bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term outcomes in early term infants (born at 37 or 38 weeks): a retrospective investigation
Authors: Kitamura Tsubasa , Tabata Kyosuke , Murano Yayoi , Yoneoka Daisuke , Nakazawa Tomoyuki , Sakamaki Ken , Shoji Hiromichi 
Published: October 2024

IntroductionRecently, researchers have introduced the concept of ‘early term’ infants, defined as infants born at 37 or 38 weeks of gestation, and their outcome has been discussed. Although the complications experienced by early term are less severe than those in preterm infants, this group accounts for a much larger proportion of newborns, making the assessment of outcomes important in clinical practice.MethodsThis observational study of term infants born at Tokyo Metropolitan Toshima Hospital aimed to understand the short-term outcomes in early term infants. Data extracted from the medical records were analyzed.ResultsAmong 4,669 eligible participants, 463 (9.9%) were born at 37 weeks and 1,270 (27.2%) were born at 38 weeks. The remaining 2,936 infants were born after 39 weeks of gestation. Logistic regression analysis showed higher odds ratio of hospitalization (1.56, 95% CI: 1.37–1.79, p &lt; 0.05), apnea (2.23, 95%CI: 1.08–4.60, p &lt; 0.05), and hypoglycemia (3.13, 95%CI: 1.95–5.03, p &lt; 0.05) in early term infants. In detail, infants born at 37 weeks of gestational age had higher odds ratio for hospitalization (2.07, 95%CI: 1.68–2.35, p &lt; 0.05) and hypoglycemia (4.11, 95%CI 2.22–7.60, p &lt; 0.05) than infants born at 38 weeks of gestational age (1.40, 95%CI: 1.20–1.62, p &lt; 0.05, and 2.78, 95%CI: 1.66–4.67, p &lt; 0.0 respectively).DiscussionThis study revealed complicated clinical course in early term infants, and represents one of the largest contributions to understanding the outcomes of early term infants, and could help to determine strategies for elective cesarean section. According to this result, elective cesarean sections would be better planned at 38 weeks of gestational age. Moreover, in clinical practice, it is important to be aware of the complicated clinical course in early term infants.
Deferasirox-induced hyperammonemia and Fanconi syndrome: a case report
Authors: Zhou Houfu , Xiong Daoxue , Feng Yan , Jiang Jianyu 
Published: October 2024

BackgroundThe exact mechanism of hyperammonemia is thought to be multifactorial, but is not yet fully understood. No studies have yet reported hyperammonemia combined with Fanconi syndrome caused by deferasirox.Case presentationA 10-year-old girl was admitted for vomiting and altered consciousness. Blood testing revealed hyperammonemia and normal liver and coagulation functions. During hospitalization, the patient also exhibited hyperchloremic metabolic acidosis, hypokalemia, hyponatremia, and hypophosphatemia. Additionally, urinalysis revealed glucose and protein levels clinically consistent with Fanconi syndrome. The patient had a history of severe beta-thalassemia and had received intermittent blood transfusions for approximately ten years. The patient had been administered oral deferasirox at a 400 mg/day dose at the age of four, which had been gradually increased to the current 750 mg/day dosage. Upon admission, deferasirox was discontinued and treatment including mechanical ventilation, continuous blood purification therapy for ammonia reduction and acidosis, and electrolyte imbalance corrections was administered. Subsequently, serological markers returned to normal, urine test findings improved. To the best of our knowledge, this is the first report of a case of hyperammonemia with Fanconi syndrome owing to deferasirox.ConclusionsFor effective management and long-term follow-up of chronic diseases in children, pediatricians must master standardized treatments and the adverse reactions of various drugs. When symptoms are difficult to explain clinically, we must trace the source and adjust the treatment plan to maximize improving the patient's prognosis.
Design and validation of a questionnaire to measure the attitudes of health professionals towards immigrants (AHPI)
Authors: Niewiadomska Iwona , Jurek Krzysztof , Dobrowolska Beata , Deluga Alina , Mamcarz Izabela 
Published: October 2024

ObjectiveThe aim of the article is to describe the validation process of a research tool used to measure the intensity and direction of medical personnel’s attitudes towards immigrant patients.DesignAn instrument validation design with a cross-sectional survey was conducted. The validation process was carried out in two phases. In phase 1, the content validity of the tool was analyzed. The competent judges method was used. The reliability of the judges was verified in terms of the consistency of evaluations (the I-CVI index was calculated). In phase 2, the questionnaire was tested among 340 healthcare professionals who have professional contact with immigrants, in terms of its factorial validity (exploratory and confirmatory factor analysis), internal consistency (reliability measured by Cronbach’s alpha coefficient) and absolute stability (measured by the test-retest method).ResultsThe research results indicate satisfactory content validity of the tool (I-CVI&gt;0.8). The reliability of the tool measured by Cronbach’s alpha coefficient was high (0.86). The reliability study based on the test - retest method (after 3 weeks) showed high consistency of measurements (0.75). Exploratory factor analysis allowed extracting 1 factor, which explains 55.7% of the variance. The validity of the one-factor solution was confirmed by confirmatory factor analysis. Satisfactory goodness of fit indices were obtained (RMSEA = 0.038; PCLOSE = 0.624; AGFI = 0.966; GFI = 0.990; CFI = 0.996).ConclusionThe presented tool has satisfactory psychometric properties. The AHPI is a tool that can be used for quick assessment of the intensity and direction of attitudes of medical students and healthcare professionals towards immigrant patients, which can help shape educational and training processes.
A systematic review and meta-analysis of the efficacy and safety of iguratimod in the treatment of inflammatory arthritis and degenerative arthritis
Authors: Long Zhiyong , Zeng Liuting , Yang Kailin , Chen Junpeng , Luo Yanfang , Dai Charles C. , He Qi , Deng Ying , Ge Anqi , Zhu Xiaofei , Hao Wensa , Sun Lingyun 
Published: October 2024

ObjectiveTo assess the efficacy and safety of iguratimod (IGU) in the treatment of inflammatory arthritis and degenerative arthritis.MethodsInitially, randomized controlled trials (RCTs) on using IGU in treating inflammatory arthritis and degenerative arthritis were systematically gathered from various databases up to February 2024. Subsequently, two researchers independently screened the literature, extracted data, assessed the risk of bias in included studies, and conducted a meta-analysis using RevMan 5.4 software.ResultsFifty-four RCTs involving three inflammatory arthritis were included, including ankylosing spondylitis (AS), osteoarthritis (OA), and rheumatoid arthritis (RA). For AS, the meta-analysis results showed that IGU may decrease BASDAI (SMD −1.68 [−2.32, −1.03], P &lt; 0.00001) and BASFI (WMD −1.29 [−1.47, −1.11], P &lt; 0.00001); IGU may also decrease inflammatory factor [ESR: (WMD −10.33 [−14.96, −5.70], P &lt; 0.0001); CRP: (WMD −10.11 [−14.55, −5.66], P &lt; 0.00001); TNF-α: (WMD −6.22 [−7.97, −4.47], P &lt; 0.00001)]. For OA, the meta-analysis results showed that IGU may decrease VAS (WMD −2.20 [−2.38, −2.01], P &lt; 0.00001) and WOMAC (WMD −7.27 [−12.31, −2.24], P = 0.005); IGU may also decrease IL-6 (WMD −8.72 [−10.00, −7.45], P &lt; 0.00001). For RA, the meta-analysis results showed that IGU may improve RA remission rate [ACR20: (RR 1.18 [1.02, 1.35], P = 0.02); ACR50: (RR 1.32 [1.05, 1.64], P = 0.02); ACR70: (RR 1.44 [1.02, 2.04], P = 0.04)] and decrease DAS28 (WMD −0.92 [−1.20, −0.63], P &lt; 0.00001); IGU may also decrease inflammatory factors [CRP: (SMD −1.36 [−1.75, −0.96], P &lt; 0.00001); ESR: (WMD −9.09 [−11.80, −6.38], P &lt; 0.00001); RF: (SMD −1.21 [−1.69, −0.73], P &lt; 0.00001)]. Regarding safety, adding IGU will not increase the incidence of adverse events.ConclusionIGU might emerge as a promising and secure therapeutic modality for addressing AS, OA, and RA.Systematic Review RegistrationIdentifier PROSPERO: CRD42021289249
Inulin alleviates atherosclerosis through improving lipid metabolism, inflammation, and gut microbiota in ApoE-knockout mice: the short-chain is more efficacious
Authors: Zhang Kun , Zeng Yu , Li Jiawei , Huang Yingchun , Zhang Nan , Gong Yue , Xiao Kaihu , Chen Jian , Chen Tiantian , Qiu Haomin , Lei Sisi , Yan Fei , Lang Chunhui , Duan Xudong , Dong Xianwen 
Published: October 2024

IntroductionAtherosclerosis (AS) is considered the underlying cause of many diseases, particularly cardiovascular and cerebrovascular diseases. Inulin, a type of fructan, has shown potential in improving atherosclerosis, although there are conflicting findings. It is hypothesized that the polymerization degree of inulin may largely influence its therapeutic effectiveness. Therefore, this study aimed to investigate the effects and mechanisms of short-chain and long-chain inulin in AS.MethodsApoE−/− mice fed a high fat diet (HFD) were used to establish an atherosclerosis model. These mice received daily oral administration of either short-chain or long-chain inulin for 12 weeks. Plasma lipid metabolism-related indices were measured using biochemical analysis, and plasma immunological indices were analyzed via ELISA. The aorta, aortic root regions, liver tissue, adipose tissue, and colon tissue were examined through various staining techniques, including ORO staining, hematoxylin and eosin staining, Alcian blue staining, and immunofluorescent or immunohistochemical assays. Microbiome analysis was conducted in the cecal content.ResultsThe results indicated that both short-chain and long-chain inulin substantially reduced the formation of atherosclerotic plaques. Inulin also improved plasma lipid concentrations and hepatic lipid metabolism, and partially alleviated both localized (atherosclerotic lesions) and systemic inflammation. Short-chain inulin was more effective than long-chain inulin in reducing atherosclerotic plaques formation, enhancing lipid metabolism and reducing inflammation. Additionally, both types of inulin showed similar effectiveness in enhancing intestinal epithelial barrier integrity, gut microbiota composition and functionality.ConclusionThese findings suggest that inulin has a protective role against atherosclerosis by enhancing lipid metabolism, reducing inflammation, and improving intestinal barrier and gut microbiota. As a dietary intervention, short-chain inulin is more effective than long-chain inulin, offering clinical implications for using inulin as a therapeutic agent for atherosclerosis.
CircFOXO3 upregulation mediates the radioresistance of glioblastoma by affecting cellular metabolome
Authors: Xu Hao , Xing Jin , Cheng Lilin , Wang Zhihan , Zhao Liang , Ren Li , Zhang Shuai 
Published: October 2024

IntroductionRadioresistance remains a significant challenge in the treatment of glioblastoma multiforme (GBM), the most prevalent and lethal brain cancer in adults. Metabolic alterations are known to contribute to radioresistance by activating antioxidant responses and promoting DNA repair. However, the role of circular RNAs in this process, particularly circFOXO3, is not well understood.MethodsIn this study, we investigated the expression of circFOXO3 in glioma cells exposed to radiation and in recurrent GBM tissues. We performed knockdown and overexpression experiments in vitro and in vivo to assess the effects of circFOXO3 on radiosensitivity. Metabolomic profiling was conducted to explore the metabolic changes associated with circFOXO3 overexpression following irradiation.ResultsOur results showed significant upregulation of circFOXO3 in glioma cells upon radiation exposure and in recurrent GBM tissues. Knockdown of circFOXO3 increased radiosensitivity both in vitro and in vivo, whereas overexpression of circFOXO3 attenuated radiosensitivity. Metabolomic analysis revealed substantial alterations in lipid and organic compound profiles between circFOXO3-overexpressing and control groups. Additionally, circFOXO3 suppression increased proapoptotic protein levels (Caspase 7 and Bax) and decreased anti-apoptotic protein Bcl-2 levels following radiotherapy.DiscussionThese findings demonstrate the pivotal role of circFOXO3 in promoting tumor radioresistance through metabolic modulation, suggesting that circFOXO3 could serve as a potential diagnostic and therapeutic target for GBM.
Higher atherogenic index of plasma is associated with increased major depressive disorder: insights from a nationally representative study
Authors: Tao Shiyi , Yu Lintong , Li Jun , Huang Xuanchun , Xue Tiantian , Yang Deshuang , Tan Yuqing 
Published: October 2024

BackgroundEmerging studies reveal a shared pathophysiological underpinning for metabolic problems and mental illnesses. The present study aimed to determine the association between atherogenic index of plasma (AIP) and the incidence of major depressive disorder (MDD).Methods7,951 subjects of US adults were collected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018. MDD was evaluated through the Patient Health Questionnaire (PHQ-9). Multivariate logistic regression, sensitivity analysis, and spline smoothing plot method were used to identify the relationship between AIP and MDD. The cut-off point was calculated using recursive partitioning analysis when segmenting effects emerged. The area under the receiver operating characteristic (ROC) curve (AUC) and Hosmer-Lemeshow test were conducted to evaluate the performance of AIP in identifying MDD. Subgroup analyses and interaction tests were used to explore whether the association was stable in different populations.ResultsA positive correlation between AIP and PHQ-9 score and MDD was both observed in 7,951 subjects included in the study, with a significant threshold of -0.42 determined using recursive partitioning analysis. In the fully adjusted model, a positive association between AIP and PHQ-9 score and MDD was observed (β=0.46, 95% CI 0.14~0.78; OR=1.42, 95% CI 1.04~1.93). Individuals in the highest AIP quartile had a 0.39-unit higher PHQ-9 score (β=0.39, 95% CI 0.12~0.66) and a significantly 33% greater risk of MDD than those in the lowest AIP quartile (OR=1.33, 95% CI 1.02~1.73). Spline smoothing plot analysis further confirmed the positive and non-linear association between AIP and PHQ-9 and MDD. ROC analysis (AUC=0.771) and the Hosmer-Lemeshow test (χ2 = 14.239, P=0.076) suggested an excellent performance and goodness-of-fit of the relatively optimal model. DCA and CIC analysis also revealed a favorable overall net benefit and clinical impact of the model. Subgroup analyses and interaction tests revealed that the association between AIP and PHQ-9 score and MDD remained consistent across different subgroups and was not modified by other covariates, and this positive correlation was more pronounced in those with diabetes or hypertension.ConclusionAn elevated AIP is linked to a higher chance of MDD, especially in those with diabetes or hypertension. Resolving dyslipidemia and managing comorbidities may help reduce the likelihood of developing MDD.
The association between borderline personality disorder, childhood trauma, neuroticism, and self-rated or clinician-rated functional impairment in euthymic bipolar disorder-1 patients
Authors: Aydın Esat Fahri , Koca Laçin Tuğba 
Published: October 2024

IntroductionIn this study, we mainly evaluated the associations of borderline personality disorder (BPD), neuroticism, and childhood trauma with the self-rated and clinician-rated overall functional impairment levels of adult euthymic patients with bipolar disorder-1 (BD-1). In addition, we compared patient and healthy control groups regarding the levels of of childhood trauma, neuroticism, BPD and functional impairment.MethodsIn total, 90 euthymic BD-1 patients and 90 healthy controls were enrolled. The Childhood Trauma Questionnaire–Short Form, the neuroticism subscale of the Eysenck Personality Questionnaire Revised–Abbreviated Form, the Borderline Personality Questionnaire, the Functioning Assessment Short Test, and the Sheehan Disability Scale were administered to the participants.ResultsThe study revealed that the levels of BPD, neuroticism, emotional abuse, physical abuse, global childhood trauma, self-rated overall functional impairment, all the subdomains of self-rated functional impairment, clinician-rated overall functional impairment, and all the subdomains of clinician-rated functional impairment (except leisure time) were significantly higher in the patients than those in the healthy controls (p &lt; 0.05). Clinician-rated functional impairment levels were significantly correlated with levels of BPD (r = 0.555, p&lt;0.001), neuroticism (r = 0.429, p &lt; 0.001), global childhood trauma (r = 0.391, p &lt;0.001), and all subtypes of childhood trauma except sexual abuse. Self-rated functional impairment levels were significantly correlated with levels of neuroticism (r= 0.289, p = 0.006), physical neglect (r = 0.213, p = 0.044), and BPD (r = 0.557, p &lt; 0.001). In the regression analyses, the self-rated overall functional impairment levels were only significantly associated with the BPD feature levels (β = 0.319, p &lt; 0.001) and the clinician-rated overall functional impairment levels were only significantly associated with the BPD feature levels (β = 0.518, p &lt; 0.001).ConclusionThe present study’s findings suggest that BPD features should be addressed in psychosocial interventions aimed at ameliorating functional impairment in patients with BD-1. Only BPD features were associated with self-rated and clinician-rated overall functional impairment levels in the regression analyses in the BD-1 patients. Performing self-rated and clinician-rated functional impairment assessments in the same clinical trial may give rise to relevant findings in the future.
HIV/AIDS-related knowledge and attitudes toward people living with HIV among college students in Xuzhou, Jiangsu Province, China: a cross-sectional survey
Authors: Li Hualing , Wu Qi , Gao Enze , Zhang Ying , Yin Dehui 
Published: October 2024

BackgroundIn the contemporary landscape, college students have emerged as a demographic increasingly vulnerable to AIDS. Recognizing that heightened awareness and progressive attitudes toward HIV are pivotal in its prevention, this study was conceived with the intent to meticulously evaluate the level of HIV understanding amongst college students, gauge their sentiments toward people living with HIV (PLHIV), and scrutinize factors influencing these perceptions.MethodThis study used an anonymous online questionnaire to collect data through a cross-sectional survey. The sample size for the survey was 4,193 students from four colleges and universities in Xuzhou City, Jiangsu Province, China, covering a variety of demographic characteristics. The survey focused on students’ level of knowledge related to HIV and their attitudes toward PLHIV. The study used descriptive statistics to describe the demographic characteristics of the sample, chi-square tests to examine differences within categorical variables, and logistic regression to investigate the associations between knowledge levels and attitudes.ResultsA total of 4,193 university students were surveyed, among whom the majority (96.85%) demonstrated a high level of knowledge related to AIDS. Moreover, 55.52% of the participants reported positive attitudes toward individuals with AIDS. The multiple regression analysis revealed that female students (OR = 0.49, p &lt; 0.001), those enrolled in medical programs (OR = 1.56, p = 0.014), students of Han Chinese ethnicity (OR = 2.46, p = 0.009), and individuals with fewer romantic involvements (OR = 1.57, p &lt; 0.001) possess greater HIV/AIDS awareness. Moreover, lower grade levels (OR = 1.12, p &lt; 0.001), reduced monthly living costs (OR = 1.14, p = 0.014), lack of sexual experience (OR = 0.75, p = 0.015), and a higher degree of HIV/AIDS knowledge (OR = 1.617, p = 0.007) were positively correlated with supportive attitudes toward PLHIV.ConclusionOverall, the awareness rate of college students in Xuzhou City about HIV/AIDS infection awareness is high. However, only about half of the university students have positive attitudes toward PLHIV. In order to ensure that a thorough understanding of HIV/AIDS is matched by positive attitudes, it is important to implement targeted educational measures aimed at bridging the gap between knowledge and attitudes toward HIV/AIDS in order to develop a more informed and empathetic student body.
Association of per- and polyfluoroalkylated substances/heavy metals and bone health in children and adolescents
Authors: Wei Yumeng , Zhang Yuxiao , Ji Qiaoyun , Yang Sufei , Yang Fan 
Published: October 2024

BackgroundResearch on the correlation between exposure to per- and polyfluoroalkylated substances (PFASs)/heavy metals and bone health during childhood and adolescence is limited. Considering their role as endocrine disruptors, we examined relationships of six PFASs and three heavy metals with bone mineral density (BMD) in children and adolescents using representative samples from the National Health and Nutrition Examination Survey (NHANES).MethodsThe study included 622 participants aged 12–19. The relationship between single pollutant and lumbar spine and total BMD was studied using linear regression analyses. Additionally, Bayesian Kernel Machine Regression (BKMR) models were applied to assess the joint effects of multiple PFASs and heavy metals exposure on the lumbar spine and total BMD.ResultsStatistically significant differences were noted in the serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid (PFHxS), blood lead (Pb), and blood manganese (Mn) between male and female participants (all p &lt; 0.05). Single-exposure studies have shown that Mn was negatively correlated with lumbar spine BMD and total BMD. Multivariate linear regression models revealed that, in the male group, total bone density decreased as the blood PFOA levels [95% CI = (−0.031, −0.001), p = 0.040] and blood manganese levels [95% CI = (−0.009, −0.002), p = 0.004] increased. Similarly, lumbar spine bone density decreased as the blood manganese levels [95% CI = (−0.011, −0.002), p = 0.009] increased. In the female group, total bone density decreased as the serum PFNA levels [95% CI = (−0.039, 0.000), p = 0.048] increased. As shown in the BKMR model, the joint effects of pollutant mixtures, including Mn, were negatively associated with both the lumbar spine and total BMD. Among the pollutants analyzed, Mn appeared to be the primary contributor to this negative association.ConclusionThis study suggests that exposure to certain PFASs and heavy metals may be associated with poor bone health. Childhood and adolescence are crucial stages for bone development, and improper exposure to PFASs and heavy metals during these stages could potentially jeopardize future bone health, consequently raising the risk of osteoporosis in adulthood.