bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term effectiveness and side effects of ketogenic diet for drug-resistant epilepsy in children with genetic epilepsy syndromes
Authors: Muthaffar Osama Y. , Alyazidi Anas S. , Alsowat Daad , Alasiri Abdulaziz A. , Albaradie Raidah , Jad Lamyaa A. , Kayyali Husam , Jan Mohammed M. S. , Bamaga Ahmed K. , Alsubaie Mohammed A. , Daghistani Rawan , Baeesa Saleh S. , Alaifan Meshari A. , Makraz Abdelhakim , Alsharief Abrar N. , Naseer Muhammad Imran 
Published: September 2024

BackgroundDrug-resistant epilepsy (DRE) impacts a significant portion, one-third, of individuals diagnosed with epilepsy. In such cases, exploring non-pharmacological interventions are crucial, with the ketogenic diet (KD) standing out as a valuable option. KD, a high-fat and low-carb dietary approach with roots dating back to the 1920s for managing DRE, triggers the formation of ketone bodies and modifies biochemistry to aid in seizure control. Recent studies have increasingly supported the efficacy of KD in addressing DRE, showcasing positive outcomes. Furthermore, while more research is needed, limited data suggests that KD May also be beneficial for specific genetic epilepsy syndromes (GESs).ObjectiveThis study aimed to assess the short-term efficacy of KD among pediatric patients diagnosed with GESs.Materials and methodsThis is a multi-center retrospective analysis of pediatric patients with GESs diagnosed using next-generation sequencing. The enrolled patients followed the keto-clinic protocol, and the KD efficacy was evaluated at 3, 6, and 12-month intervals based on seizure control and compliance. The collection instrument included demographic, baseline, and prognostic data. The collected data was coded and analyzed promptly.ResultsWe enrolled a cohort of 77 patients with a mean current age of 7.94 ± 3.83 years. The mean age of seizure onset was 15.5 months. Notably, patients experienced seizures at a younger age tended to have less positive response to diet. Overall, 55 patients responded favorably to the diet (71.4%) while 22 patients (28.6%) showed no improvement. Patients with genetic etiology showed a significantly more favorable responses to the dietary intervention. Patients with Lennox–Gastaut syndrome showed the most significant improvement (14/15) followed by patients with Dravet syndrome (6/8), and West syndrome (3/4). The number of used anti-seizure medications also played a significant role in determining their response to the diet. While some patients experienced mild adverse events, the most common being constipation, these occurrences were not serious enough to necessitate discontinuation of the diet.ConclusionThe study revealed a high improvement rate in seizure control, especially among younger patients and those with later seizure onset. The success of dietary treatment hinges greatly on early intervention and the patient’s age. Certain genetic mutations responded favorably to the KD, while efficacy varied among various genetic profiles.
Cooperation objective evaluation in aviation: validation and comparison of two novel approaches in simulated environment
Authors: Capotorto Rossella , Ronca Vincenzo , Sciaraffa Nicolina , Borghini Gianluca , Di Flumeri Gianluca , Mezzadri Lorenzo , Vozzi Alessia , Giorgi Andrea , Germano Daniele , Babiloni Fabio , Aricò Pietro 
Published: September 2024

IntroductionIn operational environments, human interaction and cooperation between individuals are critical to efficiency and safety. These states are influenced by individuals' cognitive and emotional states. Human factor research aims to objectively quantify these states to prevent human error and maintain constant performances, particularly in high-risk settings such as aviation, where human error and performance account for a significant portion of accidents.MethodsThus, this study aimed to evaluate and validate two novel methods for assessing the degree of cooperation among professional pilots engaged in real-flight simulation tasks. In addition, the study aimed to assess the ability of the proposed metrics to differentiate between the expertise levels of operating crews based on their levels of cooperation. Eight crews were involved in the experiments, consisting of four crews of Unexperienced pilots and four crews of Experienced pilots. An expert trainer, simulating air traffic management communication on one side and acting as a subject matter expert on the other, provided external evaluations of the pilots' mental states during the simulation. The two novel approaches introduced in this study were formulated based on circular correlation and mutual information techniques.Results and discussionThe findings demonstrated the possibility of quantifying cooperation levels among pilots during realistic flight simulations. In addition, cooperation time is found to be significantly higher (p &lt; 0.05) among Experienced pilots compared to Unexperienced ones. Furthermore, these preliminary results exhibited significant correlations (p &lt; 0.05) with subjective and behavioral measures collected every 30 s during the task, confirming their reliability.
Association of healthy eating index-2015 and overactive bladder: a cross-sectional study
Authors: Hao Xuanyu , Liu Gang , Li Dongyang 
Published: September 2024

ObjectiveThe aim of this cross-sectional study was to investigate the association of HEI-2015 and overactive bladder (OAB) in a large population.MethodsData were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2005–2020 datasets. Univariate and multivariate logistic regression were performed to evaluate the association between HEI-2015 and OAB. The restricted cubic spline (RCS) model was conducted to investigate the dose–response relationship.ResultsTotally, this study included 29,206 participants with 6,184 OAB patients among them. The higher continuous HEI-2015 value was independently associated with lower OAB incidence (OR: 0.87; 95%CI: 0.78, 0.98). Similarly, the highest quartile categorical HEI-2015 was significantly associated with a lower OAB odds (OR: 0.72; 95%CI: 0.52, 0.99) when compared with the lowest quartile. The RCS curve also showed a favorable non-linear dose–response relationship between HEI-2015 and OAB.ConclusionA higher HEI-2015 had a favorable association with OAB and there was a non-linear dose–response relationship between them. We suggest adherence to the United States diet recommendation as a potential behavioral prevention of OAB. Large-scale long term prospective cohort studies across various regions are needed to verify the findings of this paper.
Plastics in human diets: development and evaluation of the 24-h Dietary Recall — Plastic Exposure and the Dietary Plastics Score
Authors: Harray Amelia , Herrmann Susan , Papendorf Hannah , Miller Claire , Vermeersch Andrea , Smith Tony , Lucas Michaela 
Published: September 2024

BackgroundHumans are commonly exposed to plastic through their dietary intake and food consumption patterns. Plastic-associated chemicals (PAC), such as bisphenols and phthalates, are recognized as endocrine-disrupting and are associated with increased risk of cardiovascular disease and metabolic syndrome. However, accurate methods to assess dietary exposure to plastic products and PAC are inadequate, limiting interrogation of health impacts.AimTo develop a tool that captures complete dietary exposure to plastics and establish a diet quality score to measure adherence to a low plastic dietary pattern.MethodsWe developed the 24-h Dietary Recall – Plastic Exposure (24DR-PE) and administered it to healthy adults (n = 422). This computer-assisted, interviewer-administered tool systematically collects data on food volumes and types, packaging materials, storage, processing, cooking, and consumption methods to assess a food’s exposure to plastic. Specifically, the 24DR-PE incorporates predefined criteria for identifying high-risk practices and food characteristics, such as individually packaged items or those microwaved in plastic, enabling the assignment of scores based on a theoretically derived Dietary Plastics Scoring Matrix.ConclusionThe 24DR-PE is the first tool specifically designed to capture detailed data on dietary exposures to plastic products. The next step is to validate the score using laboratory results of urine samples we collected contemporaneous to the dietary information. Once validated, the tool has potential for widespread distribution making it valuable for population monitoring, intervention guidance, and future research investigating the interplay between plastics, diet, and human health.
The role of duel hydrolysis of soybean on functional properties and protein digestibility: a sustainable approach
Authors: Jogi Nishithkumar , Adusumilli Somya , Nagesh Madhukar , Yannam Sudheer Kumar , Mamatha Bangera Sheshappa 
Published: September 2024

BackgroundProtein hydrolysates derived from food sources contains enormous number of peptides which are composed of amino acid possessess various bioactive properties. However, the use of protein hydrolysates as a nutraceutical is hindered due to their unpleasant flavour. The study aims to enhance the biological activity and palatability of protein hydrolysates.MethodologyIn the present study, soybean protein hydrolysate (SPH) was prepared using alcalase for 4 h (control). Modification of hydrolysis (MPH) was carried out by reiterating the hydrolysis of the supernatant obtained after 2 h of hydrolysis using an enzyme to 50% of alcalase during each successive hydrolysis. Samples were characterised by their physio-chemical and functional properties. Furthermore, the effect of modification on the protein digestibility and bitterness intensity using e-tongue was studied. The suppressive effect on retrogradation of corn starch was analysed using texture profile analysis.ResultsThe results demonstrated increased protein content by 1.6 and 1.9% in MPH compared to SPH and UNH, respectively. MPH showed 1.5- and 1.6-fold higher DH% than SPH before and after gastrointestinal digestion (p &lt; 0.05). A decrease in molecular weight was found in the order of UNH &gt; SPH &gt; MPH. Nevertheless, MPH displayed significantly higher functional properties (p ≤ 0.05). The hardness of retrograded corn starch was significantly reduced in the MPH (1.21N) than SPH (1.55 N) and UNH (1.81N) compared to control (1.71N) during 7-day storage at 4°C (p ≤ 0.05). E-tongue analysis of MPH showed a 4-fold reduction in bitterness than SPH.ConclusionModification of hydrolysis of soybean has demonstrated its significance in improved DH% functional properties and palatability. In addition, improved protein digestibility with promising benefits in deferral action on retrogradation of starch over the traditional process of hydrolysis was observed. The outcome of this study contributes to the potential utilisation of MPH as an ingredient in the formulation of nutraceutical products.
The effect of cumulative exposure with unhealthy lifestyles on the H-type hypertension among Chinese adults: a community-based, propensity-score-matched, and case–control study
Authors: Li Ling , Wang Jia , Li Jing , Li Minqi , Long Tianyao , Zhengliu Yangyi , Lv Yuan , Hong Xiuqin 
Published: September 2024

ObjectiveTo assess whether cumulative exposure of unhealthy lifestyles is associated with HTH in Chinese adults and to explore the combination of unhealthy lifestyles.MethodsThis study combined a community-based cross-sectional study with a 1:1 matched case–control study using propensity scores among adults in six randomly selected districts from Hunan Province, China. We recruited 5,258 people, of whom 4,012 met the criteria. Lifestyles and personal characteristics were collected by a questionnaire. Lifestyle score was calculated using cigarette smoking, heavy alcohol consumption, inactive exercise, unhealthy diet and abnormal BMI. HTH was defined as having a diagnosis of essential hypertension with Hcy ≥ 15 umol/L. Logistic regression models and multivariate analyses were used to explore the associations. We calculated odds ratios (ORs) and attributable risk proportion (ARP) for the association of HTH with lifestyle score. The dose–response relationship was evaluated using restricted cubic splines method.ResultsOf the 4,012 adults, 793 had HTH, with a population prevalence of 19.8%. In the propensity-score-matched case–control study, 1,228 (614 cases and 614 controls) were included, and those with at least four unhealthy lifestyle factors had a higher risk of HTH than those with 0 unhealthy lifestyle factor (adjusted OR = 2.60, 95%CI:1.42–4.78), with an ARP of the cumulative exposure of unhealthy lifestyle was 28.23% (95% CI: 6.34–37.86%). For three unhealthy lifestyles group, the combination of heavy alcohol consumption, unhealthy diet and BMI ≥24 Kg/m2 was most associated with HTH (OR = 7.49, 95%CI: 1.12–50.08). For four unhealthy lifestyles group, the combination of smoking, heavy alcohol consumption, unhealthy diet and BMI ≥24 Kg/m2 had the greatest correlation with HTH (OR = 3.75, 95%CI: 1.24–7.38). Notably, there was a monotonically increasing curve (J-shaped) relationship between unhealthy lifestyles and the risk of HTH (p = 0.014).ConclusionOur findings suggest that there was a significant cumulative exposure effect of unhealthy lifestyles on the risk of HTH, with the largest effect combination being heavy alcohol consumption, unhealthy diet and BMI ≥24 Kg/m2. Targeted interventions that reducing heavy alcohol consumption, quitting smoking, promoting physical activity and a healthy diet, and keep a normal BMI could substantially reduce the burden of HTH.
Development and validation of a digital biopsy model to predict microvascular invasion in hepatocellular carcinoma
Authors: Birgin Emrullah , Nebelung Heiner , Abdelhadi Schaima , Rink Johann S. , Froelich Matthias F. , Hetjens Svetlana , Rahbari Mohammad , Téoule Patrick , Rasbach Erik , Reissfelder Christoph , Weitz Jürgen , Schoenberg Stefan O. , Riediger Carina , Plodeck Verena , Rahbari Nuh N. 
Published: September 2024

BackgroundMicrovascular invasion is a major histopathological risk factor of postoperative recurrence in patients with hepatocellular carcinoma. This study aimed to develop and validate a digital biopsy model using imaging features to predict microvascular invasion before hepatectomy.MethodsA total of 217 consecutive patients who underwent hepatectomy for resectable hepatocellular carcinoma were enrolled at two tertiary-care reference centers. An imaging-based digital biopsy model was developed and internally validated using logistic regression analysis with adjustments for age, sex, etiology of disease, size and number of lesions.ResultsThree imaging features, i.e., non-smoothness of lesion margin (OR = 16.40), ill-defined pseudocapsula (OR = 4.93), and persistence of intratumoral internal artery (OR = 10.50), were independently associated with microvascular invasion and incorporated into a prediction model. A scoring system with 0 - 3 points was established for the prediction model. Internal validation confirmed an excellent calibration of the model. A cutoff of 2 points indicates a high risk of microvascular invasion (area under the curve 0.87). The overall survival and recurrence-free survival stratified by the risk model was significantly shorter in patients with high risk features of microvascular invasion compared to those patients with low risk of microvascular invasion (overall survival: median 35 vs. 75 months, P = 0.027; recurrence-free survival: median 17 vs. 38 months, P &lt; 0.001)).ConclusionA preoperative assessment of microvascular invasion by digital biopsy is reliable, easily applicable, and might facilitate personalized treatment strategies.
Association of hemoglobin, albumin, lymphocyte, and platelet score with risk of all-cause and cause-specific mortality among cancer survivors: NHANES 1999-2018
Authors: Fu Jixin , Yue Xiaohan , Zou Yanan , Zhang Jian , Wang Xinjian , Zhang Dianliang 
Published: September 2024

BackgroundThe HALP score, comprising hemoglobin, albumin, lymphocyte, and platelet levels, serves as an indicator of both nutritional and inflammatory status. However, its correlation with all-cause and cause-specific mortality among cancer survivors remains unclear. Therefore, this study aims to investigate the relationship between HALP scores and mortality outcomes in this population.MethodWe extracted cohort data spanning ten cycles (1999-2018) from the U.S. National Health and Nutrition Examination Survey (NHANES). Mortality rates, determined using the National Death Index (NDI) as of December 31, 2019, were assessed. Weighted multivariate logistic regression analyzed the association between HALP scores and cancer prevalence. Kaplan-Meier analyses and weighted multivariate-adjusted Cox analyses investigated the link between HALP scores and all-cause and cause-specific mortality in cancer survivors. Restricted cubic spline (RCS) analysis was employed to assess nonlinear relationships. Furthermore, multi-parametric subgroup analyses were conducted to ensure the robustness of the results.ResultsOur study included 41,231 participants, of whom 3,786 were cancer survivors (prevalence: 9.5%). Over a median follow-up of 91 months (range: 51-136), we observed 1,339 deaths, including 397 from cancer, 368 from cardio-cerebrovascular disease, and 105 from respiratory disease. Elevated HALP scores showed a consistent association with reduced cancer incidence (P for trend &lt;0.001). In multivariable-adjusted Cox regression analyses, HALP scores were significantly inversely associated with all-cause mortality, cancer mortality, cardio-cerebrovascular disease mortality, and respiratory disease mortality in cancer survivors (P for trend &lt; 0.05). Nonlinear relationships between HALP scores and all-cause and cause-specific mortality in cancer survivors were evident through RCS regression modeling (P for nonlinearity &lt; 0.01). Kaplan-Meier analyses demonstrated that higher HALP scores were indicative of a poorer prognosis.ConclusionOur findings indicate a notable inverse correlation between HALP scores and both all-cause and cause-specific mortality among cancer survivors.
Successful treatment of anastomotic leakage with an intestinal obstruction catheter and stent by colonoscopy: a case report and brief literature review
Authors: Huang Wang , Tan Zhenzong , Sun Hao 
Published: September 2024

BackgroundAnastomotic leakage (AL) is one of the most common, severe, and difficult-to-treat complications after colorectal cancer surgery. However, to date, the best treatment options for AL remain elusive.Case descriptionHere, we report the case of a 70-year-old man who had previously undergone Hartmann’s surgery and developed a large AL after a colostomy reversal surgery in an external hospital. The condition mainly manifested as passage of the fecal material through the abdominal drainage tube accompanied by fever after intestinal surgery. We used a new method involving a transanal obstruction catheter combined with an anastomotic stent, along with fasting, administration of parenteral nutrition, and anti-infection treatment. By following this approach, AL was successfully cured without any complications.ConclusionTo the best of our knowledge, this is the first case of the use of a transanal intestinal obstruction catheter combined with an anastomotic stent for treating colorectal AL; the findings may guide clinicians to better treat and manage AL.
Impact of SGLT2 inhibitors on lower limb complications: a mendelian randomization perspective
Authors: Chen Baixing , Huang Mingling , Pu Bin , Dong Hang 
Published: September 2024

BackgroundWhile Sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective in managing diabetes and reducing cardiovascular risk, concerns about their association with lower limb complications, including, osteomyelitis, ulcers, and peripheral artery disease (PAD), persist. This study employs Mendelian Randomization (MR) to assess the causal relationship between SGLT2 inhibitors and these lower limb safety outcomes.MethodsA two-sample drug-target MR approach was used, complemented by a one-sample MR and genetic association analysis. Six SNPs were selected as instrumental variables to proxy the effect of SGLT2 inhibition. Primary outcomes were major limb safety outcomes, including osteomyelitis, lower limb ulcers, PAD, and cellulitis. The primary analytical method was the generalized inverse variance-weighted (IVW) approach, along with several sensitivity analyses.ResultsThe MR analysis indicated no significant causal association between genetically proxied SGLT2 inhibition and most of the studied lower limb safety outcomes. However, a significant association with PAD was observed, necessitating careful interpretation due to discrepancies between IVW and MR-Egger results. Sensitivity analyses supported these findings, showing little evidence of heterogeneity or directional pleiotropy.ConclusionThis study suggests that SGLT2 inhibitors may not be significantly associated with an increased risk of most lower limb safety outcomes, including osteomyelitis, lower limb ulcers, and cellulitis, in patients with type 2 diabetes. However, the complex relationship with PAD highlights the need for further research. These findings contribute to the understanding of the safety profile of SGLT2 inhibitors, supporting their continued use in diabetes management while underlining the importance of continuous safety monitoring.
Intelligent diagnostic method for developmental hip dislocation
Authors: Sun Hang , Li Hong , Zhao Yuhang , Pan Shinong 
Published: September 2024

BackgroundDevelopmental dislocation of the hip joint (DDH) is a condition that severely threatens children’s healthy growth. Without timely and correct treatment, it will lead to osteoarthritis and hip dysfunction in the evolution of children.ObjectiveIt is essential to develop an intelligent model for diagnosing hip dislocation and performing accurate quantitative analysis.MethodsIn this paper, 46 cases of computed tomography (CT) images were retrospectively collected, including 19 cases of hip dislocation and 27 cases of healthy people. The experiment first uses ITK-SNAP to sketch the ilium and femoral head in the original image. Then, it uses 3D U-Net to send the label of the background, ilium, and femoral head into three channels, respectively, to realize the three-dimensional segmentation of the ilium and femoral head. Next, the extraction of the surface of the acetabulum and femoral head is performed. Subsequently, the erroneous points are eliminated, and the spherical surfaces of the acetabulum and femoral head are fitted using the least squares method. Ultimately, the spherical center distance is calculated quantitatively to predict whether the hip joint is dislocated.ResultsUnder the independent test set, the segmentation average dice coefficients of the ilium and femoral head are 89% and 93%, respectively. The spherical center distance between the acetabulum and femoral head is calculated quantitatively. If the value exceeds 10 mm, it is considered a hip dislocation. Compared with the doctor’s diagnosis, the accuracy result is 94.4%.ConclusionThis paper successfully implements a precise and automated intelligent diagnostic system for the identification of hip dislocation. Commencing with the development of a 3D segmentation algorithm for the ilium and femoral head, we further introduce a novel method that computes the spherical distance for the prediction of hip dislocation. This approach provides robust quantitative analysis, thereby facilitating more informed clinical decision-making.