bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of disability level between Early and Late Onset Parkinson’s Disease using WHODAS 2
Authors: Nascimento Isaíra Almeida Pereira da Silva , Nobrega Kátia Cirilo Costa , Souza Bruno Rafael Antunes , Barone Isabela Carneiro , Checchio Giovanna , Ponciano Vitória Pereira , de Paula Clara Greif Cerveira , Possani Arieni Nunes , Penha Natália Cardoso , Helene André Frazão , Roque Antonio Carlos , Savica Rodolfo , Piemonte Maria Elisa Pimentel 
Published: November 2023

BackgroundParkinson’s disease (PD) is a degenerative neurological disorder that usually affects people over the age of 60. However, 10%–20% of patients have an early onset of PD (EOPD).ObjectivesTo compare disability levels according to the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2) between people with EOPD and those with late-onset PD (LOPD).MethodsWe conducted a cross-sectional study with 95 EOPD patients (mean-age 44.51 ± 4.63, H&amp;Y 1.93 ± 0.93) and 255 LOPD patients (mean-age 63.01 ± 7.99, H&amp;Y 2.02 ± 0.95). Demographic information, clinical characteristics, cognitive evaluation by Telephone-Montreal-Cognitive-Assessment (T-MoCA), functionality self-evaluation by WHODAS-2 and the Unified-Parkinson’s-Disease-Rating-Scale (MDS-UPDRS), parts I and II, were documented for each patient by an individual remote interview.ResultsAnalysis showed a statistically significant difference between EOPD and LOPD in two domains of WHODAS-2 only: cognition (Z-adjusted = 2.60; p-value adjusted &lt;0.009) and activities of daily living related to work/school (Z-adjusted = 2.34; p-value adjusted &lt;0.01). T-MoCA scores confirmed more impaired cognition capacity in LOPD (Z-adjusted = 2.42; p-value adjusted &lt;0.01). The two groups had no significant differences in levodopa daily dosage, Hoehn and Yahr (H&amp;Y) stages, disease time duration, and MDS-UPDRS I and II scores.ConclusionPeople living with EOPD face similar disability levels as those with LOPD, except for cognition, where LOPD patients exhibited higher levels of disability than EOPD and for work activities where the EOPD exhibited higher levels of disability than LODP. These results highlight the challenges faced by people with EOPD in interacting with society and living with the disease for a longer time. The WHODAS-2 can be a useful tool to assess disability and tailor interventions for people with PD of different age groups.
Comparing neuromotor functions in 45- and 65-year-old adults with 18-year-old adolescents
Authors: Kakebeeke Tanja H. , Chaouch Aziz , Caflisch Jon , Eichelberger Dominique A. , Wehrle Flavia M. , Jenni Oskar G. 
Published: November 2023

AimThis cross-sectional analysis investigates how neuromotor functions of two independent cohorts of approximately 45- and 65-year-old individuals are different from 18-year-old adolescents using the Zurich Neuromotor Assessment-2 (ZNA-2).MethodsA total of 186 individuals of the Zurich Longitudinal Studies (ZLS) born in the 1950s (mean age 65.1 years, SD = 1.2 year, range of ages 59.0–67.5 years, n = 151, 82 males) and 1970s (mean age 43.6 years, SD = 1.3 year, range of ages 40.8–46.6 years, n = 35, 16 males) were tested with the ZNA-2 on 14 motor tasks combined in 5 motor components: fine motor, pure motor, balance, gross motor, and associated movements. Motor performance measures were converted into standard deviation scores (SDSs) using the normative data for 18-year-old individuals as reference.ResultsThe motor performance of the 45-year-old individuals was remarkably similar to that of the 18-year-olds (SDS from −0.22 to 0.25) apart from associated movements (−0.49 SDS). The 65-year-olds showed lower performance than the 18-year-olds in all components of the ZNA-2, with the smallest difference observed for associated movements (−0.67 SDS) and the largest for gross motor skills (−2.29 SDS). Higher body mass index (BMI) was associated with better performance on gross motor skills for 45-year-olds but with worse performance for 65-year-olds. More educational years had positive effects on gross motor skills for both ages.InterpretationWith the exception of associated movements, neuromotor functions as measured with the ZNA-2 are very similar in 45- and 18-year-olds. In contrast, at age 65 years, all neuromotor components show significantly lower function than the norm population at 18 years. Some evidence was found for the last-in-first-out hypothesis: the functions that developed later during adolescence, associated movements and gross motor skills, were the most vulnerable to age-related decline.
A descriptive analysis of human milk dispensed by the Leipzig Donor Human Milk Bank for neonates between 2012 and 2019
Authors: Siziba Linda P. , Baier Caroline , Pütz Elisabeth , Ascherl Rudolf , Wendt Thomas , Thome Ulrich H. , Gebauer Corinna , Genuneit Jon 
Published: November 2023

BackgroundHuman milk banking has become an important aspect of Nutritional medicine. It is not just about the provision of mother’s own milk (MOM) or donor human milk (DHM) in the hospital, but also a strategy to encourage breastfeeding in the clinical setting and beyond.ObjectiveTo describe the feeding patterns of hospitalised infants including human milk dispensed by the Leipzig Donor Human Milk Bank (LMB).DesignA descriptive analysis of daily data on milk feeds dispensed by LMB for hospitalised infants distinguishing between MOM or DHM, either fresh or frozen, and raw/pasteurised milk from 2012–2019.ResultsWe included 2,562 infants with median hospitalisation of 23 days, for whom human milk was dispensed on median 76% of those days and other nutrition on the remaining days. Raw MOM and raw DHM comprised 52% and 8% of the dispensed milk, respectively. Dispensing exclusive DHM instead of MOM for at least one full day was required for 55% of the infants, mostly at the beginning but also later during hospitalisation. Exclusive raw DHM was dispensed on at least 1 day for 37% of the infants, in different birthweight strata &lt;1,000 g: 10%, 1,000-1500 g: 11%, 1,500-2500 g: 13% and &gt; 2,500 g: 3%. At discharge, MOM was dispensed for more than 60% of the infants.ConclusionDuring an infant’s hospital stay, LMB dispenses various human milk feeds with interspersed DHM resulting in complex intra-individual and time-variant feeding patterns. LMB dispenses raw MOM and especially raw DHM with the intention to retain the properties of human milk unlike a diet containing pasteurised DHM and/or formula. Although raw DHM comprises a small percentage of all dispensed milk, raw DHM is dispensed for a substantial portion of infants. Our results document that dispensing raw DHM, is possible in routine settings.
A comprehensive comparative assessment of eight risk stratification systems for thyroid nodules in the elderly population
Authors: Ma Xiao , Yu Jing , Huang Yuanjing , Cui Yiyang , Cui Kefei 
Published: November 2023

ObjectiveThis study aims to investigate the diagnostic value of eight risk stratification systems (RSSs) for thyroid nodules in the elderly and explore the reasons in comparison with a younger group.MethodsCases of thyroid nodules that underwent ultrasound examination with thyroidectomy or fine-needle aspiration (FNA) at our hospital between August 2013 and March 2023 were collected. The patients were categorized into two groups: an elderly group (aged ≥60) and a younger group (aged &lt;60). Eight RSSs were applied to evaluate these nodules respectively.ResultsThe malignant rate in the elderly group was significantly lower than that in the younger group (28.2% vs. 49.6%, P=0.000). There were statistically significant differences in nodule diameter, multiplicity, composition, echogenicity, orientation, margin, and echogenic foci between the elderly and younger groups (P&lt;0.05). Among the eight RSSs evaluated in elderly adults, the artificial intelligence-based Thyroid Imaging Reporting and Data System (AI TIRADS) demonstrated the highest overall diagnostic efficacy, but with relatively high unnecessary FNA rate (UFR) and missed cancer rate (MCR) of 55.0% and 51.3%, respectively. By modifying the size thresholds, the new AI TI-RADS achieved the lowest UFR and MCR while maintaining nearly the lowest FNA rate (FNAR) among all the RSSs (P=0.172, 0.162, compared to the ACR and original AI, respectively, but P&lt;0.05 compared to the other six RSSs).ConclusionAmong the eight RSS systems, AI demonstrated higher diagnostic efficacy in the elderly population. However, the size thresholds for FNA needed to be adjusted.
Eflornithine for chemoprevention in the high-risk population of colorectal cancer: a systematic review and meta-analysis with trial sequential analysis
Authors: Yang Lifeng , Wang Yan , Hu Shasha , Wang Xiaoyan 
Published: November 2023

ObjectivesTo evaluate the efficacy of Difluoromethylornithine (DFMO) chemoprevention in the high-risk population for colorectal cancer (CRC).MethodsMeta-analysis was conducted to assess the caliber of the included literature by searching five databases for randomized controlled trials of DFMO chemoprevention in the high-risk population of CRC, with RevMan 5.4, Stata 15.0 and TSA 0.9.5.10 employed to statistically analyze the extracted data. Grade profiler 3.6 was employed for grading the evidence for the outcome indicators (disease progression and adenoma incidence).ResultsSix trials were finally included in this research, with the collective data indicating that the DFMO combination therapy was efficacious in lowering the incidence of recurrent adenomas in patients who had experienced advanced CRC [RR 0.34, 95% CI 0.14 - 0.83, P &lt; 0.05]. Meta-analysis showed that DFMO combined therapy had no statistical difference in disease progression in patients with familial adenomatous polyposis[RR 0.52, 95% CI 0.14 - 1.86, P &gt; 0.05]; Trial Sequential Analysis reveals that the combination therapy of DFMO effectively diminishes the occurrence of recurrent adenomas in patients with a history of advanced colorectal tumors, displaying a Risk Ratio (RR) of 0.33 with a 95% Confidence Interval (CI) of 0.12 - 0.90 and a significance level of P &lt; 0.05. This combination exhibits a statistically significant difference. Subgroup analysis demonstrates that, depending on the drug treatment regimen (DFMO+ Aspirin/DFMO+ Sulindac), the combination of DFMO and aspirin exhibits an effect comparable to a placebo in diminishing the occurrence of new adenomas in patients with a history of advanced colorectal tumors. However, the combination of DFMO and sulindac significantly mitigates the incidence of recurrent adenomas in this patient population.ConclusionThis meta-analysis indicates that the existing randomized controlled trials are adequate to ascertain the efficacy of DFMO combination therapy in diminishing the incidence of recurrent adenomas in patients who have previously encountered advanced colorectal tumors. However, further clinical trials need to be conducted to evaluate the optimum dosage and treatment course of prophylactic implementation of DFMO combination therapy in high-risk populations.
Effects of variations in atmospheric temperature and humidity on the estimation of exclusive breastfeeding status using the deuterium oxide dose-to-mother technique
Authors: Baby Jeswin , Kaestel Pernille , Preston Tom , Duffull Stephen B. , Liu Zheng , Diana Aly , Houghton Lisa , Kurpad Anura V. , Thomas Tinku 
Published: November 2023

BackgroundThe deuterium dose-to-mother (DTM) method measures the human milk intake of breastfed children. Recently, the use of this method has been expanded to classify babies objectively as exclusively breast fed (EBF) or not (non-EBF) based on quantification of non-milk oral water intake (NMOI). However, the calculation of NMOI estimates involves atmospheric temperature and humidity.ObjectiveTo evaluate the effects of atmospheric temperature and humidity on NMOI calculation and the classification of exclusive breastfeeding.MethodsThe effect of indoor temperature and relative humidity on NMOI and the estimated prevalence of non-EBF were examined in two existing data sets of DTM in children by varying temperature in the range of 15 to 35°C and relative humidity in the range of 20 to 80% representing the maximum span of indoor conditions expected. Population-level estimates of NMOI distributions were derived using the rstan package for R v2.21.2.ResultsThe NMOI decreased at a rate of −1.15 g/day per °C increase and at a rate of −1.01 g/day per percent increase in relative humidity; this was due to variations in non-oral water intake from the atmosphere, a component of the calculation of NMOI, which is dependent on temperature and humidity. For the various locations considered, the mean calculated NMOI varied between 24.6 and 53.3 g/day using the same input data. In the mixed-fed sample of babies, the prevalence of non-EBF based on the earlier defined NMOI cut-off of 86.6 g/day was reduced by 19% when relative humidity was increased by 60%.ConclusionsAtmospheric conditions are essential factors in the computation of NMOI, used in the objective classification of babies as exclusively breast fed or not, and should be considered when the DTM method is used to classify exclusive breastfeeding.
Human N-acetyltransferase 2 (NAT2) gene variability in Brazilian populations from different geographical areas
Authors: Lopes Márcia Quinhones P. , Teixeira Raquel Lima F. , Cabello Pedro Hernan , Nery José Augusto C. , Sales Anna Maria , Nahn J. R. Edilbert Pellegrini , Moreira Marilda Vieira , Stahlke Ewalda Von Rosen , Possuelo Lia Gonçalves , Rossetti Maria Lucia R. , Rabahi Marcelo F. , Silva Luciana F. M. , Leme Patrícia Almeida , Woods William John , Nobre Mauricio Lisboa , Oliveira Maria Leide Wan-Del-Rey de , Narahashi Kazuê , Cavalcanti Milde , Suffys Philip Noel , Boukouvala Sotiria , Gallo Maria Eugênia N. , Santos Adalberto Rezende 
Published: November 2023

Introduction: Several polymorphisms altering the NAT2 activity have already been identified. The geographical distribution of NAT2 variants has been extensively studied and has been demonstrated to vary significantly among different ethnic population. Here, we describe the genetic variability of human N-acetyltransferase 2 (NAT2) gene and the predominant genotype-deduced acetylation profiles of Brazilians.Methods: A total of 964 individuals, from five geographical different regions, were genotyped for NAT2 by sequencing the entire coding exon.Results: Twenty-three previously described NAT2 single nucleotide polymorphisms (SNPs) were identified, including the seven most common ones globally (c.191G&gt;A, c.282C&gt;T, c.341T&gt;C, c.481C&gt;T, c.590G&gt;A, c.803A&gt;G and c.857G&gt;A). The main allelic groups were NAT2*5 (36%) and NAT2*6 (18.2%), followed to the reference allele NAT2*4 (20.4%). Combined into genotypes, the most prevalent allelic groups were NAT2*5/*5 (14.6%), NAT2*5/*6 (11.9%) and NAT2*6/*6 (6.2%). The genotype deduced NAT2 slow acetylation phenotype was predominant but showed significant variability between geographical regions. The prevalence of slow acetylation phenotype was higher in the Northeast, North and Midwest (51.3%, 45.5% and 41.5%, respectively) of the country. In the Southeast, the intermediate acetylation phenotype was the most prevalent (40.3%) and, in the South, the prevalence of rapid acetylation phenotype was significantly higher (36.7%), when compared to other Brazilian states (p &lt; 0.0001). Comparison of the predicted acetylation profile among regions showed homogeneity among the North and Northeast but was significantly different when compared to the Southeast (p = 0.0396). The Southern region was significantly different from all other regions (p &lt; 0.0001).Discussion: This study contributes not only to current knowledge of the NAT2 population genetic diversity in different geographical regions of Brazil, but also to the reconstruction of a more accurate phenotypic picture of NAT2 acetylator profiles in those regions.
Prognostic role of short-term heart rate variability and deceleration/acceleration capacities of heart rate in extensive-stage small cell lung cancer
Authors: Wu Shuang , Guan Weizheng , Zhao Huan , Li Guangqiao , Zhou Yufu , Shi Bo , Zhang Xiaochun 
Published: November 2023

Background: Prior research suggests that autonomic modulation investigated by heart rate variability (HRV) might act as a novel predictive biomarker for cancer prognosis, such as in breast cancer and pancreatic cancer. It is not clear whether there is a correlation between autonomic modulation and prognosis in patients with extensive-stage small cell lung cancer (ES-SCLC). Therefore, the purpose of the study was to examine the association between short-term HRV, deceleration capacity (DC) and acceleration capacity (AC) of heart rate and overall survival in patients with ES-SCLC.Methods: We recruited 40 patients with ES-SCLC, and 39 were included in the final analysis. A 5-min resting electrocardiogram of patients with ES-SCLC was collected using a microelectrocardiogram recorder to analyse short-term HRV, DC and AC. The following HRV parameters were used: standard deviation of the normal-normal intervals (SDNN) and root mean square of successive interval differences (RMSSD). Overall survival of patients with ES-SCLC was defined as time from the date of electrocardiogram measurement to the date of death or the last follow-up. Follow-up was last performed on 07 June 2023. There was a median follow-up time of 42.2 months.Results: Univariate analysis revealed that the HRV parameter SDNN, as well as DC significantly predicted the overall survival of ES-SCLC patients (all p &lt; 0.05). Multivariate analysis showed that the HRV parameters SDNN (hazard ratio = 5.254, 95% CI: 1.817–15.189, p = 0.002), RMSSD (hazard ratio = 3.024, 95% CI: 1.093–8.372, p = 0.033), as well as DC (hazard ratio = 3.909, 95% CI: 1.353–11.293, p = 0.012) were independent prognostic factors in ES-SCLC patients.Conclusion: Decreased HRV parameters (SDNN, RMSSD) and DC are independently associated with shorter overall survival in ES-SCLC patients. Autonomic nervous system function (assessed based on HRV and DC) may be a new biomarker for evaluating the prognosis of patients with ES-SCLC.
Bile acid receptors and renal regulation of water homeostasis
Authors: Guo Yanlin , Luo Taotao , Xie Guixiang , Zhang Xiaoyan 
Published: November 2023

The kidney is the key organ responsible for maintaining the body’s water and electrolyte homeostasis. About 99% of the primary urine filtered from the Bowman’s capsule is reabsorbed along various renal tubules every day, with only 1–2 L of urine excreted. Aquaporins (AQPs) play a vital role in water reabsorption in the kidney. Currently, a variety of molecules are found to be involved in the process of urine concentration by regulating the expression or activity of AQPs, such as antidiuretic hormone, renin-angiotensin-aldosterone system (RAAS), prostaglandin, and several nuclear receptors. As the main bile acid receptors, farnesoid X receptor (FXR) and membrane G protein-coupled bile acid receptor 1 (TGR5) play important roles in bile acid, glucose, lipid, and energy metabolism. In the kidney, FXR and TGR5 exhibit broad expression across all segments of renal tubules, and their activation holds significant therapeutic potential for numerous acute and chronic kidney diseases through alleviating renal lipid accumulation, inflammation, oxidative stress, and fibrosis. Emerging evidence has demonstrated that the genetic deletion of FXR or TGR5 exhibits increased basal urine output, suggesting that bile acid receptors play a critical role in urine concentration. Here, we briefly summarize the function of bile acid receptors in renal water reabsorption and urine concentration.
Khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia: a community-based study
Authors: Geremew Habtamu , Kebede Fekadu Abera , Negash Abraham , Mengstie Misganaw Asmamaw , Geremew Demeke 
Published: November 2023

IntroductionDespite its deleterious consequences, khat chewing is escalating worldwide. However, there is a lack of evidence about the extent of khat chewing among pregnant women in Ethiopia, particularly in the current study area. Therefore, this study aimed to assess the prevalence of current khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia.MethodsThis community-based cross-sectional study was conducted in Chiro district from November 1 to 30, 2022 G.C. Study participants were selected using the systematic random sampling technique. An interview-administered structured questionnaire was used to collect data through a house-to-house survey. The data were entered into EpiData version 3.1 and analyzed in STATA 14 software. Characteristics of study participants were summarized using descriptive analysis, and binary logistic regression was used to identify determinants of khat chewing.ResultsA total of 409 pregnant women participated in this study, with a response rate of 99%. The overall prevalence of khat chewing was 60.4% (95% CI: 55.5%, 65.2%). Religion (AOR: 2.08; 95% CI: 1.13, 3.82), khat cultivation (AOR: 0.43; 95% CI: 0.25, 0.77), partner khat use (AOR: 5.54; 95% CI: 3.11, 9.88), pre-pregnancy khat use (AOR: 9.95; 95% CI: 5.55, 17.81), antenatal care (ANC) visit (AOR: 2.71; 95% CI: 1.41, 5.21), and mental distress (AOR: 4.89; 95% CI: 2.38, 10.02) were significantly associated with current khat chewing.ConclusionThe majority of pregnant women in the study area practice khat chewing. Thus, accessible and comprehensive pre-conception and pre-natal care incorporating the prevention and management of antenatal khat chewing is crucial to overcome this problem. Provision of mental healthcare involving partners of pregnant women is also important to reduce the extent and impacts of khat chewing during pregnancy. Further longitudinal studies triangulated with qualitative designs are recommended.
High prevalence of low bone mineral density but normal trabecular bone score in Norwegian elite Para athletes
Authors: Koivisto-Mørk Anu E. , Steffen Kathrin , Finnes Trine E. , Pretorius Mikkel , Berge Hilde Moseby 
Published: November 2023

BackgroundLow bone mineral density (BMD) increases the risk of bone stress injuries (BSI) and is one of several clinical concerns in Para athlete sports medicine. However, whether bone microarchitecture is altered in Para athletes is not known.ObjectiveWe aimed to investigate BMD, bone microarchitecture and incidence of bone stress injuries in Norwegian elite Para athletes.DesignIn this cross-sectional study in Para athletes, Dual energy x-ray absorptiometry (iDXA, Lunar, GE Health Care) derived areal BMD, trabecular bone score (TBS), a surrogate marker for bone microarchitecture, and body composition (body weight (BW), lean body mass (LBM), fat mass (FM), fat percentage) were investigated and compared between ambulant and non-ambulant athletes. Also, the association between BMD, TBS and body composition variables was investigated. Incidence of BSI was assessed with a questionnaire and confirmed by a sports physician in a clinical interview. BMD Z-score &lt;−1 was defined as low and ≤−2 as osteoporotic. TBS ≥ 1.31 was normal, 1.23–1.31 intermediate and &lt;1.23 low.ResultsAmong 38 athletes (26 ± 6 yrs, 14 females), BMD Z-score was low in 19 athletes, and osteoporotic in 11 athletes' lumbar spine (LS) or femoral neck (FN). BMD was lower in non-ambulant vs. ambulant athletes both in LS (1.13 ± 0.19 vs. 1.25 ± 0.14 g/cm2, p = 0.030) and FN (0.90 ± 0.15 vs. 1.07 ± 0.16 g/cm2, p = 0.003). TBS was normal for all athletes. BMD Z-score in LS was positively associated with TBS (r = 0.408, p = 0.013), body weight (r = 0.326, p = 0.046) and lean body mass (r = 0.414, p = 0.010), but not with fat mass or fat percentage. None of the athletes reported any BSI.ConclusionsHalf of the Norwegian elite Para athletes had low BMD, and 29% had BMD Z-score &lt;−2 suggesting osteoporosis. Non-ambulant athletes were more prone to low BMD than ambulant athletes. However, despite high prevalence of low BMD, TBS was normal in all athletes, and BSI was absent in this young population.