bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in the cost and environmental impact between the current diet in Brazil and healthy and sustainable diets: a modeling study
Authors: Caldeira Thaís Cristina Marquezine , Vandevijvere Stefanie , Swinburn Boyd , Mackay Sally , Claro Rafael Moreira 
Published: July 2024

Abstract
Background
While healthy and sustainable diets benefit human and planetary health, their monetary cost has a direct impact on consumer food choices. This study aimed to identify the cost and environmental impact of the current Brazilian diet (CBD) and compare it with healthy and sustainable diets.

Methods
Data from the Brazilian Household Budget Survey 2017/18 and the Footprints of Foods and Culinary Preparations Consumed in Brazil database were used for a modeling study comparing the cost of healthy and sustainable diets (based on the Brazilian Dietary Guidelines (BDG) diet and the EAT-Lancet diet) versus the CBD. The DIETCOST program generated multiple food baskets for each scenario (Montecarlo simulations). Nutritional quality, cost, and environmental impact measures (carbon footprint (CF) and water footprint (WF)) were estimated for all diets and compared by ANOVA. Simple linear regressions used standardized environmental impacts measures to estimate differentials in costs and environmental impacts among diets scenarios.

Results
We observed significant differences in costs/1000 kcal. The BDG diet was cheaper (BRL$4.9 (95%IC:4.8;4.9) ≈ USD$1.5) than the CBD (BRL$5.6 (95%IC:5.6;5.7) ≈ USD$1.8) and the EAT-Lancet diet (BRL$6.1 (95%IC:6.0;6.1) ≈ USD$1.9). Ultra-processed foods (UPF) and red meat contributed the most to the CBD cost/1000 kcal, while fruits and vegetables made the lowest contribution to CBD. Red meat, sugary drinks, and UPF were the main contributors to the environmental impacts of the CBD. The environmental impact/1000 kcal of the CBD was nearly double (CF:3.1 kg(95%IC: 3.0;3.1); WF:2,705 L 95%IC:2,671;2,739)) the cost of the BDG diet (CF:1.4 kg (95%IC:1.4;1.4); WF:1,542 L (95%IC:1,524;1,561)) and EAT-Lancet diet (CF:1.1 kg (95%IC:1.0;1.1); WF:1,448 L (95%IC:1,428;1,469)). A one standard deviation increase in standardized CF corresponded to an increase of BRL$0.48 in the cost of the CBD, similar to standardized WF (BRL$0.56). A similar relationship between the environmental impact and the cost of the BDG (CF: BRL$0.20; WF: BRL$0.33) and EAT-Lancet (CF: BRL$0.04; WF: BRL$0.18) was found, but with a less pronounced effect.

Conclusions
The BDG diet was cost-effective, while the EAT-Lancet diet was slightly pricier than the CBD. The CBD presented almost double the CF and WF compared to the BDG and EAT-Lancet diets. The lower cost in each diet was associated with lower environmental impact, particularly for the BDG and EAT-Lancet diets. Multisectoral public policies must be applied to guide individuals and societies towards healthier and more sustainable eating patterns.
Correlation between serum trimethylamine-N-oxide and body fat distribution in middle-aged and older adults: a prospective cohort study
Authors: Chen Si , Chen Xiao-yan , Huang Zi-hui , Fang Ai-ping , Li Shu-yi , Huang Rong-zhu , Chen Yu-Ming , Huang Bi-xia , Zhu Hui-lian 
Published: July 2024

Abstract
Background
Trimethylamine-N-oxide (TMAO) is linked with obesity, while limited evidence on its relationship with body fat distribution. Herein, we investigated the associations between serum TMAO and longitudinal change of fat distribution in this prospective cohort study.

Methods
Data of 1964 participants (40–75y old) from Guangzhou Nutrition and Health Study (GNHS) during 2008–2014 was analyzed. Serum TMAO concentration was quantified by HPLC–MS/MS at baseline. The body composition was assessed by dual-energy X-ray absorptiometry at each 3-y follow-up. Fat distribution parameters were fat-to-lean mass ratio (FLR) and trunk-to-leg fat ratio (TLR). Fat distribution changes were derived from the coefficient of linear regression between their parameters and follow-up duration.

Results
After an average of 6.2-y follow-up, analysis of covariance (ANCOVA) and linear regression displayed women with higher serum TMAO level had greater increments in trunk FLR (mean ± SD: 1.47 ± 4.39, P-trend = 0.006) and TLR (mean ± SD: 0.06 ± 0.24, P-trend = 0.011). Meanwhile, for women in the highest TMAO tertile, linear mixed-effects model (LMEM) analysis demonstrated the annual estimated increments (95% CI) were 0.03 (95% CI: 0.003 – 0.06, P = 0.032) in trunk FLR and 1.28 (95% CI: -0.17 – 2.73, P = 0.083) in TLR, respectively. In men, there were no similar significant observations. Sensitivity analysis yielded consistent results.

Conclusion
Serum TMAO displayed a more profound correlation with increment of FLR and TLR in middle-aged and older community-dwelling women in current study. More and further studies are still warranted in the future.

Trial registration
NCT 03179657.
Sex- and age-specific associations of serum essential elements with diabetes among the Chinese adults: a community-based cross-sectional study
Authors: Wang Dongmei , Ye Hong , Liu Siyang , Duan Hualin , Ma Qintao , Yao Nanfang , Gui Zihao , Yu Genfeng , Liu Lan , Wan Heng , Shen Jie 
Published: July 2024

Abstract
Background
Although several studies have found the relationship between essential elements and diabetes, the studies about the association of essential elements with diabetes diagnosed according to an oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) in a sex- and age-specific manner were limited. To investigate the linear and nonlinear relationship of five essential elements including iron (Fe), copper (Cu), Zinc (Zn), magnesium (Mg), and calcium (Ca) with diabetes, fasting plasma glucose (FPG), 2-h postprandial plasma glucose (PPG), and HbA1c and to evaluate the sex- and age-specific heterogeneities in these relationships.

Methods
A total of 8392 community-dwelling adults were recruited to complete a questionnaire and undergo checkups of anthropometric parameters and serum levels of five metals (Fe, Cu, Zn, Mg, and Ca). The multivariable logistic and linear regression, the restricted cubic spline (RCS) analysis, and subgroup analysis were applied to find the associations between the essential elements and the prevalence of diabetes as well as FPG, PPG, and HbA1c.

Results
In the multivariable logistic regression and multivariable linear regression, serum Cu was positively associated with FPG, PPG, and HbA1c while serum Mg was significantly inversely correlated with FPG, PPG, HbA1c, and diabetes (all P < 0.001). In the RCS analysis, the non-linear relationship of Cu and diabetes (P < 0.001) was found. In the subgroup analysis, stronger positive associations of Cu with diabetes (P for interaction = 0.027) and PPG (P for interaction = 0.002) were found in younger women.

Conclusions
These findings may lead to more appropriate approaches to essential elements supplementation in people with diabetes of different ages and sexes. However, more prospective cohort and experimental studies are needed to probe the possible mechanism of sex- and age-specific associations between serum essential elements and diabetes.
Associations between adrenal gland volume and adipose tissue compartments – a whole body MRI study
Authors: Askani Esther , Rospleszcz Susanne , Lorbeer Roberto , Wintergerst Charlotte , Müller-Peltzer Katharina , Kiefer Lena S. , Kellner Elias , Reisert Marco , Rathmann Wolfgang , Peters Annette , Schlett Christopher L. , Bamberg Fabian , Storz Corinna 
Published: July 2024

Abstract
Background
Obesity is associated with alterations in the hypothalamic–pituitary–adrenal (HPA) axis. Effects of glucocorticoids on adipose tissues appear to depend on the specific adipose depot, in which they take place. In this study, we aimed to investigate the role of MRI-based adrenal gland volume as an imaging marker in association with different adipose tissue compartments.

Methods
The study cohort derives from the population-based research platform KORA (Cooperative Health Research in the Augsburg Region, Germany) MRI sub-study, a cross-sectional sub-study investigating the interactions between subclinical metabolic changes and cardiovascular disease in a study sample of 400 participants. Originally, eligible subjects underwent a whole-body MRI. MRI-based segmentations were performed manually and semi-automatically for adrenal gland volume, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), epi- and pericardial fat and renal sinus fat. Hepatic and pancreatic lipid content were measured as pancreatic proton density fraction (PDFF) and MR-spectroscopic hepatic fat fraction (HFF). Multivariable linear regression analyses were performed.

Results
A number of 307 participants (56.2 ± 9.1 years, 60.3% male, 14.3% with type 2 diabetes (T2DM), 30.6% with obesity, 34.2% with hypertension) were included. In multivariable analyses, strong positive associations between adrenal gland volume and VAT, total adipose tissue (TAT) as well as HFF persisted after extensive step-wise adjustment for possible metabolic confounders (VAT: beta = 0.31, 95%-CI [0.71, 0.81], p < 0.001; TAT: beta = 0.14, 95%-CI [0.06, 0.23], p < 0.001; HFF: beta = 1.17, 95%-CI [1.04, 1.31], p = 0.009). In contrast, associations between adrenal gland volume and SAT were attenuated in multivariate analysis after adjusting for BMI. Associations between pancreatic PDFF, epi- and pericardial fat and renal sinus fat were mediated to a great extent by VAT (pancreatic PDFF: 72%, epicardial adipose tissue: 100%, pericardial adipose tissue: 100%, renal sinus fat: 81.5%).

Conclusion
Our results found MRI-based adrenal gland volume as a possible imaging biomarker of unfavorable adipose tissue distribution, irrespective of metabolic risk factors. Thus, adrenal gland volume may serve as a potential MRI-based biomarker of metabolic changes and contributes to an individual characterization of metabolic states and individual risk stratification. Future studies should elucidate in a longitudinal study design, if and how HPA axis activation may trigger unfavorable adipose tissue distribution and whether and to which extent this is involved in the pathogenesis of manifest metabolic syndrome.
Synthetic CT generation for pelvic cases based on deep learning in multi-center datasets
Authors: Li Xianan , Jia Lecheng , Lin Fengyu , Chai Fan , Liu Tao , Zhang Wei , Wei Ziquan , Xiong Weiqi , Li Hua , Zhang Min , Wang Yi 
Published: July 2024

Abstract
Background and purpose
To investigate the feasibility of synthesizing computed tomography (CT) images from magnetic resonance (MR) images in multi-center datasets using generative adversarial networks (GANs) for rectal cancer MR-only radiotherapy.

Materials and methods
Conventional T2-weighted MR and CT images were acquired from 90 rectal cancer patients at Peking University People’s Hospital and 19 patients in public datasets. This study proposed a new model combining contrastive learning loss and consistency regularization loss to enhance the generalization of model for multi-center pelvic MRI-to-CT synthesis. The CT-to-sCT image similarity was evaluated by computing the mean absolute error (MAE), peak signal-to-noise ratio (SNRpeak), structural similarity index (SSIM) and Generalization Performance (GP). The dosimetric accuracy of synthetic CT was verified against CT-based dose distributions for the photon plan. Relative dose differences in the planning target volume and organs at risk were computed.

Results
Our model presented excellent generalization with a GP of 0.911 on unseen datasets and outperformed the plain CycleGAN, where MAE decreased from 47.129 to 42.344, SNRpeak improved from 25.167 to 26.979, SSIM increased from 0.978 to 0.992. The dosimetric analysis demonstrated that most of the relative differences in dose and volume histogram (DVH) indicators between synthetic CT and real CT were less than 1%.

Conclusion
The proposed model can generate accurate synthetic CT in multi-center datasets from T2w-MR images. Most dosimetric differences were within clinically acceptable criteria for photon radiotherapy, demonstrating the feasibility of an MRI-only workflow for patients with rectal cancer.
The correlation between hepatic controlled attenuation parameter (CAP) value and insulin resistance (IR) was stronger than that between body mass index, visceral fat area and IR
Authors: Li Zhouhuiling , Liu Renjiao , Gao Xinying , Hou Dangmin , Leng Mingxin , Zhang Yanju , Du Meiyang , Zhang Shi , Li Chunjun 
Published: July 2024

Abstract
Background
Hepatic controlled attenuation parameter (CAP) is a novel marker for quantifying hepatic fat accumulation. Insulin resistance (IR) plays a major role in the pathogenesis and natural history of hepatic steatosis. This study aimed to investigate the possible relationship between CAP value and IR.

Methods
This study included a total of 420 patients with overweight or obesity who came to the obesity clinic at Tianjin Union Medical Center. Vibration-controlled transient elastography examination was conducted to detect CAP and liver stiffness measurement (LSM) values. Body composition, including visceral fat area (VFA), and body fat mass (BFM), was evaluated by the direct segmental multi-frequency bioelectrical impedance analysis (BIA). The associations between CAP value, body mass index (BMI), VFA, BFM and homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed.

Results
CAP value was positively associated with HOMA-IR (r = 0.568, P < 0.001), the strength of which was much stronger than BMI, VFA, and BFM. In multivariate linear regression, CAP value and HOMA-IR showed a significant positive association (adjusted β = 0.015, 95% CI 0.007–0.022, P < 0.001). Subgroup analysis suggested no significant interaction between CAP value and HOMA-IR across age, BMI, LSM, hypertension, and sex groups (all P for interaction > 0.05).

Conclusions
Hepatic CAP value is more remarkably than other obesity markers associated with HOMA-IR in individuals with overweight or obesity, regardless of age, BMI, LSM, hypertension, and sex.
Childhood PFAS exposure and immunotoxicity: a systematic review and meta-analysis of human studies
Authors: Antoniou Evangelia E. , Dekant Wolfgang 
Published: July 2024

Abstract
Background
Exposure to poly- and perfluoroalkyl substances (PFAS) may affect infant and childhood health through immunosuppression. However, the findings of epidemiological literature examining relationships between prenatal/childhood PFAS exposure and vaccine response and infection in humans are still inconclusive. The aim of this review was to examine the effects of PFAS exposure on vaccine antibody response and infection in humans.

Methods
The MEDLINE/Pubmed database was searched for publications until 1 February 2023 to identify human studies on PFAS exposure and human health.
Eligible for inclusion studies had to have an epidemiological study design and must have performed logistic regression analyses of gestational or childhood exposure to PFAS against either antibody levels for pediatric vaccines or the occurrence of children’s infectious diseases. Information on baseline exposure to PFAS (in ng/mL), the age of PFAS exposure (gestational or in years), and the outcome was measured, potentially leading to multiple exposure-outcome comparisons within each study was collected. Percentage change and standard errors of antibody titers and occurrence of infectious diseases per doubling of PFAS exposure were calculated, and a quality assessment of each study was performed.

Results
Seventeen articles were identified matching the inclusion criteria and were included in the meta-analysis. In general, a small decrease in antibody response and some associations between PFAS exposure and childhood infections were observed.

Conclusions
This meta-analysis summarizes the findings of PFAS effects on infant and childhood immune health. The immunosuppression findings for infections yielded suggestive evidence related to PFAS exposure, particularly PFOS, PFOA, PFHxS, and PFNA but moderate to no evidence regarding antibody titer reduction.

Systematic review registration
The research protocol of this systematic review is registered and accessible at the Open Science Framework (https://doi.org/10.17605/OSF.IO/5M2VU).
Lateral root enriched Massilia associated with plant flowering in maize
Authors: Wang Danning , He Xiaoming , Baer Marcel , Lami Klea , Yu Baogang , Tassinari Alberto , Salvi Silvio , Schaaf Gabriel , Hochholdinger Frank , Yu Peng 
Published: July 2024

Abstract
Background
Beneficial associations between plants and soil microorganisms are critical for crop fitness and resilience. However, it remains obscure how microorganisms are assembled across different root compartments and to what extent such recruited microbiomes determine crop performance. Here, we surveyed the root transcriptome and the root and rhizosphere microbiome via RNA sequencing and full-length (V1–V9) 16S rRNA gene sequencing from genetically distinct monogenic root mutants of maize (Zea mays L.) under different nutrient-limiting conditions.

Results
Overall transcriptome and microbiome display a clear assembly pattern across the compartments, i.e., from the soil through the rhizosphere to the root tissues. Co-variation analysis identified that genotype dominated the effect on the microbial community and gene expression over the nutrient stress conditions. Integrated transcriptomic and microbial analyses demonstrated that mutations affecting lateral root development had the largest effect on host gene expression and microbiome assembly, as compared to mutations affecting other root types. Cooccurrence and trans-kingdom network association analysis demonstrated that the keystone bacterial taxon Massilia (Oxalobacteraceae) is associated with root functional genes involved in flowering time and overall plant biomass. We further observed that the developmental stage drives the differentiation of the rhizosphere microbial assembly, especially the associations of the keystone bacteria Massilia with functional genes in reproduction. Taking advantage of microbial inoculation experiments using a maize early flowering mutant, we confirmed that Massilia-driven maize growth promotion indeed depends on flowering time.

Conclusion
We conclude that specific microbiota supporting lateral root formation could enhance crop performance by mediating functional gene expression underlying plant flowering time in maize.
Increasing plasma calprotectin (S100A8/A9) is associated with 12-month mortality and unfavourable functional outcome in critically ill COVID-19 patients
Authors: Didriksson Ingrid , Lengquist Maria , Spångfors Martin , Leffler Märta , Sievert Theodor , Lilja Gisela , Frigyesi Attila , Friberg Hans , Schiopu Alexandru 
Published: July 2024

Abstract
Background
Calprotectin (S100A8/A9) is a pro-inflammatory mediator primarily released from neutrophils. Previous studies have revealed associations between plasma calprotectin, disease severity and in-hospital mortality in unselected COVID-19 patients.

Objective
We aimed to assess whether plasma calprotectin dynamics during the first week of intensive care are associated with mortality and functional outcome in critically ill COVID-19 patients.

Methods
This prospective study included 498 COVID-19 patients admitted to six intensive care units (ICUs) in Sweden between May 2020 and May 2021. Blood samples were collected on ICU admission and on day 7. The primary outcome was 12-month mortality. Secondary outcomes were functional outcome of survivors at 3 and 12 months, and the need for invasive mechanical ventilation (IMV) or continuous renal replacement therapy (CRRT) during the ICU stay. Functional outcome was assessed by the Glasgow Outcome Scale Extended (GOSE, range 1–8, with < 5 representing an unfavourable outcome). Associations between plasma calprotectin and outcomes were examined in binary logistic regression analyses adjusted for age, sex, BMI, hypertension, smoking, and creatinine.

Results
High plasma calprotectin on admission and day 7 was independently associated with increased 12-month mortality. Increasing calprotectin from admission to day 7 was independently associated with higher mortality at 12 months [OR 2.10 (95% CI 1.18–3.74), p = 0.012], unfavourable functional outcome at 3 months [OR 2.53 (95% CI 1.07–6.10), p = 0.036], and the use of IMV [OR 2.23 (95% CI 1.10–4.53), p = 0.027)] and CRRT [OR 2.07 (95% CI 1.07–4.00), p = 0.031)]. A receiver operator characteristic (ROC) model including day 7 calprotectin and age was a good predictor of 12-month mortality [AUC 0.79 (95% CI 0.74–0.84), p < 0.001]. Day 7 calprotectin alone predicted an unfavourable functional outcome at 3 months [AUC 0.67 (95% CI 0.58–0.76), p < 0.001].

Conclusion
In critically ill COVID-19 patients, increasing calprotectin levels after admission to the ICU are associated with 12-month mortality and unfavourable functional outcome in survivors. Monitoring plasma calprotectin dynamics in the ICU may be considered to evaluate prognosis in critical COVID-19.
Study registration: ClinicalTrials.gov Identifier: NCT04974775, registered April 28, 2020.
Effectiveness of educational programs for patients with diabetic kidney disease: a systematic review and meta-analysis
Authors: Kemmochi Takashi , Oka Michiyo , Inokuma Ayako , Shirato Natsumi , Totsuka Ryotaro 
Published: July 2024

Abstract
Background
To prevent the progression of diabetic nephropathy, educational programs to improve self-management are important. However, the effectiveness of educational programs to prevent worsening of diabetic kidney disease on renal function and quality of life is under characterised.

Objectives
The purpose of this study was to conduct a systematic review and meta-analysis to identify effective educational programs for diabetic kidney disease and the impact of educational programs on improving renal function and quality of life in patients with diabetic kidney disease.

Design
The study design is a systematic review and meta-analysis.

Method
We systematically collected research papers, and two authors independently selected papers and evaluated them according to the inclusion criteria. The extracted data were entered into Review Manager 5.4, and the standardised mean difference of the delta estimated glomerular filtration rate (ml/min/1.73m2/year) was calculated using a random effect size model for the renal function evaluation.

Results
Overall, 207 articles were retrieved from five electronic databases and three studies were shortlisted. Data from the two studies on delta estimated glomerular filtration rate (ml/min/1.73 m2/year) were combined, but the results were not significant. The effect on quality of life was observed in only one of the three studies, so they could not be pooled.

Conclusions
Effective educational programs for self-management of diabetic kidney disease could not be identified because of the small number of studies included. Educational programs reviewed also lacked a significant effect on kidney function, likely related to their short durations. The effect of the education programs on quality of life is unknown because studies could not be pooled.