bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence to the Mediterranean diet as a possible additional tool to be used for screening the metabolically unhealthy obesity (MUO) phenotype
Authors: Barrea Luigi , Verde Ludovica , Simancas-Racines Daniel , Zambrano Ana Karina , Frias-Toral Evelyn , Colao Annamaria , Savastano Silvia , Muscogiuri Giovanna 
Published: September 2023

Abstract
Background
The terms metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) categorize subjects with obesity based on the presence or absence of cardio-metabolic risk factors. Detecting MUO phenotype is crucial due to the high risk of cardio-metabolic complications, requiring tailored and intensive follow-up. However, diagnosing MUO is time-consuming and costly. Thus, we aimed to investigate the role of Mediterranean diet (MD) in determining MHO/MUO phenotypes and whether adherence to MD could serve as an additional screening tool for MUO phenotype.

Methods
The study population of this cross-sectional observational study consisted of 275 subjects with obesity. We assessed their lifestyle habits (physical activity and smoking habits), anthropometric measurements (weight, height, waist circumference, body mass index), blood pressure, metabolic parameters, inflammatory marker (high sensitivity C reactive protein levels), adherence to MD (by PREvención con DIetaMEDiterránea (PREDIMED) questionnaire), and MHO/MUO phenotypes.

Results
The study included 275 individuals with obesity (256F/19M; 34.0 ± 10.5 years; BMI 38.3 ± 5.95 kg/m2). Among them, 114 (41.5%) exhibited MHO phenotype, while 161 (58.5%) had MUO phenotype. MHO phenotype exhibited favorable anthropometric and cardio-metabolic profiles, characterized by lower waist circumference (p < 0.001), BMI (p < 0.001), insulin resistance (p < 0.001), blood pressure (p < 0.001), inflammation (p < 0.001), and lipid levels (p < 0.001) compared to MUO phenotype. Notably, we found that MHO phenotype had higher adherence to MD (p < 0.001) and consumed more extra virgin olive oil (EVOO) (p < 0.001), vegetables (p < 0.001), fruits (p < 0.001), legumes (p = 0.001), fish (p < 0.001), wine (p = 0.008), and nuts (p = 0.001), while reporting lower intake of red/processed meats (p < 0.001), butter, cream, margarine (p = 0.008), soda drinks (p = 0.006), and commercial sweets (p = 0.002) compared to MUO phenotype. Adherence to MD (p < 0.001) and EVOO (p = 0.015) intake were identified as influential factors in determining the presence of MUO/MHO phenotypes. Furthermore, a PREDIMED score < 5 proved to be the most sensitive and specific cut-point value for predicting the presence of MUO phenotype (p < 0.001).

Conclusion
High adherence to MD was associated with MHO phenotype. Moreover, we suggest that a specific cut-off of the PREDIMED score could be an indicator to discriminate patients with MUO/MHO phenotypes and therefore help in identifying patients at higher cardiovascular risk who will require specific dietary intervention.
A high-throughput phenotyping method for sugarcane rind penetrometer resistance and breaking force characterization by near-infrared spectroscopy
Authors: Shen Yinjuan , Adnan Muhammad , Ma Fumin , Kong Liyuan , Wang Maoyao , Jiang Fuhong , Hu Qian , Yao Wei , Zhou Yongfang , Zhang Muqing , Huang Jiangfeng 
Published: September 2023

Abstract
Background
Sugarcane (Saccharum spp.) is the core crop for sugar and bioethanol production over the world. A major problem in sugarcane production is stalk lodging due to weak mechanical strength. Rind penetrometer resistance (RPR) and breaking force are two kinds of regular parameters for mechanical strength characterization. However, due to the lack of efficient methods for determining RPR and breaking force in sugarcane, genetic approaches for improving these traits are generally limited. This study was designed to use near-infrared spectroscopy (NIRS) calibration assay to accurately assess mechanical strength on a high-throughput basis for the first time.

Results
Based on well-established laboratory measurements of sugarcane stalk internodes collected in the years 2019 and 2020, considerable variations in RPR and breaking force were observed in the stalk internodes. Following a standard NIRS calibration process, two online models were obtained with a high coefficient of determination (R2) and the ratio of prediction to deviation (RPD) values during calibration, internal cross-validation, and external validation. Remarkably, the equation for RPR exhibited R2 and RPD values as high as 0.997 and 17.70, as well as showing relatively low root mean square error values at 0.44 N mm−2 during global modeling, demonstrating excellent predictive performance.

Conclusions
This study delivered a successful attempt for rapid and precise prediction of rind penetrometer resistance and breaking force in sugarcane stalk by NIRS assay. These established models can be used to improve phenotyping jobs for sugarcane germplasm on a large scale.
Comparison of the two surgery methods combined with accelerated rehabilitation in the treatment of lateral compression type 1 pelvic fractures in the elderly
Authors: Zou Min , Duan Xin , Li Mufan , Ma Liangyu , Fang Miao , Sun Jiachen 
Published: September 2023

Abstract
Background
Treating lateral compression type 1 (LC1) pelvic ring injuries in older patients is controversial. This study evaluated surgical treatments combined with ERAS for treating LC1 pelvic fractures in the elderly.

Methods
In this retrospective study, patients who underwent surgery with INFIX (supra-acetabular spinal pedicle screws, and a subcutaneous connecting rod; the experimental group) or superior pubic ramus cannulated screw (the control group) fixation of LC1 pelvic fracture from January 2019 to January 2022 were reviewed. Injury radiography and computed tomography were performed to determine the Young–Burgess classification. All patients performed standardized early rehabilitation exercises after surgery and were followed up for > 12 months. After surgery, the Matta score and the visual analog scale (VAS) were evaluated, and the postoperative weight-bearing time and the length of stay (LOS) were recorded. The Barthel index and the Majeed score were evaluated at 4 months after surgery and at the last follow-up.

Results
Fifty-three patients were included. Thirty-two patients included in the experimental group had a mean age of 75.0 ± 6.2 (range, 66–86) years, and the other 21 patients in the control group had a mean age of 74.6 ± 4.6 (range, 68–83) years. The mean follow-up time was 13.1 ± 1.6 (range, 12–18) months in the experimental group and 13.4 ± 1.3 (range, 12–16) months in the control group. There were no significant differences in follow-up time between the groups (P > 0.05). The mean VAS score, time to weight-bearing, and LOS were 2.0 ± 0.7 (range, 1–3), 1.1 ± 0.3 (range, 1–2) d, and 5.8 ± 0.9 (range, 4–7) d in the experimental group and 2.3 ± 1.2 (range, 1–5), 2.5 ± 1.6 (range, 1–7) d, and 6.1 ± 1.6 (range, 5–11) d in the control group, respectively. Between the two groups, there was a significant difference in the postoperative time to weight-bearing (P < 0.05), while there was no significant difference in the LOS (P > 0.05). No bedrest-related complications occurred in either group. The Matta score was 90.6% in the experimental group and 90.4% in the control group (P > 0.05). At the 4-months follow-up, the experimental group had a better Barthel index and Majeed score compared with the control group, which were 86.1 ± 6.2 (range, 70–95) vs. 81.2 ± 4.1 (range, 75–90) and 86.3 ± 3.3 (range, 78–91) vs. 80.3 ± 3.9 (range, 76–86), respectively. The experimental group had better early rehabilitation effect than the control group. There was no significant difference in Barthel index and Majeed score between the two groups at the last follow-up (P > 0.05).

Conclusion
Both INFIX and intramedullary superior pubic ramus cannulated screws can successfully treat LC1 pelvic fractures and reduce bed rest complications among older patients.
Late-onset cblC defect: clinical, biochemical and molecular analysis
Authors: Ding Si , Ling Shiying , Liang Lili , Qiu Wenjuan , Zhang Huiwen , Chen Ting , Zhan Xia , Xu Feng , Gu Xuefan , Han Lianshu 
Published: September 2023

Abstract
Background
cblC defect is the most common type of methylmalonic acidemia in China. Patients with late-onset form (>1 year) are often misdiagnosed due to heterogeneous symptoms. This study aimed to describe clinical characteristics and evaluate long-term outcomes of Chinese patients with late-onset cblC defect.

Methods
A total of 85 patients with late-onset cblC defect were enrolled. Clinical data, including manifestations, metabolites, molecular diagnosis, treatment and outcome, were summarized and analyzed.

Results
The age of onset ranged from 2 to 32.8 years old (median age 8.6 years, mean age 9.4 years). The time between first symptoms and diagnosis ranged from a few days to 20 years (median time 2 months, mean time 20.7 months). Neuropsychiatric symptoms were presented as first symptoms in 68.2% of cases, which were observed frequently in schoolchildren or adolescents. Renal involvement and cardiovascular disease were observed in 20% and 8.2% of cases, respectively, which occurred with the highest prevalence in preschool children. Besides the initial symptoms, the disease progressed in most patients and cognitive decline became the most frequent symptom overall. The levels of propionylcarnitine, propionylcarnitine / acetylcarnitine ratio, methylmalonic acid, methylcitric acid and homocysteine, were decreased remarkably after treatment (P<0.001). Twenty-four different mutations of MMACHC were identified in 78 patients, two of which were novel. The c.482G>A variant was the most frequent mutated allele in this cohort (25%). Except for 16 patients who recovered completely, the remaining patients were still left with varying degrees of sequelae in a long-term follow-up. The available data from 76 cases were analyzed by univariate analysis and multivariate logistic regression analysis, and the results showed that the time from onset to diagnosis (OR = 1.025, P = 0. 024) was independent risk factors for poor outcomes.

Conclusions
The diagnosis of late-onset cblC defect is often delayed due to poor awareness of its various and nonspecific symptoms, thus having an adverse effect on the prognosis. It should be considered in patients with unexplained neuropsychiatric and other conditions such as renal involvement, cardiovascular diseases or even multiple organ damage. The c.482G>A variant shows the highest frequency in these patients. Prompt treatment appears to be beneficial.
Long non-coding RNA MIDEAS-AS1 inhibits growth and metastasis of triple-negative breast cancer via transcriptionally activating NCALD
Authors: Luo Dan , Liang Yiran , Wang Yajie , Ye Fangzhou , Jin Yuhan , Li Yaming , Han Dianwen , Wang Zekun , Chen Bing , Zhao Wenjing , Wang Lijuan , Chen Xi , Jiang Liyu , Yang Qifeng 
Published: September 2023

Abstract
Background
Triple-negative breast cancer (TNBC) is a subtype of breast cancer with higher aggressiveness and poorer outcomes. Recently, long non-coding RNAs (lncRNAs) have become the crucial gene regulators in the progression of human cancers. However, the function and underlying mechanisms of lncRNAs in TNBC remains unclear.

Methods
Based on public databases and bioinformatics analyses, the low expression of lncRNA MIDEAS-AS1 in breast cancer tissues was detected and further validated in a cohort of TNBC tissues. The effects of MIDEAS-AS1 on proliferation, migration, invasion were determined by in vitro and in vivo experiments. RNA pull-down assay and RNA immunoprecipitation (RIP) assay were carried out to reveal the interaction between MIDEAS-AS1 and MATR3. Luciferase reporter assay, Chromatin immunoprecipitation (ChIP) and qRT-PCR were used to evaluate the regulatory effect of MIDEAS-AS1/MATR3 complex on NCALD.

Results
LncRNA MIDEAS-AS1 was significantly downregulated in TNBC, which was correlated with poor overall survival (OS) and progression-free survival (PFS) in TNBC patients. MIDEAS-AS1 overexpression remarkably inhibited tumor growth and metastasis in vitro and in vivo. Mechanistically, MIDEAS-AS1 mainly located in the nucleus and interacted with the nuclear protein MATR3. Meanwhile, NCALD was selected as the downstream target, which was transcriptionally regulated by MIDEAS-AS1/MATR3 complex and further inactivated NF-κB signaling pathway. Furthermore, rescue experiment showed that the suppression of cell malignant phenotype caused by MIDEAS-AS1 overexpression could be reversed by inhibition of NCALD.

Conclusions
Collectively, our results demonstrate that MIDEAS-AS1 serves as a tumor-suppressor in TNBC through modulating MATR3/NCALD axis, and MIDEAS-AS1 may function as a prognostic biomarker for TNBC.
Knowledge and practice of the physical activity prescription by generalists and specialist physicians of the city of Kinshasa: a cross-sectional study
Authors: Christian-Khalifa Emeka Bowamou , Aliocha Nkodila Natuhoyila , Constant Nkiama Ekisawa , Jean-Paul Divengi Nzambi , Eleuthère Kintoki Vita , Benjamin Longo-Mbenza , Jean-Réné M’buyamba-Kabangu , Bernard Kianu Phanzu 
Published: September 2023

Abstract
Background
The health benefits of regular physical activity (PA) are well documented. However, several people in both developed and developing countries do not meet PA recommendations. Health professionals are believed to be potential PA promoters. The purpose of this study is to gain insight into general and specialist practitioners’ knowledge, practices and PA prescription-related factors in private and public hospitals in Kinshasa.

Methods
A multicenter cross-sectional analytical study was conducted among general and specialist practitioners in the Democratic Republic of the Congo’s capital using a declarative and anonymous questionnaire.

Results
Overall, 40.2% of the participants were interested in their patient’s PA, 2.3% prescribed PA, and 0.9% did it correctly. Specialist physicians (SPs) prescribed PA more frequently than general practitioners (GP), and private hospital physicians prescribed PA more frequently than public hospital physicians. Five factors were independently associated with participants in prescribing PA: being in a private hospital increased the likelihood of prescribing PA by twofold (aOR, 1.83; 95% CI, 0.99–3.39; p = 0.055), being an SP increased the likelihood by sixfold (aOR, 6.22; 95% CI, 3.78–10.51; p = 0.000), being an internist increase the likelihood by sixfold (aOR, 5.81; 95% CI, 3.45–9.78; p = 0.000), being cardiologist by a factor of 12 (aOR, 12.91; 95% CI, 4.37–38.15; p = 0.000) and knowing the benefits of PA by a factor of 2 (aOR, 2.29; 95% CI, 1.29–4.08; p = 0.006). The most common reason given for a lack of interest in patients’ PA, followed by a lack of knowledge about current PA prescribing recommendations and a lack of time.

Conclusions
SPs and professionals in the private health sector were the most interested in their patients’ PA. A small portion of them actually prescribed it, and only a tiny proportion did it correctly. This bleak picture highlights a need to rethink the undergraduate medical curricula, especially about teachings on the importance and use of PA as a medicine in its own right in disease prevention and treatment.
Efficacy of tyrosine kinase inhibitors in patients with non-small-cell lung cancer with performance status 4: a case series and review of the literature
Authors: Sasaki Akinori , Fujimoto Yutaro , Inada Takashi , Ishizuka Azusa , Ehara Jun , Ogita Shin , Norisue Yasuhiro 
Published: September 2023

Abstract
Background
Current guidelines for non-small-cell lung cancer (NSCLC) recommend that each tyrosine kinase inhibitor (TKI) is indicated even for driver mutation-positive patients with a poor performance status (PS). In previous studies, most patients had a PS of 2–3, but those with a PS of 4 were very few. Therefore, the efficacy of TKIs in patients with NSCLC with a PS of 4 remains unclear.

Case presentation
We retrospectively reviewed the clinical records of four patients with NSCLC with PS 4 treated with TKIs: an 89-year-old Japanese woman (Case 1), a 80-year-old Japanese woman (Case 2), an 50-year-old Japanese man (Case 3), and a 81-year-old Japanese woman (Case 4). Genetic alterations were epidermal growth factor receptor (EGFR), MET exon 14 skipping, BRAFV600E, and ROS1 proto-oncogene receptor tyrosine kinase (ROS1). One case with ROS1 fusion showed a significant response with the recovery of PS. However, in the remaining three cases (i.e., EGFR, MET exon 14 skipping, and BRAFV600E mutations), patients died despite the administration of TKIs. These three patients had to be hospitalized at the end of their life to receive treatment.

Conclusions
This is the first case series to summarize the efficacy of TKIs in patients with NSCLC with a PS of 4. Additionally, this case series poses a question concerning the indication of TKIs for older patients with a PS of 4.
Research on the development and innovation of online education based on digital knowledge sharing community
Authors: Huang Xi , Li Hongwei , Huang Lirong , Jiang Tao 
Published: September 2023

Abstract
Background
Digital knowledge sharing (DKS) communities have emerged as a promising approach to support learning and innovation in online higher education. These communities facilitate the exchange of knowledge, resources, and ideas among educators, students, and experts, creating opportunities for collaboration, innovation, and lifelong learning. However, the impact and role of DKS communities in online education are not well understood, and further research is needed to explore their potential benefits and challenges.

Purpose
This multi-objective qualitative study aims to investigate the impact and role of DKS communities in online higher education, identifying the factors that promote student success and the implications for the development of online education. The study collected data from 20 informants who have experienced teaching online during and after the pandemic. Data were collected through in-depth interviews and analyzed using thematic analysis. The informants were selected through theoretical sampling.

Methodology
To explore the impact and role of DKS communities in online higher education, this study employed a multi-objective qualitative research method. Data were collected through in-depth interviews conducted with 20 informants who possessed experience in teaching online during and after the pandemic. The informants were selected through theoretical sampling to ensure diverse perspectives and insights. The collected data were subsequently analyzed using thematic analysis, allowing for the identification of key themes and patterns.

Findings
The findings of this study provide valuable insights into the impact and role of DKS communities in online higher education. These insights encompass various aspects, including the benefits and challenges of DKS in online education, the factors that contribute to student success, and the implications for the ongoing development and innovation of online education.

Conclusions
In conclusion, this multi-objective qualitative study sheds light on the significance of DKS communities in online higher education. It underscores their potential to enhance collaboration, innovation, and lifelong learning. The findings also emphasize the importance of addressing challenges and fostering an inclusive and supportive online learning environment. These insights inform best practices and contribute to the continuous development and innovation of online education, particularly in the post-pandemic educational landscape.
Cerebrospinal Fluid Metabolomic Pattern of Different Pituitary Stalk Lesions
Authors: Wang Linjie , Chen Xiaoxue , Liu Xiaoyan , Miao Hui , Gong Fengying , Yang Hongbo , Duan Lian , Zhu Huijuan , Sun Wei 
Published: September 2023

Abstract

Objective
To describe the cerebrospinal fluid (CSF) metabolomic pattern of pituitary stalk lesions.

Methods
CSF was collected from patients with different pituitary stalk lesions treated at Peking Union Medical College Hospital: germ cell tumor (GCT, n = 27); hypophysitis (n = 10); and Langerhans cell histiocytosis (LCH) or Erdheim-Chester disease (ECD) (LCH + ECD, n = 10). The CSF metabolome profiles were characterized by liquid chromatography–mass spectrometry (LC-MS).

Results
There were 44 metabolites that significantly differed between patients with GCT and those with hypophysitis (P &lt; .05). Between patients with GCT with CSF level of beta subunit of human chorionic gonadotrophin (β-hCG) &lt; 5 mIU/mL and those with hypophysitis, there were 15 differential metabolites (P &lt; .05, fold change &gt; 1.5 or &lt; 1/1.5). All of the metabolites had an area under the curve (AUC) above 0.7. There were 9 metabolites that significantly differed between patients with GCT and those with LCH + ECD (P &lt; .05) and 7 metabolites had significant differences between GCT (CSF β-hCG &lt; 5 mIU/mL) and LCH + ECD (P &lt; .05, fold change &gt; 1.5 or &lt; 1/1.5). We found 6 metabolites that were significantly different between patients with hypophysitis and those with LCH + ECD (P &lt; .05) and 5 of these had fold change more than 1.5 or less than 1/1.5. Three metabolites, 5-deoxydiplosporin, cloversaponin I, and phytosphingosine, showed excellent capabilities to differentiate the 3 disease categories. Furthermore, we identified 67 metabolites associated with clinical test results (ρ &gt; 0.2, P &lt; .05) and 29 metabolites showed strong correlation (ρ &gt; 0.4, P &lt; .05).

Conclusion
Our study is the first to systematically investigate the metabolomics of CSF in different pituitary stalk lesions. CSF metabolomics is a useful strategy for biomarker discovery.
Salivary Cortisol Response to ACTH Stimulation Is a Reliable Alternative to Serum Cortisol in Evaluating Hypoadrenalism
Authors: El-Farhan Nadia , Tennant Sarah , Rees Seren E , Evans Carol , Rees D Aled 
Published: September 2023

Abstract

Context
The serum total cortisol response to the ACTH stimulation test is widely used to assess adrenocortical function but is affected by changes in cortisol-binding globulin (CBG) concentration. Salivary cortisol reflects free cortisol concentrations and may offer a reliable alternative.

Objectives
(1) To establish the salivary cortisol response to ACTH stimulation in healthy volunteers and patients with altered CBG concentrations; (2) to evaluate the performance of a lower reference limit (LRL) determined in healthy volunteers in patients with suspected hypoadrenalism (SH-patients).

Design
A 250 µg ACTH stimulation test was undertaken in 139 healthy volunteers, 24 women taking an estradiol-containing oral contraceptive pill (OCP-females), 10 patients with low serum protein concentration (LP-patients), and 30 SH-patients. Salivary cortisol was measured by liquid chromatography-tandem mass spectrometry. Mean and LRL of the 30-minute salivary cortisol response (mean—1.96 standard deviation) were derived from log-transformed concentrations. The LRL was applied as a diagnostic cut-off in SH-patients, with comparison to the serum response.

Results
Mean CBG concentrations (range) were 58 (42-81) mg/L, 64 (43-95) mg/L, 41 (28-60) mg/L, and 116 (84-159) mg/L in males, females, LP-patients, and OCP-females, respectively. The mean 30-minute salivary cortisol concentration was 19.3 (2.5th-97.5th percentile 10.3-36.2) nmol/L in healthy volunteers. Corresponding values were not different in OCP-females [19.7 (9.5-41.2) nmol/L; P = .59] or LP-patients [19.0 (7.7-46.9) nmol/L; P = .97]. Overall diagnostic agreement between salivary and serum responses in SH-patients was 79%.

Conclusion
Salivary cortisol response to ACTH stimulation offers a reliable alternative to serum and may be especially useful in conditions of altered CBG concentration.