bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical presentations, electrophysiologic features, and long-term follow-up in Lambert–Eaton myasthenic syndrome: a series of six patients
Authors: Alhammad Reem M. , Alshamlan Yafa , Alneseyan Ruwa , Al-Harbi Talal M. , Alhijab Ali , Alanazy Mohammed H. 
Published: December 2024

BackgroundLambert–Eaton myasthenic syndrome (LEMS) is an autoimmune disorder of the presynaptic neuromuscular junction associated with antibody mediated dysfunction of voltage-gated calcium channels (VGCCs). LEMS can exist as a paraneoplastic syndrome, paraneoplastic-LEMS (P-LEMS), when associated with tumors, most commonly, small cell lung carcinoma (SCLC) or as a non-paraneoplastic condition (NP-LEMS) when no malignancies are detected.MethodsA retrospective chart review was conducted in 3 tertiary hospitals in Saudi Arabia for patients diagnosed with LEMS between January 2010 and January 2020. Patients meeting all the following criteria were included: (1) weakness or fatigability of one or more extremity or oculo-bulbar muscles, (2) 60% or higher increment of compound muscle action potential (CMAP) amplitudes immediately following isometric exercise, and (3) positive serum P/Q type VGCC antibodies. Clinical, laboratory, and electrophysiologic features, as well as radiologic imaging modalities performed for tumor screening were reviewed.ResultsThe study included six patients diagnosed with LEMS, split evenly between P-LEMS and NP-LEMS. Fatigability, particularly in the lower extremities, and dyspnea on exertion were commonly reported symptoms. Low CMAP amplitudes were more frequently seen in NP-LEMS as compared to P-LEMS when recorded from both abductor pollicis brevis and abductor digiti minimi muscles. An incremental response above 60% in post activation CMAPs was detected at similar rates following variable durations of isometric exercise (10, 15, and 20 s). Tumor types detected in 3 patients with P-LEMS are SCLC, breast carcinoma, colon adenocarcinoma, and prostate acinar adenocarcinoma. Triple malignancy was detected in one patient.ConclusionThis is the first study to describe clinical and electrophysiologic features of LEMS in an Arab ethnic cohort. Early recognition of LEMS has a significant impact on prognosis, especially given the aggressive nature of associated cancers such as SCLC.
High-fat diet mouse model receiving L-glucose supplementations propagates liver injury
Authors: Amer Johnny , Amleh Athar , Salhab Ahmad , Kolodny Yuval , Yochelis Shira , Saffouri Baker , Paltiel Yossi , Safadi Rifaat 
Published: December 2024

Background and aimsLimited data link manufactured sweeteners impact on metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the effects of manufactured sugars (L-glucose) compared to natural sugars (D-glucose) on phenotype, molecular and metabolic changes in mice models fed with either regular diet (RD) or high fat diet (HFD).MethodsC57BL/6 mice fed 16-weeks with either RD; 70% carbohydrate or HFD; 60% fat, with or without additional glucose (Glu, at 18% w/v) to drinking tap water at weeks 8–16; of either natural (D-Glu) or manufactured (L-Glu) sugars. Liver inflammation (ALT and AST serum levels, liver H&amp;E histologic stains and cell viability profile by p-AKT), liver fibrosis [quantitated α smooth-muscle-actin (αSMA) by western blot and RT-PCR, Masson Trichrome staining (MTC) of liver tissue], liver lipid [steatosis stain by H&amp;E, Adipose Differentiation-Related Protein (ADRP) lipid accumulation, serum and lipid peroxidation Malondialdehyde (MDA) markers by ELISA], glucose hemostasis (serum Glucose and C-peptide with HOMA-IR score calculation) and liver aspects [hepatic glucose transporter 2 (GLUT2), insulin receptor (IR) expressions and GYS2/PYGL ratio] evaluated.ResultsD- and L-Glu supplementations propagate hepatocytes ballooning and steatosis in HFD-fed mice and were associated with αSMA down-expressions by 1.5-fold compared to the untreated group while showed an acceleration in liver fibrosis in the RD-fed mice. Lipid profile (Steatosis, ADRP and MDA) significantly increased in HFD-fed mice, both Glu supplementations (mainly the L-Glu) increased serum MDA while decreased ADRP. HOMA-IR score and IR significantly increased in HFD-fed mice, with further elevation in HOMA-IR score following Glu supplementations (mainly L-Glu). The increase in HOMA-IR negatively correlated with IR and Glut2 expressions. D- and L-Glu supplementations showed significant decrease of Glycogenesis (low GYS2/PYGL ratio) and unchanged p-AKT pattern compared to their RD counterparts.ConclusionOur data indicate an increase in rate of de-novo lipogenesis (DNL) in RD-fed mice (High carbohydrate diet) and liver fibrosis following additional sugar supplementations. In contrast, HFD-fed mice (with pre-existing high lipid profile) supplemented with sugar showed less liver fibrosis, because of reduced de-novo fatty acids synthesis and subsequently, the lipid oxidation pathways become dominated and induce the net results of lipid clearance.
Prediction model construction for the occurrence of LARS after neoadjuvant therapy combined with laparoscopic total mesorectal excision in male patients with mid-low rectal cancer
Authors: Wang Deng-Chao , Peng Xue-Feng , Yu Miao 
Published: December 2024

BackgroundNeoadjuvant chemoradiotherapy for rectal cancer improves surgical outcomes and reduces recurrence but can cause low anterior resection syndrome (LARS), affecting quality of life. This study aims to predict the risk of LARS in male patients with mid-low rectal cancer after laparoscopic total mesorectal excision (TME).MethodsClinical data from 203 male patients with mid-low rectal cancer who underwent neoadjuvant therapy and laparoscopic resection were collected. Patients were divided into training (n=143) and validation (n=60) cohorts. LARS risk factors were identified using logistic regression, and a predictive model was constructed and validated using ROC curve, Hosmer-Lemeshow test, calibration curve, and decision curve analysis (DCA).ResultsLARS occurred in 53.6% of the patients in this study. Multivariate logistic regression analysis revealed that BMI ≥ 25 kg/m², tumor distance from the anal margin &lt; 5 cm, radiotherapy, and anastomotic leakage were independent risk factors for postoperative LARS in patients (P &lt; 0.05). The areas under the ROC curves for the training cohort and validation cohort were 0.866 (95% CI: 0.807-0.925) and 0.724 (95% CI: 0.595-0.853), respectively, with both groups showing good goodness-of-fit test results (P &gt; 0.05). The DCA curve indicated that the model had a high clinical utility.ConclusionsBMI ≥ 25 kg/m², tumor distance from the anal margin &lt; 5 cm, radiotherapy, and anastomotic leakage are independent risk factors for the occurrence of LARS after neoadjuvant therapy combined with laparoscopic TME in male patients with mid-low rectal cancer. These factors should be emphasized in clinical practice, and corresponding preventive measures should be promptly implemented.
Structured training on gross motor skills and physical fitness in 4–5-year-old children
Authors: Quan Sheng , Liao Yutong , Ji Yulin , Zheng Shuwen 
Published: December 2024

ObjectivePreschool children are in a period of rapid physical development, and improving their gross motor skills and physical fitness is quite important for their health. This study aimed to investigate the effectiveness of a structured physical training program in improving Chinese preschool children's gross motor development and physical fitness.MethodA sample of 80 children aged 4 to 5 from Fujian, China, were randomly assigned to the intervention group (N = 41), which received a 15-week structured physical training, while the control group (N = 39) continued with their daily physical activity. The Test of Gross Motor Development-3, and the National Physical Fitness Measurement Standards Manual -Preschool Children Version (2003) were assessed before and after the intervention.ResultsA series of ANCOVA analyses revealed significant group differences in aspects of gross motor skills (F = 10.17, p &lt; 0.01) including locomotor skills (F = 5.31, p &lt; 0.05) and ball skills (F = 15.09, p &lt; 0.001) after controlling the effect of the age, sex, and pre-test scores. Moreover, the results also indicated a higher improvement in young children's physical fitness (F = 91.33, p &lt; 0.001) including their body shape (F = 5.05, p &lt; 0.05), health-related fitness (F = 43.09, p &lt; 0.001), and skill-related fitness (F = 61.47, p &lt; 0.001) in the intervention group over the control group. The results demonstrated that the effect size of the structured training on young children's health-related fitness (η2 = 0.38) and skill-related fitness (η2 = 0.50) was much stronger than on children's body shape (η2 = 0.07).ConclusionThe structured training program effectively improved young children's gross motor skills and physical fitness.
The combination of decitabine with multi-omics confirms the regulatory pattern of the correlation between DNA methylation of the CACNA1C gene and atrial fibrillation
Authors: Yang Yuling , Li Qijun , Liu Xiaoning , Shao Caixia , Yang Heng , Niu Siquan , Peng Hong , Meng Xiangguang 
Published: December 2024

BackgroundStudies have shown that DNA methylation of the CACNA1C gene is involved in the pathogenesis of various diseases and the mechanism of drug action. However, its relationship with atrial fibrillation (AF) remains largely unexplored.ObjectiveTo investigate the association between DNA methylation of the CACNA1C gene and AF by combining decitabine (5-Aza-2′-deoxycytidine, AZA) treatment with multi-omics analysis.MethodsHepG2 cells were treated with AZA to observe the expression of the CACNA1C gene, which was further validated using gene expression microarrays. Pyrosequencing was employed to validate differentially methylated sites of the CACNA1C gene observed in DNA methylation microarrays. A custom DNA methylation dataset based on the MSigDB database was combined with ChIP-sequencing and RNA-sequencing data to explore the regulatory patterns of DNA methylation of the CACNA1C gene.ResultsTreatment of HepG2 cells with three different concentrations of AZA (2.5 µM, 5.0 µM, and 10.0 µM) resulted in 1.6, 2.5, and 2.9-fold increases in the mRNA expression of the CACNA1C gene, respectively, compared to the DMSO group, with statistical significance at the highest concentration group (p &lt; 0.05). Similarly, AZA treatment of T47D cells showed upregulated mRNA expression of the CACNA1C gene in the gene expression microarray results (adj P &lt; 0.05). DNA methylation microarray analysis revealed that methylation of a CpG site in intron 30 of the CACNA1C gene may be associated with AF (adj P &lt; 0.05). Pyrosequencing of this site and its adjacent two CpG sites demonstrated significant differences in DNA methylation levels between AF and sinus rhythm groups (p &lt; 0.05). Subsequent multivariate logistic regression models confirmed that the DNA methylation degree of these three sites and their average was associated with AF (p &lt; 0.05). Additionally, the UCSC browser combined with ChIP-sequencing revealed that the aforementioned region was enriched in enhancer markers H3K27ac and H3K4me1. Differential expression and pathway analysis of RNA-sequencing data ultimately identified ATF7IP and KAT2B genes as potential regulators of the CACNA1C gene.ConclusionThe DNA methylation levels at three CpG sites in intron 30 of the CACNA1C gene are associated with AF status, and potentially regulated by ATF7IP and KAT2B.
Investigating proactive aggression in patients with borderline personality disorder and major depressive disorder using a modified version of the Taylor aggression paradigm
Authors: Boccadoro Sara , Hüpen Philippa , Raine Adrian , Habel Ute , Wagels Lisa 
Published: December 2024

IntroductionInappropriate reactive (provoked) aggression is common in various psychiatric disorders, including Borderline Personality Disorder (BPD) and, to a lesser extent, Major Depressive Disorder (MDD). Less is known about proactive (unprovoked) aggression in these patients, with mixed findings in the literature. Drawing from the current evidence, we expect higher trait aggression in both patient groups and higher behavioral proactive aggression and physiological arousal in patients with BPD compared to both MDD and healthy participants (HC).MethodsWe investigated behavioral and psychophysiological correlates of proactive aggression in 23 patients with MDD, 20 with BPD, and 21 HC using a proactive version of the Taylor Aggression Paradigm (pTAP). The pTAP consists of reaction time games in which only the participant can interfere with the ostensible opponent’s performance by modifying the blurriness of the opponent’s screen. The levels of blurriness chosen by participants reflect their proactive aggression. We collected self-report measures of aggression and other personality traits. We further adopted a transdiagnostic approach by clustering participants based on proactive aggression characteristics.ResultsBoth patient groups reported higher trait aggression than HC but not higher aggression in the task nor differences in the associated physiological arousal. Trial-by-trial mixed model analyses revealed that the group characterized by higher proactive aggression traits behaved more aggressively after losing, suggesting a role of frustration or sensitivity to loss.DiscussionOur study confirms that patients with MDD and BPD report higher aggression than HC despite the absence of observable behavioral and psychophysiological differences and highlights the ubiquity of proactive aggression characteristics across diagnoses.
Association between breakfast consumption frequency and handgrip strength and standing long jump: a systematic review and meta-analysis
Authors: Ren Zhongyu , Zhang Xiaoping , Wei Yanqing , Liu Shuai , Cao Bing , Wang Hejin 
Published: December 2024

Background and aimsOver the past decade, numerous studies investigating the relationship between breakfast consumption frequency and handgrip strength and standing long jump have produced conflicting evidence, leading to uncertainty regarding this association. This study aimed to provide further clarity on the relationship between breakfast consumption frequency and handgrip strength and standing long jump.MethodsA comprehensive search of the literature up to September 15, 2023, was conducted on Web of Science, PubMed, Scopus, MEDLINE, and CNKI. Six studies related to grip strength and three studies related to standing long jump performance were included in the meta-analysis. For studies defining breakfast consumption frequency as an ordinal variable, the effect sizes of the lowest and highest frequency groups were analyzed.ResultsNo significant differences in handgrip strength were found between the highest and lowest breakfast consumption groups. Furthermore, unlike in men, women with the highest frequency of breakfast consumption showed significantly higher handgrip strength levels than women with the lowest frequency of breakfast consumption. No significant positive associations were found between breakfast intake frequency and standing long jump levels.ConclusionThese results suggest that while regular breakfast consumption may enhance handgrip strength in women, it does not influence standing long jump performance in both sexes.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD42024547903
Building happier bonds: gratitude as a mediator between dyadic coping and relationship satisfaction in romantic couples
Authors: Roth Michelle , Good Nicolas , Ledermann Thomas , Landolt Selina A. , Weitkamp Katharina , Bodenmann Guy 
Published: December 2024

IntroductionGratitude has been found to be relevant for relational well-being, and there has been ongoing interest in uncovering the mechanisms by which gratitude functions in interpersonal relationships. Only recently, gratitude has been studied within the context of dyadic coping—the interpersonal process of how partners communicate their stress, support each other during stressful times, and jointly cope with stress—in romantic couples. Drawing up on theoretical models on the functions of gratitude within close relationships and previous research, we aimed to advance this line of research and examined the potential mediating role of gratitude between dyadic coping and relationship satisfaction applying a dyadic perspective. For a more nuanced understanding of gratitude, we differentiated between felt and expressed dyadic coping-related gratitude.MethodsWe used data of 163 romantic mixed-gender couples living in Switzerland. To examine the mediation model dyadically, we applied the Actor Partner Interdependence Mediation Model (APIMeM).ResultsWhile in the presence of gratitude as a mediator, almost no significant direct effects from dyadic coping on relationship satisfaction were found, evidence pointed to a mediating role of gratitude within this process: Provided dyadic coping was related to higher gratitude, which was in turn related to higher own and partner relationship satisfaction. The results were similar for felt and expressed dyadic coping-related gratitude.DiscussionThe finding that gratitude plays an important mediating role within the dyadic coping process offers important future directions for research as well as preventative and clinical work with couples.
Modification of gemcitabine with oxaliplatin in China for unresectable gallbladder cancer: a cost-effectiveness analysis
Authors: Chen Zhaoyan , Tian Fangyuan 
Published: December 2024

BackgroundThe incidence of gall bladder cancer (GBC), one of the most prevalent bile duct malignancies, differs with ethnicity and geographic location. To treat unresected GBC in the Chinese setting, this study aimed to assess the financial effectiveness of a combination of modified gemcitabine and oxaliplatin.MethodsData from a randomized controlled study in which individuals with metastatic GBC were treated with oxaliplatin and gemcitabine demonstrated improved survival. A Markov model is built to calculate the incremental cost–benefit ratio (ICER) from the viewpoint of Chinese society on the basis of clinical symptoms and disease development. One-way certainty and probability sensitivity analyses are used to describe the uncertainty in the model.ResultsCompared with those of fluorouracil (FU) and folinic acid, the utility value of modified oxaliplatin combined with gemcitabine increased by 0.22QALY throughout the course of the 10-year simulation (FA). In a Chinese healthcare setting, the cost-effectiveness ratio (ICER) is $52765.59/QALY, with a 0% chance of cost–benefit at the WTP (willing-to-pay) level of $37697.00/QALY. The ICERs predicted by sensitivity analysis were not significantly affected by cost variations related to the management of Grade 3–4 AEs, the diagnostics used, or hospitalization expenditures.ConclusionIn a Chinese healthcare context, modified gemcitabine coupled with oxaliplatin (mGEMOX) is not a cost-effective treatment option for unresectable GBC.
Prevalence and influencing factors of oral frailty in older adults: a systematic review and meta-analysis
Authors: Zhou Yutong , Zhou Li , Zhang Wen , Chen Yao , She Keyi , Zhang Hongtao , Gao Yue , Yin Xinhong 
Published: December 2024

ObjectiveThis study aimed to conduct a systematic review and meta-analysis, assessing the pooled prevalence and influencing factors of oral frailty in older people to assist healthcare professionals in enhancing their understanding of this condition and formulating efficient interventions.MethodsThis systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA) guidelines. We searched PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, ProQuest, the National Knowledge Infrastructure (CNKI), WAN FANG DATA, VIP Information, SinoMed and Scopus for literature published in English or Chinese from inception to June 19, 2024. Subsequently, we evaluated the potential for bias in the cross-sectional studies that met our criteria through the Agency for Healthcare Research and Quality (AHRQ) tool. In contrast, we utilized the robust Newcastle-Ottawa scale for cohort and case–control studies. We performed statistical analyses using STATA 17 software. Prevalence was studied using a meta-analysis of a single proportion. For influencing factors, dichotomous variables were expressed as odds ratios (ORs) and 95% confidence intervals (Cls), and continuous variables were expressed as weighted mean differences (WMDs) and 95% confidence intervals (Cls).ResultsInvestigation into 17 studies encompassing 24,983 participants discovered a striking 28% overall prevalence rate for oral frailty among older individuals (95% CI 20–36%, p &lt; 0.001). Upon assessing the literature’s quality, nine articles acquired high ratings; all others received medium ratings. These findings imply a complex interplay among biological, socio-economic, lifestyle, and disease-pharmacological factors in the manifestation of oral frailty in older adults.ConclusionOral frailty is prevalent in older adults and is impacted by diverse factors. Enhanced surveillance and effective interventions for oral frailty are required in older cohorts.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024544552, identifier CRD42024544552.
The impact of university freshmen’s mental health on academic performance: an empirical study based on M University in Fujian Province, China
Authors: Deng Xue , Li Cheng 
Published: December 2024

ObjectiveTo investigate the impact of freshmen’s mental health on their short-and long-term academic performance, as well as to provide empirical evidence for improving university students’ mental health intervention tactics and higher education quality.MethodsA multiple regression model was used to analyze student data from 3 years of enrollment at M University in Fujian Province.ResultsDifferent mental health problems have a significant impact on academic performance, which varies by gender, enrollment year, and subject. Somatization, anxiety, and depression have a significant negative impact on both comprehensive and single-subject scores, while anxiety, social aggression, and other variables can increase academic performance in certain settings. Some effects are notably moderated by gender and enrollment year.ConclusionUniversity officials should strengthen mental health surveillance and intervention during the first few years of student enrollment to mitigate the harmful impact of mental health issues on academic performance. The moderate to strong effect sizes for variables like somatization, depression, and anxiety indicate that early interventions could be crucial in reducing their negative impact on both short-and long-term academic outcomes. Furthermore, the study discovered disparities in mental health and academic performance across students of different genders and enrollment years, emphasizing that educational personnel should design more tailored mental health support methods that consider these differences.