bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transfer of celiac disease-associated immunogenic gluten peptides in breast milk: variability in kinetics of secretion
Authors: Ruiz-Carnicer Ángela , Segura Verónica , Moreno María de Lourdes , Coronel-Rodríguez Cristóbal , Sousa Carolina , Comino Isabel 
Published: July 2024

BackgroundExposure to antigens is crucial for child immune system development, aiding disease prevention and promoting infant health. Some common food antigen proteins are found in human breast milk. However, it is unclear whether gluten antigens linked to celiac disease (CD) are transmitted through breast milk, potentially impacting the development of the infant’s immune system.ObjectiveThis study aimed to analyze the passage of gluten immunogenic peptides (GIP) into human breast milk. We evaluated the dynamics of GIP secretion after lactating mothers adopted a controlled gluten-rich diet.MethodsWe prospectively enrolled 96 non-CD and 23 CD lactating mothers, assessing total proteins and casein in breast milk, and GIP levels in breast milk and urine. Subsequently, a longitudinal study was conducted in a subgroup of 12 non-CD lactating mothers who adopted a controlled gluten-rich diet. GIP levels in breast milk and urine samples were assayed by multiple sample collections over 96 hours.ResultsAnalysis of a single sample revealed that 24% of non-CD lactating mothers on a regular unrestricted diet tested positive for GIP in breast milk, and 90% tested positive in urine, with significantly lower concentrations in breast milk. Nevertheless, on a controlled gluten-rich diet and the collection of multiple samples, GIP were detected in 75% and 100% of non-CD participants in breast milk and urine, respectively. The transfer dynamics in breast milk samples were long-enduring and GIP secretion persisted from 0 to 72 h. In contrast, GIP secretion in urine samples was limited to the first 24 h, with inter-individual variations. In the cohort of CD mothers, 82.6% and 87% tested negative for GIP in breast milk and urine, respectively.ConclusionsThis study definitively established the presence of GIP in breast milk, with substantial inter-individual variations in secretion dynamics. Our findings provide insights into distinct GIP kinetics observed in sequentially collected breast milk and urine samples, suggesting differential gluten metabolism patterns depending on the organ or system involved. Future research is essential to understand whether GIP functions as sensitizing or tolerogenic agents in the immune system of breastfed infants.
Enhanced feature selection and ensemble learning for cardiovascular disease prediction: hybrid GOL2-2 T and adaptive boosted decision fusion with babysitting refinement
Authors: Praveen S. Phani , Hasan Mohammad Kamrul , Abdullah Siti Norul Huda Sheikh , Sirisha Uddagiri , Tirumanadham N. S. Koti Mani Kumar , Islam Shayla , Ahmed Fatima Rayan Awad , Ahmed Thowiba E. , Noboni Ayman Afrin , Sampedro Gabriel Avelino , Yeun Chan Yeob , Ghazal Taher M. 
Published: July 2024

IntroductionGlobal Cardiovascular disease (CVD) is still one of the leading causes of death and requires the enhancement of diagnostic methods for the effective detection of early signs and prediction of the disease outcomes. The current diagnostic tools are cumbersome and imprecise especially with complex diseases, thus emphasizing the incorporation of new machine learning applications in differential diagnosis.MethodsThis paper presents a new machine learning approach that uses MICE for mitigating missing data, the IQR for handling outliers and SMOTE to address first imbalance distance. Additionally, to select optimal features, we introduce the Hybrid 2-Tier Grasshopper Optimization with L2 regularization methodology which we call GOL2-2T. One of the promising methods to improve the predictive modelling is an Adaboost decision fusion (ABDF) ensemble learning algorithm with babysitting technique implemented for the hyperparameters tuning. The accuracy, recall, and AUC score will be considered as the measures for assessing the model.ResultsOn the results, our heart disease prediction model yielded an accuracy of 83.0%, and a balanced F1 score of 84.0%. The integration of SMOTE, IQR outlier detection, MICE, and GOL2-2T feature selection enhances robustness while improving the predictive performance. ABDF removed the impurities in the model and elaborated its effectiveness, which proved to be high on predicting the heart disease.DiscussionThese findings demonstrate the effectiveness of additional machine learning methodologies in medical diagnostics, including early recognition improvements and trustworthy tools for clinicians. But yes, the model’s use and extent of work depends on the dataset used for it really. Further work is needed to replicate the model across different datasets and samples: as for most models, it will be important to see if the results are generalizable to populations that are not representative of the patient population that was used for the current study.
Increased dual-task interference during upper limb movements in stroke exceeding that found in aging – a systematic review and meta-analysis
Authors: Lindberg Påvel G. , AmirShemiraniha Nadia , Krewer Carmen , Maier Marc A. , Hermsdörfer Joachim 
Published: July 2024

ObjectiveTo determine whether dual-task interference during upper limb tasks is increased in patients after stroke compared to healthy older subjects and to compare magnitude of stroke-induced change in interference to that explained by aging.MethodsWe conducted a systematic literature search in MEDLINE, CINAHL, Google Scholar and PEDro databases up to October 2023 for studies on upper limb dual-tasks in stroke and elderly healthy subjects. Eleven upper limb dual-task studies in stroke patients and 11 studies in healthy older subjects were identified and systematically reviewed. A meta-analysis was performed on seven stroke studies and on five studies in healthy older subjects that included control groups.ResultsMost stroke studies investigated proximal arm movements with kinematic measures, but few studies evaluated manual dexterity. In contrast, studies in healthy older subjects used more distal (finger tapping) tasks. The meta-analysis showed that stroke patients had on average a 19% (CI 95% = 1.0–37.3) increase in dual-task interference compared to age-matched healthy controls (Z = 2.06, p = 0.04). Older healthy subjects showed greater dual-task interference compared to younger subjects (19% greater, CI 95% = 6.5–31.2, Z = 2.98, p = 0.003).ConclusionMeta-analysis revealed an increase in dual-task interference during upper limb movements in stroke patients, exceeding age-related changes, supporting the presence of subclinical impairments in divided attention post-stroke that may impede motor recovery.
The efficacy of acupuncture for trigeminal neuralgia: an overview of systematic reviews
Authors: He Hong-xian , Li Ya-xin , Xiao Ya-song , Fan Wen-hui , Xue Hua 
Published: July 2024

BackgroundMany systematic reviews (SRs) and meta-analysis (MAs) have reported the efficacy of acupuncture treatment for primary trigeminal neuralgia (PTN), but the quality of evidence is unknown and therefore needs to be evaluated comprehensively.MethodsEight electronic databases were searched from their inception until January 5, 2024. The methodological quality, reporting quality, and risk of bias of the included SRs were assessed by the assessment of multiple systematic reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The quality of evidence for outcome measures was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).ResultsWe identified 13 SRs/MAs met inclusion criteria. According to the results of the AMSTAR-2, six were rated as critically low quality and seven as low quality. According to ROBIS assessment, 8 SRs/MAs were classified as low risk, and 5 SRs/MAs were found to be high risk. The PRISMA report still has some reporting deficiencies in aspects such as protocol and registration, search strategy, risk of bias, additional analyzes and funding. According to the GRADE system, no high-quality evidence was found, 1 was of moderate quality, 4 were of low quality, and 8 were of critical low quality.ConclusionBased on the evidence collected, acupuncture shows promise as a treatment for PTN patients. However, it is important to note that the included SRs/MAs generally have low methodological quality and evidence quality. Therefore, caution must be exercised when interpreting this conclusion. To enhance future research in this area, it is recommended to adequately report methodological details and adhere to guidelines for conducting SRs/MAs.Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024499280.
Interaction effect between blood selenium levels and stroke history on all-cause mortality: a retrospective cohort study of NHANES
Authors: Li Yanli , Liu Lanqun , Yang Zufu , Xu Jimin 
Published: July 2024

AimThe study aimed to investigate the interaction effect between blood selenium levels and stroke history on all-cause mortality.MethodsIn this retrospective cohort study, participant data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011–2018. The covariates were screened via the backward selection method in weighted univariate and multivariate Cox regression models. Weighted univariate and multivariate Cox regression models were conducted to investigate the association of blood selenium and stroke history with all-cause mortality. The results were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs). The synergy index (SI) was used to assess the assistive interaction. The association was further explored in different gender groups.ResultsTotally, 8,989 participants were included, of whom 861 (9.57%) died. Participants with blood selenium ≥192.96 ug/L were associated with lower odds of all-cause mortality (HR = 0.70, 95% CI: 0.58–0.84), whereas those with a stroke history were associated with a higher risk of all-cause mortality (HR = 1.57, 95% CI: 1.15–2.16). Compared to participants with blood selenium ≥192.96 ug/L and non-stroke history, participants with both blood selenium &lt; 192.96 ug/L and stroke history had a higher all–cause mortality risk (HR = 2.31, 95% CI: 1.62–3.29; SI = 0.713, 95% CI: 0.533–0.952). All participants with blood selenium &lt; 192.96 ug/L and stroke history were related to higher all–cause mortality risk (HR = 1.61, 95% CI: 1.21–2.13). In males, the interaction effect of blood selenium and stroke history on all–cause mortality (HR = 2.27, 95% CI: 1.50–3.46; SI = 0.651, 95% CI: 0.430–0.986) increased twice.ConclusionBlood selenium and stroke history have an interaction effect on all-cause mortality. Increasing selenium-rich food or supplement intake, especially for individuals with a stroke history, may improve poor prognosis.
Maternal docosahexaenoic acid supplementation during lactation improves exercise performance, enhances intestinal glucose absorption and modulates gut microbiota in weaning offspring mice
Authors: Lu Dalu , Yao Die , Hu Gaoli , Zhou Jiefei , Shen Xiuhua , Qian Linxi 
Published: July 2024

IntroductionIntestinal dysfunction induced by weaning stress is common during breastfeeding period. Docosahexaenoic acid (DHA) is well known for promoting visual and brain development, but its effects on early intestinal development remain unknown. This study investigated the impact of maternal DHA supplementation during lactation on intestinal glucose absorption and gut microbiota in weaning offspring mice.Materials and methodsDams were supplemented with vehicle (control), 150 mg/(kg body weight · day) DHA (L-DHA), or 450 mg/(kg body weight · day) DHA (H-DHA) throughout lactation by oral administration. After weaning, pups were randomly divided into three groups for athletic analysis, microbial and proteomic analysis, biochemical analysis, 4-deoxy-4-fluoro-D-glucose (4-FDG) absorption test, and gene expression quantitation of glucose transport-associated proteins and mTOR signaling components.ResultsThe H-DHA group exhibited enhanced grip strength and prolonged swimming duration compared to the control group. Additionally, there were significant increases in jejunal and ileal villus height, and expanded surface area of jejunal villi in the H-DHA group. Microbial analyses revealed that maternal DHA intake increased the abundance of beneficial gut bacteria and promoted metabolic pathways linked to carbohydrate and energy metabolism. Proteomic studies indicated an increased abundance of nutrient transport proteins and enrichment of pathways involved in absorption and digestion in the H-DHA group. This group also showed higher concentrations of glucose in the jejunum and ileum, as well as elevated glycogen levels in the liver and muscles, in contrast to lower glucose levels in the intestinal contents and feces compared to the control group. The 4-FDG absorption test showed more efficient absorption after oral 4-FDG gavage in the H-DHA group. Moreover, the expressions of glucose transport-associated proteins, GLUT2 and SGLT1, and the activation of mTOR pathway were enhanced in the H-DHA group compared to the control group. The L-DHA group also showed similar but less pronounced improvements in these aspects relative to the H-DHA group.ConclusionOur findings suggested that maternal DHA supplementation during lactation improves the exercise performance, enhances the intestinal glucose absorption by increasing the expressions of glucose transporters, and beneficially alters the structure of gut microbiome in weaning offspring mice.
Yiqi Wenyang Jiedu prescription for preventing and treating postoperative recurrence and metastasis of gastric cancer: a randomized controlled trial protocol
Authors: Cao Luchang , Zhu Guanghui , Wang Xinmiao , Kuang Ziyu , Song Xiaotong , Ma Xinyi , Zhu Xiaoyu , Gao Ruike , Li Jie 
Published: July 2024

IntroductionPostoperative recurrence and metastasis of gastric cancer (GC) are primary factors that contribute to poor prognosis. GC recurs at a rate of approximately 70%–80% within 2 years after local treatment and approximately 90% within 5 years. “Yang-deficient toxic node” is the core pathogenesis of GC recurrence and metastasis. The Yiqi Wenyang Jiedu prescription (YWJP), a form of complementary and alternative medicine in China, is an empirical remedy to prevent postoperative recurrence and metastasis of GC. Taking the main therapeutic principles of “nourishing Qi and warming Yang, strengthening Zhengqi, and detoxifying” can aid in preventing the recurrence and metastasis of GC in patients during the watchful waiting period after surgery and adjuvant chemotherapy. This approach aims to enhance the quality of life of patients. However, high-quality evidence to support this hypothesis is lacking. This study will aim to investigate the efficacy and safety of YWJP to prevent and treat postoperative metastasis and GC recurrence.MethodsThe study will be a multicenter, randomized, double-blind, placebo-parallel-controlled clinical trial. A total of 212 patients who completed adjuvant chemotherapy within 8 months of radical gastrectomy will be enrolled. Patients in the intervention group will receive the YWJP, whereas those in the control group will receive a placebo. The main outcome was the disease-free survival (DFS) rate 2 years after surgery. The secondary outcomes included DFS time, overall survival, annual cumulative recurrence and rate of metastasis after 1–3 years, cumulative annual survival after 1–3 years, fat distribution-related indicators, tumor markers, peripheral blood inflammatory indicators, prognostic nutritional index, symptoms and quality of life evaluation, medication compliance, and adverse reaction rate.DiscussionThere is a lack of effective therapy after the completion of adjuvant therapy during the postoperative period of watchful waiting. This study will be the first randomized clinical trial to evaluate whether complementary and alternative medical interventions can effectively prevent recurrence and metastasis during the watchful waiting period after GC surgery and to provide evidence for surveillance treatment management after GC surgery.Clinical trial registrationClinicalTrials.gov, identifier NCT05229809.
A phase Ib study to assess the safety of the human papillomavirus DNA vaccine (AMV002) in combination with durvalumab for HPV-associated oropharyngeal squamous cell carcinoma
Authors: Ladwa Rahul , Chandra Janin , Woo Wai-Ping , Finlayson Neil , Liu Howard , McGrath Margaret , See Adrienne , Hughes Brett G. , Cooper Caroline L. , Jackson Jim E. , Dzienis Marcin , Xu Yan , Panizza Benedict , Frazer Ian , Porceddu Sandro V. 
Published: July 2024

BackgroundProgrammed cell death ligand 1 (PD-L1) inhibitors have limited efficacy as monotherapy in patients with recurrent/metastatic (R/M) Human Papilloma Virus (HPV) oropharyngeal squamous cell carcinoma (OPSCC). A phase I study of the therapeutic HPV-16 DNA vaccine AMV002 in curatively treated patients with OPSCC demonstrated a measurable immune response against HPV while being associated with high safety and tolerability. This prospective phase Ib single centre pilot study aims to test the safety and tolerability of combined PD-L1 inhibitor, Durvalumab, with AMV002 in 12 patients with recurrent OPSCC.MethodsParticipants had evidence of R/M HPV-associated OPSCC. They received three intradermal administrations of AMV002 with Durvalumab followed by Durvalumab maintenance. Safety and tolerability data was the primary endpoint. The study was conducted with ethical approval (HREC/2018/QMS/47293) in Brisbane, Australia.FindingsThe most common adverse event (AE) related to vaccine administration was erythema at the injection site. There were no grade 3 or 4 vaccine related AEs. There was one presumed immune-related grade 3 elevation in lipase secondary to Durvalumab with no intervention required. No patient ceased study due to treatment-related AEs. At week 16, objective response rate was 8% (N=1) and disease control rate was 17% (N=2). At a median follow up of 25.6 (20.0-26.6) months there was one long term complete response while all other participants developed progressive disease. Of the 11 evaluated patients, 9, (82%) had E6 and/or E7-specific T cell responses to the vaccine.ConclusionThe combination of AMV002 therapeutic HPV-16 vaccine and Durvalumab was found to be safe and well tolerated with no increased safety signals generated. T cell responses to vaccine were observed but further work will be required to improve efficacy.
Long-term trends in cancer incidence and mortality among U.S. children and adolescents: a SEER database analysis from 1975 to 2018
Authors: Tang Xiao-Wei , Jiang Jiao , Huang Shu , Shi Xiao-Min , Xu Huan , Xu Jia , Peng Jie-Yu , Zhang Wei , Shi Lei , Zhong Xiao-Lin , Kang Min , Lü Mu-Han 
Published: July 2024

BackgroundChildhood and adolescent cancer represent a significant health burden in the United States. Current and precise epidemiological data are crucial to develop effective cancer control plans and ultimately reduce the burden of childhood and adolescent cancer.MethodsWe analyzed data obtained from cancer registries in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Age-standardized incidence and death rates, assessed using joinpoint analysis, were quantified as annual percentage changes (APC) and average percentage changes (AAPC).ResultsThe overall cancer incidence rate in 2008–2018 was 187.9 per 1,000,000 persons. Cancer incidence rates demonstrated a sustained upward trend, with an APC of 0.8 from 1975 to 2018. Incidence rates during 2008–2018 remained stable among non-Hispanic Black children but increased among other racial and ethnic groups. Leukemias, central nervous system tumors, and lymphomas were the most common cancer groups for patients aged 0–19 years. Cancer death rates decreased among children [AAPC, −1.3 (95% CI, −1.5 to −1.1)] during 2009–2019, while were stable among adolescents during that period.ConclusionsIn this study, we analyzed cancer incidence and mortality rates and trends in children aged 0–19 years in the United States. Our findings revealed an overall increase in cancer incidence rates among children and adolescents, accompanied by a decline in cancer mortality rates over time. These rates and trends varied by age, sex, and particularly race and ethnicity, highlighting the significance of comprehending and addressing disparities and ultimately reducing the disease burden of childhood and adolescent cancer.
Rectal and axillary admission temperature in preterm infants less than 32 weeks' gestation, a prospective study
Authors: Halabi Shaimaa , Almuqati Rana , Al Essa Amenah , Althubaiti Manal , Alshareef Musab , Mahlangu Radha , Homedi Abdulaziz , Alsehli Faisal , Alsaif Saif , Ali Kamal 
Published: July 2024

ObjectivesThe purpose of this research was to evaluate the differences between rectal and axillary temperature measurements in preterm infants who were born less than 32 weeks’ gestation using digital thermometers upon their admission to the Neonatal Intensive Care Unit (NICU).MethodsProspective, observational, single centre study. Rectal and axillary temperatures measurements were performed using a digital thermometer. The study examined various maternal and neonatal factors to describe the study group, including the use of prenatal corticosteroids, the occurrence of maternal diabetes and hypertension, a history of maternal prolonged rupture of membranes (PROM), maternal chorioamnionitis, the mode of delivery, along with the neonate's gender, birth weight, and gestational age. The Pearson correlation coefficient (R) was calculated to ascertain the linear relationship between the temperatures taken at the rectal and axillary sites. The concordance between the two sets of temperature data was analyzed using the Bland-Altman method.ResultsEighty infants with a mean gestational age of 28.4 weeks (SD = 2.9) and a mean birth weight of 1,229 g (SD = 456) were included in the study. The mean axillary temperature was 36.4 °C (SD = 0.7), which was lower than the mean rectal temperature of 36.6 °C (SD = 0.6) (p = 0.012). Rectal temperatures surpassed axillary measurements in 59% of instances, while the reverse was observed in 21% of cases. Rectal and axillary temperatures had a strong correlation (Pearson correlation coefficient of 0.915, p &lt; 0.001). Bland-Altman plot showed a small mean difference of 0.1C between the two temperatures measurements but the limits of agreement were wide (+0.7 to −0.6 °C). For hypothermic infants, the mean difference between rectal and axillary temperatures was 0.27 °C, with a wide limit of agreement ranging from −0.5 °C to +1 °C. Conversely, for normothermic infants, the mean difference was smaller at 0.1 °C, with a narrower limit of agreement from −0.4 °C to +0.6 °C.ConclusionsWhile there is a good correlation between axillary and rectal temperatures, the wider limits of agreement indicate variability, particularly in hypothermic infants. For a more accurate assessment of core body temperature in hypothermic infants, clinicians should consider using rectal measurements to ensure effective thermal regulation and better clinical outcomes.