bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative effects of acupuncture and metformin on insulin sensitivity in overweight/obese and lean women with polycystic ovary syndrome and insulin resistance: a post hoc analysis of a randomized trial
Authors: Cao Jie , Nie GuanHua , Dai Zhihao , Shan Dan , Wei Zhihong 
Published: December 2023

ObjectiveThis study explored the efficacy of acupuncture and metformin in enhancing insulin sensitivity among women with polycystic ovary syndrome (PCOS) and insulin resistance (IR), distinguishing between overweight/obese and lean groups.MethodsA post-hoc analysis of a randomized trial (NCT02491333) was undertaken. Participants were women aged 18–40 with PCOS and IR. They were randomized to receive true acupuncture with a placebo, metformin with sham acupuncture, or sham acupuncture with a placebo for 4 months, with follow-up visits over 3 months. Our study, involving 339 women, assessed the differential impact of acupuncture and metformin on insulin sensitivity in overweight/obese [body mass index (BMI) ≥ 24] versus lean women (BMI &lt; 24). Primary outcomes measured changes in the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) at 4 and 7 months. Secondary outcomes assessed changes in glucose area under the curve (glucoseAUC) during the oral glucose tolerance test (OGTT) and BMI changes at 4 months.ResultsOverweight/obese participants were generally older with higher measurements in various health metrics, but lower levels in specific hormonal metrics compared to lean women (p &lt; 0.05). Among overweight/obese women, metformin outperformed acupuncture in reducing HOMA-IR levels (p = 0.004) and showed a significant drop from the baseline after 4 months (p &lt; 0.05). In contrast, acupuncture’s effect on HOMA-IR did not significantly differ from sham acupuncture at 4 and 7 months. For lean women, metformin and acupuncture showed comparable improvements in HOMA-IR, with notable declines at 4 and 7 months (p &lt; 0.05). Acupuncture proved more beneficial for lean women than their overweight/obese counterparts after 4 months (p = 0.021).ConclusionIn overweight/obese women with PCOS and IR, acupuncture was less effective than metformin in enhancing insulin sensitivity. However, in lean women, acupuncture’s efficacy was comparable to metformin. Further studies are required to validate these observations.
Comparative analysis of codon usage patterns of Plasmodium helical interspersed subtelomeric (PHIST) proteins
Authors: Yang Baoling , Cheng Ziwen , Luo Like , Cheng Kuo , Gan Shengqi , Shi Yuyi , Liu Che , Wang Dawei 
Published: December 2023

BackgroundPlasmodium falciparum is a protozoan parasite that causes the most severe form of malaria in humans worldwide, which is predominantly found in sub-Saharan Africa, where it is responsible for the majority of malaria-related deaths. Plasmodium helical interspersed subtelomeric (PHIST) proteins are a family of proteins, with a conserved PHIST domain, which are typically located at the subtelomeric regions of the Plasmodium falciparum chromosomes and play crucial roles in the interaction between the parasite and its human host, such as cytoadherence, immune evasion, and host cell remodeling. However, the specific utilization of synonymous codons by PHIST proteins in Plasmodium falciparum is still unknown.MethodsCodon usage bias (CUB) refers to the unequal usage of synonymous codons during translation, resulting in over- or underrepresentation of certain nucleotide patterns. This imbalance in CUB can impact various cellular processes, including protein expression levels and genetic variation. To investigate this, the CUB of 88 PHIST protein coding sequences (CDSs) from 5 subgroups were analyzed in this study.ResultsThe results showed that both codon base composition and relative synonymous codon usage (RSCU) analysis identified a higher occurrence of AT-ended codons (AGA and UUA) in PHIST proteins of Plasmodium falciparum. The average effective number of codons (ENC) for these PHIST proteins was 36.69, indicating a weak codon preference among them, as it was greater than 35. Additionally, the correlation analysis among codon base composition (GC1, GC2, GC3, GCs), codon adaptation index (CAI), codon bias index (CBI), frequency of optimal codons (FOP), ENC, general average hydropathicity (GRAVY), aromaticity (AROMO), length of synonymous codons (L_sym), and length of amino acids (L_aa) revealed the influence of base composition and codon usage indices on codon usage bias, with GC1 having a significant impact in this study. Furthermore, the neutrality plot analysis, PR2-bias plot analysis, and ENC-GC3 plot analysis provided additional evidence that natural selection plays a crucial role in determining codon bias in PHIST proteins.ConclusionIn conclusion, this study has enhanced our understanding of the characteristics of codon usage and genetic evolution in PHIST proteins, thereby providing data foundation for further research on antimalarial drugs or vaccines.
The burden of myasthenia gravis – highlighting the impact on family planning and the role of social support
Authors: Stein Maike , Grittner Ulrike , Stegherr Regina , Gerischer Lea , Stascheit Frauke , Hoffmann Sarah , Herdick Meret , Legg David , Marbin Derin , Meisel Andreas , Lehnerer Sophie 
Published: December 2023

BackgroundMyasthenia gravis (MG) is a rare autoimmune disease and chronic condition that necessitates specialized care. Patients experience a significant burden of disease affecting various aspects of their lives. The aim of this study was to investigate the impact of MG on family planning, challenges associated with pregnancy, childcare responsibilities and the extent to which MG patients perceive and utilize social support.MethodsThis analysis used data from our main data of a large cross-sectional study built on a questionnaire-based survey encompassing 1,660 MG patients and members of the German Myasthenia Association (Deutsche Myasthenie Gesellschaft), and focused on sociodemographic, clinical and family planning relevant data points.ResultsDecisions regarding family planning were significantly impacted for individuals with MG when MG symptoms started either before or during their family planning (men: n = 19 and 29.7%; women: n = 156 and 58.4%). In this subgroup a substantial proportion opted against parenthood due to MG (men: n = 8 and 50.0%; women: n = 54 and 38.0% and/or another n = 12 and 8.4% of female participants encountered partner-related refusals). In the subgroup of female SP with MG starting before or during family planning who have reported ever been pregnant the self-reported miscarriage rate was 29.0% (n = 51). MG patients with medium incomes or moderate disease severity reported lower levels of perceived social support. 42.7% (n = 606) of participants needed assistance in negotiations with health insurers and 28.0% (n = 459) needed support for transportation to medical appointments.ConclusionThis study shows a significant impact of MG on family planning decisions, affecting both women and men, and often resulting in life-altering decisions such as voluntary childlessness due to MG. The significance of social support becomes evident as a vital factor, especially when navigating through the healthcare system. Tailored healthcare approaches, organized guidance and comprehensive support is needed to enable informed decision-making and offer assistance for MG patients.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT03979521, Registered 7 June 2019 (retrospectively registered).
Automatic epileptic seizure detection based on EEG using a moth-flame optimization of one-dimensional convolutional neural networks
Authors: Wang Baozeng , Yang Xingyi , Li Siwei , Wang Wenbo , Ouyang Yichen , Zhou Jin , Wang Changyong 
Published: December 2023

IntroductionFrequent epileptic seizures can cause irreversible damage to the brains of patients. A potential therapeutic approach is to detect epileptic seizures early and provide artificial intervention to the patient. Currently, extracting electroencephalogram (EEG) features to detect epileptic seizures often requires tedious methods or the repeated adjustment of neural network hyperparameters, which can be time- consuming and demanding for researchers.MethodsThis study proposes an automatic detection model for an EEG based on moth-flame optimization (MFO) optimized one-dimensional convolutional neural networks (1D-CNN). First, according to the characteristics and need for early epileptic seizure detection, a data augmentation method for dividing an EEG into small samples is proposed. Second, the hyperparameters are tuned based on MFO and trained for an EEG. Finally, the softmax classifier is used to output EEG classification from a small-sample and single channel.ResultsThe proposed model is evaluated with the Bonn EEG dataset, which verifies the feasibility of EEG classification problems that involve up to five classes, including healthy, preictal, and ictal EEG from various brain regions and individuals.DiscussionCompared with existing advanced optimization algorithms, such as particle swarm optimization, genetic algorithm, and grey wolf optimizer, the superiority of the proposed model is further verified. The proposed model can be implemented into an automatic epileptic seizure detection system to detect seizures in clinical applications.
Causal link between prefrontal cortex and EEG microstates: evidence from patients with prefrontal lesion
Authors: Zhao Zongya , Ran Xiangying , Lv Shiyang , Wang Junming , Qiu Mengyue , Wang Chang , Xu Yongtao , Guo Xiao , Gao Zhixian , Mu Junlin , Yu Yi 
Published: December 2023

IntroductionAt present, elucidating the cortical origin of EEG microstates is a research hotspot in the field of EEG. Previous studies have suggested that the prefrontal cortex is closely related to EEG microstate C and D, but whether there is a causal link between the prefrontal cortex and microstate C or D remains unclear.MethodsIn this study, pretrial EEG data were collected from ten patients with prefrontal lesions (mainly located in inferior and middle frontal gyrus) and fourteen matched healthy controls, and EEG microstate analysis was applied.ResultsOur results showed that four classical EEG microstate topographies were obtained in both groups, but microstate C topography in patient group was obviously abnormal. Compared to healthy controls, the average coverage and occurrence of microstate C significantly reduced. In addition, the transition probability from microstate A to C and from microstate B to C in patient group was significantly lower than those of healthy controls.DiscussionThe above results demonstrated that the damage of prefrontal cortex especially inferior and middle frontal gyrus could lead to abnormalities in the spatial distribution and temporal dynamics of microstate C not D, showing that there is a causal link between the inferior and middle frontal gyrus and the microstate C. The significance of our findings lies in providing new evidence for elucidating the cortical origin of microstate C.
Moderate or greater daily coffee consumption is associated with lower incidence of metabolic syndrome in Taiwanese militaries: results from the CHIEF cohort study
Authors: Tsai Kun-Zhe , Huang Wei-Chun , Sui Xuemei , Lavie Carl J. , Lin Gen-Min 
Published: December 2023

BackgroundDaily moderate coffee intake was found with a lower risk of specific metabolic abnormalities, e.g., hypertension and hyperglycemia, while the association of coffee intake and incident metabolic syndrome (MetS) has not been clarified in prior studies, particularly in young adults.MethodsA total of 2,890 military personnel, aged 18–39 years, free of MetS were followed for incident MetS from baseline (2014) until the end of 2020 in Taiwan. Daily coffee amount consumed was grouped to those ≥3 cups or 600 mL (moderate or more amount) and those without. Incidence of MetS was identified in annual health examinations. MetS was diagnosed on the basis of the guideline of the International Diabetes Federation. Multivariable Cox regression model with adjustments for sex, age, body mass index, physical activity and substance use status at baseline was performed to determine the association.ResultsAt baseline, there were 145 subjects with daily coffee intake ≥3 cups or 600 mL (5.0%) in the overall cohort. During a mean follow-up of 6.0 years, 673 incident MetS (23.3%) were found. As compared to those consuming less coffee or none, those consuming daily coffee ≥3 cups had a lower risk of MetS [hazard ratio (HR): 0.69 (95% confidence interval: 0.48, 0.99)].ConclusionThis study suggests that adhering to the guideline recommended moderate or greater daily coffee consumption for promoting health, may confer advantages in preventing the development of MetS among young adults.
Clinical efficacy and safety evaluation of camrelizumab plus lenvatinib in adjuvant therapy after hepatocellular carcinoma surgery
Authors: Wang Xudan , Cao Weiwei , Qiu Yan , Ji Hongchen , Yuan Juzheng , Wu Weikang , Liu Fuyuan , Feng Liangyong , Ding Rui , Li Xiao , Tao Kaishan 
Published: December 2023

ObjectiveTo assess the efficacy and safety of camrelizumab plus different targeted drugs in adjuvant therapy after hepatocellular carcinoma (HCC) surgery.Patients and methodsThis retrospective cohort study included HCC patients who, after undergoing failed postoperative adjuvant lenvatinib therapy, received intravenous camrelizumab 200 mg every 3 weeks (C group, n = 97), camrelizumab plus oral apatinib 250 mg daily (C+A group, n = 125), camrelizumab plus oral lenvatinib 12 mg daily (for bodyweight ≥60 kg)/lenvatinib 8 mg daily (for bodyweight &lt;60 kg) (C+L group, n = 120), or camrelizumab plus oral sorafenib 400 mg bi-daily (C+S group, n = 114) between October 2020 and October 2021. The outcomes including the objective response rate (ORR) and disease control rate (DCR) were evaluated by RECIST 1.1 and iRECIST. The median progression-free survival (mPFS), median overall survival (mOS), 6-month OS rate, 12-month OS rate, and adverse events were evaluated.ResultsAs of 31 May 2022 with last follow-up time, the ORR was 17.2% for the C group, 44.6% for the C+A group, 47.9% for the C+L group, and 36.3% for the C+S group. The DCR was 72.0% for the C group, 81.8% for the C+A group, 85.5% for the C+L group, and 77.9% for the C+S group. The mPFS was 11.0 months (10.1–12.8) for the C group, 14.0 months (12.7–16.5) for the C+A group, 18.0 months (16.9–20.1) for the C+L group, and 12.0 months (9.7–14.4) for the C+S group. The mOS was 13.0 months (11.6–15.3) for the C group, 17.0 months (15.8–19.4) for the C+A group, 19.0 months (17.7–20.2) for the C+L group, and 15.0 months (14.1–17.3) for the C+S group. Grade 3 or 4 treatment-related adverse events occurred in 14 patients (14.4%) for the C group, 10 patients (8.0%) for the C+A group, 5 patients (4.2%) for the C+L group, and 11 patients (9.6%) for the C+S group. The most common adverse events were fatigue and transaminitis.ConclusionCamrelizumab combined with lenvatinib as adjuvant therapy showed promising efficacy and manageable safety in HCC patients. It might be a potential adjuvant therapy or second-line treatment for these patients.
Efficacy and safety of chlorpromazine as an adjuvant therapy for glioblastoma in patients with unmethylated MGMT gene promoter: RACTAC, a phase II multicenter trial
Authors: Pace Andrea , Lombardi Giuseppe , Villani Veronica , Benincasa Dario , Abbruzzese Claudia , Cestonaro Ilaria , Corrà Martina , Padovan Marta , Cerretti Giulia , Caccese Mario , Silvani Antonio , Gaviani Paola , Giannarelli Diana , Ciliberto Gennaro , Paggi Marco G. 
Published: December 2023

IntroductionDrug repurposing is a promising strategy to develop new treatments for glioblastoma. In this phase II clinical trial, we evaluated the addition of chlorpromazine to temozolomide in the adjuvant phase of the standard first-line therapeutic protocol in patients with unmethylated MGMT gene promoter.MethodsThis was a multicenter phase II single-arm clinical trial. The experimental procedure involved the combination of CPZ with standard treatment with TMZ in the adjuvant phase of the Stupp protocol in newly-diagnosed GBM patients carrying an unmethylated MGMT gene promoter. Progression-free survival was the primary endpoint. Secondary endpoints were overall survival and toxicity.ResultsForty-one patients were evaluated. Twenty patients (48.7%) completed 6 cycles of treatment with TMZ+CPZ. At 6 months, 27 patients (65.8%) were without progression, achieving the primary endpoint. Median PFS was 8.0 months (95% CI: 7.0-9.0). Median OS was 15.0 months (95% CI: 13.1-16.9). Adverse events led to reduction or interruption of CPZ dosage in 4 patients (9.7%).DiscussionThe addition of CPZ to standard TMZ in the first-line treatment of GBM patients with unmethylated MGMT gene promoter was safe and led to a longer PFS than expected in this population of patients. These findings provide proof-of-concept for the potential of adding CPZ to standard TMZ treatment in GBM patients with unmethylated MGMT gene promoter.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT04224441, identifier NCT04224441.
Moderate selenium mitigates hand grip strength impairment associated with elevated blood cadmium and lead levels in middle-aged and elderly individuals: insights from NHANES 2011–2014
Authors: Liang Yafeng , Wang Junqi , Wang Tianyi , Li Hangyu , Yin Chaohui , Liu Jialin , Wei Yulong , Fan Junxing , Feng Shixing , Zhai Shuangqing 
Published: December 2023

Background: Selenium (Se) has been reported to have an antagonistic effect on heavy metals in animals. Nevertheless, there is a lack of epidemiological research examining whether Se can mitigate the adverse effects of cadmium (Cd) and lead (Pb) on hand grip strength (HGS) in middle-aged and elderly individuals.Methods: This study used data from the 2011–2014 National Health and Nutrition Examination Survey (NHANES). HGS measurements were conducted by trained examiners with a dynamometer. Concentrations of Se, Cd, and Pb in blood were determined via inductively coupled plasma mass spectrometry. We employed linear regression, restricted cubic splines, and quantile g-computation (qgcomp) to assess individual and combined associations between heavy metals and HGS. The study also explored the potential influence of Se on these associations.Results: In both individual metal and multi-metal models adjusted for confounders, general linear regression showed Se’s positive association with HGS, while Cd and Pb inversely related to it. At varying Se-Cd and Se-Pb concentrations, high Se relative to low Se can attenuate Cd and Pb’s HGS impact. An inverted U-shaped correlation exists between Se and both maximum and combined HGS, with Se’s benefit plateauing beyond approximately 200 μg/L. Stratified analysis by Se quartiles reveals Cd and Pb’s adverse HGS effects diminishing as Se levels increase. Qgcomp regression analysis detected Se alleviating HGS damage from combined Cd and Pb exposure. Subsequent subgroup analyses identified the sensitivity of women, the elderly, and those at risk of diabetes to HGS impairment caused by heavy metals, with moderate Se supplementation beneficial in mitigating this effect. In the population at risk for diabetes, the protective role of Se against heavy metal toxicity-induced HGS reduction is inhibited, suggesting that diabetic individuals should particularly avoid heavy metal-induced handgrip impairment.Conclusion: Blood Cd and Pb levels are negatively correlated with HGS. Se can mitigate this negative impact, but its effectiveness plateaus beyond 200 μg/L. Women, the elderly, and those at risk of diabetes are more vulnerable to HGS damage from heavy metals. While Se supplementation can help, its protective effect is limited in high diabetes risk groups.
Confirmatory factor analysis and gender invariance of the Persian version of psychological control scale: association with internalizing and externalizing behavior problems
Authors: Habibi Asgarabad Mojtaba , Salehi Yegaei Pardis , Mokhtari Sima , Izalnoo Balal , Trejos-Castillo Elizabeth 
Published: December 2023

IntroductionThe current cross-sectional study aimed to examine the reliability, construct validity, gender invariance and concurrent validity of the psychological control scale-youth self-report (PCS-YSR) among Iranian adolescents.MethodsA total of 1,453 high school students (49.2% boys; Mage = 15.48, SD = 0.97), who aged between 14 and 18 years old completed the PCS-YSR and the youth self-report (YSR) scale of behavior problems.ResultsReliability was established using Cronbach’s alpha and ordinal alpha for maternal and paternal psychological control. The confirmatory factor analysis (CFA) results supported the original unidimensional model of the PCS-YSR scale for both mother and father forms. Results also revealed that mother and father forms of PCS-YSR were invariant across adolescents’ gender. When comparing the mean differences, mothers were more psychologically controlling toward their sons, compared to their daughters. The mother and father forms of PCS-YSR were found to have acceptable concurrent validity through their relationship to internalizing and externalizing behavioral problems.DiscussionOverall, our findings supported the psychometric properties of the Persian version of the Psychological Control Scale-Youth Self-Report among Iranian adolescents. This scale can be used as an efficient tool for parental psychological control among adolescents in Iran. The negative effect of the intrusive parenting behavior on child’ negative outcomes in Iran, irrespective of culture, was shown.
Mitochondrial DNA oxidation, methylation, and copy number alterations in major and bipolar depression
Authors: Ceylan Deniz , Karacicek Bilge , Tufekci Kemal Ugur , Aksahin Izel Cemre , Senol Sevin Hun , Genc Sermin 
Published: December 2023

BackgroundMood disorders are common disabling psychiatric disorders caused by both genetic and environmental factors. Mitochondrial DNA (mtDNA) modifications and epigenetics are promising areas of research in depression since mitochondrial dysfunction has been associated with depression. In this study we aimed to investigate the mtDNA changes in depressive disorder (MDD) and bipolar disorder (BD).MethodsDisplacement loop methylation (D-loop-met), relative mtDNA copy number (mtDNA-cn) and mtDNA oxidation (mtDNA-oxi) were investigated in DNA samples of individuals with MDD (n = 34), BD (n = 23), and healthy controls (HC; n = 40) using the Real-Time Polymerase Chain Reaction (RT-PCR). Blood samples were obtained from a subset of individuals with MDD (n = 15) during a depressive episode (baseline) and after remission (8th week).ResultsThe study groups exhibited significant differences in D-loop-met (p = 0.020), while relative mtDNA-cn and mtDNA-oxi showed comparable results. During the remission phase (8th week), there were lower levels of relative mtDNA-cn (Z = −2.783, p = 0.005) and D-loop-met (Z = −3.180, p = 0.001) compared to the acute MDD baseline, with no significant change in mtDNA-oxi levels (Z = −1.193, p = 0.233).ConclusionOur findings indicate significantly increased D-loop methylation in MDD compared to BD and HCs, suggesting distinct mtDNA modifications in these conditions. Moreover, the observed alterations in relative mtDNA-cn and D-loop-met during remission suggest a potential role of mtDNA alterations in the pathophysiology of MDD. Future studies may provide valuable insights into the dynamics of mtDNA modifications in both disorders and their response to treatment.