bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of eight cognitive training regimes upon cognitive screening tool performance in post-stroke survivors: a network meta-analysis
Authors: Zhou Liqin , Huang Xiaofeng , Wang Jieyu , Wang Fengming , Liu Jihong , Liu Nanhai 
Published: July 2024

BackgroundTraditional meta-analysis offers only direct comparative evidence. The optimal cognitive training for poststroke cognitive impairment (PSCI) remains largely undetermined.ObjectivesThis study aims to assess and compare the effectiveness of selected cognitive training methods for PSCI patients and to identify and rank the most effective intervention programs.MethodsSearches were conducted in PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Database for randomized controlled trials up to September 30, 2023. Two researchers independently performed literature screening, data extraction, and quality assessment. Network meta-analysis was utilized to synthesize the main findings. The primary outcome focused on the intervention’s impact on subjective cognitive function, with secondary outcomes including effects on activities of daily living, motor function, and functional independence. This study is registered with PROSPERO (CRD42023463282).ResultsFifty eligible randomized controlled trials were identified, revealing eight distinct interventions. These interventions collectively demonstrate efficacy in enhancing cognition. Traditional cognitive training significantly improves overall cognitive function, daily living function, motor function, and functional independence. In Loewenstein Occupational Therapy Cognitive Assessment, Barthel Index, Fugl-Meyer Assessment, and Functional Independence Measure scales, a combination of computer-based and traditional cognitive training outperformed the conventional control group MD = 29.97 (95%CI: 16.3, 44.2), MD = 18.67 (95%CI: 9.78, 27.45), MD = 28.76 (95%CI: 5.46, 51.79) and MD = 42.2 (95%CI: 5.25, 78.99). In the MMSE scale, virtual reality cognitive training combined with traditional training was most effective MD = 8.01 (95%CI: 3.6, 12.4). On the MoCA scale, the combination of exercise and cognitive training showed superior results MD = 6.68 (95%CI: 2.55, 10.78). Only the combined computer-based and traditional cognitive training, as well as traditional cognitive training alone, significantly enhanced functional independence, with no notable differences in other pairwise interventions.ConclusionThe network meta-analysis suggests that augmenting traditional training with other modalities may enhance overall effectiveness. Specifically, interventions incorporating computer-based cognitive training appear to surpass other methods in improving cognition, daily living function, motor skills, and functional independence. The findings of this network meta-analysis provide evidence-based guidance for clinical decision-making.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier in PROSPERO (CRD42023463282).
Association between dietary intake of niacin and stroke in the US residents: evidence from national health and nutrition examination survey (NHANES) 1999–2018
Authors: Qiu Jie-Yu , Zhang Wen-Hui , Zhu Xiao-Ming , Wu Li-Da , Huang Ji-Hua , Zhang Jie 
Published: July 2024

ObjectiveThis study aims to explore the association between niacin intake and stroke within a diverse, multi-ethnic population.MethodsA stringent set of inclusion and exclusion criteria led to the enrollment of 39,721 participants from the National Health and Nutrition Examination Survey (NHANES). Two interviews were conducted to recall dietary intake, and the USDA’s Food and Nutrient Database for Dietary Studies (FNDDS) was utilized to calculate niacin intake based on dietary recall results. Weighted multivariate logistic regression was employed to examine the correlation between niacin and stroke, with a simultaneous exploration of potential nonlinear relationships using restricted cubic spline (RCS) regression.ResultsA comprehensive analysis of baseline data revealed that patients with stroke history had lower niacin intake levels. Both RCS analysis and multivariate logistic regression indicated a negative nonlinear association between niacin intake and stroke. The dose-response relationship exhibited a non-linear pattern within the range of dietary niacin intake. Prior to the inflection point (21.8 mg) in the non-linear correlation between niacin intake and stroke risk, there exists a marked decline in the risk of stroke as niacin intake increases. Following the inflection point, the deceleration in the decreasing trend of stroke risk with increasing niacin intake becomes evident. The inflection points exhibit variations across diverse populations.ConclusionThis investigation establishes a negative nonlinear association between niacin intake and stroke in the broader American population.
Analyzing the impact of heavy metal exposure on osteoarthritis and rheumatoid arthritis: an approach based on interpretable machine learning
Authors: Fan Wenxuan , Pi Zhipeng , Kong Keyu , Qiao Hua , Jin Minghao , Chang Yongyun , Zhang Jingwei , Li Huiwu 
Published: July 2024

IntroductionThis investigation leverages advanced machine learning (ML) techniques to dissect the complex relationship between heavy metal exposure and its impacts on osteoarthritis (OA) and rheumatoid arthritis (RA). Utilizing a comprehensive dataset from the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2020, this study aims to elucidate the roles specific heavy metals play in the incidence and differentiation of OA and RA.MethodsEmploying a phased ML strategy that encompasses a range of methodologies, including LASSO regression and SHapley Additive exPlanations (SHAP), our analytical framework integrates demographic, laboratory, and questionnaire data. Thirteen distinct ML models were applied across seven methodologies to enhance the predictability and interpretability of clinical outcomes. Each phase of model development was meticulously designed to progressively refine the algorithm’s performance.ResultsThe results reveal significant associations between certain heavy metals and an increased risk of arthritis. The phased ML approach enabled the precise identification of key predictors and their contributions to disease outcomes.DiscussionThese findings offer new insights into potential pathways for early detection, prevention, and management strategies for arthritis associated with environmental exposures. By improving the interpretability of ML models, this research provides a potent tool for clinicians and researchers, facilitating a deeper understanding of the environmental determinants of arthritis.
The effect of folic acid intake on congenital anomalies. A systematic review and meta-analysis
Authors: Moges Natnael , Sisay Chanie Ermias , Anteneh Rahel Mulatie , Zemene Melkamu Aderajew , Gebeyehu Asaye Alamneh , Belete Melaku Ashagrie , Kebede Natnael , Anley Denekew Tenaw , Dessie Anteneh Mengist , Alemayehu Ermiyas , Dagnaw Fentaw Teshome , Asmare Zufan Alamrie , Tsega Sintayehu Simie 
Published: July 2024

BackgroundCongenital anomalies pose a significant challenge to global health and result in considerable morbidity and mortality in early childhood. With the decline of other causes of death among children under five, the burden of congenital anomalies is rising, emphasizing the need for improved prenatal care, screening, and nutrition for pregnant women. This systematic review and meta-analysis aim to estimate the pooled effect of folic acid intake on congenital anomalies.MethodsTo identify relevant research published up until December 30/2023, we conducted electronic searches of PubMed/Medline, PubMed Central, Hinary, Google, African Journals Online, Web of Science, Science Direct, and Google Scholar databases using predefined eligibility criteria. We used Excel to extract data and evaluated the studies using the JBI appraisal checklist. We computed the pooled effect size with 95% confidence intervals for maternal folic acid intake on congenital anomalies using STATA version 17 and the DerSimonian and Laird random effects meta-analysis model. We assessed statistical heterogeneity using Cochran's Q-test, I2 statistic, and visual examination of the funnel plot.ResultsThe review included 16 case-control, cohort, and cross-sectional studies. According to the results of this systematic review and meta-analysis, maternal folic acid intake significantly lowers the incidence of congenital anomalies (odds ratio (OR), 0.23; confidence interval (CI), 0.16, 0.32). Among the included studies, both the Cochrane Q-test statistic (χ2 = 118.82, p &lt; 0.001) and I2 test statistic (I2 = 87.38%, p &lt; 0.001) revealed statistically significant heterogeneity. Egger's weighted regression (p &lt; 0.001) and funnel plot show evidence of publication bias in this meta-analysis.ConclusionThe results of the recent meta-analysis and systematic review have demonstrated a significant association between maternal folic acid intake and the risk of congenital anomalies. Specifically, children whose mothers received periconceptional folic acid supplementation had a 77% reduced risk of congenital anomalies. To further investigate the correlation between maternal folic acid supplementation and the occurrence of various congenital anomalies, particularly in developing countries, it is recommended that a comprehensive prospective study be conducted.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42024511508).
Sequential model for predicting patient adherence in subcutaneous immunotherapy for allergic rhinitis
Authors: Li Yin , Xiong Yu , Fan Wenxin , Wang Kai , Yu Qingqing , Si Liping , van der Smagt Patrick , Tang Jun , Chen Nutan 
Published: July 2024

ObjectiveSubcutaneous Immunotherapy (SCIT) is the long-lasting causal treatment of allergic rhinitis (AR). How to enhance the adherence of patients to maximize the benefit of allergen immunotherapy (AIT) plays a crucial role in the management of AIT. This study aims to leverage novel machine learning models to precisely predict the risk of non-adherence of AR patients and related local symptom scores in 3 years SCIT.MethodsThe research develops and analyzes two models, sequential latent-variable model (SLVM) of Stochastic Latent Actor-Critic (SLAC) and Long Short-Term Memory (LSTM). SLVM is a probabilistic model that captures the dynamics of patient adherence, while LSTM is a type of recurrent neural network designed to handle time-series data by maintaining long-term dependencies. These models were evaluated based on scoring and adherence prediction capabilities.ResultsExcluding the biased samples at the first time step, the predictive adherence accuracy of the SLAC models is from 60% to 72%, and for LSTM models, it is 66%–84%, varying according to the time steps. The range of Root Mean Square Error (RMSE) for SLAC models is between 0.93 and 2.22, while for LSTM models it is between 1.09 and 1.77. Notably, these RMSEs are significantly lower than the random prediction error of 4.55.ConclusionWe creatively apply sequential models in the long-term management of SCIT with promising accuracy in the prediction of SCIT nonadherence in AR patients. While LSTM outperforms SLAC in adherence prediction, SLAC excels in score prediction for patients undergoing SCIT for AR. The state-action-based SLAC adds flexibility, presenting a novel and effective approach for managing long-term AIT.
Monoterpene antifungal activities: evaluating geraniol, citronellal, and linalool on Candida biofilm, host inflammatory responses, and structure–activity relationships
Authors: Vasconcelos Priscilla Guimarães Silva , Lee Kyu Min , Abuna Gabriel Flores , Costa Edja Maria Melo Brito , Murata Ramiro Mendonça 
Published: July 2024

Introduction: Despite the rising concern with fungal resistance, a myriad of molecules has yet to be explored. Geraniol, linalool, and citronellal are monoterpenes with the same molecular formula (C10H18O), however, neither the effect of these compounds on inflammatory axis induced by Candida spp. nor the antibiofilm Structure-Activity Relationship (SAR) have been well-investigated. Herein we analyzed geraniol, linalool and citronellal antifungal activity, cytotoxicity, and distinctive antibiofilm SAR, also the influence of geraniol on Candida spp induced dysregulated inflammatory axis, and in vivo toxicity.Methods: Minimal inhibitory (MIC) and fungicidal (MFC) concentrations against Candida spp were defined, followed by antibiofilm activity (CFU–colony forming unit/mL/g of dry weight). Cytotoxic activity was assessed using human monocytes (THP-1) and oral squamous cell (TR146). Geraniol was selected for further analysis based on antifungal, antibiofilm and cytotoxic results. Geraniol was tested using a dual-chamber co-culture model with TR146 cells infected with C. albicans, and THP-1 cells, used to mimic oral epithelium upon fungal infection. Expression of Candida enzymes (phospholipase–PLB and aspartyl proteases–SAP) and host inflammatory cytokines (interleukins: IL-1β, IL-6, IL-17, IL-18, IL-10, and Tumor necrosis factor–TNF) were analyzed. Lastly, geraniol in vivo toxicity was assessed using Galleria mellonella.Results: MIC values obtained were 1.25–5 mM/mL for geraniol, 25-100 mM/mL for linalool, and 100–200 mM/mL for citronellal. Geraniol 5 and 50 mM/mL reduced yeast viability during biofilm analysis, only 500 mM/mL of linalool was effective against a 72 h biofilm and no biofilm activity was seen for citronellal. LD50 for TR146 and THP-1 were, respectively: geraniol 5.883 and 8.027 mM/mL; linalool 1.432 and 1.709 mM/mL; and citronellal 0.3006 and 0.1825 mM/mL. Geraniol was able to downregulate expression of fungal enzymes and host pro-inflammatory cytokines IL-1β, IL-6, and IL-18. Finally, safety in vivo parameters were observed up to 20 mM/Kg.Discussion: Despite chemical similarities, geraniol presented better antifungal, antibiofilm activity, and lower cytotoxicity when compared to the other monoterpenes. It also showed low in vivo toxicity and capacity to downregulate the expression of fungal enzymes and host pro-inflammatory cytokines. Thus, it can be highlighted as a viable option for oral candidiasis treatment.
Adherence to ACSM exercise guidelines and its influence on Fibromyalgia treatment outcomes: a meta-analysis of randomized controlled trials
Authors: Han Tianran , Xi Rui , Wang Jialin , Yan Huiqian , Li Linhua 
Published: July 2024

BackgroundThe Fibromyalgia Syndrome (FMS) is a multifaceted chronic pain disorder that exerts a substantial impact on the overall state of health and quality of life of patients.PurposeInvestigate the effects of exercise therapy and adherence to the American College of Sports Medicine (ACSM) guidelines on treatment outcomes in FMS patients.MethodsThe literature search, which concluded in October 2023, encompassed studies investigating the impact of exercise interventions on patients diagnosed with FMS and providing adequate data for calculating standardized mean difference (SMD). The primary outcome measures encompassed the Fibromyalgia Impact Questionnaire (FIQ) and Health Assessment Questionnaire (HAQ), while secondary outcome measures comprised pain levels, sleep quality, fatigue, and mental health.ResultsAmong 4,008 records, 19 studies (patients = 857) were eligible for qualitative synthesis. The meta-analysis revealed that the SMD for overall state of health impact was −0.94 (95%CI −1.26, −0.63), and the pooled SMD for the subgroup with high adherence to ACSM guidelines was −1.17 (95%CI −1.65, −0.69). The SMD for the subgroup with low or uncertain adherence was −0.73 (95%CI −1.12, −0.34). The overall effects included a −1.21 (95%CI −1.62, −0.79) SMD for pain relief, with high adherence achieving a −1.32 (95%CI −2.00, −0.64) SMD and low adherence a −1.06 (95%CI −1.55, −0.57) SMD. Mental health improvements showed a −0.95 (95%CI −1.32, −0.57) overall SMD, with high and low adherence subgroups at −0.96 (95%CI −1.62, −0.30) and −0.94 (95%CI −1.29, −0.60), respectively. Sleep quality impact was −1.59 (95%CI −2.31, −0.87) overall, with high adherence at −1.71 (95%CI −2.58, −0.83) and low adherence at −1.11 (95%CI −1.88, −0.33). Fatigue impact had a −1.55 (95%CI −2.26, −0.85) overall SMD, with −1.77 (95%CI −3.18, −0.36) for high adherence and −1.35 (95%CI −2.03, −0.66) for low adherence.ConclusionExercise therapy can improve the overall state of health, pain, sleep, and fatigue of FMS patients, particularly when adhering to ACSM guidelines. However, adherence levels do not affect mental health gains, indicating a need for future research on psychological impact.Systematic Review Registration:https://inplasy.com/inplasy-2024-3-0106/, identifier INPLASY202430106.
Growth, yield and oil quality of adult pedestrian olive orchards grown at four different planting systems
Authors: Massenti Roberto , Ioppolo Antonino , Carella Alessandro , Imperiale Valeria , Lo Bianco Riccardo , Servili Maurizio , Selvaggini Roberto , Caruso Tiziano 
Published: July 2024

This study evaluated growth, yield and olive oil quality of mature pedestrian olive orchards. Trees of three Sicilian cultivars Calatina, Nocellara del Belice and Abunara were planted at four combinations of planting densities and training forms. Trees at 2 × 5 m were trained to central leader (CLx2), those at 3 × 5 m to free palmette (FPx3), those at 4 x 5 to globe vase (GVx4), and those at 5 x 5 to poly-conic vase (PVx5). ‘Calatina’ had the smallest trees in terms of trunk size in all growing systems, while canopy size of trees at higher densities was similar for all three cultivars. ‘Calatina’ was also the most growth efficient (m3 of canopy per cm2 of TCSA) and produced the least amount of pruning wood in the hedgerow systems (CLx2 and FPx3). Fruit yield per tree tended to be higher in more vigorous cultivars (Abunara and Nocellara) grown to 3D systems (GVx4 and PVx5), while ‘Calatina’ was the most yield efficient (kg of fruit per cm2 of TCSA) especially in the hedgerow growing systems. Fruit and oil yield per ha and average production value tended to be highest in CLx2 trees and lowest in GVx4 trees, with ‘Calatina’ showing the sharpest changes and ‘Nocellara’ the smallest changes among growing systems. According to the Jaen index, CLx2 tended to induce earlier fruit maturation, followed by PVx5, GVx4, and FPx3. The growing system did not affect oil fatty acid composition, while ‘Calatina’ had the highest amount of mono-unsaturated fatty acids and the lowest amount of saturated fatty acids. ‘Abunara’ oils exhibited the highest amount of total phenols in CLx2, while ‘Calatina’ and ‘Nocellara’ oils exhibited the highest amount in FPx3 and PVx5. Both, trans-2-hexenal (“cut grass” sensory note) and hexenyl acetate (“floral” sensory note) tended to be lowest in oils from trees grown at CLx2 and highest in those from trees grown at GVx4, showing a somewhat inverse relationship with fruit ripening degree. The outcome of the present study on mature pedestrian orchards shows that proper combinations of cultivars, planting densities, and training forms (canopy shape) may result in efficient intensive systems for growing olive in areas where super-high density systems cannot be profitable due to agronomic and environmental limitations (water shortage, steep sloping sites, small farm size, etc.). Pedestrian growing systems can also be used to exploit olive biodiversity by allowing the use of available local genotypes. For this reason, they may represent an effective and sustainable solution against unexpected climate changes and associated emerging diseases.
Influence of cultural values and hierarchical social norms on buying counterfeits online: a 17-country study
Authors: Kononova Anastasia , Huddleston Patricia , Moldagaliyeva Moldir , Lee Heijin , Alhabash Saleem 
Published: July 2024

IntroductionAs a globally prevalent phenomenon, buying counterfeit products harms consumers, economies, societies, governments, and the environment. The study examined the hierarchy of injunctive normative influence (personal vs. societal) on counterfeit purchase intentions and trends in non-deceptive (known) counterfeit purchase behavior. The current research expands the hierarchical norms approach by examining how the cultural values of power distance and individualism–collectivism predict injunctive normative perceptions and counterfeit buying intention and behavior.MethodsA cross-sectional survey (N = 13,053) of consumers from 17 nations, administered in seven languages, explored cross-country differences in perceived social norms about buying counterfeits.ResultsThe findings of multilevel moderated mediation analyses showed that personal injunctive norms (perceived acceptance of buying counterfeits by close friends) mediated the relationship between societal injunctive norms (perceived acceptance for buying counterfeits by peers in the same country) and the outcome variables. Selected paths of the mediation model were moderated by the two cultural dimensions.DiscussionTheoretical implications are discussed within the context of cultural orientations’ and social norms’ roles in informing risky behavior, and practically, within the context of awareness-raising and behavior-change interventions.
Stress, repetitive negative thinking, and mental health in Chilean university students: an ecological momentary assessment study
Authors: Inostroza Carolina , Bustos Claudio , Bühring Vasily , González Lorena , Cova Félix 
Published: July 2024

BackgroundMental disorders in university students are a growing attention problem in the international community due to their high prevalence and serious consequences. One possible reason is university students’ difficulties in coping with stress. Repetitive negative thinking (RNT) is a transdiagnostic process that, when combined with stress, can lead to the development of various disorders. We aim to determine the effect of stress and RNT on predicting various mental health syndromes in university students across 7 days.MethodProspective observational study using Momentary Ecological Assessment (EMA) with the OURMIND Mobile App. On day one, 238 university students responded to the SCL-90R questionnaire for symptoms of depression, anxiety, hostility, obsession, psychoticism, paranoia, somatization, and interpersonal sensitivity; RNT styles questionnaires, RRS for rumination and negative reflection, PSWQ for worry; SISCO-II for term academic stress, and sociodemographic. EMA consisted of five assessments a day for 6 days; each time, the students answered items about academic and non-academic stress (EMA-stress), reactive RNT duration and intrusiveness (EMA-RNT process), and reactive RNT rumination, reflection, and worry (EMA-RNT content). On day eight, symptoms were re-assessed. Seven hierarchical stepwise linear regression models were used to test the predictive power of the study variables in the development of SCL-90R symptoms.ResultsWhen comparing models, adding baseline symptoms increased the models’ predictive power in all symptom groups. In most cases, including EMA-stress generated greater predictive power, except for paranoia and interpersonal sensitivity. Adding the EMA-RNT process increased the prediction of paranoia and obsessive symptoms; for hostility symptoms, RNT styles increased predictive power. For the final regression models, considering the initial symptoms, the EMA-RNT process predicted the progression of symptoms in six out of eight groups, while EMA-non-academic stress predicted the remaining two. Additionally, living with other relatives or friends was a predictor of depressive symptoms.DiscussionThe stress of university life impacts the development of psychiatric symptoms in university students. These results provide evidence of RNT as a transdiagnostic process in several syndromic groups. Universal preventive programs should consider the impact of academic and non-academic stress on university students’ mental health. Targeting RNT would also benefit selective preventive interventions.