bluuebunny/crossref_metadata_2025 huggingface dataset:
Case report: Ketogenic diet alleviated anxiety and depression associated with insulin-dependent diabetes management
Authors: Winje Eirin , Lake Ian , Dankel Simon N.
Published: October 2024

Differentiating between an irrational versus a rational fear of hypoglycemia has treatment implications and presents significant challenge for clinicians facing patients with type 1 diabetes, illustrated in this case. A 39-year-old woman with autoimmune-positive insulin-dependent diabetes sought help to alleviate severe diabetes distress, and symptoms of depression and anxiety, associated with unpredictable drastic blood glucose drops. After exhausting conventional methods, she adopted a ketogenic diet (KD). Her glucose values decreased from around 20 mmol/L to 12 mmol/L (360 mg/dL to 216 mg/dL) in the first days. Then, by combining a KD with an insulin pump, her time in optimal glucose range increased from 8 to 51% after 2 months, reducing her HbA1c with 25 mmol/mol (2.2%). This reduced biological and psychological stress, immediately improving her mental health and renewing her hope for the future. The main concerns regarding KD in patients with comorbid type 1 diabetes is the assumed increased risk of ketoacidosis, theoretical depletion of glycogen stores, and a potential adverse effect of saturated fat on cardiovascular risk factors. These concerns are evaluated against existing empirical evidence, suggesting instead that a KD may protect against acidosis, hypoglycemia, and cardiovascular risk. The present case, together with available data, indicate that patients with type 1 diabetes experiencing high levels of biological and psychological stress should be informed of the expected benefits and possible risks associated with a KD, to ensure their right to take informed decisions regarding their diabetes management.
Mediterranean diet and atrial fibrillation: a case-control study from China
Authors: Zhang Qian , Wu Su-Ping , Liu Xu , Wang Yun-Long
Published: October 2024

Objective

The aim of this study was to assess the association between adherence to Mediterranean diet and the presence of atrial fibrillation (AF) in a Northern Chinese population.

Methods

This study was a single center, case–control study. A total of 952 low risk participants in Beijing Anzhen Hospital from 2016 to 2021 were collected, including 476 patients with first diagnosed of atrial fibrillation and 476 age and sex matched controls. According to the food frequency questionnaire (FFQ), the alternate Mediterranean diet score (AMED) was calculated, which was 0–9 points, indicating the adherence to the Mediterranean diet from low to high.

Results

The average age of the participants was 57.6 ± 9.1 years old, and 70.2% were men. After analyzing every component of AMED, vegetable consumption shows a negative correlation with the risk of AF, whereas alcohol consumption demonstrates a positive correlation with it (OR = 0.61, 95% CI 0.44–0.80, p < 0.001; OR = 1.99, 95% CI 1.48–2.58, p < 0.001). All patients were grouped according to AMED score. A significant inverse association between AMED and the risk of AF was observed. Compared with participants with AMED<4, the multivariable-adjusted ORs of AF were 0.75 (95% CI 0.55–1.06) for AMED 4–5 and 0.61 (95% CI 0.43–0.89) for AMED ≥6, with a trend in risk (p = 0.008). Results were consistent in stratified analyses of gender, age, BMI and smoking.

Conclusion

The Mediterranean diet was inversely associated with the risk of AF in this Northern Chinese population.
Associations of dietary sources of antioxidant intake and NAFLD: NHANES 2017–2020 and Mendelian randomization
Authors: Yue Zilong , Jiang Ziming , Qian Long , Li Lele , Qi Xianliang , Hu Kaifeng
Published: October 2024

Purpose

To determine the association between dietary antioxidant sources and non-alcoholic fatty liver disease (NAFLD).

Methods

In this observational study, we utilized NHANES 2017–2020 data to identify the factors associated with NAFLD in dietary antioxidant sources via weighted multivariate logistic regression models. Then, Mendelian randomization (MR) was applied to investigate the effect of dietary antioxidant sources on NAFLD at the genetic level.

Results

Of the six dietary sources of antioxidants, only vitamin E (Vit E) was significantly associated with NAFLD (OR = 0.98; 95% CI: 0.97–0.99; p = 0.001). Upon adjusting for all covariates, it was determined that the highest quartile of dietary Vit E intake was associated with a decreased NAFLD occurrence compared with the lowest quartile of dietary Vit E intake (p < 0.001). The results of IVW-MR analysis revealed an association between Vit E and NAFLD (OR = 0.028; p = 0.039).

Conclusion

Our research indicates a negative and linear relationship between daily vitamin E intake and NAFLD.
The association of vitamin D insufficiency with the prevalence of obesity in children: implications for serum calcium levels, alkaline phosphatase activity, and bone maturation
Authors: Xu Yue , Song Lingyun , Zhou Li
Published: October 2024

Background

Vitamin D deficiency has been identified as a potential risk factor for various adverse health outcomes. However, its specific role in metabolic regulation and skeletal development in school-aged children is not fully understood. This study aimed to explore the correlation between vitamin D deficiency and childhood obesity rates, and its impact on serum calcium, alkaline phosphatase, and bone age in children.

Methods

The study analyzed clinical data from 159 school-aged children who underwent medical examinations. Participants were divided into the 25-hydroxyvitamin D3 (25(OH)D3) deficiency group and the 25(OH)D3 normal group based on their serum levels. We compared body mass index (BMI), total cholesterol (TC), triglycerides (TG), Ca, ALP, bone age, fasting blood glucose (FBG), and hemoglobin A1c (HbA1c) between the two groups. Logistic regression and Spearman correlation analyses were performed to further investigate relationships between 25(OH)D3 levels and metabolic and bone-related markers.

Results

This study showed that the 25(OH)D3 deficiency cohort exhibited significantly higher BMI, TC, TG, and ALP levels, with lower Ca levels and delayed bone age compared to the normal group. Logistic regression analysis identified Ca, ALP, and bone age as significant predictors of 25(OH)D3 deficiency. Subgroup analysis showed that in the 25(OH)D3 deficient group, children with higher BMI had elevated TC, ALP levels, and delayed bone age, while Ca levels were lower. Correlation analysis confirmed the predictive value of these markers for 25(OH)D3 deficiency.

Conclusion

Our findings demonstrate that 25(OH)D3 deficiency is strongly associated with obesity in school-aged children and may negatively affect normal skeletal development. Regular monitoring of 25(OH)D3 levels in school-aged children is essential for ensuring proper growth and development, especially in those at risk for obesity.
Case report: A second case of cerebral cavernous malformation after high-dose chemotherapy for medulloblastoma
Authors: Pionelli Maria Grazia , Mazio Federica , Errico Maria Elena , Russo Carmela , Cristofano Adriana , Covelli Eugenio Maria , Donofrio Vittoria , Capasso Maria , Capozza Michele Antonio , De Gregorio Fabiola , Ruotolo Serena , Abate Massimo Eraldo , Cinalli Giuseppe
Published: October 2024

The development of cerebral cavernous malformations (CCMs) is a well-recognized sequela of irradiation to the brain in pediatric tumors, particularly in medulloblastoma, glioma, and acute lymphoblastic leukaemia. So far, only one case of cerebral cavernoma after chemotherapy with autologous hematopoietic stem cell transplantation (HSCT) has been described. We describe a case of a patient with medulloblastoma aged 18 months at the time of oncological diagnosis who was treated with high-dose chemotherapy followed by HSCT and who developed CCM two years later. The patient was not treated for vascular malformation since he remained asymptomatic until now and is regularly followed with neuro-radiological check-ups. This represents the second case of acquired cavernoma developed in a patient who has not received radiation therapy.
The value of multiple diffusion metrics based on whole-lesion histogram analysis in evaluating the subtypes and proliferation status of non-small cell lung cancer
Authors: Chen Yao , Yang Hong , Qin Yuan , Guan Chuanjiang , Zeng Wenbing , Luo Yong
Published: October 2024

Objective

Limited studies have explored the utility of whole-lesion histogram analysis in discerning the subtypes and proliferation status of non-small cell lung cancer (NSCLC), despite its potential to provide comprehensive tissue assessment through the computation of additional quantitative metrics. This study sought to assess the significance of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) histogram parameters in discriminating between squamous cell carcinoma (SCC) and adenocarcinoma (AC), and to examine the correlation of each parameter with the proliferative marker Ki-67.

Materials and methods

Patients with space-occupying lesions detected by chest CT examination and with further routine MRI, DKI and IVIM functional sequence scans were enrolled. Based on the pathological results, seventy patients with NSCLC were selected and divided into AC and SCC groups. Histogram parameters of IVIM (D, D*, f) and DKI (Dapp, Kapp) were calculated, and the Mann–Whitney U test or independent samples t test was used to analyze the differences in each histogram parameter of the SCC and AC groups. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the histogram parameters. The correlation coefficient between histogram parameters and Ki-67 was calculated using Spearman’s or Pearson’s methods.

Results

The D 10th percentile, D 90th percentile, D mean, D median, Dapp10th percentile, Dapp90th percentile, Dappmean, Dappmedian, Dappskewness, DappSD of the AC groups were significantly higher than those of the SCC groups, while the Kappentropy and KappSD of the SCC groups were significantly higher than those of the AC groups. All the above differences were statistically significant (all P < 0.05). ROC curve analysis revealed that Dappmean showed the best performance for differentiating AC from SCC lesions, with an area under the ROC curve of 0.832 (95% confidence interval [CI]: 0.707-0.919). But there was no statistically significant difference in diagnostic efficacy compared to other histogram parameters (all P>0.05). Dapp90thpercentile, Dappmean, Kappskewnes showed a slight negative correlation with Ki-67 expression (r value -0.340, -0.287, -0.344, respectively; P< 0.05), while the other histogram parameters showed no significant correlation with Ki-67 (all P > 0.05).

Conclusions

Our study demonstrates the utility of IVIM and DKI histogram analyses in differentiating NSCLC subtypes, particularly AC and SCC. Correlations with the Ki-67 index suggest that Dappmean, Dapp90th percentile, and Kappskewness may serve as markers of tumor aggressiveness, supporting their use in NSCLC diagnosis and treatment planning.
Analysis of the therapeutic effect and influencing factors on unresectable gastric cancer treated with conversion therapy
Authors: Han Saiyi , Han Shaoliang , Qian Jun , Guo Mengfu , Fan Jianping
Published: October 2024

Background

Gastric cancer (GC) is one of the leading causes of cancer-related death in China, and with the extensive development of conversion therapy, the treatment of advanced unresectable gastric cancer (AUGC) patients has ushered in a new dawn. This study aimed to analyze the efficacy of conversion therapy in AUGC patients and explored the relevant factors affecting the efficacy.

Method

We collected information from GC patients who received conversion therapy from this center and designed a retrospective study.

Results

We collected relevant clinical data from 160 patients with AUGC. A total of 120 patients who underwent routine R0 resection were identified as conversion cases. A total of 25 patients (15.6%) achieved pCR, 92 patients (57.5%) achieved objective response rate (ORR), 140 patients (87.5%) achieved disease control rate (DCR), and 20 cases (12.5%) observed tumor progression. There were 86 patients who achieved pathological downgrading, with a total downgrading rate of 53.8%. Among the 160 patients, 37 patients (23.1%) had postoperative complications of varying degrees. A total of 72 patients (45.0%) had tumor recurrence/progression at the end of follow-up. The last chemotherapy and surgery (CST) (OR = 1.046, 95% CI 1.013–1.081, p = 0.006), tumor invasion (OR = 32.096, 95% CI 5.091–202.349, p < 0.001), and distant metastasis (OR = 7.050, 95% CI 1.888–26.323, p = 0.004) were independent factors influencing the efficacy of conversion therapy.

Conclusion

Conversion therapy may have a good therapeutic efficacy for AUGC, and some clinical factors affect the efficacy response.
Endoscopic and clinicopathological features of early gastric papillary adenocarcinoma
Authors: Zuo Zhenxiang , Qi Xing , Cui Xiujie , Yu Bin , Zhang Huimin , Wu Honglei
Published: October 2024

Objectives

Gastric papillary adenocarcinoma (GPA), a well-differentiated gastric adenocarcinoma, is associated with a worse prognosis compared to other differentiated gastric adenocarcinomas. Therefore, there is an urgent need to characterize its endoscopic manifestations for guiding biopsy site selection and achieving accurate diagnosis.

Methods

From January 1, 2016, to December 31, 2022, the data of 46 cases of early gastric papillary adenocarcinoma (EGPA) and 183 cases of early gastric differentiated tubular adenocarcinoma (EGDTA) diagnosed via pathological examination following endoscopic submucosal dissection (ESD) at the Second Hospital of Shandong University were collected. Propensity score matching (PSM) was employed to match 92 EGDTA patients at a ratio of 1:2, serving as the control group. Differences between the two groups were analyzed using multivariable logistic regression. Lastly, the relationship between vessels within epithelial circle (VEC) structures in EGPA and the degree of malignancy was assessed.

Results

Compared with EGDTA, EGPA was more likely to infiltrate the submucosa, more frequently associated with poorly differentiated cancer components, and more prone to invading lymphatic and blood vessels. EGPA was primarily located in the lower stomach and manifested as a uniformly elevated pattern under endoscopy, while VEC structural positivity could be visualized under ME-NBI. Moreover, EGPA lesions had larger diameters and were characterized by high expression of gastric mucins, namely MUC5AC and MUC6. When EGPA infiltrated the submucosa or contained poorly differentiated cancer components, the VEC structures were smaller.

Conclusions

The present study demonstrated that EGPA exhibits a higher degree of malignancy. Endoscopic findings of a raised lesion with a uniform color under endoscopy and the presence of VEC structures under ME-NBI suggest a high possibility of EGPA. Moreover, smaller VEC structures were associated with a higher degree of malignancy, which may assist in guiding the selection of biopsy sites under endoscopy.
Comparative efficacy of microwave ablation and radiofrequency ablation for treating metastatic liver cancer: a systematic review and meta-analysis
Authors: Li Zheng , Yan Tingting , Cai Xiujun
Published: October 2024

Objective

This study aims at evaluating and juxtaposing the efficacy of radiofrequency ablation (RFA) and microwave ablation (MWA) for hepatic metastases treatment.

Methods

We undertook an extensive literature search across the Cochrane Library, Web of Science, Embase, PubMed, CNKI, and databases for studies published up to December 2023, assessing the outcomes of RFA versus MWA in hepatic metastases treatment. Studies were included or excluded based on established criteria. Continuous variables were analyzed with the aid of the weighted mean difference (WMD) and its 95% confidence interval (CI), while the odds ratio (OR) with its 95% CI was utilized for dichotomous variables. Data were processed by use of STATA 17.0 software. Key outcomes assessed included ablation time, post-operative local tumor progression (LTP), disease-free survival (DFS), and post-operative complications (POCs).

Results

Seven studies, comprising 357 patients undergoing MWA and 452 patients undergoing RFA, fulfilled the inclusion criteria. As unveiled by the meta-analysis, RFA and MWA did not significantly differ in ablation time, DFS, and POCs. Nonetheless, MWA resulted in a strikingly reduced rate of post-operative LTP versus RFA.

Conclusion

MWA offers superior control over post-operative LTP, suggesting better overall efficacy in hepatic metastases treatment compared with RFA.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42023385201.
Sexual life in adults treated for brain tumors: a retrospective study
Authors: Leonetti Antonella , Puglisi Guglielmo , Rossi Marco , Viganò Luca , Conti Nibali Marco , Gay Lorenzo , Sciortino Tommaso , Fornia Luca , Cerri Gabriella , Bello Lorenzo
Published: October 2024

Objective

Sexual functioning is a multifaceted aspect of human life that can be profoundly affected in patients with glioma. Most frequent symptoms include reduced sexual desire, difficulties in sexual arousal, or low satisfaction. Such symptoms may cause distress or interpersonal difficulties, inevitably resulting in negative outcomes on different domains of patients’ quality of life. Despite this, sexuality is rarely addressed by medical staff and remains understudied. An important question still unanswered is whether sexual dysfunctions in glioma patients correlate with features of the tumor itself, with its treatment, or with the secondary effects of the tumor on the patient’s psychological status. To answer this question, the present study aims to investigate the incidence of sexual life impairments in a very large population of patients with low- and high-grade gliomas, focusing on demographic, clinical, and treatment factors associated with their occurrence and developments.

Methods

A total of 148 patients treated for glioma were evaluated for sexual functioning, i.e., sexual dysfunction (SD), relationship status (RS), intercourse frequency (IF), and sexual satisfaction (SS), by using a specific anonymous questionnaire. Descriptive statistics were utilized to investigate participant characteristics and to evaluate the occurrence of sexual problems. Chi-squared tests were performed to detect the association between “SS” or “IF” and different clinical/demographic factors as well as between “SS” or “IF” and the “subjective–personal skills judgment”.

Results

Results showed no difference between male and female patients, a very low frequency (1.4%) of SD, but a consistent percentage (25%) of subjective deterioration in sexual wellbeing. Notably, 24% of patients reported to have interrupted their relationship after the diagnosis. Chi-squared analyses reveal an association between adjuvant treatments (chemotherapy and radiotherapy) and reduction of IF. Interestingly, “SS” or “IF” was not associated with demographic, clinical, or histomolecular factors.

Conclusion

Our study showed that sexual problems in glioma patients are not uncommon, and they are especially linked to SS, RS, and IF. Specifically, intercourse frequency reduction is associated with the adjuvant treatments. Results highlight the need for improved assessment strategies and interventions tailored to the unique needs of brain tumor patients.
First case report of a vertebral osteomyelitis caused by carbapenem-resistant Enterobacter cloacae treated with imipenem/cilastatin/relebactam prolonged infusion then meropenem/vaborbactam in continuous infusion
Authors: Laffont-Lozes Paul , Naciri Tayma , Pantel Alix , Martin Aurélie , Pruvot-Occean Anne-Sophie , Haignere Vincent , Loubet Paul , Sotto Albert , Larcher Romaric
Published: October 2024

Introduction

Bone and joint infections (BJIs) caused by multidrug-resistant bacteria are becoming more frequent. However, data on the use of novel β-lactam/β-lactamase inhibitors, such as imipenem/cilastatin/relebactam (I-R) and meropenem/vaborbactam (MVB), to treat BJIs is lacking. Furthermore, prolonged infusions of these β-lactams should theoretically optimize pharmacokinetic/pharmacodynamics target in these indications, but there are currently no reports on this type of infusions, especially in the setting of BJI.

Case Presentation

We report a case of a vertebral osteomyelitis caused by carbapenem-resistant Enterobacter cloacae successfully treated with extended-infusion of I-R (1.25 g q6h over 2 h), then with continuous infusion of MVB (2 g q4h as over 4 h). Therapeutic drug monitoring confirmed that extended-infusion of I-R and continuous infusion of MVB achieved serum concentrations up to 12 mg/L of imipenem and 19 mg/L of meropenem, respectively.

Conclusion

The favourable outcome of this patient treated for a vertebral osteomyelitis caused by carbapenem-resistant E. cloacae suggest that extended- and continuous infusions of I-R and MVB, are promising regimens for treatment of BJIs caused by carbapenem-resistant Enterobacterales.
Immune-related adverse events in small-cell lung cancer patients treated with immune checkpoint inhibitors: a comprehensive analysis from the FDA adverse event reporting system
Authors: Bai Yifeng , Wang Xiaomei , Dai Xiaoqin , Ma Qinghua , Hu Honglin
Published: October 2024

Background

The discovery and development of immune checkpoint inhibitors (ICIs) have resulted in their application as a novel therapeutic strategy for patients with small-cell lung cancer (SCLC). However, a comprehensive analysis of the potential adverse effects of ICIs in patients with SCLC remains to be conducted.

Methods

Adverse event (ADE) reports relating to SCLC patients, submitted to the FDA Adverse Event Reporting System (FAERS) from the first quarter of 2013 to the second quarter of 2022, were extracted for analysis. The extracted data were subsequently screened and analyzed using the reporting odds ratio (ROR) method to assess the AE reports.

Results

A total of 4,522 ADE reports were obtained from patients with SCLC who had received either chemotherapy alone or a combination of ICIs with chemotherapy. The ROR analysis identified a total of 91 immune-related adverse events in SCLC patients associated with the ICIs (SCLC-irAEs).

Conclusion

This study revealed that the adverse effects resulting from irAEs in SCLC patients predominantly affected the hematologic and gastrointestinal systems, with the most severe cases potentially leading to fatality.
Efficacy and safety of guanxinshutong capsule combined with western medicine on stable angina pectoris: a systematic review and meta-analysis
Authors: Yu Liyuan , Wu Lulu , Peng Weihang , Huang Peiying , Chen Li , Deng Yi , Wang Meida , Zeng Jing , Chen Bojun
Published: October 2024

Aims: To systematically evaluate the efficacy and safety of the Guanxinshutong capsule (GXST) combined with Western medicine (WM) in treating stable angina pectoris (SAP).

Methods: Randomized controlled trials (RCTs) evaluating the efficacy of GXST combined with WM for the treatment of patients with SAP were searched across several databases, including the Cochrane Library, PubMed, Embase, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Journal Database (VIP), and Wan Fang, from inception until 30 April 2024. Two independent reviewers rigorously performed study selection, data extraction, and quality assessment. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was employed to assess the methodological quality of included RCTs. R version 4.2.2 was applied for data synthesis.

Results: Between 2012 and 2024, 31 RCTs involving 4,172 patients were identified, with 2,101 in the experimental group and 2,071 in the control group. GXST and WM combination was significantly more effective than WM alone across several metrics: clinical efficacy rate (odds ratio [OR] = 4.05, 95% confidence interval [CI] = 3.42–4.80), electrocardiogram improvement (OR = 3.39, 95% CI = 2.35–4.87), enhancement in left ventricular ejection fraction (mean difference [MD] = 1.07, 95% CI = 0.69–1.46), reduction in total cholesterol levels (MD = −0.78, 95% CI = −1.20 to −0.35), decrease in tumor necrosis factor-alpha (MD = −1.36, 95% CI = −2.18 to −0.53), and improvement in Chinese medicine evidence score (OR = 3.77, 95% CI = 2.20–6.43). No significant difference was observed in the reduction in C-reactive protein levels (MD = −6.66, 95% CI = −15.91 to 2.59), triglyceride levels (MD = −1.62, 95% CI = −3.39 to 0.15), or in the occurrence of adverse drug reactions (OR = 0.60, 95% CI = 0.23–1.57). Based on meta-regression and subgroup analyses, the observed heterogeneity was attributed to variations in GXST capsule dosage, the duration of treatment, and the baseline characteristics of patients.

Conclusion: GXST and WM combination therapy demonstrates the potential to enhance clinical outcomes for SAP patients. Nevertheless, additional rigorous studies are imperative to substantiate the reliability and safety of this combined treatment modality.

Systematic Review Registration: The protocols for this meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=543537, Identifier CRD42024543537).
Combining single-cell RNA sequencing and network pharmacology to explore the target of cangfu daotan decoction in the treatment of obese polycystic ovary syndrome from an immune perspective
Authors: Liu Danqi , Wei Chaofeng , Guan Lu , Ju Wenhan , Xiang Shan , Lian Fang
Published: October 2024

Background

Polycystic ovary syndrome (PCOS) is a heterogeneous gynecological endocrine disorder linked to immunity. Cangfu Daotan Decoction (CFDT), a classic Chinese medicine prescription, is particularly effective in treating PCOS, specifically in patients with obesity; however, its specific mechanism remains unclear.

Methods

Part 1: Peripheral blood mononuclear cells were collected on egg retrieval day from obese and normal-weight patients with PCOS and healthy women undergoing in vitro fertilization (IVF)-embryo transfer. Next, scRNA-seq was performed to screen the key genes of bese patients with PCOS. Part 2: Active ingredients of CFDT and obesity-related PCOS targets were identified based on public databases, and the binding ability between the active ingredients and targets was analyzed. Part 3: This part was a monocentric, randomized controlled trial. The obese women with PCOS were randomized to CFDT (6 packets/day) or placebo, and the healthy women were included in the blank control group (43 cases per group). The clinical manifestations and laboratory outcomes among the three groups were compared.

Results

Based on the scRNA-seq data from Part 1, CYLD, ARPC3, CXCR4, RORA, JUN, FGL2, ZEB2, GNLY, FTL, SMAD3, IL7R, KIR2DL1, CTSD, BTG2, CCL5, HLA, RETN, CTSZ, and NCF2 were potential key genes associated with obese PCOS were identified. The proportions of T, B, and natural killer cells were higher in patients with PCOS compared to healthy women, with even higher proportions observed in obese patients with PCOS. Gene ontology and the Kyoto encyclopedia of genes and genomes analysis depicted that the differentially expressed genes were related to immune regulation pathways. Network pharmacology analysis identified that the key active components in CFDT were quercetin, carvacrol, β-sitosterol, cholesterol, and nobiletin, and TP53, AKT1, STAT3, JUN, SRC, etc. were the core targets. The core targets and their enrichment pathways overlapped with those in Part 1. Clinical trials in Part 3 found that CFDT reduced the dosage of gonadotropins use in patients with PCOS, increased the number of high-quality embryos, and improved the ongoing pregnancy rate.

Conclusion

CFDT can improve the immune microenvironment of patients to some extent, reduce their economic burden, and enhance IVF outcomes. The improvement in the immune microenvironment in obese patients with PCOS may be linked to targets such as JUN and AKT.
The role of candidate pharmacogenetic variants in determining valproic acid efficacy, toxicity and concentrations in patients with epilepsy
Authors: Yazbeck Hady , Youssef Joe , Nasreddine Wassim , El Kurdi Abdullah , Zgheib Nathalie , Beydoun Ahmad
Published: October 2024

Background

Antiseizure medications (ASM) exhibit considerable interindividual variability in terms of efficacy and adverse events. Genetic variation is thought to contribute to these differences in clinical outcomes. Specifically, the response to valproic acid (VPA), a widely used ASM, is influenced by multiple pharmacogenetic factors. However, and in contrast to other ASMs such as phenytoin and carbamazepine, there is a paucity of data on the association between VPA and various gene variants. The aim of this study was hence to evaluate the influence of candidate pharmacogenetic variants on VPA efficacy, toxicity and serum concentrations in a homogeneous cohort of patients newly diagnosed with genetic generalized epilepsies (GGE).

Methods

In this prospective cohort study, demographic, clinical and treatment outcomes of GGE patients were retrieved from their medical records. Whole exome sequencing was performed in collaboration with Epi25. Gene variants associated with VPA efficacy, metabolism and toxicities were retrieved from PharmGKB. An analysis was then conducted to explore potential associations between these gene variants and VPA clinical outcomes.

Results

Of the 166 patients included, 60 (36.1%) experienced treatment failure while 106 (63.9%) achieved treatment success. After adjusting for VPA maintenance dose, carriers of the rs3892097 (CYP2D6) variant were 2.5 times more likely to experience treatment failure compared to wildtype (p = 0.026). The rs1057910 variant (CYP2C9*3) was associated with increased serum VPA concentrations (p = 0.034). Moreover, the rs1137101 variant (LEPR gene, a metabolism regulator) was significantly associated with a higher risk of weight gain (regression coefficient of 3.430 [0.674; 6.186], p = 0.015) and a higher frequency of hair loss (OR = 3.394 [1.157; 9.956], p = 0.026), while the rs4480 variant (SOD2 gene, encoding for a mitochondrial scavenging enzyme) was correlated with a lower frequency of hair loss (OR = 0.276 [0.089; 0.858], p = 0.026).

Conclusion

These findings highlight the role of genetic factors in VPA treatment and underscore the potential for developing therapeutic strategies to enhance patient outcomes and minimize adverse effects.
Nonlinear pathological trajectory of a high-myopia C57/BL6J mouse model induced by form deprivation
Authors: Wen Yue , Li Yan , Zhu Li , Tang Tao , Yan Huichao , Hu Jie , Wang Kai , Zhao Mingwei , Xu Qiong
Published: October 2024

Introduction

To establish a high myopia model in C57BL/6J mice with monocular form deprivation myopia (FDM) and investigate its ocular structure pathological trajectory.

Methods

Healthy 3-week-old C57BL/6J mice were divided into an FDM group (n = 36) and a control group (n = 24). The left eyes of the FDM group were patched, while the right eyes served as controls. Biometric parameters and fundus morphology were assessed at baseline and after 4, 8, and 12 weeks of form deprivation.

Results

Significant differences were observed in the deprived eyes, including longer axial length, higher refractive power, deeper vitreous chambers, thinner retina, choroid, and sclera, and smaller scleral fibers’ diameters under a transmission electron microscope. Retinal vascular area proportion in covered eyes decreased significantly (P < 0.05), with a decline rate of 11% from weeks 4 to 8 and a faster decline of 19% from weeks 8 to 12, while this proportion increased significantly in control eyes.

Discussion

This study successfully induced a high myopia model in mice with long-term form deprivation. The axial length grew dramatically in FDM in the first 8 weeks, while the pathological progress of the fundus accelerated from weeks 8 to 12.
Skeletal muscle metabolic characteristics and fresh meat quality defects associated with wooden breast
Authors: Rimmer Linnea A. , Zumbaugh Morgan D.
Published: October 2024

Wooden breast (WB) is a myopathy that occurs in pectoralis major (PM) muscles, predominately affecting large, fast-growing broilers. Severe myodegeneration, increased hypoxia, reduced blood flow, and increased collagen deposition are hallmark characteristics of WB that culminate in unsatisfactory fresh meat quality attributes, such as poor water-holding capacity, tenderness, and processing characteristics. Therefore, WB meat is often downgraded resulting in economic losses for the United States poultry industry. Although WB has been well characterized, its etiology remains undefined. As the scientific community continues to resolve mechanisms responsible for WB onset, understanding biochemical changes associated with WB may facilitate solutions to negate its poor meat quality attributes. Given changes in metabolism of living muscle can alter biochemical processes during the conversion of muscle to meat, this review aims to summarize and discuss the current knowledge of WB muscle and meat biochemistry. For example, it appears metabolic pathways that support combating stress are upregulated in WB muscle at the expense of glycolytic flux, which presumably contributes to the high ultimate pH of WB meat. Further, perturbed function of WB mitochondria, such as altered calcium handling, impacts aspects of postmortem metabolism and proteolysis. Collectively, metabolic dysfunction of WB muscle alters the biochemical processes that occur during the conversion of muscle to meat, and thus contributes to the poor WB meat quality.
Antiproliferative and biochemical evaluation of rose extracts: impact on tumor and normal skin cells
Authors: Faur Cosmin-Alin , Zăhan Marius , Bunea Claudiu Ioan , Hârșan Eugenia , Bora Florin-Dumitru , Bunea Andrea
Published: October 2024

Rose petals (Rosa L.) are rich sources of phenolic compounds, including anthocyanins. Anthocyanins and anthocyanidins are associated with multiple health benefits due to their antioxidant properties. In this study, eighteen rose cultivars were comparatively analyzed to determine their total polyphenol and flavonoid content, as well as their antioxidant activity using the 2,2-diphenylpicrylhydrazyl (DPPH) radical scavenging method. The extracts were purified using Amberlite XAD-7 and Sephadex LH-20 columns to obtain anthocyanin-rich fractions. Individual anthocyanins were separated and identified using high-performance liquid chromatography coupled with electrospray ionization mass spectrometry (HPLC-ESI-MS). The three cultivars with the highest anthocyanin content were further examined for cytotoxic effects on cell cultures at various extract concentrations (200-1000 µg/mL) using two skin cell lines: a melanoma cell line (A375) and a normal skin cell line (Hs27). The HPLC-MS analysis identified nine different anthocyanin compounds, with the total anthocyanin content in the rose cultivars varying from 12.42 to 331.95 mg of cyanidin-3-glucoside equivalent/100g of fresh weight. The total polyphenol and total flavonoid contents ranged from 289 to 2703 mg gallic acid equivalent/100g fresh weight and 102 to 603 mg catechin equivalent/100g fresh weight, respectively. Antioxidant activity ranged from 450 to 1304 µmol trolox equivalent/g fresh weight. A significant correlation was observed between antioxidant activity and the content of anthocyanins (R = 0.875, p < 0.001), flavonoids (R = 0.982, p < 0.001), and polyphenols (R = 0.991, p < 0.001). Furthermore, principal component analysis, along with dendrograms and heatmaps, illustrated the relationships among these key compounds and their association with antioxidant activity. The MTT assay showed a substantial suppression of A375 cancer skin cells, while simultaneously exhibiting cell proliferation in Hs27 normal skin cells in a concentration-dependent manner. Altogether, results suggest that the anthocyanins from these rose cultivars could be considered as a promising agent for adjuvant treatment of skin melanoma.
Mediating effect of self-efficacy on the relationship between Big Five personality and medication adherence in Chinese hypertensive patients: a national cross-sectional study
Authors: Du Mingliang , Wu Yibo , Wang Boran , Jiang Miao , Chen Jiangyun , Hui Hui
Published: October 2024

Objective

The study aims to evaluate personality characteristics, self-efficacy, and medication adherence in Chinese patients with hypertension, while also investigating how self-efficacy mediates the relationship between personality traits and medication adherence.

Methods

This investigation included 787 Chinese patients diagnosed with hypertension, as reported in the “2021 China Family Health Index Survey Report.” The study employed several assessment tools such as a General Information Questionnaire, the Brief Big Five Inventory (BFI-10), the New General Self-Efficacy Scale (NGSES), and the Medication Adherence Rating Scale (MARS). Statistical analyses encompassed the Mann–Whitney U test, chi-square test, multiple logistic regression, Spearman’s rank correlation, standardized regression coefficients, and Bootstrap techniques.

Results

(1) Individuals with debt, who also possess high levels of self-efficacy, tend to adhere more consistently to their medication regimens. (2) An analysis of personality traits indicated that Extroversion,Conscientiousness and Openness positively influences self-efficacy,while Agreeableness and Neuroticism negatively impacts it. (3) Self-efficacy plays a mediating role in the indirect relationship between personality traits such as Extroversion and neuroticism and medication adherence.

Conclusion

In the context of Chinese adults, both self-efficacy and Extroversion positively influence medication adherence, whereas high levels of neuroticism adversely impact it. Furthermore, self-efficacy serves as a mediating factor in the linkage between personality traits and medication adherence.
The timing of vision in basketball three-point shots
Authors: Piras Alessandro
Published: October 2024

The aim of the present study was to explore the relationship between gaze behaviour, motor responses and the direction of visual attention when different levels of basketball players were engaged in a basketball three-point shot. Twelve near-experts and 12 amateur basketball players, wearing an eye tracker and an inertial sensor, performed 20 shots on a basketball field, receiving the ball from a teammate, who then acted as the opponent. The trial sequence was subdivided into catching, aiming and ball flight phases. The analysis demonstrated that near-experts exhibited longer fixation durations and saccades of lower amplitude and peak velocity than amateurs. The gaze behaviour showed that all players utilized fixations during the last part of the catching phase, during most of the aiming phase, and during the final part of the ball flight phase. The greatest number of saccades was exhibited between the aiming and the ball flight phases, when the ball was released by the players. Saccades were oriented toward the teammate during the catching phase. Instead, during the aiming and ball flight phases, saccade orientations were not polarized toward a specific visual cue. In conclusion, vision plays a critical role in every aspect of the three-point shot in basketball, from catching the ball, to aiming preparation, and shot execution. It is a key factor in decision-making, spatial awareness, and overall performance in team sports.
The influence of family socioeconomic status on college students’ mental health literacy: the chain mediating effect of parenting styles and interpersonal relationships
Authors: Wu Jie , Shen Haoyuan , Shen Yunbo , Liao Xianglin , Yu Xianglian
Published: October 2024

Introduction

With the increasing prevalence of mental health challenges among college students, understanding how family background and interpersonal dynamics affect mental health literacy is critical. This study examined the relationships between family socioeconomic status, mental health literacy, parenting styles, and interpersonal relationships among 1,107 college students.

Methods

Using an online questionnaire, the study explored how family socioeconomic status, parenting styles, and interpersonal relationships influence mental health literacy.

Results and discussion

The results showed that family socioeconomic status significantly and positively predicts mental health literacy. Both positive and negative parenting styles were found to partially mediate the relationship between family socioeconomic status and mental health literacy. Additionally, interpersonal relationships partially mediated this relationship. Finally, the study revealed that positive and negative parenting styles acted as sequential mediators between family socioeconomic status and mental health literacy through interpersonal relationships. These findings provide insights into the mechanisms by which family socioeconomic factors shape mental health literacy among college students.
Health literacy and loneliness among physically inactive Danes aged 18–65: a cross-sectional study
Authors: Sarmanlu Delal , Heuck Iben Rask , Maindal Helle Terkildsen , Lim Michelle H. , Ryom Knud
Published: October 2024

Introduction

Both physical inactivity and loneliness are public health threats bringing huge costs to society and quality of life. The two health challenges often co-exist, suggesting physically inactive and lonely individuals to be a high-risk group. Health literacy as a concept is understood as a modifiable health determinant, and it has been proposed for promoting equity in future health promotion.

Aim

The aim of this study was to examine the association between health literacy and loneliness among physically inactive adults.

Methods

A representative sample of 6,196 Danish adults, aged 18–65 years, was invited to a screening on a set of health outcomes for physical inactivity, which was based on the International Physical Activity Questionnaire-Short Form. A total of 1,033 adults were classified as physically inactive and therefore received the full questionnaire screening on a set of different health outcomes including the Health Literacy Questionnaire (HLQ) and the Three-Item Loneliness Scale (T-ILS). Two statistical approaches were applied: (1) health literacy expressed as nine different continuous variables corresponding to the domains of HLQ using logistic regressions analyses to examine the association between health literacy and loneliness; (2) health literacy expressed as nine different binary variables showing proportions of low literacy among lonely versus non-lonely participants. Statistical analyses were performed using Stata/IC version 16.1.

Results

Among a sample of 1,010 physically inactive adults, 23.7% felt lonely with a T-ILS score below ≥7. Regression analyses predicted a negative association between health literacy and loneliness in all HLQ domains, after adjusting for gender, age, education, and occupation. Adjusted ORs ranged from 0.21 (95% CI: 0.16; 0.27) to 0.69 (95% CI: 0.57; 0.83) in domains 1–5 and 0.50 (95% CI: 0.41; 0.61) to 0.70 (95% CI: 0.55; 0.89) in domains 6–9. A similar pattern was found in the analysis with health literacy as a binary variable as the proportions of low health literacy were the highest among persons with loneliness in all HLQ domains.

Conclusion

Even after adjusting for sociodemographic factors, a negative association was predicted between health literacy and loneliness in physically inactive adults. This suggests that strategies for improving physical activity among inactive individuals might be more effective if they include a focus on enhancing health literacy and addressing loneliness.
Accelerated biological aging: unveiling the path to cardiometabolic multimorbidity, dementia, and mortality
Authors: He Yi , Jia Yu , Li Yizhou , Wan Zhi , Lei Yi , Liao Xiaoyang , Zhao Qian , Li Dongze
Published: October 2024

Background

Cardiometabolic multimorbidity (CMM) and aging are increasing public health concerns. This prospective study used UK Biobank cohort to investigate the relationship between biological aging and the trajectory of CMM to dementia and mortality.

Methods

CMM is the coexistence of at least two cardiometabolic diseases (CMD), including stroke, ischemic heart disease, and diabetes. Biological age was calculated using the KDM-BA and PhenoAge algorithms. Accelerated aging indicated biological age advances more rapidly than chronological age.

Results

The study included 415,147 individuals with an average age of 56.5 years. During the average 11-year follow-up period, CMD-free individuals with accelerated aging had a significantly greater risk of CMD (KDM-BA, HR 1.456; PhenoAge, HR 1.404), CMM (KDM-BA, HR 1.952; PhenoAge, HR 1.738), dementia (KDM-BA, HR 1.243; PhenoAge, HR 1.212), and mortality (KDM-BA, HR 1.821; PhenoAge, HR 2.047) in fully-adjusted Cox regression models (p < 0.05 for all). Accelerated aging had adjusted HRs of 1.489 (KDM-BA) and 1.488 (PhenoAge) for CMM, 1.434 (KDM-BA) and 1.514 (PhenoAge) for dementia, and 1.943 (KDM-BA) and 2.239 (PhenoAge) for mortality in participants with CMD at baseline (p < 0.05 for all). CMM significantly mediated accelerated aging’s indirect effects on dementia by 13.7% (KDM-BA, HR) and 21.6% (PhenoAge); those on mortality were 4.7% (KDM-BA) and 5.2% (PhenoAge). The population attributable-risk of Life’s Essential 8 score (≥80 vs. <80) were 0.79 and 0.43 for KDM-BA and PhenoAge accelerated aging, respectively.

Conclusion

Biological aging involves the entire trajectory of CMM from a CMD-free state to CMD, to CMM, and ultimately to dementia and death. Life’s Essential 8 may be a potential target to counter age acceleration.
Exploring the impact of polychlorinated biphenyls on comorbidity and potential mitigation strategies
Authors: Gao Ying , Lu Han , Zhou Huan , Tan Jiaxing
Published: October 2024

Introduction

Polychlorinated Biphenyls (PCBs) persist in the environment and accumulate in humans. Currently, there is a lack of understanding about the overall impact of PCBs on human health, and effective interventions for exposed populations are insufficient.

Methods

Our study aimed to assess the impact of PCBs on various diseases and mortality risks using data from the National Health and Nutrition Examination Survey, while proposing lifestyle adjustments, particularly dietary modifications, to mitigate mortality risk. Statistical analyses employed principal component analysis, multifactorial logistic regression, multifactorial Cox regression, comorbidity network analysis, and machine learning prediction models.

Results

Results indicated significant associations between 7 types of PCBs and 12 diseases (p < 0.05), with 6 diseases showing significant positive correlations (OR > 1, p < 0.05), along with listing the 25 most relevant diseases, such as asthma and chronic bronchitis (OR [95% CI] = 5.85 [4.37, 7.83], p < 0.0001), arthritis and osteoporosis (OR [95% CI] = 6.27 [5.23, 7.55], p < 0.0001). This suggested that PCBs may be intimately involved in the development and progression of multiple diseases. By constructing multidimensional machine learning models and conducting multiple iterations for precision and error measurement, PCBs may have the potential to become specific biomarkers for certain diseases in the future. Building upon this, we further suggested that controlling dietary intake to reduce dietary inflammatory index (DII) could lower mortality and disease risks.

Discussion

While PCBs were independent risk factors for mortality, substantial evidence suggested that adjusting DII might mitigate the adverse effects of PCBs to some extent. Further physiological mechanisms require deeper exploration through additional research.