bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of hyperglucagonemia in pediatric non-alcoholic fatty liver disease
Authors: Maruszczak Katharina , Radzikowski Konrad , Schütz Sebastian , Mangge Harald , Bergsten Peter , Forslund Anders , Manell Hannes , Pixner Thomas , Ahlström Håkan , Kullberg Joel , Mörwald Katharina , Weghuber Daniel 
Published: September 2022

ObjectiveOver the years, non-alcoholic fatty liver (NAFLD) disease has progressed to become the most frequent chronic liver disease in children and adolescents. The full pathology is not yet known, but disease progression leads to cirrhosis and hepatocellular carcinoma. Risk factors included hypercaloric diet, obesity, insulin resistance and genetics. Hyperglucagonemia appears to be a pathophysiological consequence of hepatic steatosis, thus, the hypothesis of the study is that hepatic fat accumulation leads to increased insulin resistance and impaired glucagon metabolism leading to hyperglucagonemia in pediatric NAFLD.Methods132 children and adolescents between 10 and 18 years, with varying degrees of obesity, were included in the study. Using Magnetic Resonance Imaging (MRI) average liver fat was determined, and patients were stratified as NAFLD (&gt;5% liver fat content) and non-NAFLD (&lt;5%). All patients underwent a standardized oral glucose tolerance test (OGTT). Additionally, anthropometric parameters (height, weight, BMI, waist circumference, hip circumference) such as lab data including lipid profile (triglycerides, HDL, LDL), liver function parameters (ALT, AST), uric acid, glucose metabolism (fasting insulin and glucagon, HbA1c, glucose 120 min) and indices evaluating insulin resistance (HIRI, SPISE, HOMA-IR, WBISI) were measured.ResultsChildren and adolescents with NAFLD had significantly higher fasting glucagon values compared to the non-NAFLD cohort (p=0.0079). In the NAFLD cohort univariate analysis of fasting glucagon was associated with BMI-SDS (p&lt;0.01), visceral adipose tissue volume (VAT) (p&lt;0.001), average liver fat content (p&lt;0.001), fasting insulin concentration (p&lt;0.001), triglycerides (p&lt;0.001) and HDL (p=0.034). This correlation equally applied to all insulin indices HOMA-IR, WBISI, HIRI (all p&lt;0.001) and SPISE (p&lt;0.002). Multivariate analysis (R² adjusted 0.509) for the same subgroup identified HIRI (p=0.003) and VAT volume (p=0.017) as the best predictors for hyperglucagonemia. Average liver fat content is predictive in pediatric overweight and obesity but not NAFLD.ConclusionsChildren and adolescents with NAFLD have significantly higher fasting plasma glucagon values, which were best predicted by hepatic insulin resistance and visceral adipose tissue, but not average liver fat content.
Effect of initial levothyroxine dose on neurodevelopmental and growth outcomes in children with congenital hypothyroidism
Authors: Esposito Andrea , Vigone Maria Cristina , Polizzi Miriam , Wasniewska Malgorzata Gabriela , Cassio Alessandra , Mussa Alessandro , Gastaldi Roberto , Di Mase Raffaella , Vincenzi Gaia , Pozzi Clara , Peroni Elena , Bravaccio Carmela , Capalbo Donatella , Bruzzese Dario , Salerno Mariacarolina 
Published: September 2022

ObjectivesWe designed a multicentre open prospective randomized trial to evaluate the risk-benefit profile of two different initial treatment schemes with levothyroxine (L-T4), 10-12.5 μg/kg/day vs 12.6-15 μg/kg/day, on growth and neurodevelopmental outcomes in children with congenital hypothyroidism (CH) detected by neonatal screening to identify the best range dose to achieve optimal neurocognitive development.Design, patients and methodsChildren detected by neonatal screening were randomly assigned to receive an initial L-T4 dose of 10-12.5 μg/kg/day (Low) or 12.6-15 μg/kg/day (High). All patients underwent periodical clinical examination with measurement of growth parameters and measurement of TSH and FT4. Neurocognitive development was evaluated at the age of 24 months using Griffiths Mental Development Scales (GMDS) and cognitive and behavioral assessment was performed at 48 months of age using Wechsler Preschool and Primary scale of Intelligence (WIPPSI-III). The study was registered with clinicaltrials.gov (NCT05371262).ResultsTreatment schemes below or above 12.5 μg/kg/day were both associated with rapid normalization of TSH and thyroid hormone levels in most patients with no differences in the risk of over- and under-treatment episodes in the first months of life. Growth parameters were normal and comparable between the two groups. Developmental quotients at 24 months of age were normal in both groups (Low 100.6 ± 15.5 vs High 96.9 ± 16.6). Likewise, at 4 years of age IQ and subtest scores were comparable between patients from Low and High (Total IQ 104.2 ± 11.4 vs 101.0 ± 20.3, Verbal IQ 103.9 ± 11.5 vs 98.7 ± 15.1, Performance IQ 105.3 ± 10.4 vs 100.3 ± 19.8). 6/45 CH patients (13.3%) showed a total IQ below 85 (73.7 ± 5.9) regardless of age at diagnosis, L-T4 starting dose, time of FT4 and TSH normalization and episodes of over and undertreatment. Worse socioeconomic status and delayed bone age at diagnosis were the only predictors of an increased risk of having suboptimal IQ at 24 and IQ at 48 months.ConclusionsOur results indicate that initial treatment with L-T4, 10-12.5 μg/kg/day vs 12.6-15 μg/kg/day, are both associated with normal growth and neurodevelopmental outcomes in children with CH detected by neonatal screening. Further studies with a long-term follow-up on a larger number of patients are needed to confirm these results.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT05371262?term=NCT05371262&amp;draw=2&amp;rank=1 identifer NCT05371262.
Serum iron is closely associated with metabolic dysfunction-associated fatty liver disease in type 2 diabetes: A real-world study
Authors: Wang Jun-Wei , Jin Chun-Hua , Ke Jiang-Feng , Ma Yi-Lin , Wang Yu-Jie , Lu Jun-Xi , Li Mei-Fang , Li Lian-Xi 
Published: September 2022

AimsThere is still a debate about the relationship between serum iron and metabolic dysfunction-associated fatty liver disease (MAFLD). Furthermore, few relevant studies were conducted in type 2 diabetes mellitus (T2DM). Therefore, this study aimed to explore the association of serum iron levels with MAFLD in Chinese patients with T2DM.MethodsThis cross-sectional, real-world study consisted of 1,467 Chinese T2DM patients. MAFLD was diagnosed by abdominal ultrasonography. Based on serum iron quartiles, the patients were classified into four groups. Clinical characteristics were compared among the four groups, and binary logistic analyses were used to assess the associations of serum iron levels and quartiles with the presence of MAFLD in T2DM.ResultsAfter adjusting for gender, age, and diabetes duration, significantly higher prevalence of MAFLD was found in the second (45.7%), third (45.2%), and fourth (47.0%) serum iron quartiles than in the first quartiles (26.8%), with the highest MAFLD prevalence in the fourth quartile (p &lt; 0.001 for trend). Moreover, increased HOMA2-IR (p = 0.003 for trend) and decreased HOMA2-S (p = 0.003 for trend) were observed across the serum iron quartiles. Fully adjusted binary logistic regression analyses indicated that both increased serum iron levels (OR: 1.725, 95% CI: 1.427 to 2.085, p &lt; 0.001) and quartiles (p &lt; 0.001 for trend) were still closely associated with the presence of MAFLD in T2DM patients even after controlling for multiple confounding factors.ConclusionsThere is a positive correlation between the presence of MAFLD and serum iron levels in T2DM patients, which may be attributed to the close association between serum iron and insulin resistance. Serum iron levels may act as one of the indicators for evaluating the risk of MAFLD in T2DM individuals.
Individual HLA heterogeneity and its implications for cellular immune evasion in cancer and beyond
Authors: Pagliuca Simona , Gurnari Carmelo , Rubio Marie Thérèse , Visconte Valeria , Lenz Tobias L. 
Published: September 2022

Structural and functional variability of human leukocyte antigen (HLA) is the foundation for competent adaptive immune responses against pathogen and tumor antigens as it assures the breadth of the presented immune-peptidome, theoretically sustaining an efficient and diverse T cell response. This variability is presumably the result of the continuous selection by pathogens, which over the course of evolution shaped the adaptive immune system favoring the assortment of a hyper-polymorphic HLA system able to elaborate efficient immune responses. Any genetic alteration affecting this diversity may lead to pathological processes, perturbing antigen presentation capabilities, T-cell reactivity and, to some extent, natural killer cell functionality. A highly variable germline HLA genotype can convey immunogenetic protection against infections, be associated with tumor surveillance or influence response to anti-neoplastic treatments. In contrast, somatic aberrations of HLA loci, rearranging the original germline configuration, theoretically decreasing its variability, can facilitate mechanisms of immune escape that promote tumor growth and immune resistance.The purpose of the present review is to provide a unified and up-to-date overview of the pathophysiological consequences related to the perturbations of the genomic heterogeneity of HLA complexes and their impact on human diseases, with a special focus on cancer.
Diversity of Escherichia coli found in the Salish Sea
Authors: Grunwald Jenny L. , Rabinowitz Peter , Weissman Scott J. , Roberts Marilyn C. 
Published: September 2022

E. coli is a species of enteric bacteria found in the intestinal tract of humans and animals that can persist in the environment and contaminate food. Anthropogenic activity has led to pathogenic E. coli from humans and animals contaminating environments through the discharge of fecal wastes in sewage and agricultural runoff. While anthropogenic sources of E. coli have been described in terrestrial and freshwater environments, gaps remain in scientific knowledge about E. coli diversity in marine environments and the risk to human and animal health. This study aims to fill in some of the knowledge gaps on the diversity of E. coli in marine ecosystems, including: 1) describe the spatial variation of the E. coli sequence types (STs) found in the study region; 2) describe available information on E. coli STs from marine environments in terms of known relationships to determine if the isolates were related to human, animal, environment strains or novel. We analyzed a dataset of 332 E. coli isolates from the Salish Sea ecosystem, comprising 196 multi-locus sequence types. Sample sources included marine water near shellfish beds, marine wildlife, river otters, and a small number of marine water sites near beaches and freshwater samples from creeks into the Salish Sea. ST10 was the most frequent ST (n=12) and was found in multiple locations and sample types. For the identified STs, we searched metadata for E. coli STs in EnteroBase, an international E. coli database. Additional information on E. coli STs was derived from searches of published studies in PubMed. We found that diversity varied between different regions of the study area, with the greatest diversity found in an area which has partially treated wastewater outflows. A higher diversity of STs associated with animals was found in an area near were animals are raised. Many of the STs identified have been associated with virulence in humans. For a number of identified STs, no references could be found in either PubMed or EnteroBase. These findings support the importance of further studies to understand the relevance of marine E. coli to human and wildlife health.
Adaptive magnetic resonance image guided radiation for intact localized prostate cancer how to optimally test a rapidly emerging technology
Authors: Hall William A. , Kishan Amar U. , Hall Emma , Nagar Himanshu , Vesprini Danny , Paulson Eric , Van der Heide Uulke A. , Lawton Colleen A. F. , Kerkmeijer Linda G. W. , Tree Alison C. 
Published: September 2022

IntroductionProstate cancer is a common malignancy for which radiation therapy (RT) provides an excellent management option with high rates of control and low toxicity. Historically RT has been given with CT based image guidance. Recently, magnetic resonance (MR) imaging capabilities have been successfully integrated with RT delivery platforms, presenting an appealing, yet complex, expensive, and time-consuming method of adapting and guiding RT. The precise benefits of MR guidance for localized prostate cancer are unclear. We sought to summarize optimal strategies to test the benefits of MR guidance specifically in localized prostate cancer.MethodsA group of radiation oncologists, physicists, and statisticians were identified to collectively address this topic. Participants had a history of treating prostate cancer patients with the two commercially available MRI-guided RT devices. Participants also had a clinical focus on randomized trials in localized prostate cancer. The goal was to review both ongoing trials and present a conceptual focus on MRI-guided RT specifically in the definitive treatment of prostate cancer, along with developing and proposing novel trials for future consideration. Trial hypotheses, endpoints, and areas for improvement in localized prostate cancer that specifically leverage MR guided technology are presented.ResultsMultiple prospective trials were found that explored the potential of adaptive MRI-guided radiotherapy in the definitive treatment of prostate cancer. Different primary areas of improvement that MR guidance may offer in prostate cancer were summarized. Eight clinical trial design strategies are presented that summarize options for clinical trials testing the potential benefits of MRI-guided RT.ConclusionsThe number and scope of trials evaluating MRI-guided RT for localized prostate cancer is limited. Yet multiple promising opportunities to test this technology and potentially improve outcomes for men with prostate cancer undergoing definitive RT exist. Attention, in the form of multi-institutional randomized trials, is needed.
Research on target recognition technology of GISC spectral imaging based on active laser lighting
Authors: Li Meixuan , Li Yanqiu , Wang Hong 
Published: September 2022

Aiming at the application requirements of spectral imaging technology in satellite remote sensing, biomedical diagnosis, marine detection and rescue, agricultural and forestry monitoring and classification, military camouflage identification, etc., this paper uses 532 and 650 nm lasers as light sources, and uses multi-spectral intensity correlation imaging equipment—snapshot spectroscopic cameras based on ghost imaging via sparsity constraints (GISC) enable precise identification of targets. In this paper, the principle of snapshot GISC spectral imaging is expounded, and the experimental research work of GISC spectral imaging target recognition technology based on active laser illumination is carried out. The experimental results show that using a 532 nm laser as the light source to illuminate the target object can accurately identify the green target letter “I”; using a 650 nm laser as the light source to illuminate the target object can accurately identify the red target letter “Q”. And gives spectral imaging results of the color target “QIT” acquired by the GISC spectroscopic camera through a single exposure at the wavelength range from 446 to 698nm, with both pseudo-color map and color fusion map. In order to further illustrate the feasibility of the experiment, the spectral distribution of the reconstructed image is analyzed, which has important practical significance and engineering value.
Case report: Castleman’s disease involving the renal sinus resembling renal cell carcinoma
Authors: Zhang Enlong , Li Yuan , Lang Ning 
Published: September 2022

IntroductionCastleman's disease (CD) is a rare benign lymphoproliferative disease that frequently involves the mediastinal thorax and the neck lymph nodes. It rarely affects extrathoracic presentations, with even fewer presentations in the renal sinus.Patient concernsIn this report, we present a case of a 40-year-old woman with no significant past medical history who presented Castleman's disease arising in the renal sinus.Diagnosis and interventionsThe patient visited our hospital with the chief complaint of left renal sinus lesion after renal ultrasonography by regular physical examination. Subsequent abdominal computed tomography urography revealed a soft tissue mass with heterogeneous obvious enhancement in the sinus of the left kidney, which was suspected to be a renal malignant tumor. Hence, the patient underwent a left radical nephrectomy. Histological examination revealed hyperplastic lymphoid follicles in the renal sinus and was finally diagnosed as Castleman's disease of the hyaline vascular type.OutcomesFive days after the surgery procedure, the patient was discharged.ConclusionDue to the low incidence of Castleman's disease in renal sinus, there is a strong likelihood of missed diagnosis or misdiagnosis, and it is, therefore, important to be aware of the risk. Heightened awareness of this disease and its radiographic manifestations may prompt consideration of this diagnosis. Therefore, we explored the radiologic findings to find out some radiologic features suggesting this condition to help clinicians to schedule nephron-sparing surgery in the future.
Plasma amyloid-beta levels correlated with impaired hepatic functions: An adjuvant biomarker for the diagnosis of biliary atresia
Authors: Lyu Hongyu , Ye Yongqin , Lui Vincent Chi Hang , Wu Weifang , Chung Patrick Ho Yu , Wong Kenneth Kak Yuen , Li Hung-Wing , Wong Man Shing , Tam Paul Kwong Hang , Wang Bin 
Published: September 2022

BackgroundBiliary atresia (BA) is an infantile fibro-obstructive cholestatic disease with poor prognosis. An early diagnosis and timely Kasai portoenterostomy (KPE) improve clinical outcomes. Aggregation of amyloid-beta (Aβ) around hepatic bile ducts has been discovered as a factor for BA pathogenesis, yet whether plasma Aβ levels correlate with hepatic dysfunctions and could be a biomarker for BA remains unknown.MethodPlasma samples of 11 BA and 24 controls were collected for liver function test, Aβ40 and Aβ42 measurement by enzyme-linked immunosorbent assay (ELISA). Pearson's chi-squared test or Mann–Whitney U test was performed to assess differences between groups. Correlation between Aβ42/Aβ40 and liver function parameters was performed using Pearson analysis. The area under the receiver-operative characteristic (ROC) curve (area under curve; AUC) was measured to evaluate the diagnostic power of Aβ42/Aβ40 for BA. Diagnostic enhancement was further evaluated by binary regression ROC analysis of Aβ42/Aβ40 combined with other hepatic function parameters.ResultsPlasma Aβ42/Aβ40 was elevated in BA patients. Aβ42 displayed a weak positive correlation with γ-glutamyl transpeptidase (GGT) (Pearson’s correlation = 0.349), while there was no correlation for Aβ40 with hepatic functions. Aβ42/Aβ40 was moderately correlated with GGT, total bile acid (TBA), direct bilirubin (DBIL) (Pearson’s correlation = 0.533, 0.475, 0.480), and weakly correlated with total bilirubin (TBIL) (Pearson’s correlation = 0.337). Aβ42/Aβ40 showed an acceptable predictive power for cholestasis [AUC = 0.746 (95% CI: 0.552–0.941), p &lt; 0.05]. Diagnostic powers of Aβ42/Aβ40 together with hepatic function parameters for cholestasis were markedly improved compared to any indicator alone. Neither Aβ42/Aβ40 nor hepatic function parameters displayed sufficient power in discriminating BA from choledochal cysts (CC); however, combinations of Aβ42/Aβ40 + GGT along with any other hepatic function parameters could differentiate BA from CC-cholestasis (AUC = 1.000, p &lt; 0.05) with a cut-off value as 0.02371, −0.28387, −0.34583, 0.06224, 0.01040, 0.06808, and 0.05898, respectively.ConclusionAβ42/Aβ40 is a good indicator for cholestasis, but alone is insufficient for a distinction of BA from non-BA. However, Aβ42/Aβ40 combined with GGT and one other hepatic function parameter displayed a high predictive power as a screening test for jaundiced neonates who are more likely to be BA, enabling them to early intraoperative cholangiography for BA confirmation and KPE to improve surgical outcomes. However, a multi-centers validation is needed before introduction into daily clinical practice.
Large Firms as Threats to Small Business Survival in South Africa: An Exploratory Literature Review
Authors: Makwara Tendai 
Published: September 2022

Objective: This study examined how large businesses negatively impact small business survival and growth in South Africa. It aims to expose harmful practices by large firms that cause small businesses to fail. Thus it seeks to challenge a commonly held assertion that larger firms are predisposed to support smaller firms to achieve growth and survival objectives. Research Design & Methods: A theoretical literature review methodology was used to conduct this study. Findings: The findings indicate that many of the threats from South African large firms targeted at small, micro and medium enterprises (SMMEs) emanate from the advantage of their size, market dominance, and close links the corporate business sector enjoys with the government. Implications & Recommendations: The study argues that larger firms in South Africa are as much of a catalyst for the demise of SMMEs as they can also be beneficial. Therefore it recommends an effective administration of the Competitions Act laws to protect SMMEs and develop new policies that seek to build SMMEs in their capacity and not as a complementary sector to big companies. Contribution & Value Added: The study contributes to the overall discourse about the role of the large business community in supporting the SMME sector in the country. It thus adds value towards broadening an understanding of the threats to small business survival in South Africa and finding solutions of how they can be supported to become viable.
TINDAK PIDANA PERKOSAAN ANAK DIBAWAH UMUR DI KOTA SEMARANG
Authors: Nafisah Nafisah , Faozi Safik 
Published: September 2022

Anak mempunyai hak, baik secara materiil maupun secara imateriil, begitupun hak mendapat perlindungan kehormatan. Kehormatan anak sangatlah menjadi keharusan khususnya untuk anak perempuan, apabila kehormatan seorang anak terangkut, maka perkembangan anak tersebut bisa terganggu, karena masa lalunya yang tidak bisa terlupakan. Kehormatan anak yang direnggut dengan cara pemerkosaan membuat penulis tertarik untuk mengkaji tindak pidana pemerkosaan yang ada di kota Semarang.dalam penelitian ini penulis akan membahas tentang apa dasar pertimbangan hakim dalam menjatuhkan putusan terhadap pelaku tindak pidana perkosaan di bawah umur di pengadilan negeri Semarang dan apa tinjauan hukum atas dasar pertimbangan hakim dalam menjatuhkan putusan terhadap pelaku tindak pidana perkosaan anak dibawah umur di pengadilan negeri Semarang.
Penelitian ini menggunakan metode yuridis normatif. Hasil penelitian yang didapat bahwa dasar pertimbangan hakim dalam menjatuhkan putusan tindak pidana perkosaan anak dibawah umur, hakim mempertimbangkan dari tiga aspek yaitu aspek fakta hukum, aspek yuridis dan aspek sosiologis dan mempertimbangkan empat hal yaitu, tinjauan hukum atas dasar pertimbangan fakta hukum, tinjauan hukum atas dasar pertimbangan yuridis, tinjauan hukum atas dasar pertimbangan sosiologis dan tinjauan hukum atas dasar pertimbangan filosofis, dari penelitian ini dapat disimpulkan bahwa hakim mengambil keputusan berdasarkan tiga aspek dan 4 hal, ini dilakukan untuk mencapai keadilan sebagaimana yang tertuang dalam ideologi Pancasila sila kelima yaitu keadilan sosial bagi seluruh rakyat Indonesia.

Kata kunci : dasar pertimbangan hakim, pelaku tindak pidana perkosaan anak dibawah umur.