bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autism Spectrum Disorder in Saudi Arabian Children: A Cross-sectional Analysis of Prevalence and Risk Factors
Authors: Aleid Kawthar Mohammed , Ismail Gawaher Mohammed , Alhawsawi Kawther Ibrahim , Aljudayba Reham Mousa , Alshammari Reef , Akoor Futon , Alkhars Ola 
Published: December 2024

Abstract

Introduction:
The study begins by contextualising autism spectrum disorder (ASD) as a multifaceted neurodevelopmental condition that significantly impacts children’s social communication, interests and behaviours, with varying severity among individuals. The significance of early detection, as emphasised by the Diagnostic and Statistical Manual of Mental Disorders 5, is highlighted, establishing the foundation for the study. The research aims to address the knowledge gap regarding the prevalence and risk factors of ASD in Saudi Arabia, a region where such data have been notably lacking. This is set against the backdrop of global trends in ASD awareness and diagnosis, with specific focus on the increased prevalence rates in the Middle East and Africa.

Methods:
A cross-sectional study design was employed across the various regions of Saudi Arabia, including North, South, East, West and Central provinces. The study population consisted of the Saudi general public from diverse regions, socioeconomic backgrounds and educational levels. A cluster random sampling method was used, with the sample size determined by statistical power analysis and the Rao-Soft program. Data collection was carried out using a structured questionnaire in Arabic, which included socio-demographic items and questions related to the study hypotheses. The study also involved a pilot study to test the reliability and validity of the questionnaires.

Results:
The study revealed a range of challenges and characteristics associated with ASD. Among the parents surveyed, 2.3% rated their child’s overall health as fair and 0.9% as poor. A small percentage of children were reported to never engage in social activities. Significant findings included a high prevalence of repetitive behaviours and communication difficulties in children. The study also noted sensory sensitivities in a considerable portion of the children. A notable finding was the association of ASD with maternal age, especially in older age groups, and family history, suggesting a genetic component to the disorder.

Conclusion:
This study provides a comprehensive understanding of the prevalence and risk factors of ASD in Saudi Arabian children. The findings emphasise the need for early intervention and tailored support, especially for children with a familial predisposition to ASD. The research highlights the importance of considering both genetic and environmental factors in ASD risk assessments and intervention strategies. It contributes significantly to the field, particularly in improving patient care and facilitating early intervention strategies for affected children, thereby addressing a critical research gap and potentially influencing global perspectives on ASD research and intervention.
Epidemiology and Clinical Profiles of Acute Myocardial Infarction in Diverse Age Groups at Saudi Emergency Departments: A Cross-sectional Analysis
Authors: Aleid Mohammed Sami , Alshammari Nafea Abdullah , Almobarak Rahaf Fadil , Al-Umran Mariam Radhi , Alharbi Sultan Fahad , Alasfoor Faris Bader , Alqahtani Thekra Saeed , Alali Zainab Abdulhadi , Albinsaad Loai Saleh 
Published: December 2024

Abstract

Introduction:
Acute myocardial infarction (AMI) is a significant cardiovascular event with varying epidemiological patterns and in-hospital outcomes worldwide. Understanding these patterns is essential for optimising patient care and healthcare resource allocation. This study aims to provide a comprehensive analysis of the epidemiological variation and in-hospital outcomes of AMI in a tertiary centre in Saudi Arabia. By examining a diverse cohort of AMI patients, we seek to address the unique characteristics and challenges associated with AMI in this region and contribute to the existing knowledge of AMI epidemiology.

Methods:
This observational study employed a retrospective cohort design, drawing data from a tertiary centre in Saudi Arabia. The study included a diverse group of AMI patients, and eligibility criteria were carefully defined to ensure the inclusion of relevant cases. Detailed data were collected, encompassing patient demographics, medical histories, clinical presentations and outcomes during hospitalisation. Robust statistical analyses were conducted to explore the relationship between demographic factors, medical histories and in-hospital outcomes amongst AMI patients. The study design and data collection methods aimed to provide an informative and balanced summary of what was done and what was found.

Results:
The analysis revealed a wide range of epidemiological variations in the presentation and outcomes of AMI amongst patients in Saudi Arabia. Notably, demographic factors such as age, gender and comorbidities were found to significantly impact the severity and prognosis of AMI cases. In addition, the study identified specific medical histories that played a crucial role in influencing the in-hospital outcomes of AMI patients. These results underscore the importance of early diagnosis, risk factor management and tailored interventions in improving the prognosis and outcomes for AMI patients in Saudi Arabia.

Conclusion:
This comprehensive analysis sheds light on the complex epidemiological patterns and in-hospital outcomes of AMI in a tertiary centre in Saudi Arabia. The findings emphasise the need for a nuanced approach to AMI management, considering the unique characteristics of the local population. This research contributes significantly to the existing body of knowledge and serves as a call to action for healthcare professionals, policymakers and researchers to collaborate in enhancing the prevention, diagnosis and treatment of AMI in Saudi Arabia. It also highlights the importance of targeted interventions based on demographic and medical history factors to improve the outcomes of AMI patients in this region.
Hemophagocytic Lymphohistiocytosis as a Presenting Manifestation of Tuberculosis: A Report of Two Cases
Authors: Singhal Anuj , Sankar J , Kumar Rajiv , Tripathi Preeti , Kumar Pavan , Dewan Kritika 
Published: December 2024

Abstract
We highlight two adult cases of secondary HLH triggered by mycobacterium tuberculosis. The first case, a 68-year-old succumbed to his illness due to lack of a definitive ante mortem diagnosis and rapid disease progression. In contrast, the second patient received a rapid evaluation and prompt diagnosis, with timely initiation of ATT and complete recovery. Both patients had evidence of disseminated tuberculosis with involvement of multiple organs, including the lungs, pleura, spleen, liver, and bone marrow. Prompt recognition and treatment of tuberculosis in patients with HLH are vital to prevent rapid disease progression and reduce mortality that to in developing countries like India where tuberculosis is more prevalent.
Fatal familial insomnia: Reporting a case of the rare nightmare
Authors: Hogue E , Weinberg D , Palecek E 
Published: December 2024

ABSTRACT
Prion diseases are rare, incurable, and rapidly progressive. Pathogenic misfolded proteins accumulate in the central nervous system causing fatal neurodegeneration. Fatal familial insomnia (FFI) is an even rarer, hereditary subset of prion disease. The initial clinical course is nonspecific, leading to difficulties with diagnosis. We describe a patient with a family history of prion disease who presented with early symptoms of FFI including disordered sleep, cognitive dysfunction, and autonomic dysregulation. Notably, diagnostic studies including magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and electroencephalography (EEG) did not show changes characteristic of prion disease. However, genetic testing showed a pathological, heterozygous mutation c.532G> A (p.Asp178Asn), confirming FFI. His clinical course progressed rapidly, and death occurred several months after the initial hospital presentation. We discuss the pathophysiology and diagnosis of FFI and the emotional care required to treat this fatal disease. General practitioners should be aware of this rare diagnosis to improve patient management.
p-Adic quotient sets: Linear recurrence sequences with reducible characteristic polynomials
Authors: Antony Deepa , Barman Rupam 
Published: December 2024

AbstractLet
$(x_n)_{n\geq 0}$
be a linear recurrence sequence of order
$k\geq 2$
satisfying
$$ \begin{align*}x_n=a_1x_{n-1}+a_2x_{n-2}+\dots+a_kx_{n-k}\end{align*} $$
for all integers
$n\geq k$
, where
$a_1,\dots ,a_k,x_0,\dots , x_{k-1}\in \mathbb {Z},$
with
$a_k\neq 0$
. In 2017, Sanna posed an open question to classify primes p for which the quotient set of
$(x_n)_{n\geq 0}$
is dense in
$\mathbb {Q}_p$
. In a recent paper, we showed that if the characteristic polynomial of the recurrence sequence has a root
$\pm \alpha $
, where
$\alpha $
is a Pisot number and if p is a prime such that the characteristic polynomial of the recurrence sequence is irreducible in
$\mathbb {Q}_p$
, then the quotient set of
$(x_n)_{n\geq 0}$
is dense in
$\mathbb {Q}_p$
. In this article, we answer the problem for certain linear recurrence sequences whose characteristic polynomials are reducible over
$\mathbb {Q}$
.
Lipid levels and insulin resistance markers in patients with colorectal cancer: Propensity score matching analysis
Authors: Hu Ren-Hao , Yan Dong-Yi , Zhang Ke-Hui , Zhang Di , Cui Xi-Mao , Jiang Xiao-Hua , Zhang Shun 
Published: December 2024

BACKGROUND
Colorectal cancer (CRC) is a prevalent malignant neoplasm characterized by subtle early manifestations.
AIM
To investigate the correlation among serum lipid profiles, the triglyceride-glucose (TyG) index, and the atherosclerotic index (AI) in patients with CRC. Furthermore, it explored the clinical diagnostic utility of combining serum lipids with cancer antigens in the context of CRC.
METHODS
A retrospective analysis encompassed 277 patients with CRC and 1034 healthy individuals.
RESULTS
Following propensity score matching, patients with CRC exhibited significantly reduced levels of serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C), as well as a diminished TyG index. Conversely, they displayed elevated AI levels compared to their healthy counterparts. Patients in advanced stages exhibited lower serum levels of TG, TC, and LDL-C compared to those in early stages. Patients with positive lymph node metastasis demonstrated reduced levels of TG, LDL-C, and the TyG index. Receiver operating characteristic analysis revealed that the combination of the TyG index, carcinoembryonic antigen, and carbohydrate antigen 19-9 yielded the highest positive prediction rate for CRC at 75.3%.
CONCLUSION
Preoperative serum lipid profiles exhibit a robust association with patients with CRC. The concurrent assessment of multiple serum lipids and cancer antigens effectively enhances the diagnostic accuracy for CRC.
Association between autoimmune gastritis and gastric polyps: Clinical characteristics and risk factors
Authors: Jin Jing-Zheng , Liang Xiao , Liu Shu-Peng , Wang Rui-Lan , Zhang Qing-Wei , Shen Yu-Feng , Li Xiao-Bo 
Published: December 2024

BACKGROUND
The relationship between autoimmune gastritis (AIG) and gastric polyps (GPs) is not well understood.
AIM
To explore the clinical characteristics and risk factors of AIG with GPs in patients.
METHODS
This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023. We collected clinical, biochemical, serological, and demographic data were of each patient. Logistic regression analyses, both multivariate and univariate, were conducted to pinpoint independent risk factors for GPs in patients with AIG patients. Receiver operating characteristic curves were utilized to establish the optimal cutoff values, sensitivity, and specificity of these risk factors for predicting GPs in patients with AIG.
RESULTS
Patients with GPs had a higher median age than those without GPs [61 (52.25-69) years vs 58 (47-66) years, P = 0.006]. The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs [91.9 (34.2-138.9) pmol/mL vs 60.9 (12.6-98.4) pmol/mL, P < 0.001]. Additionally, the positive rate of parietal cell antibody (PCA) antibody was higher in these patients than in those without GPs (88.6% vs 73.6%, P < 0.001). Multivariate and univariate analyses revealed that PCA positivity [odds ratio (OR) = 2.003, P = 0.017], pepsinogen II (OR = 1.053, P = 0.015), and enterochromaffin like cells hyperplasia (OR = 3.116, P < 0.001) were significant risk factors for GPs, while pepsinogen I was identified as a protective factor.
CONCLUSION
PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG. Elevated gastrin-17 levels may also play a role in this process. These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
Transarterial chemoembolization combined with lenvatinib and sintilimab vs lenvatinib alone in intermediate-advanced hepatocellular carcinoma
Authors: Wu Fei-Da , Zhou Hai-Feng , Yang Wei , Zhu Di , Wu Bi-Fei , Shi Hai-Bin , Liu Sheng , Zhou Wei-Zhong 
Published: December 2024

BACKGROUND
Hepatocellular carcinoma (HCC) is the most common form of liver cancer that has limited treatment options and a poor prognosis. Transarterial chemoembolization (TACE) is the first-line treatment for intermediate-stage HCC but can induce tumour hypoxia, thereby promoting angiogenesis. Recent studies suggested that combining TACE with anti-angiogenic therapies and immunotherapy might improve efficacy. Lenvatinib, a tyrosine kinase inhibitor, has demonstrated superior outcomes compared to sorafenib, while immune checkpoint inhibitors such as sintilimab show potential when combined with TACE. However, the efficacy and safety of TACE combined with lenvatinib and sintilimab (TACE + SL) compared to TACE with lenvatinib alone (TACE + L) in patients with intermediate-advanced HCC has not yet been investigated.
AIM
To evaluate the efficacy and safety of TACE + SL therapy in comparison to TACE + L therapy in patients with intermediate-advanced HCC.
METHODS
A retrospective analysis was performed on patients with intermediate-advanced HCC who received TACE plus lenvatinib with or without sintilimab between September 2019 and September 2022. Baseline characteristics were compared, and propensity score matching was applied. Overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were evaluated between the two groups, and adverse events were analyzed.
RESULTS
The study included 57 patients, with 30 in the TACE + SL group and 27 in the TACE + L group. The TACE + SL group demonstrated significantly improved median PFS and OS compared to the TACE + L group (PFS: 14.1 months vs 9.6 months, P = 0.016; OS: 22.4 months vs 14.1 months, P = 0.039), along with a higher ORR (70.0% vs 55.6%). After propensity score matching, 30 patients were included, with the TACE + SL group again showing longer median PFS and a trend toward improved OS (PFS: 14.6 months vs 9.2 months, P = 0.012; OS: 23.9 months vs 16.3 months, P = 0.063), and a higher ORR (73.3% vs 53.3%). No severe adverse events were reported.
CONCLUSION
TACE + SL demonstrated superior outcomes in terms of OS and PFS, compared to TACE + L. These findings suggest that the addition of sintilimab might enhance the therapeutic response in patients with intermediate-advanced HCC.
Development of a nomogram for overall survival in patients with esophageal carcinoma: A prospective cohort study in China
Authors: Yu Shi-Shi , Zheng Xi , Li Xiao-Sheng , Xu Qian-Jie , Zhang Wei , Liao Zhong-Li , Lei Hai-Ke 
Published: December 2024

BACKGROUND
Esophageal carcinoma (EC) presents a significant public health issue in China, with its prognosis impacted by myriad factors. The creation of a reliable prognostic model for the overall survival (OS) of EC patients promises to greatly advance the customization of treatment approaches.
AIM
To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.
METHODS
This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1, 2018, and December 12, 2020. Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model. Its efficacy was assessed by concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA).
RESULTS
Nine variables were determined to be significant predictors of OS in EC patients: Body mass index (BMI), Karnofsky performance status, TNM stage, surgery, radiotherapy, chemotherapy, immunotherapy, platelet-to-lymphocyte ratio, and albumin-to-globulin ratio (ALB/GLB). The model demonstrated a C-index of 0.715 (95%CI: 0.701-0.729) in the training cohort and 0.711 (95%CI: 0.689-0.732) in the validation cohort. In the training cohort, AUCs for 1-year, 3-year, and 5-year OS predictions were 0.773, 0.787, and 0.750, respectively; in the validation cohort, they were 0.772, 0.768, and 0.723, respectively, illustrating the model's precision. Calibration curves and DCA verified the model's predictive accuracy and net benefit.
CONCLUSION
A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.
Retrospective analysis of pathological types and imaging features in pancreatic cancer: A comprehensive study
Authors: Luo Yang-Gang , Wu Mei , Chen Hong-Guang 
Published: December 2024

BACKGROUND
Pancreatic cancer remains one of the most lethal malignancies worldwide, with a poor prognosis often attributed to late diagnosis. Understanding the correlation between pathological type and imaging features is crucial for early detection and appropriate treatment planning.
AIM
To retrospectively analyze the relationship between different pathological types of pancreatic cancer and their corresponding imaging features.
METHODS
We retrospectively analyzed the data of 500 patients diagnosed with pancreatic cancer between January 2010 and December 2020 at our institution. Pathological types were determined by histopathological examination of the surgical specimens or biopsy samples. The imaging features were assessed using computed tomography, magnetic resonance imaging, and endoscopic ultrasound. Statistical analyses were performed to identify significant associations between pathological types and specific imaging characteristics.
RESULTS
There were 320 (64%) cases of pancreatic ductal adenocarcinoma, 75 (15%) of intraductal papillary mucinous neoplasms, 50 (10%) of neuroendocrine tumors, and 55 (11%) of other rare types. Distinct imaging features were identified in each pathological type. Pancreatic ductal adenocarcinoma typically presents as a hypodense mass with poorly defined borders on computed tomography, whereas intraductal papillary mucinous neoplasms present as characteristic cystic lesions with mural nodules. Neuroendocrine tumors often appear as hypervascular lesions in contrast-enhanced imaging. Statistical analysis revealed significant correlations between specific imaging features and pathological types (P < 0.001).
CONCLUSION
This study demonstrated a strong association between the pathological types of pancreatic cancer and imaging features. These findings can enhance the accuracy of noninvasive diagnosis and guide personalized treatment approaches.
BIBR1532 inhibits proliferation and metastasis of esophageal squamous cancer cells by inducing telomere dysregulation
Authors: Wang Qin , Li Qing-Rong , Xu Lei , Yuan Zi-Chun , Liu Xiao , Tang Mao-Ju , Luo Man , Zhong Xiao-Wu , Ma Qiang , Guo Xiao-Lan 
Published: December 2024

BACKGROUND
Esophageal squamous cell carcinoma (ESCC) is a malignant tumor with high morbidity and mortality, and easy to develop resistance to chemotherapeutic agents. Telomeres are DNA-protein complexes located at the termini of chromosomes in eukaryotic cells, which are unreplaceable in maintaining the stability and integrity of genome. Telomerase, an RNA-dependent DNA polymerase, play vital role in telomere length maintain, targeting telomerase is a promising therapeutic strategy for cancer.
AIM
To investigate the efficacy and underlying mechanisms of BIBR1532, a telomerase inhibitor, in ESCC.
METHODS
KYSE150 and KYSE410 cells were cultured and exposed to various concentrations of BIBR1532. Cell viability was assessed at 48 hours and 72 hours to determine the IC50 values. The effects of BIBR1532 on ESCC cell proliferation, migration, and cellular senescence were evaluated using the cell counting kit-8 assay, plate colony formation assay, scratch assay, transwell assay, and β-galactosidase staining, respectively. Western blotting was performed to detect the expression of proteins in BIBR1532-treated ESCC cells, such as human telomerase reverse transcriptase (hTERT), key molecules involved in DNA damage response (DDR) or cellular senescence, as well as telomere-binding proteins. Additionally, a tumor-bearing nude mouse model was established to evaluate the anti-cancer effect of BIBR1532 in vivo .
RESULTS
The IC50 values for KYSE150 and KYSE410 cells after 48 hours of BIBR1532 exposure were 48.53 μM and 39.59 μM, respectively. These values decreased to 37.22 μM and 22.71 μM, respectively, following a longer exposure of 72 hours. BIBR1532 exhibited dose-dependent effects on KYSE150 and KYSE410 cells, including decreased hTERT expression, inhibition of proliferation and metastasis, and induction of cellular senescence. Mechanistically, BIBR1532 upregulated the expression of the DDR protein, γ-H2AX, and activated the ataxia telangiectasia and Rad3-related protein (ATR)/ check point kinase 1 (CHK-1) and ataxia-telangiectasia mutated gene (ATM)/CHK2 pathways. BIBR1532 downregulated the expression of telomere-binding proteins, including telomeric-repeat binding factor 1 (TRF1), TRF2, protection of telomeres 1, and TIN2-interacting protein 1. In a nude mouse xenograft model, BIBR1532 significantly suppressed tumor growth, reduced hTERT expression, and increased γ-H2AX protein levels. Hematoxylin and eosin staining of various organs, including the heart, liver, spleen, lungs, and kidneys, revealed no apparent adverse effects.
CONCLUSION
BIBR1532 exerts anti-cancer effects on ESCC by inducing DDR through the ATR/CHK1 and ATM/CHK2 pathways and downregulating the expression of telomere-binding proteins.