bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of myasthenia gravis in the United States
Authors: Ye Yun , Murdock Dana Jorgensen , Chen Chao , Liedtke Wolfgang , Knox Caitlin A. 
Published: February 2024

IntroductionGlobal studies of epidemiology of myasthenia gravis (MG) have pointed to increasing prevalence of this rare autoimmune disorder affecting the neuromuscular synapse; however, no new data for the USA were available for decades. We aimed to estimate the incidence rate and prevalence of MG in a large-scale insured US population.MethodsWe conducted a population-based retrospective cohort study to estimate the annual incidence and prevalence of MG cases in the USA during 2017. Using a previously validated algorithm, we identified cases of MG in two Truven Health MarketScan databases, which during 2017 included a sample of approximately 20 million commercially insured and Medicare recipients, plus 10 million Medicaid recipients. We report crude incidence and prevalence and calculated age-and sex-standardized estimates for the USA based on the 2017 American Community Survey. We estimated the number of adult cases during 2021 by extrapolating from the stratified estimates to the population size from the 2021 American Community Survey.ResultsFrom the US commercially/Medicare-insured cohort, we calculated an age-and sex-standardized incidence of 68.5 new cases per million person-years with an adjusted prevalence of 316.4 per million. Within the Medicaid-insured population, similar yet slightly lower numbers emerged: the adjusted incidence was 49.7 new cases per million person-years, and the adjusted prevalence rate was 203.7 cases per million. Given our results, we were able to estimate that there were approximately 82,715 US adults living with MG in 2021 (or an estimated 320.2 cases per million adults in the USA). We observed a strong effect of age and sex when stratifying the identified incidence rate and prevalence, with a pattern of female preponderance among the younger age brackets, a male preponderance for older cases in the commercially/Medicare-insured cohort, and the disease incidence and prevalence steadily increasing with age.DiscussionOur updated US population-based estimates of MG epidemiology demonstrate an increase in the previously reported incidence and prevalence from over 20 years ago, in keeping with developments in westernized, industrialized countries. Notable findings of steadily increasing prevalence with age, driven by robust increases in elderly males, prompts questions for basic-translational research, therapeutics, and public health.
Sleep disturbances and behavioral symptoms in pediatric Sotos syndrome
Authors: Frattale Ilaria , Sarnataro Rachele , Siracusano Martina , Riccioni Assia , Galasso Cinzia , Valeriani Massimiliano , Conteduca Giuseppina , Coviello Domenico , Mazzone Luigi , Moavero Romina 
Published: February 2024

BackgroundSotos syndrome (SoS) is a rare overgrowth genetic disease caused by intragenic mutations or microdeletions of the NSD1 gene located on chromosome 5q35. SoS population might present cognitive impairment and a spectrum of behavioral characteristics, with a worse profile in patients with microdeletion. Although patients with SoS are known to have impaired sleep habits, very little data are available. The present study aimed to assess the prevalence of sleep disorders (SDs) in a pediatric cohort of patients with SoS and their correlation with neuropsychiatric profiles.MethodsWe included patients with a SoS diagnosis and age &lt; 18 years; all patients underwent a comprehensive neuropsychological assessment, including evaluation of cognition, adaptive functions through the Adaptive Behavior Assessment System-Second Edition (ABAS-II), and behavioral problems using the Achenbach Child Behavior Checklist (CBCL) and Conners’ Parent Rating Scale-Revised (CPRS-R:L) questionnaire. To investigate the presence of SD parents, the Sleep Disturbance Scale for Children (SDSC) was completed.ResultsThirty-eight patients (M 61%, F 39%, mean age 11.1 ± 4.65 years) were included in the study. Although only two had a prior SD diagnosis, 71.1% (N = 27) exhibited pathological scores on SDSC. No statistically significant associations were found between positive SDSC results and genetic microdeletion, intellectual disability (ID), or other medical conditions/treatments. However, a positive correlation emerged between SDSC scores and Conners’ Global Index (p = 0.048) and Restless/Impulsive (p = 0.01) scores, CBCL externalizing (p = 0.02), internalizing (p = 0.01), and total scores (p = 0.05). Conversely, a negative linear relationship was observed between the SDSC score and the ABAS GAC and ABAS CAD scores (p = 0.025).ConclusionWe detected an SD in 71.1% of our sample, with a positive relation between SD and internalizing and externalizing symptom levels, especially hyperactivity and impulsivity. Our study demonstrated a high prevalence of SD in pediatric patients with SoS, highlighting that all patients should be screened for this problem, which has a great impact on the quality of life of patients and their families.
Personalized probiotic strategy considering bowel habits: impacts on gut microbiota composition and alleviation of gastrointestinal symptoms via Consti-Biome and Sensi-Biome
Authors: Min Uigi , Jin Yoo-Jeong , Jang You Jin , Lim Jonghyun , Kim Byung-Yong 
Published: February 2024

Personalized probiotic regimens, taking into account individual characteristics such as stool patterns, have the potential to alleviate gastrointestinal disorders and improve gut health while avoiding the variability exhibited among individuals by conventional probiotics. This study aimed to explore the efficacy of personalized probiotic interventions in managing distinct stool patterns (constipation and diarrhea) by investigating their impact on the gut microbiome and gastrointestinal symptoms using a prospective, randomized, double-blind, placebo-controlled clinical trial design. This research leverages the multi-strain probiotic formulas, Consti-Biome and Sensi-Biome, which have previously demonstrated efficacy in alleviating constipation and diarrhea symptoms, respectively. Improvement in clinical symptoms improvement and compositional changes in the gut microbiome were analyzed in participants with predominant constipation or diarrhea symptoms. Results indicate that tailored probiotics could improve constipation and diarrhea by promoting Erysipelotrichaceae and Lactobacillaceae, producers of short-chain fatty acids, and regulating inflammation and pain-associated taxa. These findings suggest the potential of tailored probiotic prescriptions and emphasize the need for personalized therapeutic approaches for digestive disorders.Clinical trial registration: https://cris.nih.go.kr/cris/index/index.do, identifier KCT0009111.
Comparative efficacy and safety of multimodality treatment for advanced hepatocellular carcinoma with portal vein tumor thrombus: patient-level network meta-analysis
Authors: Leung John Hang , Wang Shyh-Yau , Leung Henry W. C. , Chan Agnes L. F. 
Published: February 2024

BackgroundPortal vein tumor thrombus (PVTT) is a common complication and an obstacle to treatment, with a high recurrence rate and poor prognosis. There is still no global consensus or standard guidelines on the management of hepatocellular carcinoma (HCC) with PVTT. Increasing evidence suggests that more aggressive treatment modalities, including transarterial chemoembolization, radiotherapy, targeted therapy, and various combination therapies, may improve the prognosis and prolong the survival of advanced hepatocellular carcinoma (aHCC) patients with PVTT. We aim to comprehensively review and compare the efficacy and safety of these advanced options for aHCC with PVTT.MethodsA comprehensive literature search was conducted on PubMed and EMBASE for phase II or III randomized controlled trials (RCTs) investigating multimodality treatments for aHCC with PVTT. Kaplan–Meier curves for overall survival (OS) and progression-free survival were constructed to retrieve individual patient-level data to strengthen the comparison of the benefits of all multimodality treatments of interest. Each study was pooled in a fixed-effects network meta-analysis (NMA). We also conducted subgroup analyses using risk ratios extracted from each study, including viral etiology, Barcelona Clinic Liver Cancer (BCLC) staging, alpha-fetoprotein (AFP) levels, macrovascular invasion or portal vein tumor thrombosis, and extrahepatic spread. Multimodality treatments were ranked using SUCRA scores.ResultsWe identified 15 randomized controlled trials with 16 multimodality regimens that met the inclusion criteria. Among them, 5,236 patients with OS results and 5,160 patients with PFS results were included in the analysis. The hepatic arterial infusion chemotherapy of fluorouracil, leucovorin, and oxaliplatin (HAIC-FO) showed OS and PFS benefits over all the other therapies. In terms of OS, HAIC-FO, nivolumab, and TACE+Len were superior to sorafenib, lenvatinib, and donatinib monotherapies, as well as HAIC-FO+Sor. In terms of PFS, TACE+Len showed better benefits than lenvatinib, donatinib, and tremelimumab+durvalumab. A low heterogeneity (I2 &lt; 50%) and consistency were observed. The SUCRA score for OS ranked HAIC-FO+sorafenib as the best treatment option among all multimodality treatments in hepatitis B, MVI, or PVTT with EHS and AFP 400 μg/L subgroups.ConclusionHAIC-FO and HAIC-FO+sorafenib are statistically better options for unresectable hepatocellular carcinoma with PVTT among the multimodality treatments, and their effective and safe implementation may provide the best outcomes for HCC-PVTT patients.
New insights into the anticancer effects of Polycladia crinita aqueous extract and its selenium nanoformulation against the solid Ehrlich carcinoma model in mice via VEGF, notch 1, NF-кB, cyclin D1, and caspase 3 signaling pathway
Authors: Alotaibi Badriyah S. , El-Masry Thanaa A. , Selim Hend , El-Bouseary Maisra M. , El-Sheekh Mostafa M. , Makhlof Mofida E. M. , El-Nagar Maysa M. F. 
Published: February 2024

Graphical AbstractSeNPs, selenium nanoparticles; P. crinita, Polycladia crinita; and PCSeNPs, Polycladia crinita selenium nanoparticles.
α-Mangostin hydrogel film with chitosan alginate base for recurrent aphthous stomatitis (RAS) treatment: study protocol for double-blind randomized controlled trial
Authors: Vitamia Cszahreyloren , Iftinan Ghina Nadhifah , Latarissa Irma Rahayu , Wilar Gofarana , Cahyanto Arief , Mohammed Ahmed Fouad Abdelwahab , El-Rayyes Ali , Wathoni Nasrul 
Published: February 2024

Background: Recurrent Aphthous Stomatitis (RAS) is a common ulcerative disease of the oral mucosa which is characterized by pain, and recurrent lesions in the oral cavity. This condition is quite painful, causing difficulty in eating, speaking and swallowing. Topical medications have been used for this condition, but the obstacle in using topical medications is the difficulty of achieving drug effects due to saliva wash out. This problem can be overcome by film hydrogel formulation which can protect the ulcer and reduce the pain to some extent. α-mangostin is a xanthone isolated from the rind of the mangosteen fruit. One of the activities of α-mangostin is anti-inflammatory effects, which operate through the characteristic mechanism of inhibiting the inflammatory response. This protocol study aims to investigate the efficacy of an α-mangostin hydrogel film with a chitosan alginate base for recurrent aphthous stomatitis (RAS) in comparison with a placebo over a period of 7 days.Study design: This is a two-arm, double blinding, randomized controlled trial enrolling patients with RAS. The efficacy test of α-mangostin Hydrogel Film will be tested against the placebo. Patients with RAS will be allocated randomly into the two arms and the hydrogel film will be administered for 7 days. The diameter of ulcer and visual analog scale (VAS) score will be used as the primary efficacy endpoint. The outcome measure will be compared between the two arms at the baseline, day 3, day 5, and at the end of 7 days.Discussion: The purpose of this clinical research is to provide scientific evidence on the efficacy of α-mangostin hydrogel film with a chitosan alginate basis in treating recurrent aphthous stomatitis. The trial is expected to improve our capacity to scientifically confirm the anti-inflammatory effectiveness of α-mangostin compounds in a final formulation that is ready to use.Trial registration: NCT06039774 (14 September 2023).
Young women’s leisure time physical activity determinants: a mixed methods approach
Authors: Fernandez-Lasa Uxue , Eizagirre-Sagastibeltza Olaia , Cayero Ruth , Romaratezabala Estibaliz , Martínez-Abajo Judit , Usabiaga Oidui 
Published: February 2024

IntroductionThe aim of the study was to analyze the habits, motives and barriers related to Leisure Time Physical Activity (LTPA) among young women of Gipuzkoa, from a mixed approach.MethodsA total of 526 women aged 18–29 (24.60 ± 3.30 years) responded to the Gipuzkoa Women’s Physical Activity Questionnaire (GWPAQ), seven of which were later interviewed.ResultsThe main motives for LTPA were intrapersonal — related to health and enjoyment — and to interpersonal networks. However, the main barriers facing LTPA were mostly intrapersonal, such as lack of time, tiredness, and laziness. Contextual factors such as the availability of safe spaces, previous negative experiences, or negative self-perception of motor competence also emerged as conditioning factors in young women’s LTPA habits.DiscussionThis study may help to promote policies aimed at incentivizing LTPA for young women based on their needs and interests, by addressing the diversity of factors.
Assessment of psychometric properties and measurement invariance of the sensation seeking scale for children in a Norwegian sample
Authors: Sandseter Ellen Beate Hansen , Sando Ole Johan , Kleppe Rasmus , Lorås Håvard , Storli Lise 
Published: February 2024

IntroductionThe aim of this study was to examine the psychometric properties of a Norwegian translation of the Sensation Seeking Scale for Children (SSSC), designed for children between 7 and 12 years of age.MethodsA sample of 393 children (7–10 years old) were recruited to participate in the study. The SSSC was administered through interviews with each child, wherein their responses to the SSSC questionnaire were recorded on a tablet.ResultsAnalysis of internal consistency reliability did not show acceptable reliability for all subscales, and confirmatory factor analysis (CFA) showed that the Thrill Seeking and Behavioral Intensity subscales were associated and somewhat overlapping, while Behavioral Inhibition appeared as a single factor. A further explanatory factor analysis (EFA) revealed a two-factor solution. CFA of the two-factor solution resulted in the removal of some items in both factors due to low factor loadings. The final factors resulting from this analysis were Thrill and Intensity Seeking (13 items) and Behavioral Inhibition (7 items). The results also show that boys scored higher than girls on Thrill and Intensity Seeking while girls scored higher than boys on Behavioral Inhibition. Furthermore, age was positively associated with both subscales, meaning that older children tended to score higher.DiscussionThe results in this study suggest that measures of children’s sensation seeking might be sensitive to cultural contexts and that, at least in a Norwegian population, a two-factor solution of the SSSC is recommended.
Effect of early intervention for early-stage psychotic disorders on suicidal behaviours – a systematic review protocol
Authors: Tahmazov Elkhan , Blachier Athéna , Nabbe Patrice , Guillou-Landreat Morgane , Walter Michel , Lemey Christophe 
Published: February 2024

BackgroundThe early stages of psychotic disorders correspond to the early phases of the disease and include the prodromal phase and first-episode psychosis; they constitute a period at high risk of suicidal behaviour. A long duration of untreated psychosis (DUP) is among the risk factors of suicidal behaviour identified in this early period. Many studies have shown the effectiveness of early interventions on the overall prognosis of psychotic disorders in the early stages, and early intervention strategies have been developed and tested worldwide. Several authors reported an improvement in suicidal behaviours; however, all these data have not been systematically analysed yet. The main objective of this systematic review was to collect evidence on the effect on suicidal behaviour of early interventions for patients in the early stages of psychotic disorders.MethodsWe will carry out a systematic review of the literature according to the PRISMA criteria by searching articles in five databases (PubMed, Cochrane, PsycINFO, Scopus, EMBASE), without restriction on the publication date. The selection criteria are: articles (any type; e.g. prospective, retrospective, controlled or uncontrolled, and literature reviews) on early interventions for psychotic disorders in the early stages with data on suicide attempts, death by suicide, suicidal ideation; articles written in English or French. Exclusion criteria are: articles on suicidal behaviours in patients with psychotic disorders in the early stages, but without early intervention, and articles on early-stage psychotic disorders without data on suicidal behaviours.DiscussionIf this review confirms the effectiveness on suicidal behaviours of early interventions for young patients with psychotic disorders, the development/implementation of such intervention programmes should be better promoted.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021237833.
Randomized controlled trial investigating web-based, therapist delivered eye movement desensitization and reprocessing for adults with suicidal ideation
Authors: Burback Lisa , Yap Sidney , Purdon Scot E. , Abba-Aji Adam , O’Shea Katie , Brémault-Phillips Suzette , Greenshaw Andrew J. , Winkler Olga 
Published: February 2024

IntroductionPromising preliminary evidence suggests that EMDR may reduce suicidal ideation (SI) when used to treat Major Depressive Disorder, Posttraumatic Stress Disorder, and trauma symptoms in the context of acute mental health crises. EMDR has never been tested specifically for treating SI, and there is a lack of data regarding the safety and effectiveness of web-based, therapist-delivered EMDR in populations with known SI. The primary objective of this study was to investigate the impact of web-based, therapist-delivered EMDR, targeting experiences associated with suicidal thinking. Secondary objectives included examining the effect of EMDR treatment on symptoms of depression, anxiety, posttraumatic stress, emotional dysregulation, and dissociation, as well as safety and attrition.MethodsThis randomized control trial (ClinicalTrials.gov ID number: NCT04181047) assigned adult outpatients reporting SI to either a web-based EMDR intervention or a treatment as usual (TAU) group. TAU included primary and mental health services available within the Canadian public health system. Participants in the EMDR group received up to 12 web-based EMDR desensitization sessions, delivered twice weekly during the COVID-19 pandemic (2021-2023). The Health Research Ethics Board at the University of Alberta approved the protocol prior to initiation of data collection for this study (protocol ID number: Pro00090989).ResultsForty-two adult outpatients received either EMDR (n=20) or TAU (n=22). Participants reported a high prevalence of early onset and chronic SI, and there was a high rate of psychiatric comorbidity. In the EMDR group, median SI, depression, anxiety, and posttraumatic symptom scale scores decreased from baseline to the four month follow-up. In the TAU group, only the median SI and posttraumatic symptom scale scores decreased from baseline to four month follow up. Although sample size precludes direct comparison, there were numerically fewer adverse events and fewer dropouts in the EMDR group relative to the TAU group.ConclusionStudy results provide promising preliminary evidence that web-based EMDR may be a viable delivery approach to address SI. In this complex population, a short treatment course was associated with reductions of SI and other symptoms across multiple diagnostic categories. Further investigation is warranted to verify and extend these results.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT04181047?id=NCT04181047&amp;rank=1, identifier NCT04181047
College students’ knowledge, attitudes, and practices of garbage sorting and their associations: a cross-sectional study of several universities in Beijing, China
Authors: Liu Siyuan , Liu Xiong , Li Yibo , Yang Dongli , Li Feng , Yang Junling 
Published: February 2024

BackgroundIn recent years, the Chinese government has placed growing emphasis on environmental development. The implementation of effective waste separation practices in schools is crucial for establishing an ecological civilization in China.ObjectiveThe present study aimed to assess the knowledge, attitude, and practice (KAP) of waste separation among Chinese university students and to understand the demographic factors influencing the KAP of the interviewed students. These sociodemographic factors include gender, age, education, and family environment.MethodsBased on the KAP theoretical model and the Lewin behavioral model (LBM), this study developed its questionnaire on college students’ KAP of rubbish sorting. A survey was conducted on 1,282 college students from five colleges and universities in Beijing. A one-way ANOVA, Pearson’s correlation analysis, and multiple linear stepwise regression analyzes were employed to explore the factors influencing college students’ KAP scores on waste sorting. The questionnaire’s reliability and validity were effectively verified through two rounds of Delphi expert consultation.ResultsThe scores for KAP dimensions were 55.64, 69.18, and 54.8%, respectively. The overall KAP score of university students in waste classification was 46.93 ± 9.93, with a percentage score of 62.57%. More than half of the college students lack a clear understanding of waste classification. Grade, gender, major, highest family education, and family economic status all influence college students’ KAP scores on waste classification. There is a notable deficiency in school education regarding waste classification, with only 30.7% reporting having received such education.ConclusionThis study unveils the overall KAP score of waste separation among Chinese college students, which is marginally acceptable. The interviewed students exhibit a positive attitude and a willingness to participate in waste separation. However, there is room for improvement in both knowledge and practices. A lack of knowledge about waste sorting emerges as the primary influence on individual-level practices. Consideration should be given to enhancing education and management of waste separation among college students, emphasizing the cultivation of an eco-conscious culture, and guiding students to establish correct ecological values.