite from physiological studies. In this study, we attempted to resolve this apparent paradox.

Methods:
The original trial publications included in multiple oxygen saturation sub-analyses in the 2006, 2010, and 2014 updates of the Cochrane review were assessed for appropriate study inclusion, correctness of calculations, and correct analysis with respect to direction of effect. The studies were also reviewed to assess whether the data was correctly transferred to the meta-analysis software. We repeated the meta-analyses calculations after correcting for suspected errors and plotted the results of the meta-analyses as originally reported and in their corrected form on an albatross plot.

Results:
We found data miscalculations, errors of transposition of albuterol and placebo data, the inclusion of inpatient data in outpatient analyses, and questionable study inclusions in the 3 Cochrane review updates. After corrections were made, the direction of effect of albuterol switched negative, albeit nonsignificantly, a finding most consistent with clinical and physiological observations. In addition, the very wide heterogeneity between the original meta-analyses disappeared.

Conclusion:
After multiple suspected data flaws were corrected our reanalyses of the reported data confirmed that decreased oxygen saturation can be expected following administration of albuterol to infants presenting with bronchiolitis syndrome, thereby resolving the apparent paradox in favor of clinical observation and research physiology.
Efficacy of mobile health interventions in the conservative management of chronic low back pain in low- and middle-income countries: a systematic review, meta-analysis, and trial sequential analysis
Authors: Rani Babina , Gupta Mayank , Ganesh Venkata , Sharma Rajni , Bhatia Anuj , Ghai Babita 
Published: February 2025

Abstract
Chronic low back pain (CLBP) is a major global health issue, particularly severe in low- and middle-income countries (LMICs), where health care resources and accessibility are limited. Mobile health (mHealth) interventions offer a promising solution by leveraging technology to deliver health care services remotely. This review aims to evaluate the effectiveness of mHealth interventions in managing CLBP in LMICs. A comprehensive search of electronic databases was performed for studies published until June 2024, evaluating mHealth interventions for CLBP in LMICs. Primary outcomes measured were pain intensity and disability, while secondary outcomes included quality of life (QoL). Risk of bias was assessed using Cochrane risk-of-bias tool (RoB2), and quality of evidence was evaluated using GRADE. Robustness of meta-analysis results was assessed via trial sequential analysis (TSA). Seven studies met the inclusion criteria. The mHealth interventions significantly reduced the overall pain intensity (MD = −1.11, 95% CI: −1.75, −0.46) and disability (MD = −6.59, 95% CI: −10.65, −2.54). Subgroup analysis indicated greater effectiveness of short-term interventions (<6 weeks) in reducing pain and Oswestry disability index (ODI) vs long-term interventions (>6 weeks). mHealth interventions notably reduced pain and ODI scores vs unsupervised programs but showed no significant difference compared to in-person programs. The z-score line remained within TSA boundaries. mHealth interventions show potential in reducing pain and disability among patients with CLBP in LMICs, although with inconclusive impact on QoL. The high heterogeneity and limited number of studies underscore the need for further research with greater sample size to validate these findings and explore the long-term benefits and implementation challenges of mHealth in resource-constrained settings.
Radiation Exposure to Patients and Others During Therapy for Pediatric Neuroblastoma With Lu-177-DOTATATE
Authors: Lu Zhaoqi , Sun Yanjinghui , Zuo Di , Li Pengfei , Sun Xiaorong 
Published: February 2025

Purpose:
This study evaluated Lutetium-177-(DOTA°,Tyr3) octreotate (Lu-177-DOTATATE) clearance in pediatric patients with neuroblastoma and assessed the effective doses received by patients, family caregivers, and medical staff during therapy.

Patients and Methods:
Twenty-three children (3–13 y) who received Lu-177-DOTATATE between 2023 and 2024 were enrolled. External dose rates were measured at 0, 1, 2, 4, 6, 24, 48, and 96 hours post-administration to estimate patients’ Lu-177-DOTATATE retention rate, the effective half-life, and the maximum cumulative effective dose around patients. Whole-body and red-marrow absorbed doses were calculated based on multi-time-point whole-body planar and SPECT/CT imaging using HERMES Dosimetry software. Whole-body effective doses to family caregivers and medical personnel were measured using thermoluminescence dosimeters (TLDs), and effective finger doses for medical staff were measured using ring TLDs.

Results:
The mean administered activity was 3.687±1.545 (range, 1.469–7.368) GBq. Whole-body retention rates at 1–96 hours post-administration ranged from 72.0% to 10.0%, with 99% clearance expected within 11 days. Clearance followed a biexponential decay model, with estimated effective half-lives of 1.4±0.8 and 52.3±18.6 hours for the fast and slow phases, respectively, at 2 m. Estimated maximum cumulative effective doses (within 11 days) at 1 and 2 m were 0.442±0.174 and 0.138±0.058 mSv, respectively. Absorbed doses for children were 0.159±0.076 mGy/MBq (whole body) and 0.611±0.416 mGy/MBq (red-marrow). Whole-body effective doses to family caregivers averaged 0.245±0.063 (range, 0.150–0.390) mSv. The whole-body and finger-effective doses to the radiopharmacists were 3.7±1.8 and 155.3±73.0 μSv/patient, respectively. The mean of whole-body and the median (P
25, P
75) of finger-effective doses to nurses were 4.7±1.4 μSv/patient and 16.7 (10, 470) μSv/patient, respectively.

Conclusion:
Lu-177-DOTATATE was rapidly cleared in children with neuroblastoma. Radiation exposure to others was below personal dose limits.
Knowledge of Pelvic Floor Disorders in English- and Spanish-Speaking Postpartum Patients
Authors: Siddique Moiuri , Passarelli Emily , Shi Carol , Myers Deborah 
Published: February 2025

Importance
Postpartum patients generally have limited knowledge of urinary incontinence (UI) and pelvic organ prolapse (POP). However, it is unclear what differences exist in knowledge level between English- and Spanish-speaking postpartum patients for each condition.

Objective
The objective of this study was to report rates of knowledge proficiency on UI and POP in English- and Spanish-speaking postpartum patients.

Study Design
In this cross-sectional study of postpartum patients at a tertiary care center, knowledge was assessed using the English and Spanish language–validated Prolapse and Incontinence Knowledge Questionnaire. Knowledge proficiency on UI was defined as answering correctly ≥80% of the questions and for POP as answering correctly ≥50% of the questions, based on cutoffs implemented by Geynisman-Tan et al previously. Pelvic floor disorder symptom severity was assessed using the Pelvic Floor Distress Inventory-20 and the Pelvic Floor Impact Questionnaire-7.

Results
Fifty English- and 50 Spanish-speaking patients completed the survey questionnaires. Spanish-speaking patients had lower rates of UI proficiency compared to English-speaking patients (10.0% vs 40.0%, P < 0.001) and were less likely to identify childbirth to be a risk factor for UI compared to English-speaking patients. For POP, proficiency levels were low but similar between English and Spanish speakers. Pelvic floor disorder symptom severity and impact on quality of life were low, did not differ between the 2 groups, and did not correlate with knowledge scores.

Conclusion
English- and Spanish-speaking postpartum patients have low knowledge of both UI and POP. Postpartum patients need educational resources to understand the risks and treatments for pelvic floor disorders.
Maternal and Fetal Complications Among Pregnant Women with Congenital Heart Disease
Authors: Patel Shayli , Raskind-Hood Cheryl , Wilson Travis , Rodriguez Fred H. , Haffner Alex , Kancherla Vijaya , Ivey Lindsey , Book Wendy M. 
Published: February 2025

ABSTRACTBackgroundSurvival to reproductive age is now common among women with congenital heart disease (CHD). Pregnancies to women with CHD may be at higher risk for maternal and fetal complications. This study examines maternal and fetal outcomes among pregnant women with CHD covered by Georgia Medicaid.MethodsThis case-control study identified 3,461 pregnant women with CHD, 11-50 years, covered by Georgia Medicaid from 2008-2019, who had 5,904 pregnancies. Maternal and fetal outcomes were determined by ICD-9-CM and ICD-10-CM codes at the encounter level. The association of select covariables, including race/ethnicity, social deprivation, CHD native anatomy, rurality, and presence of pre-existing maternal comorbidities on maternal and fetal outcomes were analyzed using chi-square. Multivariate logistic regression models adjusting for covariates were conducted.ResultsWomen with severe CHD had more fetal complications and fetal deaths/stillbirths than women with non-severe CHD (53.9% vs. 50.2% p=0.01 and 4.4% vs. 3.0%, p=0.007, respectively), but no difference in maternal complications were revealed (60.7% vs. 59.9%, p=ns). In multivariate analysis, pregnancies to women with severe CHD were 25% more likely to have fetal complications than pregnancies to women with non-severe CHD (aOR 1.25, 95CI 1.07-1.47). The most common fetal complications by maternal CHD anatomy were fetal distress, fetal growth restriction, and preterm delivery (27.2% vs. 23.1%, 27.6% vs. 19.4%, 23.1% vs. 19.6% for severe vs. non-severe, respectively, p=<0.05).ConclusionsPregnancies to women with CHD were associated with a high rate of maternal and fetal complications. Fetal complications, fetal death and stillbirth were highest among women with severe CHD.
Beyond the Checklist: A large-scale analysis of under-recognised weight loss behaviours in individuals with eating disorders
Authors: Kakar Saakshi , Foye Una , Davies Helena L. , Palaiologou Elisavet , Malouf Chelsea M. , Meldrum Laura , Smith Iona , Kalsi Gursharan , Allen Karina L. , Breen Gerome , Herle Moritz , Hübel Christopher 
Published: February 2025

AbstractObjectiveThis study aimed to identify and categorise under-recognised weight loss behaviours in individuals with eating disorders, addressing diagnostic gaps.MethodWe text mined free-text responses from 1,675 participants with anorexia nervosa, bulimia nervosa, or binge-eating disorder in the Genetic Links to Anxiety and Depression (GLAD) Study and the United Kingdom Eating Disorders Genetics Initiative (EDGI UK). In secondary analyses, we investigated differences by eating disorder and gender.ResultsFrequently endorsed behaviours included structured diets (341 endorsements) and calorie counting (321 endorsements) but also less commonly considered behaviours like compression garments (113 endorsements) and self-harm (63 endorsements). We identified four overarching themes: restriction-based approaches, medical intervention, body manipulation, and food avoidance. The most frequently reported weight loss behaviours and resultant themes did not differ among eating disorders or genders, closely resembling those in the broader sample.DiscussionOur findings identify a crucial gap in current diagnostic criteria, which may hamper recognition and lead to underdiagnosis of eating disorders. By incorporating our insights, clinicians could capture a broader spectrum of behaviours, thus improving diagnostic accuracy. However, our sample homogeneity implicates the need for more diverse samples. Our study contributes essential insights for enhancing diagnostic criteria.Public Significance StatementOur study revealed under-recognised weight loss behaviours in people with eating disorders that current diagnostic tools miss, which may lead to underdiagnoses. By identifying these behaviours and taking a broader diagnostic approach, our research can help clinicians better understand eating disorders by improving diagnostic accuracy and opening up new avenues for personalised care.
Age-related differences in Rostral-Middle Locus Coeruleus Microstructure: A Critical Role in Cognitive Decline Revealed by Magnetic Resonance Relaxometry
Authors: Bae Jonghyun , Gong Zhaoyuan , Mazucanti Caio , Bilgel Murat , Laporte John P. , Faulkner Mary E. , Guo Alex , Bergeron Christopher M. , Egan Josephine M. , Resnick Susan M. , Ramsden Christopher E. , Bouhrara Mustapha 
Published: February 2025

AbstractBACKGROUNDThe Locus Coeruleus (LC) is a critical brain region affected by neurodegenerative diseases and cognitive decline in aging. Despite its importance, in-vivo investigations of age-related LC degeneration and association with cognitive decline have been limited.METHODWe employed the Bayesian Monte-Carlo analysis of multicomponent driven equilibrium single pulse observation of T1and T2(BMC-mcDESPOT) method to estimate longitudinal (R1) and transverse (R2) relaxation rates in the LC of a diverse cohort of cognitively unimpaired individuals aged 22 to 94 years. BMC-mcDESPOT offers high spatial resolution and is effective for mapping detailed microstructural changes within the LC as reflected by R1and R2. We examined age-related differences in LC microstructure, their associations with cognitive changes, and the spatial variation of these microstructural changes within the LC, exploring their distinctive contributions to cognitive decline.RESULTSAge was significantly associated with LC microstructural integrity, with advanced ages exhibiting lower R2values. We also found that lower LC- R1and LC-R2are correlated with steeper decline longitudinally in multiple cognitive domains, including memory, verbal fluency, processing speed and executive function. Furthermore, we observed distinctive spatial variations between young and old participants, with R1and R2values in the rostral-middle regions being more strongly associated with cognitive changes as compared to the caudal region.CONCLUSIONSThis study reveals age-related differences in LC integrity, which are associated with cognitive decline. LC relaxometry metrics (R1and R2values) may serve as sensitive biomarkers for detecting early alterations and age-related cerebral degeneration.
Trajectories of microbiome-derived bile acids in early life – insights into the progression to islet autoimmunity
Authors: Lamichhane Santosh , Dickens Alex M , Buchacher Tanja , Lou Evita Tianai , Charron-Lamoureux Vincent , Kattelus Roosa , Karmacharya Pragya , Pinto da Silva Lucas , Kråkström Matilda , Rasool Omid , Sen Partho , Walker Corinn , Patan Abubaker , Gentry Emily C. , Arzoomand Aron , Lakshmikanth Tadepally , Mikeš Jaromir , Mebrahtu Aman , Vatanen Tommi , Raffatellu Manuela , Zengler Karsten , Hyötyläinen Tuulia , Xavier Ramnik J. , Brodin Petter , Lahesmaa Riitta , Dorrestein Pieter C. , Knip Mikael , Orešič Matej 
Published: February 2025

AbstractRecent studies reveal that gut microbes produce diverse bile acid conjugates, termed microbially conjugated bile acids (MCBAs). However, their regulation and health effects remain unclear. Here, we analyzed early-life MCBA patterns and their link to islet autoimmunity. We quantified 110 MCBAs in 303 stool samples collected longitudinally (3– 36 months) from children who developed one or more islet autoantibodies and controls who remained autoantibody-negative. Stool MCBAs showed distinct age-dependent trajectories and correlated with gut microbiome composition. Altered levels of ursodeoxycholic and deoxycholic acid conjugates were linked to islet autoimmunity as well as modulated monocyte activation in response to immunostimulatory lipopolysaccharide and Th17/Treg cell balance. These findings suggest MCBAs influence immune development and type 1 diabetes risk.
Biomechanical assessment of upright birthing positions using marker-based and markerless motion capture systems
Authors: Haworth Lauren , Kaur Inderjeet , Ahmed Maimoona , Topalidou Anastasia 
Published: February 2025

AbstractUnderstanding the effects of birthing positions on labour is crucial for optimising maternal and foetal outcomes. Upright positions are encouraged but their biomechanics are not fully understood. Biomechanical changes during labour can make certain positions more or less favourable depending on individual physical characteristics. Understanding these factors is essential for tailoring strategies that enhance maternal comfort and facilitate labour. This study aimed to quantify the biomechanics of seven common upright birthing positions, comparing their biomechanical characteristics and evaluating the sensitivity and accuracy of marker-based and markerless motion capture systems. Fifteen healthy, non-pregnant women performed seven upright birthing positions. Hip, pelvis, and trunk kinematics were assessed using a 9-camera marker-based system and an 8-camera markerless system. Significant biomechanical differences were found between birthing positions. The “squat” position showed the most hip flexion and abduction, “B-Ball” had the greatest anterior pelvic tilt, and “all-fours” exhibited the most posterior tilt. For the trunk, “upright” led to the most extension, and “elbows bent knees” showed the most flexion. The markerless system aligned well with the marker-based system in the coronal and transverse planes but lacked sensitivity in the sagittal plane. This study highlights the biomechanical differences in upright birthing positions and emphasises the need for personalised birthing strategies. Understanding labour biomechanics is crucial for improving maternal and foetal well-being and reducing complications. By providing comprehensive and evidence-based information, women can make informed decisions about their birthing positions, enhancing outcomes and lowering the risk of maternal and neonatal complications globally.
Complex Traces: Using a Complex Adaptive Systems approach to examine morbidity and mortality among 19th Century migrants to South Australia
Authors: Gurr Angela , Brook O’Donnell Matthew , Brook Alan Henry 
Published: February 2025

AbstractIn multidisciplinary research interpreting interactions between diverse data sources requires a Complexity approach. A Complex Adaptive Systems (CAS) framework allows the relationships of multiple factors to be explored and may provide a more holistic and nuanced understanding. This study is innovative in explaining the potential benefits in a CAS approach to combining bioarchaeological and historical data when examining a rare archaeological skeletal sample of early migrants to South Australia (SA).Macroscopic, radiographic and micro-CT methods were used for the analysis of the skeletal remains of a group of 19thcentury migrants buried in an unmarked area of St Mary’s Anglican Church Cemetery. The relevant historical records explored were from British emigrant ships to SA (1836 to 1885) and the Church burial records (1847-1885).Evidence of poor oral and general health was present in the skeletal material. Dental developmental defects indicated earlier health insults. Pathological manifestations in bone were compatible with joint and infectious diseases, and metabolic deficiencies. Historical documents recorded that the voyages to SA were challenging, with some ships experiencing a high death rate. Diseases e.g., measles and scarlet fever, and diarrhoea were frequently recorded as causes of death at sea for both subadults and adults. In the Colony, burial records showed similar causes of death for subadults, but for adults, accidents and tuberculosis were often reported.The CAS approach provided insights beyond those from analysis of the individual sources. It increased understanding of emergent, non-predicted outcomes that resulted from interactions between multiple factors e.g., the impact of fluctuating economy, political instability and ideological pressures, on the health of migrants. The CAS framework is a valuable methodology for interpreting health patterns and can be further developed for a range of historical and contemporary health contexts.
AMPK mediates the anti-ferroptosis effect of acupuncture in cerebral ischemia-reperfusion rats
Authors: Wang Rong , Xu Jun-feng 
Published: February 2025

AbstractBackgroundAcupuncture is clinically effective in the treatment of ischemic stroke. The report suggests that energy stress inhibits ferroptosis in part through AMPK. However, whether the effect of activating AMPK is related to ferroptosis in ischemic stroke and whether acupuncture can achieve neuroprotection against ischemic brain injury through the pathway of inhibiting ferroptosis by activating AMPK has not been confirmed.MethodsIn this experiment, all rats were randomly divided into 4 groups: Sham group, MCAO/R group, MA (MCAO/R + acupuncture) group, and MAM (MCAO/R + acupuncture + metformin) group. The middle cerebral artery occlusion/reperfusion injury (MCAO/R) model was created by the wire embolism method, and the MA and MAM groups received acupuncture treatment with electrotherapy (1 mA, 2/15 Hz, 20 min each), while the MAM group continued to receive metformin (oral gavage 200 mg/kg) after successful modelling. Neurological deficit score and infarct volume were measured, Prussian blue staining and mitochondrial structural changes were observed, and Fe2+ and MDA levels were determined in the brain tissue of the rats. Western blot results were analyzed to determine differences in the expression of TFR1, SLC7A11, GPX4 and AMPK、 p-AMPK proteins in order to explore the possible pathological processes involved in cerebral ischemia at behavioral, histological and molecular levels and the possible protective mechanisms of acupuncture.ResultsAcupuncture attenuated ischemia-reperfusion-induced brain damage and mitochondrial damage. Further studies showed that acupuncture reduced the levels of Fe2+, MDA and the expression of TFR1 protein and increased the expression of SLC7A11 and GPX4 protein in the diseased hippocampal region of MCAO/R rats. In addition, metformin, as an AMPK activator, significantly enhanced the protective effect of acupuncture on cerebral ischemic injury and enhanced the acupuncture-mediated reduction of Fe2+, MDA levels and TFR1 protein expression and the increase of SLC7A11 and GPX4 protein expression in the lesioned hippocampal region of MCAO/R rats.ConclusionsThese findings suggest that acupuncture can inhibit ferroptosis and thus exert a protective effect against ischemic brain injury, and that this mechanism may be achieved by activating AMPK. This extends the mechanism of action of acupuncture in the treatment of ischemic stroke.