bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wernicke encephalopathy in a patient with drug-induced liver failure: a case report
Authors: Cao Jiao-Jiao , Li Jing , Cheng Yan , Luo Li-Min , Chen Yang , Huang Chang-Xing , Zhang Ye 
Published: January 2025

IntroductionWernicke encephalopathy is a metabolic disease mainly associated with vitamin B1 deficiency, which is common in chronic alcoholism. Non-alcoholic Wernicke encephalopathy is difficult for early diagnosis.Case presentationOne case involved a 62-year-old man who was admitted to hospital with drug-induced liver failure. He presented lower extremity weakness and progressive worsening of consciousness disturbance post-admission and was eventually identified as Wernicke encephalopathy by magnetic resonance imaging scan and deficiency in vitamin B1. The classic symmetric hyperintense signals on T2-weighted and diffusion-weighted images were reversible after intravenous vitamin B1 supplementation.ConclusionA high index of clinical suspicion is required for early diagnosis and appropriate preventive and therapeutic strategies by adequate and immediate vitamin B1 supplements in the reversible stage of Wernicke encephalopathy.
Interventions to promote healthy nutrition and lifestyle and to tackle overweight and obesity amongst children in need in Europe: a rapid literature review
Authors: Halilagic Anela , Roussos Renos , Argyropoulou Matzourana , Svolos Vaios , Mavrogianni Christina , Androutsos Odysseas , Mouratidou Theodora , Manios Yannis , Moschonis George 
Published: January 2025

IntroductionThe global prevalence of overweight and obesity has reached epidemic proportions amongst children and adolescents, with approximately one third of children in Europe being overweight or obese. There is a higher likelihood for overweight and obesity reported for vulnerable groups of children, also known as children in need. As there is currently no knowledge of the best practice interventions for improving nutrition and physical activity habits amongst these vulnerable groups, the aim of this rapid review was to examine evidence that focused on best practice interventions to tackle overweight and obesity in children in need in Greece and/or other European countries.MethodsStudies were sought that presented methods and results of interventions and their evaluation. There were 989 results originally identified from database searches, which then reduced to 8 studies for inclusion following abstract and full-text screening processes. A narrative synthesis was conducted to present the characteristics and results of each study.ResultsThe only group of children in need that was identified was of low socioeconomic status (SES). There were several interventions identified that were successful across various countries in Europe, however there is a lack of best practice interventions to contribute to longer lasting solutions to preventing overweight and obesity.ConclusionOur findings encourage the implementation of interventions that will be inclusive of children with vulnerabilities other than low SES, as well as the establishment of specific criteria guiding the design of best practice interventions.
Association of serum calcium level with periodontitis: a cross-sectional study from NHANES 2009–2014
Authors: Cao Hongliang , Wang Min , Duan Mengna , Wang Song , Zhang Haiyang 
Published: January 2025

PurposeThis study aimed to investigate the association between serum calcium levels and periodontitis in a U.S. adult population, using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2014.MethodData were analyzed from 8,601 participants aged over 30 years, who were categorized based on the presence or absence of periodontitis. Serum calcium levels were measured using standardized NHANES protocols, and periodontitis status was determined through clinical oral examinations. To assess the relationship between calcium levels and periodontitis, multivariate logistic regression models were applied across three levels of adjustment. Additionally, trend tests and subgroup analyses were conducted to explore associations across different demographic and clinical subgroups. A smoothing curve fitting and threshold effect analysis were also performed to examine potential nonlinear relationships.ResultsAfter adjusting multiple covariates, participants in the highest quartile of serum calcium showed an 18% reduced risk of periodontitis compared to those in the lowest quartile (OR = 0.82, 95% CI: 0.71–0.95, p = 0.0083; p for trend = 0.0057). The association remained stable across various subgroups. Smoothing curve fitting indicated a nonlinear negative correlation between calcium levels and periodontitis, though without a significant inflection point at 2.48 mmol/L (p = 0.094).ConclusionElevated serum calcium levels appear to be associated with a lower risk of periodontitis in adults. These findings suggest that adequate calcium intake may play a role in periodontitis prevention, providing valuable insight for clinical guidance on nutritional and preventive strategies in periodontal health.
A novel interplay between bacteria and metabolites in different early-stage lung cancer: an integrated microbiome and metabolome analysis
Authors: Zhai Xiaoqian , Lin Dongqi , Shen Yi , Zhai Ni , Yu Fan , Zhang Jiabi , Lin Yiyun , Wang Yuqing , Zhou Qinghua , Zheng Xi 
Published: January 2025

BackgroundThe carcinogenesis mechanism of early-stage lung cancer (ESLC) remains unclear. Microbial dysbiosis is closely related to tumor development. This study aimed to analyze the relationship between microbiota dysbiosis in ESLC.MethodsWe investigated a total of 108 surgical specimens of lung nodules, including ground glass nodules (GGN) diagnosed as lung adenocarcinoma (n = 25), solid nodules (SN) diagnosed as lung adenocarcinoma (n = 27), lung squamous carcinoma (LUSC) presenting as solid nodules (n = 26), and benign pulmonary nodules (BPD) (n = 30) that were collected. 16S rDNA amplicon sequencing and non-targeted metabolomics analysis were performed in all of the specimens.ResultsWe found a significantly lower microbiota richness in SN than in the GGN and LUSC. Ralstonia may be an important flora promoting the development of early lung adenocarcinoma, while Feacalibacterium and Blautia play a protective role in the progression of GGN to SN. Akkermansia, Escherichia-shigella, and Klebsiella exhibited high abundance in early lung squamous carcinoma. Compared with BPD, the differential metabolites of both early adenocarcinomas (SN and GGN) are mainly involved in energy metabolic pathways, while early LUSC is mainly involved in glutathione metabolism, producing and maintaining high levels of intracellular redox homeostasis. A correlation analysis revealed that different microbiota in GGN may function in energy metabolism via N-acetyl-1-aspartylglutamic acid (NAAG) when compared to BPD, while creatine and N-acetylmethionine were the main relevant molecules for the function of differential microbiota in LUSC.ConclusionOur study identified that early-stage lung adenocarcinoma and squamous carcinoma differ in microbial composition and metabolic status. Ralstonia may be an important flora promoting the development of early lung adenocarcinoma, while Feacalibacterium and Blautia play a protective role in the progression of GGN to SN. Conversely, Akkermansia, Escherichia-shigella, and Klebsiella exhibited high abundance in early lung squamous carcinoma. The metabolites of both early adenocarcinomas (SN and GGN) are mainly involved in energy metabolic pathways, while early LUSC is mainly involved in glutathione metabolism. Our study provides new insights into the carcinogenesis of ESLC.
Characterizing microbial communities and their correlation with genetic mutations in early-stage lung adenocarcinoma: implications for disease progression and therapeutic targets
Authors: Yang Hao-Shuai , Zhang Jin , Feng Hong-Xiang , Qi Fei , Kong Fan-Jia , Zhu Wei-Jie , Liang Chao-Yang , Zhang Zhen-Rong 
Published: January 2025

BackgroundLung adenocarcinoma (LUAD), the most prevalent form of lung cancer. The transition from adenocarcinoma in situ (AIS), and minimally invasive adenocarcinoma (MIA) to invasive adenocarcinoma (IAC) is not fully understood. Intratumoral microbiota may play a role in LUAD progression, but comprehensive stage-wise analysis is lacking.MethodsTumor and bronchoalveolar lavage fluid (BALF) samples from patients with AIS/MIA or IAC were collected for next-generation sequencing to characterize microbial diversity and composition. DNA extraction involved lysing samples with nuclease and protease, followed by homogenization and elution. Sequencing libraries were prepared and sequenced on the Illumina platform. Whole exome sequencing was performed to identify somatic mutations and genetic variants. Bioinformatics analysis, including taxonomic annotation with Kraken2 and de novo assembly with MEGAHIT, was conducted to process metagenomic data. Correlation analysis was performed to link microbial species with mutated genes using custom R scripts.ResultsMetagenomic analysis revealed a distinct microbial profile in IAC compared to AIS/MIA, with increased abundance of Bacteroidetes and Firmicutes in the IAC group. Bosea sp. and Microbacterium paludicola, were less abundant in IAC, suggesting a potential protective role in early-stage disease. Conversely, Mycolicibacterium species were more prevalent in IAC, indicating a possible contribution to disease progression. Genetic sequencing identified PTPRZ1 strongly correlating with microbial composition, suggesting a mechanistic link between microbiota and genetic alterations in LUAD.ConclusionThis study characterizes microbial communities in various stages of LUAD, revealing links between microbiota and genetic mutations. The unique microbiota suggests its role in LUAD progression and as a therapeutic target.
Case report: A case of lateral neck mass: ectopic thyroid carcinoma or lymph node metastasis?
Authors: Wei Xinran , Yu Ping , Duan Chengcheng , Zhong Jingyue , Wu Xianji , Xiao Siqi , Yu Wenxi , Zhang Guang 
Published: January 2025

ObjectiveTo review a rare case of a lateral neck mass pathologically confirmed as an encapsulated papillary thyroid carcinoma in our center for complementing the lack of management of rare cases, and to explore the differentiation of primary ectopic thyroid carcinoma and metastatic disease in the context of the presence of malignant tumors within the situ thyroid gland.MethodsWe searched for studies on lateral neck ectopic thyroid cancer to compare and analyze it with metastatic carcinoma of the thyroid gland in terms of clinical features, imaging manifestations, pathological features at molecular level, and treatment principles.ResultsBased on available data, we concluded that the mass of this patient was consistent with metastatic lateral neck ectopic thyroid carcinoma.ConclusionOur findings suggest that differentiating between these two conditions is challenging, as there is currently no reliable methods that can adequately determine their nature. Developing a preoperative diagnostic method would be significant for diagnosing pathologic masses in the lateral neck and selecting appropriate surgical extent and adjuvant therapy.
AI predicting recurrence in non-muscle-invasive bladder cancer: systematic review with study strengths and weaknesses
Authors: Abbas Saram , Shafik Rishad , Soomro Naeem , Heer Rakesh , Adhikari Kabita 
Published: January 2025

BackgroundNon-muscle-invasive Bladder Cancer (NMIBC) is notorious for its high recurrence rate of 70-80%, imposing a significant human burden and making it one of the costliest cancers to manage. Current prediction tools for NMIBC recurrence rely on scoring systems that often overestimate risk and lack accuracy. Machine learning (ML) and artificial intelligence (AI) are transforming oncological urology by leveraging molecular and clinical data to enhance predictive precision.MethodsThis comprehensive review critically examines ML-based frameworks for predicting NMIBC recurrence. A systematic literature search was conducted, focusing on the statistical robustness and algorithmic efficacy of studies. These were categorised by data modalities (e.g., radiomics, clinical, histopathological, genomic) and types of ML models, such as neural networks, deep learning, and random forests. Each study was analysed for strengths, weaknesses, performance metrics, and limitations, with emphasis on generalisability, interpretability, and cost-effectiveness. ResultsML algorithms demonstrate significant potential, with neural networks achieving accuracies of 65–97.5%, particularly with multi-modal datasets, and support vector machines averaging around 75%. Models combining multiple data types consistently outperformed single-modality approaches. However, challenges include limited generalisability due to small datasets and the "black-box" nature of advanced models. Efforts to enhance explainability, such as SHapley Additive ExPlanations (SHAP), show promise but require refinement for clinical use.ConclusionThis review illuminates the nuances, complexities and contexts that influence the real-world advancement and adoption of these AI-driven techniques in precision oncology. It equips researchers with a deeper understanding of the intricacies of the ML algorithms employed. Actionable insights are provided for refining algorithms, optimising multimodal data utilisation, and bridging the gap between predictive accuracy and clinical utility. This rigorous analysis serves as a roadmap to advance real-world AI applications in oncological care, highlighting the collaborative efforts and robust datasets necessary to translate these advancements into tangible benefits for patient management.
Concurrent versus sequential immunotherapy with chemoradiotherapy for unresectable stage III non-small-cell lung cancer: a retrospective study
Authors: Meng-Xi Zhou , Wen-Jie Fan , Ning Zhang , Li-Yang Zhu , Hong-Yan Wang 
Published: January 2025

BackgroundImmunotherapy combined with chemoradiotherapy has demonstrated promising efficacy in stage III non-small-cell lung cancer (NSCLC). However, the optimal timing for immunotherapy intervention during radiotherapy remains unclear. This study aimed to compare the efficacy and safety of immune checkpoint inhibitors (ICIs) administered concurrently or sequentially with chemoradiotherapy in unresectable stage III NSCLC.MethodsA retrospective analysis of 98 patients with unresectable stage III NSCLC, treated between January 1, 2019, and June 30, 2023, was conducted. Patients were grouped based on concurrent or sequential administration of ICIs with chemoradiotherapy. Median progression-free survival (mPFS), median overall survival (mOS), 1 and 2-year PFS rates, 2 and 3-year OS rates, objective remission rate (ORR), and disease control rate (DCR) were evaluated. Survival analysis was performed using the Kaplan–Meier method. Univariate and multivariate analyses were conducted using the log-rank test and Cox proportional hazards model. Treatment-related adverse effects were assessed and graded.ResultsA total of 98 patients with unresectable stage III NSCLC treated with chemoradiotherapy and ICIs were included. The mPFS and mOS were 19.0 (14.2-23.8) months and 31.5 (24.3-38.7) months, 12.8 (9.5-16.1) months and 28.5 (19.3-37.7) months in the concurrent and sequential ICI groups, respectively, and mPFS showed a significant difference (P=0.047). The estimated 1 and 2-year PFS rates were 79.6% (95% confidence interval [CI]: 67.6-91.6) and 40.4% (95% CI: 15.8-49.2) for the concurrent group, compared to 51.0% (95% CI: 35.9-66.1) and 31.6% (95% CI: 14.5-48.7) for the sequential group. The estimated 2 and 3-year OS rates were 65.7% (95% confidence interval [CI]: 48.6-82.8) and 40.0% (95% CI: 16.1-63.9) for the concurrent group, compared to 54.6% (95% CI: 35.8-73.4) and 28.7% (95% CI: 4.8-52.6) for the sequential group. The Eastern Cooperative Oncology Group Performance Status Scale (ECOG) score and tumor differentiation were identified as independent factors associated with PFS and OS. Distant metastasis occurred in 13.8% and 25.5% of patients in the concurrent and sequential ICI groups, respectively (P=0.049). The incidence of any grade of pneumonitis was 43.1% and 38.3% in two groups, with grade 3 or higher in 7.8% and 8.5% of patients, respectively. Hematologic toxicity of any grade was observed in 29.4% and 34.0% of the two groups, with grade 3 or higher toxicity identified in 3.9% and 2.1% of patients, respectively.ConclusionsConcurrent immunotherapy combined with chemoradiotherapy demonstrated superior efficacy than sequential immunotherapy, with good safety and tolerability in patients with unresectable stage III NSCLC.
Real-world evaluation of select adverse drug reactions and healthcare utilization associated with parenteral Ibuprofen and ketorolac in adult and pediatric patients
Authors: Afolabi Mosadoluwa , Rodriguez-Silva Jensy , Chopra Ishveen , Macias-Perez Ines , Makii Jason , Durr Emily , Human Theresa 
Published: January 2025

IntroductionIntravenous non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in healthcare settings, but their comparative safety and resource utilization impacts remain understudied. This study aimed to compare adverse drug reactions (ADRs) and healthcare resource utilization (HCRU) between patients receiving IV-ibuprofen versus IV/IM ketorolac.MethodsA retrospective, longitudinal analysis was conducted using an all-payer database, examining records from January 1, 2014, to June 3, 2023. The study included both adult (≥18 years) and pediatric (&lt;18 years) populations who received one or more doses of either medication. Propensity score matching was applied to both populations, and HCRU was tracked for 29 days post-final dose. The adult cohort included 31,046 IV-ibuprofen and 124,184 ketorolac records, while the pediatric cohort had 5,579 patients per treatment arm.ResultsBoth adult and pediatric patients receiving IV-ibuprofen demonstrated lower ADR incidence and reduced HCRU compared to those receiving ketorolac.DiscussionThe findings suggest IV-ibuprofen may be a safer alternative to ketorolac, potentially improving patient care outcomes while reducing healthcare system burden. These results have implications for clinical practice and healthcare resource management.
Construction of a nomogram model to predict the risk of retinopathy of prematurity reactivate after intravitreal anti-vascular endothelial growth factor therapy: a retrospective study
Authors: Shen Ziyun , Hao Qingfei , Yang Tiantian , Cheng Xiuyong 
Published: January 2025

ObjectiveTo explore the risk factors for the reactivate of retinopathy of prematurity (ROP) after intravitreal injection of anti-vascular endothelial growth factor (VEGF) and to construct a nomogram model to predict the risk of ROP reactivate.MethodsA retrospective analysis was conducted on 185 ROP children who underwent anti-VEGF treatment at the First Affiliated Hospital of Zhengzhou University from January 2017 to October 2023. They were randomly divided into a training set (129 cases) and a validation set (56 cases) at a ratio of 7:3. The training set was further divided into a reactivate group (n = 18) and a non-reactivate group (n = 111) based on whether ROP recurred after treatment. Multivariable logistic regression analysis was used to screen for risk factors for ROP reactivate. A nomogram model was constructed using R software and validated using the validation set. The discrimination, calibration, and clinical net benefit of the model were evaluated using the receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis, respectively.ResultsMultivariable logistic regression analysis showed that the number of red blood cell transfusions, use of pulmonary surfactant (PS) 2 times or more, and preoperative fundus hemorrhage were independent risk factors for ROP reactivate (P &lt; 0.05). The area under the ROC curve (AUC) of the training set was 0.810 (95% CI: 0.706–0.914), and that of the validation set was 0.756 (95% CI: 0.639–0.873). The Hosmer-Leme show goodness-of-fit test indicated a good fit of the model (P = 0.31). Calibration curve analysis and decision curve analysis suggested high predictive efficacy and clinical application value of the model.ConclusionsThe number of red blood cell transfusions, use of PS 2 times or more, and preoperative fundus hemorrhage are independent risk factors for ROP reactivate. The nomogram model constructed based on these factors has high predictive efficacy and clinical application value.
Effects of physical exercise on anxiety depression and emotion regulation in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis
Authors: Song Yagang , Jia Shuqi , Wang Xing , Wang Aiwei , Ma Tao , Li Shufan , Chen Jiwei , Guo Zhaohui , Ding Feng , Ren Yuxi , Qin Man 
Published: January 2025

ObjectiveThis systematic review and meta-analysis aimed to comprehensively evaluate the impact of physical exercise interventions on anxiety, depression, and emotional regulation in children diagnosed with attention deficit hyperactivity disorder (ADHD).MethodsA comprehensive search was conducted across multiple databases, including Embase, Web of Science (WOS), PubMed, The Cochrane Library, Wanfang Data, VIP Information, and China National Knowledge Infrastructure (CNKI), from their inception up to July 2024. The search aimed to identify randomized controlled trials (RCTs) investigating the impact of physical exercise on anxiety, depression, and emotional regulation in children diagnosed with ADHD. The Physiotherapy Evidence Database (PEDro) scale was employed to assess the quality of the literature, while the revised Cochrane risk-of-bias tool (ROB-2) was used to evaluate the overall risk of bias. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) profiler method was utilized to further assess the quality of evidence. Meta-analysis, sensitivity analysis, and publication bias testing were performed using Stata 18.0 software. Effect sizes were calculated using the standardized mean difference (SMD) and 95% confidence intervals (CI).ResultsThe analysis included 18 RCTs, encompassing 830 participants. Physical exercise exhibited a significant positive effect on anxiety (SMD = −0.58, p &lt; 0.05), depression (SMD = −0.57, p &lt; 0.05), and emotional regulation (SMD = 1.03, p &lt; 0.05) in children diagnosed with ADHD. Subgroup analysis revealed that exercise programs with monotypic and mixed modalities, short duration, high frequencies, medium duration, and moderate intensities were the most efficacious in ameliorating anxiety symptoms. The mixed exercise program, when conducted for short duration, with low frequencies, medium duration, and moderate intensity was the most effective in alleviating depression symptoms. Exercise programs featuring mixed modalities, longer duration, moderate to high frequencies, shorter duration, and low intensity yielded the most significant improvements in emotional regulation.ConclusionsResearch demonstrates that physical exercise mitigates anxiety and depression and improves emotional regulation in children with ADHD. A dose-response relationship is evident, correlating with the type, duration, intensity, frequency, and overall exercise duration.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, PROSPERO identifier (CRD42024571577).