bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge and attitudes about vitamin A consumption and its relationship with night blindness in university students
Authors: Suparmi Suparmi , Prasetya Harka , Rahmawati Atik , Lailaulaan Millam Shinta 
Published: April 2024

IntroductionNight blindness is the first sign of vitamin A deficiency (VAD), which can lead to blindness if left untreated. University students may be at risk of VAD-related night blindness due to unhealthy eating attitudes and inadequate vitamin A intake. This study aimed to determine the relationship between knowledge and attitudes toward vitamin A consumption affecting night blindness in university students.MethodsThis cross-sectional study involved 409 third-year university students of Universitas Islam Sultan Agung, Semarang, Indonesia. Participants completed questionnaires about socio-demographics, their knowledge of vitamin A, and attitudes toward vitamin A consumption. Night blindness symptoms among university students were assessed using the Low Luminance Questionnaire (LLQ), followed by a bivariate analysis of the Chi-Square test. Multivariate binary logistic regressions were used to determine whether the independent variables were associated with night blindness. A p-value less than 0.05 indicated significance.ResultsThe prevalence of high-symptom night blindness was higher among males (26.4%) than females (5.7%). Out of 409 university students, 48 from the non-medicine cluster of the study program had a night blindness symptom. The prevalence was lower in students who studied in the medicine cluster program. The level of knowledge on vitamin A had a significant relationship with symptoms of night blindness [prevalence ratio (PR) = 2.239 (95% CI = 1.110–4.516)]. The attitudes toward vitamin A consumption were significantly associated with night blindness (PR = 2.560, 95% CI = 1.215–5.392).DiscussionThe results of this study show that the risk of night blindness in university students can be prevented by increasing their knowledge and attitudes toward consuming vitamin A-rich food. The university can provide health promotion and vitamin A supplementation to avoid night blindness among academia.
CSF pulsations measured in Parkinson’s disease patients using EPI-based fMRI data
Authors: Kim Jun-Hee , Kim Suhong , Im Jae-Geun , Chung Seok Jong , Lee Phil Hyu , Jeong Yong , Park Sung-Hong 
Published: April 2024

IntroductionCerebrospinal fluid (CSF) flow is involved in brain waste clearance and may be impaired in neurodegenerative diseases such as Parkinson’s disease. This study aims to investigate the relationship between the CSF pulsation and the development of dementia in Parkinson’s disease (PD) patients using EPI-based fMRI.MethodsWe measured CSF pulsation in the 4th ventricle of 17 healthy controls and 35 PD patients using a novel CSF pulsation index termed “CSFpulse” based on echo-planar imaging (EPI)-based fMRI. The PD patients were classified into a PD with dementia high-risk group (PDD-H, n = 19) and a low risk group (PDD-L, n = 16), depending on their development of dementia within 5 years after initial brain imaging. The size of the 4th ventricle was measured using intensity-based thresholding.ResultsWe found that CSF pulsation was significantly higher in PD patients than in healthy controls, and that PD patients with high risk of dementia (PDD-H) had the highest CSF pulsation. We also observed an enlargement of the 4th ventricle in PD patients compared to healthy controls.ConclusionOur results suggest that CSF pulsation may be a potential biomarker for PD progression and cognitive decline, and that EPI-based fMRI can be a useful tool for studying CSF flow and brain function in PD.
Effectiveness of Yijinjing on cognitive and motor functions in patients with Parkinson’s disease: study protocol for a randomized controlled trial
Authors: Luo Kailiang , Ma Xinran , Jin Xueming , Liu Xinhao , Li Yujia , Ma Shujie , Hu Jun 
Published: April 2024

BackgroundParkinson’s disease (PD) is a common neurodegenerative disorder that affects motor and non-motor functions, significantly reducing patients’ quality of life. No effective drug-based treatments are known to solve this problem. Non-drug therapies such as Yijinjing exercise have shown potential in improving cognitive and motor functions in PD patients. However, solid evidence must still be provided to support their clinical efficacy. This study aims to evaluate the clinical efficacy of Yijinjing exercise interventions in PD patients and explore the underlying mechanisms between the cognitive and motor functions in PD.MethodsThis is a single-center randomized controlled trial in which 96 eligible PD patients will be randomly assigned to receive either Yijinjing exercise group or brisk walking group or control group in a ratio of 1:1:1. Interventions (Yijinjing exercise or brisk walking training, 40 min per session) will be provided in 3 sessions per week (Monday, Wednesday, Friday) for 12 weeks, with a total of 36 sessions. After the treatment, there will be a 1-month follow-up period. The primary outcomes will be measured using the Montreal Cognitive Assessment (MoCA) and the Unified Parkinson’s Disease Rating Scale motor section (UPDRS-III). Secondary outcomes include balance function, executive function, walking function, sleep quality, and quality of life. Additionally, the prefrontal cerebral and sensorimotor cortex blood oxygen signal level will be collected to explore the underlying mechanisms. All outcomes will be assessed at baseline, at the end of 12 weeks of treatment and after an additional 1-month follow-up period.DiscussionThe results of the study protocol will provide high-quality evidence for the potential of intervention measures based on the Yijinjing exercise to improve the cognitive and activity levels of Parkinson’s disease patients. We envision the Yijinjing exercise as a non-pharmacological family activity that can provide a new and more effective method for the treatment of Parkinson’s disease patients or those at risk.Clinical trial registrationThis study was approved by the Ethics Committee of the Second Rehabilitation Hospital of Shanghai (2020-05-01). The trial has been registered in the China Clinical Trials Registry (ChiCTR2200055636).
Efficacy and safety of EGFR-TKI combined with WBRT vs. WBRT alone in the treatment of brain metastases from NSCLC: a systematic review and meta-analysis
Authors: Li Shuai , Xu Shumei , Li Luwei , Xue Zhihong , He Lang 
Published: April 2024

BackgroundThe efficacy and safety of combining epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) with whole-brain radiotherapy (WBRT) for treating brain metastases in non-small cell lung cancer patients remains to be determined.MethodsA systematic search was conducted using databases including PubMed, Embase, Web of Science, Cochrane, Wanfang, and China National Knowledge Infrastructure (CNKI), aiming to identify relevant clinical studies on the treatment of brain metastases originating from non-small cell lung cancer through the combination of EGFR-TKI and WBRT. Statistical analysis was performed utilizing Stata 17.0 software, covering clinical studies published until March 1, 2023.ResultsThis analysis incorporated 23 randomized controlled trials (RCTs), involving a total of 2,025 patients. Of these, 1,011 were allocated to the group receiving both EGFR-TKI and WBRT, while 1,014 were assigned to the WBRT alone group. The findings reveal that the combination of EGFR-TKI and WBRT significantly improves the intracranial objective remission rate (RR = 1.57, 95% CI: 1.42–1.74, p &lt; 0.001), increases the intracranial disease control rate (RR = 1.30, 95% CI: 1.23–1.37, p &lt; 0.001), and enhances the 1-year survival rate (RR = 1.48, 95% CI: 1.26–1.73, p &lt; 0.001). Additionally, this combined treatment was associated with a significant survival advantage (RR = 1.48, 95% CI: 1.26–1.73, p &lt; 0.001) and a reduced incidence of adverse effects (RR = 0.65, 95% CI: 0.51–0.83, p &lt; 0.001), particularly with respect to nausea and vomiting (RR = 0.54, 95% CI: 0.37–0.81, p = 0.002) and myelosuppression (RR = 0.59, 95% CI: 0.40–0.87, p = 0.008). However, no statistically significant differences were observed for diarrhea (RR = 1.15, 95% CI: 0.82–1.62, p = 0.418), and skin rash (RR = 1.35, 95% CI: 0.88–2.07, p = 0.164).ConclusionIn contrast to WBRT alone, the combination of EGFR-TKI and WBRT significantly improves intracranial response, enhancing the objective response rate, disease control rate, and 1-year survival rate in NSCLC patients with brain metastases. Moreover, aside from mild cases of rash and diarrhea, there is no statistically significant increase in the incidence of additional adverse effects. Based on the comprehensive evidence collected, the use of third-generation EGFR-TKI combined with WBRT is recommended as the preferred treatment for NSCLC patients with brain metastases, offering superior management of metastatic brain lesions.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#, CRD42023415566.
Patterns of multiple sclerosis presentation to the emergency department
Authors: Makkawi Seraj , Maglan Alaa , Khojah Osama , Allaf Faris , Alamoudi Saeed , Ahmed Mohamed Eldigire , Alsharif Rawaf , Altayeb Meral , Alharthi Abdulrhman , Abulaban Ahmad , Al Malik Yaser 
Published: April 2024

BackgroundMultiple sclerosis (MS) patients are no strangers to the emergency department (ED) due to the relapsing and progressive nature of the disease and the associated complications. This study aimed to identify patterns of ED visits among patients diagnosed with MS, the underlying causes of these visits, and the factors associated with these visits.MethodsThis was a single center retrospective cohort study which utilized a non-probability consecutive sampling technique to include all patients diagnosed with MS (471 patients) from March 2016 to October 2021 in King Abdulaziz Medical City, Jeddah, Saudi Arabia. ED visits were categorized as directly related to MS, indirectly related to MS, or unrelated to MS.ResultsOne in four people with MS visited the ED at least once with a total of 280 ED visits. Most ED visits were ones directly related to MS 43.6%, closely followed by unrelated to MS 41.1%, and then indirectly-related MS visits 15.4%. The most common presenting symptoms in directly-related MS visits were weakness 56.6% and numbness/tingling 56.6% followed by gait impairment 29.5%. Indirectly related to MS or unrelated to MS ED visits were commonly due to neurological 17.7% and gastrointestinal 17.1% causes. Using disease modifying therapy (DMT) was significantly associated with no ED visits (p &lt; 0.001). The use of high-efficacy DMTs was significantly associated with no ED visits than using moderate efficacy DMT (p &lt; 0.001). The use of B-cell depleting therapy (ocrelizumab and rituximab) was significantly associated with no visits to the ED than using any other DMT (p &lt; 0.001). Evidence of brain atrophy on imaging was significantly associated with patients who presented to the ED ≥3 times (p = 0.006, UOR = 3.92).ConclusionDue to the nature of the disease, many MS patients find themselves visiting the ED due to MS related and unrelated issues. These patients are not only required to be treated by neurologists but also by multiple disciplines. The use of high-efficacy DMTs and B-cell depleting therapy may reduce the total frequency of ED visits. Special attention should be paid to patients who have evidence of brain atrophy on imaging.
Development and short evaluation of the Dutch healthy diet index for pregnant women; DHD-P
Authors: Faessen Janine P. M. , Feskens Edith J. M. , Brouwer-Brolsma Elske M. 
Published: April 2024

IntroductionDiet quality indices provide a quick indicator of overall diet and are commonly used in research and surveillance. We developed a Dutch Healthy Diet for pregnant women (DHD-P) index, comprising 22 components aligned with the 2021 Dutch food-based dietary guidelines for pregnant women. Our evaluation focused on assessing its performance and sensitivity to change.MethodsThe DHD-P index was quantified by using a validated Food Frequency Questionnaire (FFQ) and two 24-h recalls at 12 and 24 weeks gestation completed by 24-to-41 year old pregnant women participating in the GLIMP-II study. Strength and direction of associations were evaluated based on de-attenuated correlation coefficients between FFQ and 24-h recall data at 24 weeks gestation (n = 47). Sensitivity to change was evaluated by comparing DHD-P index data assessed by both FFQ and recalls at 12 and 24 weeks gestation using paired t-tests or Wilcoxon Signed Rank Test (n = 27).ResultsDe-attenuated correlation coefficients between FFQ and 24-recall data showed a good correlation for the total DHD-P score (rho = 0.57) and moderate to good correlations for component scores. FFQ as well as recall data showed comparable dietary intake at 12 and 24 weeks, suggesting minimal changes during pregnancy. Correlations over time were moderate-to-good for scores based on FFQ and low to moderate for scores based on 24hRs, indicating better reproducibility of scores based on FFQ data.ConclusionConsidering the moderate to good correlations, the DHD-P index appears to be an appropriate index to assess diet quality among pregnant women, and could serve as a foundation to provide dietary feedback toward healthier food choices. Studies including dietary data for all relevant food groups and nutrients are needed to substantiate our findings and further explore the DHD-P sensitivity to change.
The clinical significance of mitochondrial calcium uniporter in gastric cancer patients and its preliminary exploration of the impact on mitochondrial function and metabolism
Authors: Xu Zipeng , Chen Xia , Zhou Haicun , Sun Luming , Bai Ruobing , Yu Wenwen , Yang Junhao , Liu Hongbin 
Published: April 2024

ObjectiveThe objective of this study is to elucidate the influence of MCU on the clinical pathological features of GC patients, to investigate the function and mechanism of the mitochondrial calcium uptake transporter MCU in the initiation and progression of GC, and to explore its impact on the metabolic pathways and biosynthesis of mitochondria. The ultimate goal is to identify novel targets and strategies for the clinical management of GC patients.MethodsTumor and adjacent tissue specimens were obtained from 205 patients with gastric cancer, and immunohistochemical tests were performed to assess the expression of MCU and its correlation with clinical pathological characteristics and prognosis. Data from TCGA, GTEx and GEO databases were retrieved for gastric cancer patients, and bioinformatics analysis was utilized to investigate the association between MCU expression and clinical pathological features. Furthermore, we conducted an in-depth analysis of the role of MCU in GC patients. We investigated the correlation between MCU expression in GC and its impact on mitochondrial function, metabolism, biosynthesis, and immune cells. Additionally, we studied the proteins or molecules that interact with MCUResultsOur research revealed high expression of MCU in the GC tissues. This high expression was associated with poorer T and N staging, and indicated a worse disease-free survival period. MCU expression was positively correlated with mitochondrial function, mitochondrial metabolism, nucleotide, amino acid, and fatty acid synthesis metabolism, and negatively correlated with nicotinate and nicotinamide metabolism. Furthermore, the MCU also regulates the function of the mitochondrial oxidative respiratory chain. The MCU influences the immune cells of GC patients and regulates ROS generation, cell proliferation, apoptosis, and resistance to platinum-based drugs in gastric cancer cells.ConclusionHigh expression of MCU in GC indicates poorer clinical outcomes. The expression of the MCU are affected through impacts the function of mitochondria, energy metabolism, and cellular biosynthesis in gastric cancer cells, thereby influencing the growth and metastasis of gastric cancer cells. Therefore, the mitochondrial changes regulated by MCU could be a new focus for research and treatment of GC.
Causal relationship between gut microbiota and differentiated thyroid cancer: a two-sample Mendelian randomization study
Authors: Hu Shaojun , Tang Chuangang , Wang Ling , Feng Fang , Li Xiaoxin , Sun Mingyu , Yao Lijun 
Published: April 2024

BackgroundThe gut microbiota has been significantly associated with differentiated thyroid cancer (DTC). However, the causal relationship between the gut microbiota and DTC remains unexplored.MethodsGenome-wide association study (GWAS) summary databases were utilized to select exposures and outcomes. The Mendelian randomization (MR) method was employed to investigate the causal relationship between the gut microbiota and DTC. A sensitivity analysis was performed to assess the reliability of the findings.ResultsFour bacterial traits were associated with the risk of DTC: Class Mollicutes [odds ratio (OR) = 10.953, 95% confidence interval (95% CI): 2.333–51.428, p = 0.002], Phylum Tenericutes (OR = 10.953, 95% CI: 2.333–51.428, p = 0.002), Genus Eggerthella (OR = 3.219, 95% CI: 1.033–10.024, p = 0.044), and Order Rhodospirillales (OR = 2.829, 95% CI: 1.096–7.299, p = 0.032). The large 95% CI range for the Class Mollicutes and the Phylum Tenericutes may be attributed to the small sample size. Additionally, four other bacterial traits were negatively associated with DTC: Genus Eubacterium fissicatena group (OR = 0.381, 95% CI: 0.148–0.979, p = 0.045), Genus Lachnospiraceae UCG008 (OR = 0.317, 95% CI: 0.125–0.801, p = 0.015), Genus Christensenellaceae R-7 group (OR = 0.134, 95% CI: 0.020–0.886, p = 0.037), and Genus Escherichia Shigella (OR = 0.170, 95% CI: 0.037–0.769, p = 0.021).ConclusionThese findings contribute to our understanding of the pathological mechanisms underlying DTC and provide novel insights for the clinical treatment of DTC.
Propranolol can correct prolonged QT intervals in patients with cirrhosis
Authors: Han Huanqin , Chen Junlian , Deng Zhirong , Li Tingting , Qi Xiaoying , Deng Wei , Wu Zunge , Xiao Chuli , Zheng Weiqiang , Du Yujun 
Published: April 2024

Background:Prolonged QT intervals are extremely common in patients with cirrhosis and affect their treatment outcomes. Propranolol is often used to prevent gastroesophageal variceal hemorrhage in patients with cirrhosis; however, it is uncertain whether propranolol exerts a corrective effect on QT interval prolongation in patients with cirrhosis.Aim:The study aimed to investigate the therapeutic effects of propranolol on patients with cirrhosis and prolonged QT intervals.Methods:A retrospective cohort study approach was adopted. Patients with cirrhosis complicated by moderate-to-severe gastroesophageal varices, who were hospitalized at the Affiliated Hospital of Guangdong Medical University between 1 December 2020 and 31 November 2022, were included in the study. The patients were divided into the propranolol and control groups based on whether they had received propranolol. Upon admission, the patients underwent tests on liver and kidney functions, electrolytes, and coagulation function, as well as abdominal ultrasonography and electrocardiography. In addition to conventional treatment, the patients were followed up after the use or non-use of propranolol for treatment and subsequently underwent reexamination of the aforementioned tests.Results:The propranolol group (26 patients) had an average baseline corrected QT (QTc) interval of 450.23 ± 37.18 ms, of which 14 patients (53.8%) exhibited QTc interval prolongation. Follow-up was continued for a median duration of 7.00 days after the administration of propranolol and conventional treatment. Electrocardiographic reexamination revealed a decrease in the QTc interval to 431.04 ± 34.64 ms (p = 0.014), and the number of patients with QTc interval prolongation decreased to five (19.2%; p &lt; 0.001). After treatment with propranolol and multimodal therapy, QTc interval normalization occurred in nine patients with QTc interval prolongation, leading to a normalization rate of 64.3% (9/14). The control group (n = 58) had an average baseline QTc interval of 453.74 ± 30.03 ms, of which 33 patients (56.9%) exhibited QTc interval prolongation. After follow-up for a median duration of 7.50 days, the QTc interval was 451.79 ± 34.56 ms (p = 0.482), and the number of patients with QTc interval prolongation decreased to 30 (51.7%; p = 0.457). The QTc interval normalization rate of patients in the control group with QTc interval prolongation was merely 10.0% (3/33), which was significantly lower than that in the propranolol group (p &lt; 0.001).Conclusion:In patients with cirrhosis complicated by QT interval prolongation, the short-term use of propranolol aids in correction of a long QT interval and provides positive therapeutic value for cirrhotic cardiomyopathy.
Exploring the potential use of melatonin as a modulator of tramadol-induced rewarding effects in rats
Authors: Hakami Alqassem Y. , Alghamdi Badrah S. , Alshehri Fahad S. 
Published: April 2024

Background:Melatonin is responsible for regulating the sleep-wake cycle and circadian rhythms in mammals. Tramadol, a synthetic opioid analgesic, is used to manage moderate to severe pain but has a high potential for abuse and dependence. Studies have shown that melatonin could be a potential modulator to reduce tramadol addiction.Methods:Male Wistar rats were used to investigate the effect of melatonin on tramadol-induced place preference. The rats were divided into four groups: control, tramadol, tramadol + melatonin (single dose), and tramadol + melatonin (repeated doses). Tramadol was administered intraperitoneally at 40 mg/kg, while melatonin was administered at 50 mg/kg for both the single dose and repeated-dose groups. The study consisted of two phases: habituation and acquisition.Results:Tramadol administration produced conditioned place preference (CPP) in rats, indicating rewarding effects. However, melatonin administration blocked tramadol-induced CPP. Surprisingly, repeated doses of melatonin were ineffective and did not reduce the expression of CPP compared to that of the single dose administration.Conclusion:The study suggests that melatonin may be a potential therapeutic option for treating tramadol addiction. The results indicate that melatonin attenuates the expression of tramadol-induced CPP, supporting its uses as an adjunct therapy for managing tramadol addiction. However, further studies are needed to investigate its effectiveness in humans.
Is muscle activation diverse in females with isolated patellofemoral osteoarthritis contrasted with age-matched healthy controls during stair descent task?
Authors: Adel Jilan , Hamoda Reham E. , Mohamed Ayah Mahmoud , Balbaa Alaa Eldin , Neamat Allah Neama H. , Hamada Hamada Ahmed 
Published: April 2024

Background: Patellofemoral osteoarthritis (PF OA) is exceptionally predominant and limiting. However, little is known about the risk factors that contribute to its onset and progression.Purpose: The aim of this study was to decide if women with PF OA descend stairs using different muscular activation strategies compared to similarly aged healthy controls.Methods: Thirty-one women with isolated PF OA and 11 similarly aged healthy women took part in this study. The activation onset and duration of PF OA in vastus medialis oblique (VMO), vastus lateralis (VL), gluteus medius (GM), transversus abdominis (TrA), and multifidus muscles were evaluated during the stair descent task using surface electromyography (EMG).Results: There was a non-significant difference between women with PF OA and healthy controls regarding all tested variables, except for the GM activation onset that was significantly delayed in women with PF OA, with the p-value of 0.011.Conclusion: The causes of PF OA differ and might not always be due to a lack of quadriceps strength or VMO activation deficiency, and prospective longitudinal studies are required to confirm this assumption.