bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tooth loss and the risk of cognitive decline and dementia: A meta-analysis of cohort studies
Authors: Li Liqing , Zhang Qi , Yang Di , Yang Sule , Zhao Yulan , Jiang Min , Wang Xiaofang , Zhao Ling , Liu Qi , Lu Zuxun , Zhou Xiaogang , Gan Yong , Wu Chunmei 
Published: April 2023

IntroductionEpidemiological studies have shown that tooth loss may be associated with an increased risk of cognitive decline and dementia. However, some results do not show a significant association. Therefore, we performed a meta-analysis to evaluate this association.MethodsRelevant cohort studies were searched in PubMed, Embase, Web of Science (up to May 2022), and the reference lists of retrieved articles. The pooled relative risk (RR) and 95% confidence intervals were computed using a random-effects model (CI). Heterogeneity was evaluated using the I2 statistic. Publication bias was evaluated using the Begg's and Egger's tests.ResultsEighteen cohort studies met the inclusion criteria. Original studies with 356,297 participants with an average follow-up of 8.6 years (ranging from 2 to 20 years) were included in this study. The pooled RRs of tooth loss on dementia and cognitive decline were 1.15 (95% CI: 1.10–1.20; P &lt; 0.01, I2 = 67.4%) and 1.20 (95% CI: 1.14–1.26; P = 0.04, I2 = 42.3%), respectively. The results of the subgroup analysis showed an increased association between tooth loss and Alzheimer's disease (AD) (RR = 1.12, 95% CI: 1.02–1.23) and vascular dementia (VaD) (RR = 1.25, 95% CI: 1.06–1.47). The results of the subgroup analysis also showed that pooled RRs varied by geographic location, sex, use of dentures, number of teeth or edentulous status, dental assessment, and follow-up duration. None of the Begg's and Egger's tests or funnel plots showed evidence of publication bias.DiscussionTooth loss is associated with a significantly increased risk of cognitive decline and dementia, suggesting that adequate natural teeth are important for cognitive function in older adults. The likely mechanisms mostly suggested include nutrition, inflammation, and neural feedback, especially deficiency of several nutrients like vitamin D.
Type 2 diabetes mellitus as a possible risk factor for myasthenia gravis: a case–control study
Authors: Liu Yu-Dong , Tang Fang , Li Xiao-Li , Liu Ya-Fei , Zhang Peng , Yang Chun-Lin , Du Tong , Li Heng , Wang Cong-Cong , Liu Ying , Yang Bing , Duan Rui-Sheng 
Published: April 2023

BackgroundA certain number of myasthenia gravis (MG) patients clinically had type 2 diabetes mellitus (T2DM) prior to MG onset, which suggests that the onset of MG may correlate with the history of T2DM. This study aimed to examine the correlation between MG and T2DM.MethodsIn a single-center, retrospective, 1:5 matched case–control study, all 118 hospitalized patients with a diagnosis of MG from 8 August 2014 to 22 January 2019 were enrolled. In total, four datasets with different sources of the control group were retrieved from the electronic medical records (EMRs). Data were collected at the individual level. A conditional logistic regression analysis was used to test the risk of MG associated with T2DM.FindingsThe risk of MG was significantly associated with T2DM, and there were notable differences by sex and age. Whether compared to the general population, general hospitalized patients without autoimmune diseases (AIDs), or patients with other AIDs except MG, women aged over 50 years with T2DM had an increased risk of MG. The mean onset age of diabetic MG patients was more than that of the non-diabetic MG patients.InterpretationThis study demonstrates that T2DM is strongly associated with the subsequent risk of MG and varies significantly by sex and age. It reveals that diabetic MG may be a unique subtype that is different from the conventional MG subgroup classification. More clinical and immunological features of diabetic MG patients need to be explored in further studies.
Case report: Cyclosporine A-induced extrapyramidal syndrome following hematopoietic stem cell transplantation
Authors: Al-Amrani Fatema , Al Rawas Abdulhakeem , Al-Ajmi Eiman , Al Futaisi Amna 
Published: April 2023

IntroductionCyclosporine A-associated neurotoxicity has been reported in up to 40% of patients and its wide range of neurological adverse effects have been reported, ranging from mild tremors to fatal leukoencephalopathy. Extrapyramidal (EP) neurotoxicity is a rare manifestation of cyclosporine. Cyclosporine-induced extrapyramidal syndrome remains a rare adverse reaction.Design/methodsA database search was performed for studies in patients from all age groups. We found a total of 10 articles reporting EP as an adverse effect of cyclosporine A. A total of 16 patients were found, and a thorough review of these patients was performed. A comparison of patients was performed to highlight common clinical presentations, investigations during the symptomatic phase, and prognosis. In addition, we describe an 8-year-old boy who developed cyclosporine-related extrapyramidal signs on day 60 post-hematopoietic stem cell transplantation for beta-thalassemia.ConclusionCyclosporine A can induce neurotoxicity resulting in diverse symptoms. Signs of EP are rare manifestations of cyclosporine neurotoxicity and should be considered when evaluating post-transplant recipients of cyclosporine when they are present with any EP symptoms. Discontinuation of cyclosporine results in good recovery in most patients.
Time from sudden sensory neural hearing loss to treatment as a prognostic factor
Authors: Chen Itay , Eligal Shalom , Menahem Ori , Salem Riki , Sichel Jean-Yves , Perez Ronen , Shaul Chanan 
Published: April 2023

IntroductionThe widely accepted treatment for sudden sensorineural hearing loss (SSNHL) is corticosteroid treatment (oral or intratympanic). The main goal of this work is to define the significance of the time between symptom onset and treatment initiation, as well as other prognostic factors, for hearing improvement.MethodsThis retrospective study included 666 patients treated for SSNHL. Demographic data, audiometry, treatment method, time since symptom onset, and associated symptoms were recorded for each patient. The patients were divided into five groups according to the treatment initiation time—half a week, one week, 2 weeks, 3 weeks, or 4 weeks and over—after symptom onset. The degree of improvement was assessed by comparing the audiometry at the beginning and the end of the treatment.ResultsThe average period of hearing loss from symptom onset to treatment initiation was 10.8 days. Significant differences were found between the groups of half a week, one week, and 2 weeks and the groups of 3 weeks and 4 weeks and over (each separately, p &lt; 0.001). No difference was found between the half-week, one-week, and two-week groups, nor was there a difference between the three-week and four-week-and-over groups. A correlation was found between the treatment initiation time in days and the degree of improvement in hearing for both speech recognition threshold (SRT) and discrimination, R = 0.26 p &lt; 0.001 and R = 0.17 p &lt; 0.001, respectively. No correlation was found for gender, age of the patients, comorbidities, or associated symptoms.ConclusionThe threshold for treatment initiation time is up to 2 weeks, after which the amplitude of hearing improvement decreases significantly. The other prognostic factors measured were not found to be statistically significant predictors.
Discrepancies of video head impulse test results in patients with idiopathic sudden sensorineural hearing loss with vertigo and vestibular neuritis
Authors: Liu Yingzhao , Leng Yangming , Zhou Renhong , Liu Jingjing , Wang Hongchang , Xia Kaijun , Liu Bo , Xiao Hongjun 
Published: April 2023

ObjectiveSudden sensorineural hearing loss with vertigo (SHLV) and vestibular neuritis (VN) remain frequent causes of acute vestibular syndrome (AVS). The aim of study was to compare the results of video head impulse test (vHIT) in patients with SHLV and VN. The characteristics of high-frequency vestibule-ocular reflex (VOR) and the differences of the pathophysiological mechanisms underlying these two AVS were explored.MethodsFifty-seven SHLV patients and 31 VN patients were enrolled. vHIT was conducted at the initial presentation. The VOR gains and occurrence of corrective saccades (CSs) of anterior, horizontal, and posterior semicircular canals (SCCs) in two groups were analyzed. Pathological vHIT results refer to impaired VOR gains and presence of CSs.ResultsIn SHLV group, pathological vHIT results was most prevalent in the posterior SCC on the affected side (30/57, 52.63%), followed by horizontal (12/57, 21.05%) and anterior SCC (3/57, 5.26%). In VN group, pathological vHIT preferentially affected horizontal SCC (24/31, 77.42%), followed by anterior (10/31, 32.26%) and posterior SCC (9/31, 29.03%) on the affected side. As for anterior and horizontal SCC on the affected side, the incidences of pathological vHIT results in VN group were significantly higher than those in SHLV group (β = 2.905, p &lt; 0.01; β = 2.183, p &lt; 0.001). There were no significant differences in the incidence of pathological vHIT result in posterior SCC between two groups.ConclusionComparison of vHIT results in patients with SHLV and VN revealed discrepancies in the pattern of SCCs impairments, which may be explained by different pathophysiological mechanisms underlying these two vestibular disorders presenting as AVS.
A Novel Theanine Complex, Mg-L-Theanine Improves Sleep Quality via Regulating Brain Electrochemical Activity
Authors: Dasdelen Muhammed Furkan , Er Sezgin , Kaplan Berkan , Celik Suleyman , Beker Mustafa Caglar , Orhan Cemal , Tuzcu Mehmet , Sahin Nurhan , Mamedova Havakhanum , Sylla Sarah , Komorowski James , Ojalvo Sara Perez , Sahin Kazim , Kilic Ertugrul 
Published: April 2023

Graphical AbstractThe effects of Mg-L-Theanine on brain electrochemical activity, antioxidant enzymes and sleep. Mg-L-Theanine increases sleep duration, slow waves powers, GABAergic and serotonergic receptor expressions, dopamine, melatonin, and serotonin levels, and antioxidant enzyme activity.
The Effect of Chronic Rhinosinusitis on the Staging and Prognosis of Extranodal Natural Killer/T-Cell Lymphoma: A Single-Center Retrospective Analysis
Authors: Lei Tingting , Chang Yu , Zhang Lei , Zhang Mingzhi 
Published: April 2023

Clinically, extranodal natural killer/T-cell lymphoma (ENKTL) patients frequently had a history of chronic rhinosinusitis (CRS) before onset, and the correlation between the two diseases has not been systematically reported at present. In this study, we applied the method—retrospective analysis—to explore the relationship between CRS and ENKTL. We collected clinical data and the length of CRS history before onset in 214 patients diagnosed with ENKTL and found that the length of CRS history was correlated with the stage of 182 ENKTL patients whose primary sites were upper aerodigestive tract (UAT) (χ2 = 21.317, p = 0.046, n = 182); the Spearman correlation coefficient was 0.162 (p = 0.029). There was no significant difference in stage of the non-UAT-ENKTL patients (χ2 = 18.910, p = 0.091, n = 32). The COX multivariate regression analysis showed that CRS history was an independent prognostic predictor for PFS of the UAT-ENKTL patients (p = 0.004), and patients without CRS had significantly better PFS than the more than 15 years CRS history group (p = 0.001). Our findings suggested that we should not ignore the existence of chronic inflammation of the nasal cavity in ENKTL patients. It is better to treat CRS as soon as possible in clinical practice to reduce the possibility of the occurrence or progression of UAT-ENKTL.
A simplified non-coplanar volumetric modulated arc therapy for the whole brain radiotherapy with hippocampus avoidance
Authors: Xue Juan , Jin Sunian , Zhang Hongtao , Zou Kun , Sheng Junxiu , Tang Jinhai , Zhao Wanying , Yang Ping , Tang Lufan , Lv Xiupeng , Lv Li 
Published: April 2023

PurposeTo evaluate the feasibility of using a simplified non-coplanar volumetric modulated arc therapy (NC-VMAT) and investigate its dosimetric advantages compared with intensity modulated radiation therapy (IMRT) and coplanar volumetric modulated arc therapy (C-VMAT) for hippocampal-avoidance whole brain radiation therapy (HA-WBRT).MethodsTen patients with brain metastase (BM) were included for HA-WBRT. Three treatment plans were generated for each case using IMRT, C-VMAT, and NC-VMAT, respectively.ResultsThe dosimetric results of the three techniques complied roughly with the RTOG 0933 criteria. After dose normalization, the V30Gy of whole brain planned target volume (WB-PTV) in all the plans was controlled at 95%. Homogeneity index (HI) of WB-PTV was significantly reduced in NC-VMAT (0.249 ± 0.017) over IMRT (0.265 ± 0.020, p=0.005) and C-VMAT (0.261 ± 0.014, p=0.020). In terms of conformity index (CI), NC-VMAT could provide a value of 0.821 ± 0.010, which was significantly superior to IMRT (0.788 ± 0.019, p&lt;0.001). According to D2% of WB-PTV, NC-VMAT could provide a value of 35.62 ± 0.37Gy, significantly superior to IMRT (36.43 ± 0.65Gy, p&lt;0.001). According to D50% of WB-PTV, NC-VMAT can achieve the lowest value of 33.18 ± 0.29Gy, significantly different from IMRT (33.47 ± 0.43, p=0.034) and C-VMAT (33.58 ± 0.37, p=0.006). Regarding D2%, D98%, and Dmean of hippocampus, NC-VMAT could control them at 15.57 ± 0.18Gy, 8.37 ± 0.26Gy and 11.71 ± 0.48Gy, respectively. D2% and Dmean of hippocampus for NC-VMAT was significantly lower than IMRT (D2%: 16.07 ± 0.29Gy, p=0.001 Dmean: 12.18 ± 0.33Gy, p&lt;0.001) and C-VMAT (D2%: 15.92 ± 0.37Gy, p=0.009 Dmean: 12.21 ± 0.54Gy, p&lt;0.001). For other organs-at-risk (OARs), according to D2% of the right optic nerves and the right lenses, NC-VMAT had the lowest values of 31.86 ± 1.11Gy and 7.15 ± 0.31Gy, respectively, which were statistically different from the other two techniques. For other organs including eyes and optic chiasm, NC-VMAT could achieve the lowest doses, different from IMRT statistically.ConclusionThe dosimetry of the three techniques for HA-WBRT could roughly comply with the proposals from RTOG 0933. After dose normalization (D95%=30Gy), NC-VMAT could significantly improve dose homogeneity and reduce the D50% in the brain. Besides, it can reduce the D2% of the hippocampus, optic nerves, and lens. With this approach, an efficient and straightforward plan was accomplished.
A mosaic mutation in the CLCNKB gene causing Bartter syndrome: A case report
Authors: Zhou Lan , Chen Xiaohui , Xiong Jiaojiao , Lei Ling 
Published: April 2023

BackgroundType III Bartter syndrome (BS) is an autosomal recessive disease caused by mutations in the CLCNKB (chloride voltage-gated channel Kb) gene that encodes CLC-Kb. CLC-Kb is mainly located in the thick ascending limb of Henle's loop and regulates chloride efﬂux from tubular epithelial cells to the interstitium. Type III BS is characterized by metabolic alkalosis, renal salt wasting, hyperreninemia, and hyperaldosteronism with normal blood pressure.Case presentationWe reported the case of a 3-day-old girl whose initial symptom we diagnosed as jaundice, but we accidentally found metabolic alkalosis. She showed recurrent metabolic alkalosis, hypokalemia, and hypochloremia and also had hyperreninemia and hyperaldosteronism with normal blood pressure. Both oral potassium supplements and potassium infusion therapy were unable to entirely restore the electrolyte imbalance. She was suspected of Bartter syndrome and genetic tests were performed on her and her parents. Next-generation sequencing identified CLCNKB gene mutation including heterozygous mutation c.1257delC (p.M421Cfs*58) and a low-level mutation c.595G &gt; T (p.E199*); both mutations were also verified in the parents.ConclusionWe reported the case of a classic Bartter syndrome in a newborn with a heterozygous frameshift mutation and a mosaic non-sense mutation in the CLCNKB gene.
Risk factors for neonatal sepsis among neonates in the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia
Authors: Shifera Nigusie , Dejenie Filagot , Mesafint Gebremeskel , Yosef Tewodros 
Published: April 2023

BackgroundNeonatal sepsis (NS) is a serious blood bacterial infection in children of 28 days or younger, manifested by systemic signs and symptoms of infection. Neonatal sepsis has become one of the leading causes of admission and death in developing countries like Ethiopia. Understanding different risk factors for neonatal sepsis is essential for early diagnosis and treatment. So, this study aimed to assess the risk factors for neonatal sepsis among neonates at Hawassa University Comprehensive Specialized Hospital and Adare General Hospital in Hawassa City, Ethiopia.Methods and materialsA case–control study design was employed on 264 neonates (66 cases and 198 controls) in Hawassa University Comprehensive Specialized Hospital and Adare General Hospital from April to June 2018. Data were collected by interviewing the mothers and reviewing neonates’ medical records. The data were edited, cleaned, coded, and entered into Epi info version 7 and were transported and analyzed using SPSS version 20. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the significance of the associations.ResultA total of 264 neonates (66 cases and 198 controls) with 100% response rate. The mean (±SD) age of mothers was 26 ± 4.042 years. The majority (84.8%) of the cases were found in children under 7 days, with a mean age of 3.32 days ± 3.376 SD. Factors such as prolonged rupture of the membrane [AOR = 4.627; 95% CI (1.997–10.72)], history of the urinary tract or sexually transmitted infections [AOR = 2.5; 95% CI (1.151–5.726)], intrapartum fever [AOR = 3.481; 95% CI (1.18–10.21)], foul smelling liquor [AOR = 3.64; 95% CI (1.034–12.86)], and low APGAR score in the fifth minute [AOR = 3.38; 95% CI (1.107–10.31)] were the independent predictors of neonatal sepsis.ConclusionProlonged rupture of the membrane, intrapartum fever, urinary tract infection, foul-smelling liquor, and low APGAR score were independent risk factors of neonatal sepsis, and this study also observed that the onset of neonatal sepsis was higher in the first week of a neonate's life. Routine sepsis evaluation must focus on neonates born with the aforementioned characteristics and make interventions for babies born with these risk factors.
The performance of metagenomic next-generation sequencing in diagnosing pulmonary infectious diseases using authentic clinical specimens: The Illumina platform versus the Beijing Genomics Institute platform
Authors: Han Shuangyu , Zhao Zhan , Yang Lei , Huang Jie , Wang Yubao , Feng Jing 
Published: April 2023

Introduction: Metagenomic next-generation sequencing (mNGS) has been increasingly used to detect infectious organisms and is rapidly moving from research to clinical laboratories. Presently, mNGS platforms mainly include those from Illumina and the Beijing Genomics Institute (BGI). Previous studies have reported that various sequencing platforms have similar sensitivity in detecting the reference panel that mimics clinical specimens. However, whether the Illumina and BGI platforms provide the same diagnostic performance using authentic clinical samples remains unclear.Methods: In this prospective study, we compared the performance of the Illumina and BGI platforms in detecting pulmonary pathogens. Forty-six patients with suspected pulmonary infection were enrolled in the final analysis. All patients received bronchoscopy, and the specimens collected were sent for mNGS on the two different sequencing platforms.Results: The diagnostic sensitivity of the Illumina and BGI platforms was notably higher than that of conventional examination (76.9% vs. 38.5%, p &lt; 0.001; 82.1% vs. 38.5%, p &lt; 0.001; respectively). The sensitivity and specificity for pulmonary infection diagnosis were not significantly different between the Illumina and BGI platforms. Furthermore, the pathogenic detection rate of the two platforms were not significantly different.Conclusion: The Illumina and BGI platforms exhibited similar diagnostic performance for pulmonary infectious diseases using clinical specimens, and both are superior to conventional examinations.
CRISPR-mediated genome editing in poplar issued by efficient transformation
Authors: Movahedi Ali , Wei Hui , Kadkhodaei Saeid , Sun Weibo , Zhuge Qiang , Yang Liming , Xu Chen 
Published: April 2023

BackgroundCRISPR has been increasingly used for plant genetic improvements because of its high efficiency and precision. Recently, the authors have reported the possibility of homology-directed repair (HDR) using CRISPR/Cas9 through woody plants such as poplar. HDR often replaces nucleotides with one donor DNA template (DDT), including homologous sequences.MethodsCRISPR–Cas9 was recruited, and three variables, Agrobacteria inoculator concentration, pDDT/pgRNA ratio, and homologous arm length, were designed to integrate nptII and 2XCamV 35S into the MKK2 promoter zone.ResultsHere, we showed that recovered poplars on kanamycin-supplemented media exhibited enhanced expression of MKK2 affected by the precise integration of 2XcamV 35S and nptII, improving biochemical and phenotypic properties. Our findings confirmed that Agrobacterium inoculator OD600 = 2.5, increased DDT numbers during cell division to 4:1 pDDT/pgRNA, and optimized homologous arms 700 bp caused efficient HDR and increased MKK2 expression.ConclusionEfficient transformations resulted from optimized variables, directly affecting the HDR efficiency through woody plants such as poplar.