bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of supplementation of a package of iron folic acid (IFA) with probiotics on hemoglobin levels in elderly with mild to moderate anemia: Protocol for a double blind randomized controlled trial (PRobiotics in Anemia Trial for Healthy Ageing Management - PRATHAM)
Authors: Ahamed Farhad , Das Semanti , Lepcha Sunom Merab , Jaiswal Abhishek , Palepu Sarika , Goswami Kalyan , Sengupta Mallika , Bandyopadhyay Arkapal , Hossain Chowdhury Mobaswar 
Published: May 2024

Abstract

Background
Anemia is a major health concern of the elderly with iron deficiency anemia and anemia of chronic diseases being the two major causes of anemia. Probiotics help in anemia correction in several ways. It increases oral iron absorption by directly modulating immunity, eliciting an anti-inflammatory response, reducing ferric iron to bioavailable ferrous iron, and enhancing iron uptake by enterocytes. This is especially relevant in old age, as aging is associated with age-related gradual attrition of protective organisms in gut microbiota. As there are no studies on the efficacy of probiotics supplementation in anemia management in the elderly, a study has been planned to determine the impact of supplementation of a therapeutic package of Iron and Folic Acid (IFA) and probiotics on hemoglobin levels in elderly with mild to moderate anemia in comparison to IFA only.
Methods
This community-based randomized controlled trial will be conducted in the Kalyani Municipality area of Nadia district, West Bengal, India. Individuals aged 60 years and above with mild to moderate anemia will be randomized into the intervention (IFA and probiotics) and control group (IFA and placebo gelatin capsules containing ORS). The medications will be self-administered. The calculated sample size is 100 in each arm. Block randomization will be done. Participants will be followed up weekly for 12 weeks.
Discussion
Changes in hemoglobin, ferritin, hepcidin, C-reactive protein (CRP), composition, and diversity of the gut microbiome from baseline to 12 weeks in both groups will be assessed.
Ethics and dissemination: Ethical approval was obtained from the Institutional Ethics Committee of AIIMS Kalyani (Ref. No: IEC /AIIMS / Kalyani / Meeting/ 2023 / 020).
Trial Registration Number: The trial was registered in Clinical Trials Registry-India (CTRI) (CTRI/2023/09/057830) on 19.09.2023
Protocol version: Version: 1.0
Ontogeny of predatory capacity and prey choice during early life of the holobenthic octopus Amphioctopus fangsiao (d’Orbigny, 1841): switching prey-choice strategy
Authors: Awa Nozomi , Dan Shigeki , Nagatsuka Kota , Sekiguchi Yumiko , Shimba Ayako , Anaguchi Yuji , Kamei Yoshinori , Hamasaki Katsuyuki 
Published: May 2024

Abstract

Benthic octopuses are well known generalist predators but the predatory behavior of juveniles is poorly understood. This study investigated prey choice of juvenile Amphioctopus fangsiao, a holobenthic species. Juveniles aged 0 to 50 d after hatching (0.1 − 5.2 g wet weight) were offered seven individuals of each of three types of prey organism: bivalves, gastropods, or mysids. The juveniles consumed all three species from the day of hatching (0 d) but the energy source of the early juveniles relied largely on gastropods. Juveniles could catch gastropods easily by detaching them from the bottom of the tank but required a longer time to consume them. Their ability to pull open bivalve shells and to successfully catch mysids developed as they grew, and the grown juveniles chose mysids and bivalves as their main prey organisms. Early juveniles of < 2.5 g tended to choose prey individuals from which they could obtain more energy. However, grown juveniles of > 2.5 g changed the criteria of prey choice to attain a shorter time of prey consumption and a faster rate of energy intake. These suggest that A. fangsiao has a switching prey-choice strategy: early juveniles give priority to growth, but grown juveniles give priority to reduce time suffering predation risk while obtaining energy quickly as much as possible. Because early juveniles can develop the predatory capacity as they grow faster, they seem to take a strategy to invest growth to go through quickly the period of high risks of predation and starvation.
Squares in a Beatty sequence and an improvement on character sums
Authors: Guo Victor Zhenyu , Qi Jinyun , Jing Mengyao 
Published: May 2024

Abstract

We consider the distribution of perfect squares in a Beatty sequence, which is of the form ⌊αn + β⌋. We also analyze it on average over positive square-free integers. The proof relies on a new bound of character sums with Beatty sequences, which answers an open question posted by Igor Shparlinski.
MSC Numbers: 11B83; 11L07; 11L40.
Diagnostic and prognostic utility of INSM1, ISL1 and secretagogin in pheochromocytoma
Authors: Sözen Mehmet , Turan Gupse , Cantürk Zeynep , Çetinarslan Berrin , Selek Alev , Tosun Mesude , Civriz Aziz Hakkı , Sevinç Burcu , Gezer Emre , Köksalan Damla 
Published: May 2024

Abstract

Background: To assess immunohistochemical expression of the second generation neuroendocrine immunohistochemical markers such as insulin gene enhancer protein 1 (ISL1), insulinoma-associated protein 1 (INSM1) and secretagogin (SECG) in pheochromocytoma (PCC) and prognostic value.
Methods: The study included 30 operated PCC patients. The tissue preparations were re-evaluated by two pathologists and PASS score and GAPP score were given. 4 µm thick paraffin block sections were stained with INSM1, ISL1 and SECG antibodies to obtain staining intensity score, staining percentage and H-score.
Results: Mean age at the diagnosis was 50.5 (±15.9) years. Eight patients were asymptomatic. The most common complaint was high blood pressure. 4 patients (13.3%) had nonfunctioning adenoma. The lesions were mostly localized in the right adrenal gland and median tumor size was 45.0 (35.0-54.2) mm. Median Ki67 was 2.0 % (0.9-3.0). According to the PASS score, 9 (30.0%) patients showed in the benign clinical behavior (score <4), while according to the GAPP score, only 4 (13.3%) patients in the well differentiated type (0-2 points) group. INSM1 and ISL1 were positive in 21 (70%) and 26 (86.7%) of the patients, respectively. However, SECG was positive only in 6 patients (20%). Among the second generation neuroendocrine immunohistochemical markers, ISL1 had the highest H-score. Correlation analysis showed a negative correlation between ISL1 and tumor HU and a positive correlation between INSM1 and Ki67.
Conclusion: INSM1, ISL1 and SECG, which are second generation neuroendocrine immunohistochemical markers, can be used in the differential diagnosis of pheochromocytoma. In addition, especially ISNM1 may have prognostic significance.
Utilizing Multimodal Data for Diagnosis of Kawasaki Disease: An AI Approach
Authors: Li Zhixin , Luo Gang , Ji Zhixian , Sibao Wang , Pan Silin 
Published: May 2024

Abstract

Objective
We propose a new multimodal artificial intelligence model that facilitate the differentiation of Kawasaki disease through the integration of clinical symptom photographs and laboratory examination indices.
Methods
This study is a retrospective investigation based on laboratory examination data, palm images, and conjunctival image databases of 620 children (comprising those with both healthy physical examinations and Kawasaki disease) who visited our hospital between January 2022 and January 2024. The multimodal model was trained and evaluated using this database. GradCAM was incorporated to analyze the attention mechanisms of the multimodal model. A human-machine double-blind controlled trial was designed to evaluate the diagnostic accuracy of the obtained multimodal model and senior clinical physicians with advanced qualifications on external dataset.
Results
The performance evaluation of the multimodal model on the validation set yielded an area under the curve of 0.97 and an accuracy of 0.96.The GradCAM analysis reveals that the model's attention is concentrated on areas such as palm swelling and peeling, as well as conjunctivitis, which aligns with clinical reasoning.The human-machine double-blind trial validated that the multimodal model and senior pediatric physicians with advanced qualifications achieved comparable accuracy rates in identifying cases within an independent external cohort.
Conclusion
The multimodal model we developed can assist junior doctors in diagnosing Kawasaki disease, providing a new approach for the auxiliary diagnosis of Kawasaki disease in medically underserved areas.
Evaluation of pulmonary tuberculosis disease burden in Shenyang, China, 2023
Authors: Chen Huijie , Li Peng , Yang Zhixing , Wen Lihai , Sun Baijun , Sun Wei , Bi Haiyan 
Published: May 2024

Abstract

Background
Pulmonary tuberculosis (PTB) is one of the most serious infectious diseases worldwide and poses a great threat to people’s health. China has a vast territory with substantial regional disparities in the PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang. The aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang.
Methods
The disability-adjusted life years (DALYs) calculated based on Global Burden of Disease (GBD) framework was used to assess the disease burden of PTB in Shenyang in 2023, and descriptive epidemiological methods were employed to elucidate the magnitude, composition, and distribution characteristics of PTB disease burden in Shenyang.
Results
In 2023, 4,169 PTB cases were reported in Shenyang, including 2,901 males and 1,268 females. The incidence of PTB was 45.50/105, of which 64.29/105 for males and 27.30/105 for females. The incidence among males was higher than that among females (X2 = 688.56, p<0.001). The highest incidence was 107.00/105 in the group of the population aged 80 and above (X2 = 1171.75, p<0.001). In 2023, 189 PTB deaths were reported in Shenyang, including 156 males and 33 females. The mortality of PTB was 2.06/105 of which 3.46/105 for males and 0.71/105 for females. The mortality among males was higher than that among females (X2 = 83.69, p<0.001). The highest mortality was 16.04/105 in the group of the population aged 80 and above (X2 = 285.61, p<0.001). The PTB DALYs rate was 58.25/105, of which 91.73/105 for males and 21.22/105 for females. The DALYs rate among males was higher than that among females (X2 = 44.04, p<0.001). The highest DALYs rate was 149.86/105 in the group of the population aged 80 and above (X2 = 305.35, p<0.001). Years of life lost (YLLs) due to PTB accounted for 71.38% of total DALYs, of which 74.33% for males and 52.89% for females.
Conclusion
The disease burden of PTB in Shenyang in 2023 was lower than that in China, showing characteristics of that the disease burden increased with age, and males was higher than that of females. The predominant disease burden of PTB was attributed to YLLs, accounting for as much as 71.38%, indicating that PTB primarily results in premature mortality rather than disability. Therefore, the focus should be shifted towards early intervention to reduce transmission, especially for the aged males.
The clinical value of serum creatinine to bilirubin ratio in predicting the severity and prognosis of acute pancreatitis
Authors: Chen Jun-Yi , He Jun-Lian , Feng Feng-Yi , Yang Xiao-Ya , Xie Wen-Rui 
Published: May 2024

Abstract

Background
Bilirubin (BIL) and creatinine (Cr) have been used as potential early predictors of the severity of many diseases. A recent study found that the Cr to BIL ratio (CTR) was more sensitive and specific than either serum Cr or BIL alone. Our research focused on the clinical significance of CTR in evaluating the severity and prognosticating outcomes of acute pancreatitis (AP) in patients.
Methods
Patients diagnosed with AP at the First Affiliated Hospital of Guangdong Pharmaceutical University between July 1, 2016, and December 31, 2020 were included. The analysis then focused on examining the relationship between CTR levels and the severity of the illness, the occurrence of complications, and the prognosticating outcomes for individuals diagnosed with AP. A total of 286 AP patients were enrolled.
Results
Multivariate regression analyses showed that patients with AP with increased CTR levels had a poorer disease (easier to develop severe AP); higher multiple organ dysfunction syndrome (MODS), Ranson, and Acute Physiology and Chronic Health Evaluation (APACHE-II) scores; higher incidence of organ failure (acute heart failure [AHF], acute kidney injury [AKI] and acute myocardial infarction [AMI] ); and leading to a worse prognosis characterized more by frequent use of vasoactive and diuretic agents than patients with lower CTR levels.
Conclusion
Patients with AP who exhibit higher CTR levels tend to experience escalating disease severity, more complications, and a poorer outcome compared with those with lower CTR levels.
Prevalence, risk factors, and treatment status of anemia in hospitalized older patients: a focus on differences between Geriatric and Nephrological Hospital Setting in Italy
Authors: Soraci Luca , De Vincentis Antonio , Aucella Filippo , Fabbietti Paolo , Corsonello Andrea , Arena Elena , Aucella Francesco , Gatta Giuseppe , Incalzi Raffaele Antonelli 
Published: May 2024

Abstract

Anemia is a common but often underdiagnosed and undertreated geriatric syndrome in hospitalized older patients. In this retrospective multicenter study, we aimed at characterizing the prevalence, risk factors, diagnostic and treatment approach to anemia in older patients admitted to acute care hospitals, focusing on differences between nephrology and geriatrics units.
Prevalence and risk factors for anemia, diagnostic inertia (lack of iron, vitamin B12, and folate status assessment), replacement inertia (omitted treatment with iron, vitamin B12 or folic acid), and erythropoiesis stimulating factors (ESA) inertia were explored.
1,963 patients aged 82.7 (6.8) years were included in the study; 66.7 % of the study population had anemia; among anemic patients, diagnostic inertia and replacement inertia were common with rates of 22-31% and 50-87 %, respectively; omitted treatment with ESA affected 67.2 % of patients and was more prevalent in geriatric units. In most cases, patients with ESA inertia were not routinely screened for iron tests. COPD, cancer, eGFR 45-60 ml/min were associated with increased tendency to ESA inertia. In conclusion, anemia had a high prevalence in older patients discharged from acute care units, but it is often underdiagnosed and undertreated.
Molecular evolution and genetic diversity of defective chorion 1 in Anastrepha fraterculus and Anastrepha obliqua (Diptera, Tephritidae)
Authors: Bisio Mariana Cassia , Santos Edyane M dos , Santos Camilla Alves , Chahad-Ehlers Samira , de Brito Reinaldo A 
Published: May 2024

Abstract

The family Tephritidae comprises numerous fruit fly species, some of which are economically significant, such as several in the genus Anastrepha. Most pest species in this genus belong to the fraterculus group, characterized by closely related species that are difficult to differentiate due to recent divergence and gene flow. Identifying genetic markers for their study is paramount for understanding the group’s evolution and eventual phytosanitary control. Because there is variation in eggshell morphology among species in the genus, we studied the rapidly evolving defective chorion 1 (dec-1) gene, which is crucial for chorion formation and reproduction. Fragments of dec-1 from two of the most important pest species in the genus, Anastrepha fraterculus and Anastrepha obliqua, were amplified and compared to transcriptome sequences, as well as dec-1 sequences from Anastrepha ludens, which was used for structure prediction. These data revealed three alternative transcripts in A. fraterculus and A. obliqua, consistent with patterns found in other Tephritidae; we obtained orthologous sequences for these other tephritids from NCBI to investigate patterns of selection affecting this gene at different hierarchical levels using different methods. These analyses show that purifying selection has had an important role across the whole gene and throughout its history, but there was evidence of positive and episodic diversifying selection at different levels. Different parts of the gene have shown distinct evolutionary rates, potentially correlating with the diverse proproteins produced by posttranslational changes. This correlation appears evident in certain lineages, including the branch that separates Anastrepha, as well as other internal branches that differentiate species within the genus. Our data showed that this gene shows remarkable variation across its different exons, which has proven to be informative at different evolutionary levels. These changes hold promise not only for studying differentiation in Anastrepha but also for the eventual management of selected pest species.
Fecal Carriage of Multidrug-Resistant Organisms Increases the Risk of Hepatic Encephalopathy in Cirrhotic Patients: Insights from Gut Microbiota and Metabolite Features
Authors: Wu Peishan , Lee Pei-Chang , Chang Tien-En , Hsieh Yun-Cheng , Chiou Jen-Jie , Lin Chao-Hsiung , Huang Yi-Long , Lin Yi-Tsung , Huo Teh-Ia , Schnabl Bernd , Lee Kuei-Chuan , Hou Ming-Chih 
Published: May 2024

Abstract

Background
Impact of fecal colonization by multidrug-resistant organisms (MDROs) on changes in gut microbiota and associated metabolites, as well as its role in cirrhosis-associated outcomes, has not been thoroughly investigated.
Methods
Eighty-eight cirrhotic patients and 22 healthy volunteers were prospectively enrolled with analysis conducted on plasma metabolites, fecal MDROs, and microbiota. Patients were followed for a minimum of one year. Predictive factors for cirrhosis-associated outcomes were identified using Cox proportional hazards regression models, and risk factors for fecal MDRO carriage were assessed using logistic regression model. Correlations between microbiota and metabolic profiles were evaluated through Spearman's rank test.
Results
Twenty-nine (33%) cirrhotic patients exhibited MDRO carriage, with a notably higher rate of hepatic encephalopathy (HE) in MDRO carriers (20.7% vs. 3.2%, p = 0.008). Cox regression analysis identified higher serum lipopolysaccharide levels and fecal MDRO carriage as predictors for HE development. Logistic regression analysis showed that MDRO carriage is an independent risk factor for developing HE. Microbiota analysis showed a significant dissimilarity of fecal microbiota between cirrhotic patients with and without MDRO carriage (p = 0.033). Thirty-two metabolites exhibiting significantly different expression levels among healthy controls, cirrhotic patients with and without MDRO carriage were identified. Six of the metabolites showed correlation with specific bacterial taxa expression in MDRO carriers, with isoaustin showing significantly higher levels in MDRO carriers experiencing HE compared to those who did not.
Conclusion
Fecal MDRO carriage is associated with altered gut microbiota, metabolite modulation, and an elevated risk of HE occurrence within a year.
Involved-field irradiation versus elective nodal irradiation in patients with locally advanced esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy
Authors: Zhou Xiaoding , Liu Ying , Zhu Jie , Li Jingqiu , Wang Yi , Huang Guiyu , Peng Lin , Han Yongtao , Leng Xuefeng , Wang Chenghao , He Wenwu , Wu Lei , Wang Qifeng 
Published: May 2024

Abstract

Background
The method of lymph node (LN) irradiation for locally advanced esophageal squamous cell carcinoma (LA-ESCC) is still a topic of debate. We investigated the efficacy, toxicity, and rate of out-of-field LNs in irradiation across different target areas in patients with LA-ESCC undergoing neoadjuvant chemoradiotherapy (nCRT).
Methods
We retrospectively reviewed patient records from June 2017 to August 2022 and divided patients into elective nodal irradiation (ENI) and involved-field irradiation (IFI) groups. The differences in hematological and non-hematological toxicities of the out-of-field LNs were analyzed between the two groups. The log-rank test was used to evaluate the Kaplan–Meier curves for overall and progression-free survival.
Results
Among the 306 included patients, 202 (66.0%) received ENI and 104 (34.0%) received IFI. At the 3-year follow-up, the survival rate did not differ significantly between the groups (p > 0.05). Although the occurrence of radiation-induced pneumonia did not differ (p > 0.05), the incidence of radiation-induced esophagitis and the degree of leukopenia differed significantly (p < 0.05). While the average heart irradiation dose or heart V20, V30, and V40 did not differ significantly (p > 0.05), we observed significant differences in the clinical target volume, average lung irradiation dose, and lung V20, V30, and V40 (p < 0.05). Among all patients, 29 cases (9.5%) experienced missed LN irradiation with 26 (93.1%) in abdominal LNs, whereas only 3 cases (6.9%) with out-of-field LNs were located in the upper esophagus. There was no statistical significance between missed LN irradiation and LN irradiation methods (p = 0.724).
Conclusions
Under similar prognostic conditions, IFI resulted in mild toxicity compared to ENI. Therefore, for patients with ESCC undergoing nCRT, IFI is the preferred irradiation approach for the lymphatic drainage area.
Metabolic Impact of Exercise Modalities in Inactive Obese Adults: A Randomized Controlled Trial
Authors: Amare Friew , Alemu Yehualaw , Enichalew Mollalign , Demlie Yalemsew , Adamu Solomon 
Published: May 2024

Abstract

Method
Twenty healthy physically inactive men (49.15 ± 2.581 years) participated in an 8-month training programme involving concurrent exercise, resistance training, and aerobic training programmes to determine the effects on glucose tolerance and plasma lipids in obese adult persons. This study adopts combining pretest posttest with a repeated measures design component to capture within-subject changes over time with a randomized control trial to assess between-group differences. Plasma glucose concentrations were measured for three hours after the ingestion of 75 g of glucose, and the total areas under the respective curves were calculated. Total plasma lipid and lipoprotein concentrations were determined during fasting. Repeated measures ANCOVA was used for primary data analysis, and the independence between blood lipid variables and group factors was tested.
Result
Pre- to post intervention mean values of body fat percentage, area under the curve, low-density lipoprotein, high-density lipoprotein and total cholesterol decreased in all three groups. The main effect of exercise modality on the AUC was significant. Post hoc analyses revealed that RT (-30.653 ± 6.766, p = 0.001) and CT (M=-0.896, SE = 3.347, P = 0.015) had greater effects than AT. LDL was significantly lower in the AT and CT (MD = 4.783, SE = 1.563, P = 0.002) and (M = 4.57, SE = 1.284, P = 0.008) than in the RT. There was a significant difference in TC between training modalities; AT significantly reduced TC during RT (MD= -17.716, SE = 5.705, P = 0.02). HDL and %BF were not significantly different because of the independent variables affecting these variables.
Conclusion
Exercise modality has emerged as a key factor in optimizing chronic lipid profiles and glycemic control. Notably, both aerobic and concurrent training demonstrated a superior ability to modulate the lipid profile, and resistance training and concurrent training were more effective in reducing the AUC.