bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between neck circumference and markers of dysglycemia, non-alcoholic fatty liver disease, and dysmetabolism independent of Body Mass Index in an Emirati population
Authors: Fojas Esphie Grace Fodra , Buckley Adam John , Lessan Nader 
Published: September 2022

AimNeck circumference (NC) is quick and easy to measure and may be a useful surrogate marker for body composition. We investigated NC as a potential marker of dysglycemia, MetS, and NAFLD.Methods674 individuals were recruited at the Imperial College London Diabetes Centre in a study of sleep apnea prevalence. Of these, 547 (Age 46 ± 11.4 years, Body Mass Index (BMI) 31 ± 6 kg/m2, 279 (51%) female, 113 normal glucose tolerance (NGT), 108 Prediabetes, 326 Type 2 diabetes (T2DM)) met all inclusion criteria for analysis. NC was measured at the thyroid cartilage, and collar size was recorded. Analysis was performed using univariate and multivariate linear regression.ResultsAdjusted for BMI, sex, and age, NC was 0.65 ± 0.3 cm greater in prediabetes (p = 0.0331), and 1.07 ± 0.28 cm greater in T2DM, compared with NGT (p = 0.0002). Adjusting for BMI, sex, and glycemic status, 1-cm increase in NC was associated with a 1.04 ± 1.01 U/L (p &lt;0.0001) increase in ALT and, additionally, correcting for statin use, a 0.03 ± 0.01 mmol/L reduction in HDL (p &lt;0.0001) and a 0.1 ± 0.02 increase in TC : HDL. A 1 cm increase in NC was associated with a 1.15 ± 1.02% (p &lt;0.0001) increase in 10-year AHA cardiovascular risk in individuals over 40 years old and a 0.16 ± 0.02 (p &lt;0.0001) increase in NAFLD fibrosis score. The neck circumference was associated with the hazard of new onset of deranged ALT adjusted for age, sex, glycemic status, and BMI (hazard ratio 1.076 (95% CI 1.015–1.14, p = 0.0131) and with the incidence of Fatty Liver Index associated with high probability of NAFLD (hazard ratio 1.153 (95% CI 1.019–1.304), p = 0.0239).ConclusionNC is associated with dysglycemia, components of the MetS, and factors predictive of NAFLD, but does not appear to independently predict subsequent progression to high risk of liver fibrosis in this predominantly diabetic population.
The association between blood glucose levels and lipids or lipid ratios in type 2 diabetes patients: A cross-sectional study
Authors: Wang Liqun , Yan Ning , Zhang Min , Pan Ruiping , Dang Yuqi , Niu Yang 
Published: September 2022

BackgroundLipids and lipid ratios are associated with complications of diabetes mellitus type 2 (T2DM), such as cardiovascular disease, but the relationship between blood glucose levels and lipid or lipid ratios is not fully understood in T2DM patients. This study assesses the association between blood glucose levels and lipid or lipid ratios in a cohort of T2DM patients.MethodsA total of 1,747 Chinese T2DM patients from the Ningxia province of China were included in this cross-sectional study. Lipid parameters, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), and fasting blood glucose levels were measured quantitatively using standard methods. Fasting blood glucose was divided into three groups. A multiple mixed-effect linear regression model was conducted to identify a potential association between blood glucose and lipid parameters.ResultsThere was a positive association between blood glucose and TG levels (β=0.34, 95% CI: (0.20, 0.48), p&lt;0.01); every 1 mmol/L increase in blood glucose levels resulted in a 0.34 mmol/L increase in TG. Blood glucose levels were also associated with high LDL (β=0.08, 95% CI: (0.02, 0.14), p&lt;0.01), TG/HDL-C (β=0.31, 95% CI: (0.13, 0.49), p&lt;0.01), and LDL-C/HDL-C (β=0.13, 95% CI: (0.06, 0.20), p&lt;0.01) levels. After controlling for demographic variables, health-related behaviors, and physical health variables, a positive association between blood glucose levels and TG (β=0.31, 95% CI: (0.17, 0.45), p&lt;0.01) and LDL-C (β=0.08, 95% CI: (0.02, 0.13), p&lt;0.01) levels and an in increase in TG/HDL-C (β=0.28, 95% CI: (0.09, 0.46), p&lt;0.01) and LDL-C/HDL-C (β=0.11, 95% CI: (0.04, 0.18), p&lt;0.01) ratios was found.ConclusionA correlation between blood glucose levels and serum lipids or lipid ratios has been established in this study. Blood glucose levels were positively associated with TG and LDL-C levels and elevated TG/HDL-C and LDL-C/HDL-C ratios.
Expression patterns of serum MicroRNAs related to endothelial dysfunction in patients with subclinical hypothyroidism
Authors: Yao Xuelin , Wang Ying , Wang Li , Cao Mingfeng , Chen Aifang , Zhang Xinhuan 
Published: September 2022

BackgroundIncreasing evidence has shown that elevated Thyroid stimulating hormone (TSH) levels are positively correlated with atherosclerosis (ATH) in patients with subclinical hypothyroidism (SCH). Some researchers found that the dysfunction of Endothelial Cells (ECs) in SCH plays an important role in the pathogenesis of ATH in SCH, but the association remains controversial.ObjectivesTo determine the expression profiles of serum microRNAs critical to the function of Endothelial cells (ECs) may help reanalyze the possible mechanism underlying ATH in SCH and the association between ATH and SCH.MethodsWe used qRT-PCR to perform microRNA profiling and analysis in normal control subjects (NC), patients with SCH alone (SCH), patients with SCH and ATH (SCH+ATH), and patients with ATH without SCH (ATH).ResultsBoth miR-221-3p and miR-222-3p showed a decreasing expression trend between the SCH and SCH+ATH groups. In addition, miR-126-3p and miR-150-5p showed a stepwise decrease from the NC to SCH groups and then to the SCH+ATH or ATH group. miR-21-5p was unregulated in the SCH, SCH+ATH, and ATH groups. Furthermore, elevated levels of miR-21-5p in SCH+ATH group were higher than SCH and ATH group. No differences were found in the levels of miR-150, miR-126, miR-221 and miR-222 between the ATH and the SCH+ATH subjects.ConclusionsmiR-21-5p may be involved in the atherosclerosis process in patients with SCH (SCH and SCH+ATH groups). miR-150-5p may be sensitive risk markers for predicting endothelial dysfunction in patients with ATH (ATH and SCH+ATH groups).
Identification of tumor microenvironment-related signature for predicting prognosis and immunotherapy response in patients with bladder cancer
Authors: Yao Zhihao , Zhang Henghui , Zhang Xuejun , Zhang Zhiyong , Jie Jirong , Xie Kunfeng , Li Fei , Tan Wanlong 
Published: September 2022

The tumor microenvironment (TME) not only provides fertile soil for tumor growth and development but also widely involves immune evasion as well as the resistance towards therapeutic response. Accumulating interest has been attracted from the biological function of TME to its effects on patient outcomes and treatment efficacy. However, the relationship between the TME-related gene expression profiles and the prognosis of bladder cancer (BLCA) remains unclear. The TME-related genes expression data of BLCA were collected from The Cancer Genome Atlas (TCGA) database. NFM algorithm was used to identify the distinct molecular pattern based on the significantly different TME-related genes. LASSO regression and Cox regression analyses were conducted to identify TME-related gene markers related to the prognosis of BLCA and to establish a prognostic model. The predictive efficacy of the risk model was verified through integrated bioinformatics analyses. Herein, 10 TME-related genes (PFKFB4, P4HB, OR2B6, OCIAD2, OAS1, KCNJ15, AHNAK, RAC3, EMP1, and PRKY) were identified to construct the prognostic model. The established risk scores were able to predict outcomes at 1, 3, and 5 years with greater accuracy than previously known models. Moreover, the risk score was closely associated with immune cell infiltration and the immunoregulatory genes including T cell exhaustion markers. Notably, the predictive power of the model in immunotherapy sensitivity was verified when it was applied to patients with metastatic urothelial carcinoma (mUC) undergoing immunotherapy. In conclusion, TME risk score can function as an independent prognostic biomarker and a predictor for evaluating immunotherapy response in BLCA patients, which provides recommendations for improving patients’ response to immunotherapy and promoting personalized tumor immunotherapy in the future.
Potential regulatory role of miRNA and mRNA link to metabolism affected by chronic intermittent hypoxia
Authors: Duan Yanru , Zhang Shihan , Li Yu , Zhao Wen , Xie Pinxue , Zhang Xi , Du Yunhui 
Published: September 2022

Aim: Intermittent hypoxia (IH) is the prominent feature of obstructive sleep apnea (OSA) pathophysiology, which is an in dependent risk factor of cardiovascular complications. The effects of IH on adipocyte metabolism were explored by high-throughput sequencing technology.Methods: Plasma was collected from OSA patients and control group to perform mRNA sequencing. 3T3-L1 cells were differentiated into adipocytes then subjected to a 5%–21% O2 hypoxic environment (IH) for 24 h. High-throughput sequencing method was used to determine differential mRNA and miRNA patterns in fat cells exposed to IH. We then performed Gene Ontology (GO) analysis, identified relevant KEGG pathways and miRNA-target-pathways.Results: Sequencing data showed that OSA affected the expression of 343 mRNAs in the plasma. At the same time, we found that IH affected the expression of 3034 mRNAs in the adipocytes. In addition, 68 differentially expressed mRNAs were overlapped in plasma from OSA patient and IH-induced adipocyte model. We observe that 68 differential genes could be connected to 49 reciprocally expressed miRNAs. We showed that IH significantly reduced the expression of miR-182-5p and miR-30c-2-3p. KEGG predicted that the function of expressed miR-182-5p and miR-30c-2-3p was enriched to AKT signaling pathway. Notably, IH activated PI3K/AKT pathway in fat cells.Conclusion: Our results demonstrated that IH might induce adipocyte metabolism by regulating miR-182-5p and miR-30c-2-3p.
Effects of rich cannabidiol oil on behavioral disturbances in patients with dementia: A placebo controlled randomized clinical trial
Authors: Hermush Vered , Ore Liora , Stern Noa , Mizrahi Nisim , Fried Malki , Krivoshey Marina , Staghon Ella , Lederman Violeta E. , Bar-Lev Schleider Lihi 
Published: September 2022

BackgroundAlmost 90% of patients with dementia suffer from some type of neurobehavioral symptom, and there are no approved medications to address these symptoms.ObjectiveTo evaluate the safety and efficacy of the medical cannabis oil “Avidekel” for the reduction of behavioral disturbances among patients with dementia.Materials and methodsIn this randomized, double-blind, single-cite, placebo-controlled trial conducted in Israel (ClinicalTrials.gov: NCT03328676), patients aged at least 60, with a diagnosis of major neurocognitive disorder and associated behavioral disturbances were randomized 2:1 to receive either “Avidekel,” a broad-spectrum cannabis oil (30% cannabidiol and 1% tetrahydrocannabinol: 295 mg and 12.5 mg per ml, respectively; n = 40) or a placebo oil (n = 20) three times a day for 16 weeks. The primary outcome was a decrease, as compared to baseline, of four or more points on the Cohen-Mansfield Agitation Inventory score by week 16.ResultsFrom 60 randomized patients [mean age, 79.4 years; 36 women (60.0%)], 52 (86.7%) completed the trial (all eight patients who discontinued treatment were from the investigational group). There was a statistically significant difference in the proportion of subjects who had a Cohen-Mansfield Agitation Inventory score reduction of ≥ 4 points at week 16: 24/40 (60.0%) and 6/20 (30.0%) for investigational and control groups, respectively (χ2 = 4.80, P = 0.03). There was a statistically significant difference in the proportion of subjects who had a Cohen-Mansfield Agitation Inventory score reduction of ≥ 8 points at week 16: 20/40 (50%) and 3/20 (15%), respectively (χ2 = 6.42, P = 0.011). The ANOVA repeated measures analysis demonstrated significantly more improvement in the investigational group compared to the control group at weeks 14 and 16 (F = 3.18, P = 0.02). Treatment was mostly safe, with no significant differences in the occurrence of adverse events between the two groups.ConclusionIn this randomized controlled trial, ‘Avidekel’ oil significantly reduced agitation over placebo in patients suffering from behavioral disturbances related to dementia, with non-serious side-effects. Further research is required with a larger sample size.
The therapeutic efficacy of transcranial magnetic stimulation in managing Alzheimer’s disease: A systemic review and meta-analysis
Authors: Wei Zhenyu , Fu Jiaqi , Liang Huazheng , Liu Mingli , Ye Xiaofei , Zhong Ping 
Published: September 2022

BackgroundRepetitive Transcranial Magnetic Stimulation (rTMS) is widely used to treat Alzheimer’s Disease. However, the effect of rTMS is still controversial. The purpose of the present study is to evaluate the effectiveness of rTMS on cognitive performance of AD patients.MethodsWe systematically searched relevant literatures in four major databases - PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials [Central] before 28th April 2022. Both randomized controlled trials and cross-section studies that compared the therapeutic effect of rTMS with blank control or sham stimuli were included.ResultsA total of 14 studies involving 513 AD patients were finally included for meta-analysis. It was found that rTMS significantly improved global cognitive function (SMD = 0.24, 95%CI, 0.12 to 0.36, P = 0.0001) and daily living ability (IADL: SMD = 0.64, 95%CI, 0.21to 1.08, P = 0.004) in patients with AD, but did not show improvement in language, memory, executive ability, and mood. In further analyses, rTMS at 10 Hz, on a single target with 20 sessions of treatment was shown to produce a positive effect. In addition, improvement in cognitive functions lasted for at least 6 weeks (SMD = 0.67, 95%CI, 0.05 to 1.30,P = 0.04).ConclusionrTMS can improve the global cognition and daily living ability of AD patients. In addition, attention should be paid to the safety of rTMS in AD patients with seizures. Given the relatively small sample size, our results should be interpreted with caution.
Efficacy evaluation of contrast-enhanced magnetic resonance imaging in differentiating glioma from metastatic tumor of the brain and exploration of its association with patients’ neurological function
Authors: Shi Zhuo , Jiang Jiuming , Xie Lizhi , Zhao Xinming 
Published: September 2022

ObjectiveTo determine the efficacy of contrast-enhanced MRI in differentiating glioma (GL) from the metastatic tumor of the brain (MTB) and its association with patients’ neurological function.MethodsA retrospective analysis was conducted on 49 cases of pathologically confirmed GL and 42 cases of MTB admitted between April 2019 and January 2022. All patients were examined by a set of MRI sequences that included T1WI, T2WI, FLAIR, and DWI. The values of fractional anisotropy (FA), apparent diffusion coefficient (ADC), and operation coefficient (Ktrans) were calculated by taking the tumor parenchyma area, cystic area, and peritumor edema area as the regions of interest (ROIs). And according to the Mini-mental state examination (MMSE) results, the contrast-enhanced MRI with patients’ neurological dysfunction was observed.ResultsThe clinical symptoms and MRI findings of MTB and GL were basically the same, mainly showing neurological symptoms. The tumor parenchyma area and cystic area were mainly located in the tumor periphery and tumor central area, respectively, while the peritumor edema area was widely distributed, showing an irregular patchy edema zone. Contrast-enhanced scans suggested an obvious enhancement in the tumor parenchymal area, presenting with nodular and annular enhancement, but no enhancement in the tumor cystic and peritumor edema areas. There was no difference between GL and MTB in FA values of tumor cystic area and peritumor edema area (P &gt; 0.05), but the FA value of the parenchyma area of GL was higher (P &lt; 0.05). Besides, GL and MTB showed no difference in ADC and Ktrans values (P &gt; 0.05), while the former presented lower ADC values and higher Ktrans values of the peritumor edema area than the latter (P &lt; 0.05). In patients with GL and MTB, the FA and Ktrans values of all ROIs in those with neurological dysfunction were higher compared with those without neurological dysfunction, while the ADC values were lower (P &lt; 0.05).ConclusionContrast-enhanced MRI of peritumor edema area can effectively distinguish GL from MTB, and improve the accuracy of early clinical screening, thus providing more reliable life security for patients.
Sub-arc collimator angle optimization based on the conformity index heatmap for VMAT planning of multiple brain metastases SRS treatments
Authors: Shen Jiuling , Dai Zhitao , Yu Jing , Yuan Qingqing , Kang Kailian , Chen Cheng , Liu Hui , Xie Conghua , Wang Xiaoyong 
Published: September 2022

ObjectiveThe aim of this study was to investigate the impact of collimator angle optimization in single-isocenter coplanar volume modulated arc therapy (VMAT) stereotactic radiosurgery (SRS) for multiple metastases with respect to dosimetric quality and treatment delivery efficiency. In particular, this is achieved by a novel algorithm of sub-arc collimator angle optimization (SACAO).MethodsTwenty patients with multiple brain metastases were retrospectively included in this study. A multi-leaf collimator (MLC) conformity index (MCI) that is defined as the ratio of the area of target projection in the beam’s eye view (BEV) to the related area fitted by MLC was applied. Accordingly, for each control point, 180 MCI values were calculated with a collimator angle interval of 1°. A two-dimensional heatmap of MCI as a function of control point and collimator angle for each full arc was generated. The optimal segmentation of sub-arcs was achieved by avoiding the worst MCI at each control point. Then, the optimal collimator angle for each sub-arc would be determined by maximizing the summation of MCI. Each patient was scheduled to undergo single-center coplanar VMAT SRS based on either the novel SACAO algorithm or the conventional VMAT with static collimator angle (ST-VMAT). The dosimetric parameters, field sizes, and the monitoring units (Mus) were evaluated.ResultsThe mean dose-volumetric parameters for the target volume of SACAO were comparable to ST-VMAT, while the conformity index (CI), homogeneity index (HI), and gradient index (GI) were reduced by SACAO. Improved sparing of organs at risk (OARs) was also obtained by SACAO. In particular, the SACAO method significantly (p &lt; 0.01) reduced the field size (76.59 ± 32.55 vs. 131.95 ± 56.71 cm2) and MUs (655.35 ± 71.99 vs. 729.85 ± 73.52) by 41.11%.ConclusionsThe SACAO method could be superior in improving the CI, HI, and GI of the targets as well as normal tissue sparing for multiple brain metastases SRS. In particular, SACAO has the potential of increasing treatment efficiency in terms of field size and MU.
CD20 expression is closely associated with Epstein–Barr virus infection and an inferior survival in nodular sclerosis classical Hodgkin lymphoma
Authors: Zhao Xia , Ma Yushuo , Bian Haiyan , Liu Zhihe 
Published: September 2022

BackgroundNodular sclerosis classical Hodgkin lymphoma (NSCHL) is a rare disease in which Epstein–Barr virus (EBV) and CD20 can be detected. The clinical significance of EBV infection, CD20 expression and their relationship are still unclear in NSCHL presently. The aim of this research was to systematically explore the clinical significance of EBV infection, expression of CD20 and their relationship in NSCHL.Methods109 NSCHL patients diagnosed in Qingdao University’s Affiliated Hospital were chosen from January 2010 to July 2019, and the clinical and survival data of all patients were collected retrospectively.ResultsAmong 109 patients, 33 patients were assigned to the group of EBV-positives, following the results of the EBV-encoded RNA (EBER1). Compared with EBV-negative group patients, those in the group of EBV-positive were older (P=0.004) and their β2-microglobulin (β2-MG) levels were higher (P=0.006). The CD20 positivity rate in the group of EBV-positive was substantially higher than that in the EBV-negative group (54.5% vs 27.6%, P=0.007). Among 109 patients, EBV+ and CD20+ double positive patients acquired the least overall survival (OS), and patients with EBV- and CD20- double negative had the best OS (P &lt; 0.001). Although old age, gender, EBV infection and CD20 positive were the risk factors for OS in NSCHL, multivariate analysis showed that CD20 positivity was the only characteristic that showed to be an independent risk factor for OS in NSCHL patients.ConclusionCD20 was found to be strongly expressed in NSCHL patients who had been infected with EBV, and it was found to be an independent risk factor for NSCHL patients’ survival.
A systematic review of hot weather impacts on infant feeding practices in low-and middle-income countries
Authors: Edney Jessica M. , Kovats Sari , Filippi Veronique , Nakstad Britt 
Published: September 2022

BackgroundIncreased rates of exclusive breastfeeding could significantly improve infant survival in low- and middle-income countries. There is a concern that increased hot weather due to climate change may increase rates of supplemental feeding due to infants requiring fluids, or the perception that infants are dehydrated.ObjectiveTo understand how hot weather conditions may impact infant feeding practices by identifying and appraising evidence that exclusively breastfed infants can maintain hydration levels under hot weather conditions, and by examining available literature on infant feeding practices in hot weather.MethodsSystematic review of published studies that met inclusion criteria in MEDLINE, EMBASE, Global Health and Web of Science databases. The quality of included studies was appraised against predetermined criteria and relevant data extracted to produce a narrative synthesis of results.ResultsEighteen studies were identified. There is no evidence among studies of infant hydration that infants under the age of 6months require supplementary food or fluids in hot weather conditions. In some settings, healthcare providers and relatives continue to advise water supplementation in hot weather or during the warm seasons. Cultural practices, socio-economic status, and other locally specific factors also affect infant feeding practices and may be affected by weather and seasonal changes themselves.ConclusionInterventions to discourage water/other fluid supplementation in breastfeeding infants below 6 months are needed, especially in low-middle income countries. Families and healthcare providers should be advised that exclusive breastfeeding (EBF) is recommended even in hot conditions.