bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations Between Different Dietary Vitamins and the Risk of Obesity in Children and Adolescents: A Machine Learning Approach
Authors: Tang Weifeng , Zhan Wenqiang , Wei Mengdan , Chen Qian 
Published: February 2022

BackgroundsSimultaneous dietary intake of vitamins is considered as a common and real scenario in daily life. However, limited prospective studies have evaluated the association between multivitamins intake and obesity in children and adolescents.ObjectivesThis study aimed to evaluate the relationship between the intake of different dietary vitamins and the risk of obesity in children (6-11 years) and adolescents (12-19 years).MethodsWe conducted a cross-sectional study based on data from U.S. National Health and Nutrition Examination Survey, 2013-2016. A total of 3634 children and adolescents were included who had available data on dietary vitamins, obesity and covariates. We analyzed the dietary intake levels of nine vitamins, including vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, vitamin C, vitamin D, vitamin E, vitamin K. Multivariate logistic regression was used to model the associations between vitamins and obesity. Bayesian kernel machine regression (BKMR) was employed to explore the joint and independent effects of vitamins on obesity among children and adolescents.ResultsIn the multivariate logistic regression model, five vitamins (vitamin A, vitamin B1, vitamin B2, vitamin B12, and vitamin D) were negatively associated with obesity in children and adolescents. BKMR analysis showed that when the concentration of the nine vitamins was at or above the 55th percentile compared with the median value, the combined intake of these vitamins could significantly reduce the risk of obesity in children and adolescents. Potential interactions between vitamin B2 and vitamin B12 in increasing the risk of obesity in children and adolescents were observed.ConclusionsWe determine the combined effects of multivitamins on obesity in children and adolescents, and observe a significant interaction between vitamin B2 and vitamin B12. Further cohort studies are needed to clarify the health effects of multivitamins intake in a larger population.
Comparison of Different Mandibular Jawlines Classifications on Transoral Endoscopic Thyroidectomy for Papillary Thyroid Carcinoma: Experiences of 690 Cases
Authors: Yu Xing , Jiang Yuancong , Li Yujun , He Qionghua , Pan Lei , Zhu Peifeng , Wang Yong , Wang Ping 
Published: February 2022

BackgroundThe influences of patients’ different mandibular jawlines on transoral endoscopic thyroidectomy via vestibular approach (TOETVA) have not been described before. The objective of this study was to introduce a new classification to assess different mandibular jawlines, and to evaluate the effects on TOETVA in terms of safety, feasibility, and postoperative feelings in the treatment of papillary thyroid carcinoma (PTC).MethodsThe crossing angle of esthetic plane and mandibular plane was defined as Wang Angle, used to assess patients’ different mandibular jawlines. Mandibular classifications of A (angle: 80° ~ 110°), B (angle &gt; 110°), and C (angle &lt; 80°) types were compared to evaluate the surgical outcomes of TOETVA by a retrospective study. 690 patients of PTC who received TOETVA were included in this study, which were divided into three groups according to mandibular classifications.ResultsClinicopathological characteristics of the patients including age, gender, body mass index, tumor size, Hashimoto thyroiditis were similar in the three groups. Patients’ length of jay in group C was significantly longer than group A and group B (P &lt; 0.01). The ratios of using suspension system in group C were significantly higher than group A and group B (P &lt; 0.01). The scores of postoperative visual analogue scale (VAS) and ratios of mandibular swell in group C were significantly higher than group A and group B (P &lt; 0.01). There was no significant difference in the three groups regarding surgical outcomes, including postoperative vocal cord paralysis, hypocalcemia, serum white blood cells and C-reactive protein levels.ConclusionsThe Wang angle and mandibular jawline classifications were firstly introduced in TOETVA. All the patients of class A, B, and C mandibular jawline can achieve safe and effective surgical outcomes in the treatment of PTC with TOETVA. Patients of class C need more assistance of suspension system, would experience higher scores of VAS, and higher ratios of mandibular swell compared with class A and B.
Improving Sustainable Field-Grown Wheat Production With Azospirillum brasilense Under Tropical Conditions: A Potential Tool for Improving Nitrogen Management
Authors: Galindo Fernando Shintate , Pagliari Paulo Humberto , Fernandes Guilherme Carlos , Rodrigues Willian Lima , Boleta Eduardo Henrique Marcandalli , Jalal Arshad , Céu Elaine Garcia Oliveira , Lima Bruno Horschut de , Lavres José , Teixeira Filho Marcelo Carvalho Minhoto 
Published: February 2022

Sustainable intensification of cropping systems requires to increase productivity and nutrients use efficiency while reducing negative impacts of agricultural management practices on ecosystem and environment. Plant growth-promoting rhizobacteria (PGPR) inoculations are considered one of the most promising and safe strategy to alleviate environmental alterations in context of climatic extremes to improve plant nutrition while reducing dependency of nitrogen (N) fertilizer application. This study investigated the interactive effects of N levels and inoculation with A. brasilense on plant biomass, grain yield, agronomic efficiency (AE) of applied N, apparent N-fertilizer recovery (AFR) and N content in plant targeting economic feasibility of wheat production system. The field trial tested 4 N application levels applied in side-dressing (control, low, average and high; named 0, 50, 100 and 200 kg N ha−1) and two inoculations (without and with A. brasilense seed inoculation). The results exhibited that inoculation with A. brasilense enhanced AE, AFR and N uptake in wheat plants with increased root and shoot N accumulation and grain N accumulation under average and high N application levels. In addition, inoculation increased root and shoot biomass, leading to a yield increase of 10.3% compared with non-inoculated plants. Wheat plant inoculation associated with application of the average N level provided the greatest profitability. Furthermore, results showed that reducing N fertilization from 100 to 50 kg N ha−1 along A. brasilense inoculation led to an increase in operating profit of 10.5%. In view of low economic cost, ease of application, and high probability of a positive response by wheat crops, even associated with different N application levels, the inoculation with A. brasilense prone to be a key sustainable management practice to improve wheat production under tropical conditions. This practice has the potential to increase wheat grain yield, N use and uptake, and overall farm profitability.
A Pan-Cancer Analysis of the Oncogenic Role of Cell Division Cycle-Associated Protein 4 (CDCA4) in Human Tumors
Authors: Fang Hui , Sheng Shuyan , Chen Bangjie , Wang Jianpeng , Mao Deshen , Han Yanxun , Liu Yuchen , Wang Xinyi , Gui Siyu , Zhang Tongyuan , Zhang Lizhi , Li Conghan , Hu Xinyang , Deng Wanyu , Liu Xin , Xu Honghai , Xu Wentao , Wang Xingyu , Liu Rongqiang , Kong Weihao 
Published: February 2022

PurposeTo unravel the oncogenic role of CDCA4 in different cancers from the perspective of tumor immunity.MethodsRaw data on CDCA4 expression in tumor samples and paracancerous samples were obtained from TCGA and GTEX databases. In addition, we investigated pathological stages and the survival analysis of CDCA4 in pan-cancer across Gene Expression Profiling Interactive Analysis (GEPIA) database. Cox Proportional Hazards Model shows that high CDCA4 levels are associated with several vital indicators in oncology. On the one hand, we explored the correlation between CADA4 expression and tumor immune infiltration by the TIMER tool; On the other hand, we utilized the methods of CIBERSORT and ESTIMATE computational to evaluate the proportion of tumor infiltrating immune cells (TIIC) and the amounts of stromal and immune components based on TCGA database. The use of antineoplastic drugs and the expression of CDCA4 also showed a high correlation via linear regression. Protein–Protein Interaction analysis was performed in the GeneMANIA database, and enrichment analysis was performed and predicted signaling pathways were identified by using Gene Ontology and Kyoto Encyclopedia of Genes. The correlation between CDCA4 expression with Copy number variations (CNV) and methylation is detailed, respectively. Molecular biology experiments including Western blotting, flow cytometry, EDU staining, Transwell and Wound Healing assay to validate the cancer promoting role of CDCA4 in hepatocellular carcinoma (HCC).ResultsMost tumors highly expressed CDCA4. Elevated CDCA4 expression was associated with poor OS and DFS. There was a significant correlation between CDCA4 expression and TITCs. Moreover, markers of TIICs exhibited distinct patterns of CDCA4 associated immune infiltration. In addition, we pay attention to the association between the expression of CDCA4 and the use of the anti-tumor drugs. CDCA4 is related to biological progress (BP), cellular component (CC) and molecular function (MF). Dopaminergic Synapse, AMPK, Sphingolipid, Chagas Disease, mRNA Surveillance were significantly enriched pathways in positive and negative correlation genes with CDCA4. CNV is thought to be a positive correlation with CDCA4 expression. Conversely, methylation is negative correlation with CDCA4 expression. Molecular biology experiments confirm a cancer promoting role for CDCA4 in HCCConclusionCDCA4 may serve as a biomarker for cancer immunologic infiltration and poor prognosis, providing a new way of thinking for cancer treatment.
Retinal Nerve and Vascular Changes in Prediabetes
Authors: Peng Rui Ping , Zhu Zi Qian , Shen Hong Yi , Lin Hong Mei , Zhong Lei , Song Si Qi , Liu Tian , Ling Shi Qi 
Published: February 2022

ObjectiveThis study aimed to observe vascular and neuroretinal alterations in people with prediabetes [impaired fasting glucose (IFG) and impaired glucose tolerance (IGT)] and normal glucose metabolism.MethodsA total of 21 patients with prediabetes (42 eyes) and 20 healthy controls (40 eyes) participated in our study. All patients underwent a complete eye examination [including fundus fluorescein angiography (FFA) and optical coherence tomography (OCT)] and a related general examination (complete biochemical analysis, routine blood tests, and glycosylated hemoglobin).ResultsOn FFA, no patients in either group showed any microvascular alterations. The total peripapillary retinal nerve fiber layer (pRNFL) in the prediabetic group was significantly thinner than that in the healthy control group (p &lt; 0.0001). Only the temporal pRNFL thickness was significantly less in patients with prediabetes compared to the normal people. There was no significant difference in the thickness of retina in the range of 1 mm diameter of macular fovea (p = 0.286), but in the prediabetic group, the macular retinal thickness within the diameter of 6 mm in nasal side (p &lt; 0.0001), superior side (p &lt; 0.0001), temporal side (p = 0.008), and inferior side (p = 0.001) were lower than that in the control group.ConclusionIn the prediabetic group, there was no microvascular alterations, but the total pRNFL and the temporal pRNFL was significantly thinner, and the macular retinal thickness within the diameter of 6 mm in the nasal, temporal, and inferior side were lower than that in the healthy control group. These data confirm neuroretinal alterations in prediabetes prior to microvascular injury.
Sleep Quality Is Associated With Severe Meibomian Gland Disruption in Dry Eye
Authors: Zhu Yirui , Huang Xiaodan , Lin Lin , Di Mengshu , Chen Ruida , Fang Fei , Jin Xiuming 
Published: February 2022

PurposeTo investigate the association between sleep quality and meibomian gland dropout characteristics in dry eye patients.MethodsThis cross-sectional study involved 172 dry eye patients with no history of conditions or factors that could confound dry eye disease (DED) and/or meibomian gland dropout. Participants underwent a comprehensive anterior eye assessment. The validated Athens Insomnia Scale (AIS) and Pittsburgh Sleep Quality Index (PSQI) were used to assess sleep quality. The measured outcomes were dry eye symptoms via the Ocular Surface Disease Index (OSDI), tear breakup time (TBUT), corneal fluorescein staining, meibomian gland function, and extent of meibomian gland dropout.ResultsOf the dry eye participants, 34.9% had severe meibomian gland dropout (SMD) and 41.3% of the subjects had poor sleep quality. Patients with poor sleep quality had greater Meibomian gland dropout while the sleep AIS and PSQI scores were significantly correlated with Meibomian gland dropout (r = 0.495, p &lt; 0.001; r = 0.24, p = 0.002; respectively). SMD patients had worse scores on all components of the PSQI (all p &lt; 0.001, corrected for age and sex). Use of sleep medication, poor habitual sleep efficiency, and sleep disturbance were particularly prevalent in SMD patients as compared to Non-severe meibomian gland dropout (NSMD) patients. Multivariate logistic regression analysis revealed that sleep quality was eventually associated with female gender (p = 0.042), OSDI (p = 0.004), TBUT (p = 0.036), and Meibomian gland dropout score (p &lt; 0.001).ConclusionIt was found that greater meibomian gland dropout in poor sleep quality individuals is especially related to use of sleep medication, poor habitual sleep efficiency, and sleep disturbance. This finding suggests a need for long-term studies of anterior eye health in people with poor sleep quality.
The Association Between White Blood Cell Count and Insulin Resistance in Community-Dwelling Middle-Aged and Older Populations in Taiwan: A Community-Based Cross-Sectional Study
Authors: Chen Jau-Yuan , Chen Yun-Hung , Lee Yu-Chien , Tsou Meng-Ting 
Published: February 2022

BackgroundInsulin resistance (IR) is a major pathophysiological factor in the development and progression of diabetes mellitus (DM). DM is highly prevalent in Taiwan and has become one of the most common health problems in family medicine and primary care. We aimed to use white blood cell count (WBC), a common physiological parameter, to develop a simple clinical prediction rule for IR in the middle-aged and old Taiwanese population.MethodsIn this cross-sectional community-based study, the participants completed a questionnaire comprising personal and medical history data and underwent anthropometric measurements and blood sampling. IR was defined as a HOMA-IR index ≥2. Independent t-test, Mann–Whitney U test, chi-square test, Pearson's correlation test, multivariate binary logistic regression, and receiver operating characteristic curves were used to evaluate the association between the WBC count and IR.ResultsA total of 398 community-dwelling middle-aged and older persons (34.9% men) with a mean age of 64.43 ± 8.45 years were enrolled for the analysis. A significant association was identified between the WBC counts and IR, with a Pearson's correlation coefficient of 0.37 (p-value &lt;0.001). Multivariate logistic regression revealed that WBC count (OR = 1.50; 95% CI = 1.25–1.81) was an independent risk factor for IR after adjusting for confounding variables. The area under the receiver operating characteristic curve for WBC count was 0.67, and the optimal threshold value was 5.65 1,000/uL.ConclusionA high WBC count is positively related to an increased risk of IR among middle-aged and older people in Taiwan.
Orphan Drug Prices and Epidemiology of Rare Diseases: A Cross-Sectional Study in Italy in the Years 2014–2019
Authors: Villa Federico , Di Filippo Aurora , Pierantozzi Andrea , Genazzani Armando , Addis Antonio , Trifirò Gianluca , Cangini Agnese , Tafuri Giovanni , Settesoldi Daniela , Trotta Francesco 
Published: February 2022

IntroductionIt is well acknowledged that the price of orphan drugs is normally higher than that resulting from the value-based pricing. A correlation between the cost of therapy for orphan drugs and the epidemiology (prevalence and incidence) of the related rare disease can be hypothesized.MethodsThis analysis includes all approved orphan drugs by European Medicines Agency whose reimbursement was granted for the first therapeutic indication in the years 2014–2019 in Italy. Regression and correlation analyses were performed to analyze the possible correlations between the logarithm of the annual therapy cost and the epidemiology of the rare diseases, between orphan drugs consumption and epidemiology of related rare disease and between therapy cost and the consumption.ResultsThe regression analysis between the annual cost of therapy estimated on the published ex-factory price and the prevalence showed a slightly decreasing, not statistically significant, trend (coefficient: −0.10, p-value: 0.41). The results were similar when using the price resulting from the application of Managed Entry Agreements (coefficient: −0.11, p-value: 0.40). The regression analysis between sales volume and prevalence showed a positive slope without an acceptable level of significance (p-value: 0.04). The correlation analysis between the therapy cost and the sales volume highlighted again an absence of significant association, similarly if considering only ATC L orphan drugs, or the incidence.DiscussionThe definition of the price of an orphan drug seems not to depend on the rarity of the disease, and sales volumes do not correlate with the epidemiology of the rare disease and with the annual cost of therapy.
Daily Step Counts in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Observational Studies
Authors: Zhang Fan , Ren Yibo , Wang Hui , Bai Yan , Huang Liuyan 
Published: February 2022

BackgroundPhysical inactivity is an essential factor in the prognosis of patients with chronic kidney disease (CKD). Daily step count is a straightforward measure to assess physical activity levels. Understanding the step counts among different CKD stages is essential to change sedentary behavior.ObjectivesThis systematic review and meta-analysis aimed to investigate the daily step counts in patients with CKD at a different stage.DesignA systematic review and meta-analysis.Data SourcesThe literature search was performed in PubMed, Embase, and Web of Science from inception to November 3rd, 2021.Review MethodsObservational studies (cross-sectional, case-control, or cohort studies) reported specific values of step counts in CKD patients by the wearable device were included. A random-effects model was used to pool the data. Subgroup analysis explored differences in outcomes by stage of CKD. Heterogeneity between studies was assessed using the χ2 test of Cochrane's Q statistic. A contour-enhanced funnel plot was conducted to investigate publication bias. Univariate and multivariate meta-regression was conducted to examine possible sources of heterogeneity.ResultsTwenty-eight articles were identified and used for quantitative analysis. The result showed that the daily step count in patients with CKD was 4642.47 (95% CI: 4274.18–5010.76), and significantly lower than the healthy population. Subgroup analysis revealed that the step counts decreased before dialysis, dropped to a freezing point at the hemodialysis phase, and increased after kidney transplantation. Meta-regression analysis showed that daily step counts were relatively higher in the Americas or younger than 60 or kidney transplant recipients.ConclusionThe status of daily step counts in patients with CKD decreases with CKD severity and increases after kidney transplantation. Although studies have begun to focus on strategies to improve step counts in patients with CKD, future studies should focus more on step counts in pre-dialysis patients and changing their physically inactive lifestyle early to alleviate deteriorating renal function.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=291551, identifier: CRD42021291551.
Proteasome and Neuroprotective Effect of Hyperbaric Oxygen Preconditioning in Experimental Global Cerebral Ischemia in Rats
Authors: Ostrowski Robert P. , Pucko Emanuela , Matyja Ewa 
Published: February 2022

ObjectivesWe investigated the involvement of the proteasome in the mechanism of preconditioning with hyperbaric oxygen (HBO-PC).MethodsThe experiments were performed on male Wistar rats subjected to a transient global cerebral ischemia of 5 min duration (2-vessel occlusion model) and preconditioned or not with HBO for 5 preceding days (1 h HBO at 2.5 atmosphere absolute [ATA] daily). In subgroups of preconditioned rats, the proteasome inhibitor MG132 was administered 30 min prior to each preconditioning session. Twenty-four hours and 7 days post-ischemia, after neurobehavioral assessment, the brains were collected and evaluated for morphological changes and quantitative immunohistochemistry of cell markers and apoptosis-related proteins.ResultsWe observed reduced damage of CA1 pyramidal cells in the HBO preconditioned group only at 7 days post-ischemia. However, both at early (24 h) and later (7 days) time points, HBO-PC enhanced the tissue expression of 20S core particle of the proteasome and of the nestin, diminished astroglial reactivity, and reduced p53, rabbit anti-p53 upregulated modulator of apoptosis (PUMA), and rabbit anti-B cell lymphoma-2 interacting mediator of cell death (Bim) expressions in the hippocampus and cerebral cortex. HBO-PC also improved T-maze performance at 7 days. Proteasome inhibitor abolished the beneficial effects of HBO-PC on post-ischemic neuronal injury and functional impairment and reduced the ischemic alterations in the expression of investigated proteins.SignificancePreconditioning with hyperbaric oxygen-induced brain protection against severe ischemic brain insult appears to involve the proteasome, which can be linked to a depletion of apoptotic proteins and improved regenerative potential.