bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Putative Causal Associations between Diet and Periodontal Disease Susceptibility
Authors: Ying X.X. , Hou Y. , Zheng X. , Ma J.X. , Wu M.L. , Liu M. , Liu X.Y. , Zhang K.L. 
Published: May 2024

Introduction: Dietary factors may play an important role in periodontal health. However, current evidence from observational studies remains inconclusive. Objective: This study aimed to investigate the causal relationships between dietary exposures and periodontal disease risks using Mendelian randomization analysis. Methods: Large-scale genome-wide association study summary statistics for 20 dietary factors were obtained from the MRC-IEU consortium. Multivariable and univariable 2-sample Mendelian randomization analyses were performed to assess the causal effects of each dietary exposure on 6 periodontal outcomes, including gingivitis and periodontitis. Results: Genetically predicted higher dried fruit intake was significantly associated with reduced risks of acute gingivitis (odds ratio [OR]: 0.02; 95% confidence interval [CI]: 0.00–0.42; P = 0.01) and bleeding gums (OR: 0.96; 95% CI: 0.93–0.99; P = 0.01). Higher fresh fruit and water intake showed protective effects against chronic gingivitis (OR: 0.18; 95% CI: 0.04–0.91; P = 0.04 and OR: 0.15; 95% CI: 0.04–0.53; P = 0.00) and bleeding gums (OR: 0.95; 95% CI: 0.92–0.981; P = 0.00 and OR: 0.98; 95% CI: 0.96–0.99; P = 0.02). Alcohol intake frequency and processed meat intake were risk factors for bleeding gums (OR: 1.01; 95% CI: 1.00–1.02; P = 0.01 and OR: 1.05; 95% CI: 1.01–1.08; P = 0.00) and painful gums (OR: 1.01; 95% CI: 1.00–1.01; P = 0.00 and OR: 1.02; 95% CI: 1.01–1.03; P = 0.00). Most of the causal relationships between genetic predisposition to the specified dietary factors and periodontal diseases remained statistically significant (P < 0.05) after adjusting for genetic risks associated with dentures, smoking, and type 2 diabetes in multivariable Mendelian randomization models. Conclusions: The findings suggest potential protective effects of higher fruit and water intake against gingivitis and other periodontal problems, while alcohol and processed meat intake may increase the risks of periodontal disease. Our study provides preliminary causal evidence on the effects of diet on periodontal health and could inform prevention strategies targeting dietary habits to improve oral health. Knowledge Transfer Statement: This study suggests that fruit and water intake may protect against periodontal disease, while alcohol and processed meats increase risk, informing dietary guidelines to improve oral health.
Development and validation of machine learning models to predict the need for haemostatic therapy in acute upper gastrointestinal bleeding
Authors: Nazarian Scarlet , Lo Frank Po Wen , Qiu Jianing , Patel Nisha , Lo Benny , Ayaru Lakshmana 
Published: May 2024

Background: Acute upper gastrointestinal bleeding (AUGIB) is a major cause of morbidity and mortality. This presentation however is not universally high risk as only 20–30% of bleeds require urgent haemostatic therapy. Nevertheless, the current standard of care is for all patients admitted to an inpatient bed to undergo endoscopy within 24 h for risk stratification which is invasive, costly and difficult to achieve in routine clinical practice. Objectives: To develop novel non-endoscopic machine learning models for AUGIB to predict the need for haemostatic therapy by endoscopic, radiological or surgical intervention. Design: A retrospective cohort study Method: We analysed data from patients admitted with AUGIB to hospitals from 2015 to 2020 ( n = 970). Machine learning models were internally validated to predict the need for haemostatic therapy. The performance of the models was compared to the Glasgow-Blatchford score (GBS) using the area under receiver operating characteristic (AUROC) curves. Results: The random forest classifier [AUROC 0.84 (0.80–0.87)] had the best performance and was superior to the GBS [AUROC 0.75 (0.72–0.78), p < 0.001] in predicting the need for haemostatic therapy in patients with AUGIB. A GBS cut-off of ⩾12 was associated with an accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 0.74, 0.49, 0.81, 0.41 and 0.85, respectively. The Random Forrest model performed better with an accuracy, sensitivity, specificity, PPV and NPV of 0.82, 0.54, 0.90, 0.60 and 0.88, respectively. Conclusion: We developed and validated a machine learning algorithm with high accuracy and specificity in predicting the need for haemostatic therapy in AUGIB. This could be used to risk stratify high-risk patients to urgent endoscopy.
Australian Headache Epidemiology Data (AHEAD): a pilot study to assess sampling and engagement methodology for a nationwide population-based survey
Authors: Foster Emma , Chen Zhibin , Wakefield Claire E , Ademi Zanfina , Hutton Elspeth , Steiner Timothy J , Zagami Alessandro S 
Published: May 2024

Abstract
Background
There are no robust population-based Australian data on prevalence and attributed burden of migraine and medication-overuse headache (MOH) data. In this pilot cross-sectional study, we aimed to capture the participation rate, preferred response method, and acceptability of self-report questionnaires to inform the conduct of a future nationwide migraine/MOH epidemiological study.

Methods
We developed a self-report questionnaire, available in hard-copy and online, including modules from the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, the Eq. 5D (quality of life), and enquiry into treatment gaps. Study invitations were mailed to 20,000 randomly selected households across Australia’s two most populous states. The household member who most recently had a birthday and was aged ≥ 18 years was invited to participate, and could do so by returning a hard-copy questionnaire via reply-paid mail, or by entering responses directly into an online platform.

Results
The participation rate was 5.0% (N = 1,000). Participants’ median age was 60 years (IQR 44–71 years), and 64.7% (n = 647) were female. Significantly more responses were received from areas with relatively older populations and middle-level socioeconomic status. Hard copy was the more commonly chosen response method (n = 736). Females and younger respondents were significantly more likely to respond online than via hard-copy.

Conclusions
This pilot study indicates that alternative methodology is needed to achieve satisfactory engagement in a future nationwide migraine/MOH epidemiological study, for example through inclusion of migraine screening questions in well-resourced, interview-based national health surveys that are conducted regularly by government agencies. Meanwhile, additional future research directions include defining and addressing treatment gaps to improve migraine awareness, and minimise under-diagnosis and under-treatment.
Migrating foreign bodies of penis: a case report and literature review
Authors: Yang Bo , Ke Ying , Qiu Aixin , Wen Lijie , Xv Xiaolong , Liu Xiaoyun , Zhang Yue 
Published: May 2024

Abstract
Background
Only a few cases have been reported about active foreign body implantation in the cavernous body of the penis.

Case presentation
A 47-year-old man inserted two needles from the glans penis into the bilateral penile sponge body. Subsequently, two needles migrated through the penile cavernous body into the pelvic cavity. Attempts to remove the needles through the penis were unsuccessful. Eventually, after a duration exceeding one month, the displaced needles were removed in stages from the buttocks.

Conclusion
A few cases of intracavernosal-injection-therapy-associated needle breakage and retention have been reported globally. And this is the first case in China documenting the migration of foreign bodies within the penile region. In this condition, it is of utmost importance to engage the expertise of experienced andrologists to minimize the risk of excessive manipulation, thereby ensuring that inadvertent deep penetration of the needle into the penile tissue is prevented. In case the foreign body has migrated deeper into the tissues and the patient does not exhibit any specific symptoms or risks of macrovascular injury-related bleeding, close surveillance of its movement can be implemented. Surgical intervention can be initiated once the foreign body has reached a suitable position. Moreover, a psychiatric evaluation should be recommended for patient to discover any underlying mental health disorders.
Comparative analysis of POD genes and their expression under multiple hormones in Pyrus bretschenedri
Authors: Li Guohui , Manzoor Muhammad Aamir , Wang Guoyu , Huang Shiping , Ding Xiaoyuan , Abdullah Muhammad , Zhang Ming , Song Cheng 
Published: May 2024

Abstract
Background
Class III peroxidase (POD) enzymes play vital roles in plant development, hormone signaling, and stress responses. Despite extensive research on POD families in various plant species, the knowledge regarding the POD family in Chinese pear (Pyrus bretschenedri) is notably limited.

Results
We systematically characterized 113 POD family genes, designated as PbPOD1 to PbPOD113 based on their chromosomal locations. Phylogenetic analysis categorized these genes into seven distinct subfamilies (I to VII). The segmental duplication events were identified as a prevalent mechanism driving the expansion of the POD gene family. Microsynteny analysis, involving comparisons with Pyrus bretschenedri, Fragaria vesca, Prunus avium, Prunus mume and Prunus persica, highlighted the conservation of duplicated POD regions and their persistence through purifying selection during the evolutionary process. The expression patterns of PbPOD genes were performed across various plant organs and diverse fruit development stages using transcriptomic data. Furthermore, we identified stress-related cis-acting elements within the promoters of PbPOD genes, underscoring their involvement in hormonal and environmental stress responses. Notably, qRT-PCR analyses revealed distinctive expression patterns of PbPOD genes in response to melatonin (MEL), salicylic acid (SA), abscisic acid (ABA), and methyl jasmonate (MeJA), reflecting their responsiveness to abiotic stress and their role in fruit growth and development.

Conclusions
In this study, we investigated the potential functions and evolutionary dynamics of PbPOD genes in Pyrus bretschenedri, positioning them as promising candidates for further research and valuable indicators for enhancing fruit quality through molecular breeding strategies.
Genetic diversity and phylogenetic relationships of Clostridium perfringens strains isolated from mastitis and enteritis in Egyptian dairy farms
Authors: Abo Elyazeed Heidy , Elhariri Mahmoud , Eldeen Nashwa Ezz , Aziz Dalal Ahmed , Elhelw Rehab 
Published: May 2024

Abstract
Background
Clostridium perfringens, a common environmental bacterium, is responsible for a variety of serious illnesses including food poisoning, digestive disorders, and soft tissue infections. Mastitis in lactating cattle and sudden death losses in baby calves are major problems for producers raising calves on dairy farms. The pathogenicity of this bacterium is largely mediated by its production of various toxins.

Results
The study revealed that Among the examined lactating animals with a history of mastitis, diarrheal baby calves, and acute sudden death cases in calves, C. perfringens was isolated in 23.5% (93/395) of the total tested samples. Eighteen isolates were obtained from mastitic milk, 59 from rectal swabs, and 16 from the intestinal contents of dead calves. Most of the recovered C. perfringens isolates (95.6%) were identified as type A by molecular toxinotyping, except for four isolates from sudden death cases (type C). Notably, C. perfringens was recovered in 100% of sudden death cases compared with 32.9% of rectal swabs and 9% of milk samples. This study analyzed the phylogeny of C. perfringens using the plc region and identified the plc region in five Egyptian bovine isolates (milk and fecal origins). Importantly, this finding expands the known data on C. perfringens phospholipase C beyond reference strains in GenBank from various animal and environmental sources.

Conclusion
Phylogenetic analyses of nucleotide sequence data differentiated between strains of different origins. The plc sequences of Egyptian C. perfringens strains acquired in the present study differed from those reported globally and constituted a distinct genetic ancestor.
Gamma-aminobutyric acid (GABA) improves salinity stress tolerance in soybean seedlings by modulating their mineral nutrition, osmolyte contents, and ascorbate-glutathione cycle
Authors: Qian Zhao , Lu Liu , Zihan Wei , Qianyue Bai , Chungang Zhao , Shuheng Zhang , Jiali Pan , Jiaxin Yu , Shuang Zhang , Jian Wei 
Published: May 2024

Abstract
Background
In plants, GABA plays a critical role in regulating salinity stress tolerance. However, the response of soybean seedlings (Glycine max L.) to exogenous gamma-aminobutyric acid (GABA) under saline stress conditions has not been fully elucidated.

Results
This study investigated the effects of exogenous GABA (2 mM) on plant biomass and the physiological mechanism through which soybean plants are affected by saline stress conditions (0, 40, and 80 mM of NaCl and Na2SO4 at a 1:1 molar ratio). We noticed that increased salinity stress negatively impacted the growth and metabolism of soybean seedlings, compared to control. The root-stem-leaf biomass (27- and 33%, 20- and 58%, and 25- and 59% under 40- and 80 mM stress, respectively]) and the concentration of chlorophyll a and chlorophyll b significantly decreased. Moreover, the carotenoid content increased significantly (by 35%) following treatment with 40 mM stress. The results exhibited significant increase in the concentration of hydrogen peroxide (H2O2), malondialdehyde (MDA), dehydroascorbic acid (DHA) oxidized glutathione (GSSG), Na+, and Cl− under 40- and 80 mM stress levels, respectively. However, the concentration of mineral nutrients, soluble proteins, and soluble sugars reduced significantly under both salinity stress levels. In contrast, the proline and glycine betaine concentrations increased compared with those in the control group. Moreover, the enzymatic activities of ascorbate peroxidase, monodehydroascorbate reductase, glutathione reductase, and glutathione peroxidase decreased significantly, while those of superoxide dismutase, catalase, peroxidase, and dehydroascorbate reductase increased following saline stress, indicating the overall sensitivity of the ascorbate-glutathione cycle (AsA-GSH). However, exogenous GABA decreased Na+, Cl−, H2O2, and MDA concentration but enhanced photosynthetic pigments, mineral nutrients (K+, K+/Na+ ratio, Zn2+, Fe2+, Mg2+, and Ca2+); osmolytes (proline, glycine betaine, soluble sugar, and soluble protein); enzymatic antioxidant activities; and AsA-GSH pools, thus reducing salinity-associated stress damage and resulting in improved growth and biomass. The positive impact of exogenously applied GABA on soybean plants could be attributed to its ability to improve their physiological stress response mechanisms and reduce harmful substances.

Conclusion
Applying GABA to soybean plants could be an effective strategy for mitigating salinity stress. In the future, molecular studies may contribute to a better understanding of the mechanisms by which GABA regulates salt tolerance in soybeans.
Impact of intravenous accessibility and prehospital epinephrine use on survival outcomes of adult nontraumatic out-of-hospital cardiac arrest patients
Authors: Park Song Yi , Choi Byungho , Kim Sun Hyu 
Published: May 2024

Abstract
Background
This study compared out-of-hospital cardiac arrest (OHCA) patient outcomes based on intravenous (IV) access and prehospital epinephrine use.

Methods
A retrospective study in Ulsan, South Korea, from January 2017 to December 2022, analyzed adult nontraumatic OHCA cases. Patients were grouped: Group 1 (no IV attempts), Group 2 (failed IV access), Group 3 (successful IV access without epinephrine), and Group 4 (successful IV access with epinephrine), with comparisons using logistic regression analysis.

Results
Among 2,656 patients, Group 4 had significantly lower survival to hospital discharge (adjusted OR 0.520, 95% CI 0.346–0.782, p = 0.002) and favorable neurological outcomes (adjusted OR 0.292, 95% CI 0.140–0.611, p = 0.001) than Group 1. Groups 2 and 3 showed insignificant survival to hospital discharge (adjusted OR 0.814, 95% CI 0.566–1.171, p = 0.268) and (adjusted OR 1.069, 95% CI 0.810–1.412, p = 0.636) and favorable neurological outcomes (adjusted OR 0.585, 95% CI 0.299–1.144, p = 0.117) and (adjusted OR 1.075, 95% CI 0.689–1.677, p = 0.751). In the shockable rhythm group, Group 3 had better survival to hospital discharge (adjusted OR 1.700, 95% CI 1.044–2.770, p = 0.033).

Conclusions
Successful IV access with epinephrine showed worse outcomes in both rhythm groups than no IV attempts. Outcomes for failed IV and successful IV access without epinephrine were inconclusive. Importantly, successful IV access without epinephrine showed favorable survival to hospital discharge in the shockable rhythm group, warranting further research into IV access for fluid resuscitation in shockable rhythm OHCA patients.
Access to primary health care: perspectives of primary care physicians and community stakeholders
Authors: Toal-Sullivan Darene , Dahrouge Simone , Tesfaselassie Johanna , Olejnik Laura 
Published: May 2024

Abstract
Background
Action on the social determinants of health is important to strengthen primary health care and promote access among underserved populations. We report on findings from stakeholder consultations undertaken at one of the Canadian sites of the Innovative Models Promoting Access-to-Care Transformation (IMPACT) program, as part of the development of a best practice intervention to improve access to primary health care. The overarching objective of this qualitative study was to understand the processes, barriers, and facilitators to connect patients to health enabling community resources (HERs) to inform a patient navigation model situated in primary care.

Methods
Focus groups and interviews were conducted with primary care physicians, and community health and social service providers to understand their experiences in supporting patients in reaching HERs. Current gaps in access to primary health care and the potential of patient navigation were also explored. We applied Levesque et al., (2013) access framework to code the data and four themes emerged: (1) Approachability and Ability to Perceive, (2) Acceptability and Ability to Seek, (3) Availability and Accommodation, and Ability to Reach, and (4) Appropriateness.

Results
Determinants of access included patient and provider awareness of HERs, the nature of the patient-provider relationship, funding of HERs, integration of primary and community care services, and continuity of information. Participants’ perspectives about the potential scope and role of a patient navigator provided valuable insight for the development of the Access to Resources in the Community (ARC) navigation model and how it could be embedded in a primary care setting.

Conclusion
Additional consultation with key stakeholders in the health region is needed to gain a broader understanding of the challenges in caring for primary care patients with social barriers and how to support them in accessing community-based primary health care to inform the design of the ARC intervention.
Physical function as a predictor of chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer
Authors: Lin Kuan-Yin , Chen Po See , Lin Cheng-Feng 
Published: May 2024

Abstract
Background
A growing body of research indicates that poor functional status before chemotherapy may be correlated with the severity of chemotherapy-induced peripheral neuropathy (CIPN) after the neurotoxic treatment. However, little is known about the associations between pre-chemotherapy physical function and CIPN in patients with pancreatic cancer.

Purpose
To identify the predictors of CIPN in relation to pre-chemotherapy physical function in patients with pancreatic cancer.

Methods
This secondary analysis included data from patients with pancreatic cancer who participated in a longitudinal research study at National Cheng Kung University Hospital, Tainan, Taiwan. Four physical function tests (i.e., grip strength, Timed Up and Go (TUG), 2-minute step test (2MST), and Romberg test) and two questionnaires (The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 [EORTC QLQ-C30] and Chemotherapy-Induced Peripheral Neuropathy Module [CIPN20]) were assessed at baseline (i.e., before first chemotherapy session) and 2-, 3-, 4-, and 6-month follow-up. Multiple linear regression with adjustment for confounding factors was used to assess the associations between the four functional tests at baseline and the CIPN20 total score and individual subscale scores (sensory, motor, and autonomic) at 6-month follow-up.

Results
Data from a total of 209 pancreatic cancer patients (mean age: 64.4 years, 54.5% male) were analyzed. The findings showed that the severity of CIPN at 6-month follow-up was significantly associated with the baseline TUG completion time (β = 0.684, p = 0.003). The TUG completion time was also positively correlated with the 6-month CIPN sensory and autonomic subscales. In addition, a baseline positive Romberg test (β = 0.525, p = 0.009) was a significant predictor of the severity of motor neuropathy at 6-month follow-up.

Conclusion
The TUG completion time and positive Romberg test before chemotherapy may be predictive factors of the CIPN severity 6 months after the commencement of chemotherapy. Accordingly, the incorporation of TUG and Romberg tests into the clinical assessment protocol emerges as imperative for individuals diagnosed with pancreatic carcinoma undergoing chemotherapy regimens.
An exploratory study on material deprivation and loneliness among older adults in Hong Kong
Authors: Tang Vivien Foong Yee , Chou Kee Lee 
Published: May 2024

Abstract
Background
Poverty, as a risk factor for loneliness, has been understudied, and there is a need to gain a better understanding of the relationship between poverty examined by material deprivation and loneliness among older adults in Hong Kong. It also aimed to explore the possible mediation and moderation effects of social support, social networks, neighborhood collective efficacy, and social engagement in the link between material deprivation and loneliness.

Methods
1696 Chinese older adults aged 60 years and above (Mage = 74.61; SD = 8.71) participated in a two-wave study. Older adults reported their loneliness level, material deprivation, perceived level of social support, social network, neighborhood collective efficacy, social engagement, and sociodemographic information. Logistic regression was conducted to examine the effect of material deprivation on loneliness, as well as the mediation and moderation models.

Results
The results indicated that material deprived older adults reported a significantly higher level of loneliness 2 years later when controlling for demographic variables, health-related factors, and loneliness at baseline. We also found that engagement in cultural activities partially mediated the effect of material deprivation and loneliness. Furthermore, neighborhood collective efficacy and engagement in cultural activities were significant moderators that buffer the relationship between material deprivation and loneliness.

Conclusions
Our results suggested the need to alleviate the negative impact of material deprivation on loneliness by developing interventions focused on promoting neighborhood collective efficacy and social engagement, which could be aimed at building meaningful bonds among Chinese older adults in Hong Kong.