bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between dietary protein intake and risk of chronic kidney disease: a systematic review and meta-analysis
Authors: Cheng Yu , Zheng Guanghao , Song Zhen , Zhang Gan , Rao Xuepeng , Zeng Tao 
Published: June 2024

ObjectiveThere is suggestive data indicating a correlation among dietary protein intake and the progression of chronic kidney disease (CKD). Nonetheless, the exact associations between dietary protein intake and the incidence of CKD have remained uncertain. We performed the first meta-analysis to explore the correlation among total protein, plant protein, animal protein intake and CKD risk.MethodsThe study conformed the PRISMA statement guidelines. We comprehensively searched PubMed, Web of Science, and Embase until to December 2023. The retrieved studies underwent rigorous evaluation for eligibility, and relevant data were meticulously extracted. The Newcastle-Ottawa Scale (NOS) tool was applied to evaluate the risk of bias. Subsequently, relevant data were extracted and pooled to evaluate the relations among dietary protein intake and CKD incidence.ResultsTotally, 6,191 articles were identified, six studies were eligible. A total of 148,051 participants with 8,746 CKD cases were included. All studies had a low overall risk of bias. Higher total, plant and animal protein intake were all correlated with decreased CKD incidence, pooled risk ratios (RRs) and 95% confidence intervals (CIs) were as follows: (RR = 0.82, 95% CI = 0.71–0.94, p = 0.005; I2 = 38%, p = 0.17); (RR = 0.77, 95% CI = 0.61–0.97, p = 0.03; I2 = 77%, p = 0.001); (RR = 0.86, 95% CI = 0.76–0.97, p = 0.02; I2 = 0%, p = 0.59), respectively. For fish and seafood within animal protein: RR = 0.84, 95% CI = 0.74–0.94. Subgroup analysis showed that geographical region, sample size, follow-up time, not assessing protein by food frequency questionnaire, using %energy as the measurement index, not adjusting for several covariates may be the sources of heterogeneity for plant protein. A significant non-linear relation among plant protein and incident CKD was observed by dose–response analysis.ConclusionThe data showed a lower CKD risk significantly associated higher-level dietary total, plant or animal protein (especially for fish and seafood) intake. Further prospective studies demonstrating the correlations of precise sources, intake and duration of dietary protein and incident CKD are warranted.
Prognostic and clinicopathological significance of systemic immune-inflammation index in upper tract urothelial carcinoma: a meta-analysis of 3911 patients
Authors: Yu Ziyi , Xiong Zhencheng , Ma Jinchao , Du Peng , Wang Shuo , Liu Jia , Cao Yudong , Yang Yong 
Published: June 2024

BackgroundSystemic immune-inflammation index (SII), a novel prognostic indicator, is being more commonly utilized in different types of cancer. This research project involved combining information from previously published studies to examine how pre-treatment SII can predict outcomes in individuals with upper tract urothelial carcinoma (UTUC). Further examination of the correlation between SII and clinical and pathological features in UTUC.MethodsWe thoroughly chose pertinent articles from various databases including PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), WanFang database, and Chinese Scientific Journal Database (VIP) until March 10, 2022.The data collected was analyzed using Stata 17.0 software (Stat Corp, College Station, TX). Subsequently, the impact of SII on the survival outcomes of UTUC patients was evaluated by combining HRs with 95% confidence intervals.ResultsSix included studies were finally confirmed, including 3911 UTUC patients in seven cohorts. The results showed that high SII before treatment predicted poor overall survival (HR =1.87, 95%CI 1.20-2.92, p=0.005), cancer specific survival (HR=2.70, 95%CI 1.47-4.96, P=0.001), and recurrence‐free survival (HR =1.52, 95%CI 1.12-2.07, P=0.007). And the elevated SII may be related to LVI (present vs. absent) (OR=0.83, 95% CI=0.71-0.97, p=0.018), pT stage (pT ≥3 vs. &lt; 3) (OR=1.82, 95% CI=1.21-2.72, p=0.004), and pN stage (N+ vs. N0) (OR=3.27, 95% CI=1.60-6.71, p=0.001).ConclusionA comprehensive analysis of all included articles in this study showed that higher pretreatment SII was related to poorer survival outcomes and adverse pathological features independently.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022316333.
Construction of a predictive model for postoperative hospitalization time in colorectal cancer patients based on interpretable machine learning algorithm: a prospective preliminary study
Authors: Wen Zhongjian , Wang Yiren , Chen Shouying , Li Yunfei , Deng Hairui , Pang Haowen , Guo Shengmin , Zhou Ping , Zhu Shiqin 
Published: June 2024

ObjectiveThis study aims to construct a predictive model based on machine learning algorithms to assess the risk of prolonged hospital stays post-surgery for colorectal cancer patients and to analyze preoperative and postoperative factors associated with extended hospitalization.MethodsWe prospectively collected clinical data from 83 colorectal cancer patients. The study included 40 variables (comprising 39 predictor variables and 1 target variable). Important variables were identified through variable selection via the Lasso regression algorithm, and predictive models were constructed using ten machine learning models, including Logistic Regression, Decision Tree, Random Forest, Support Vector Machine, Light Gradient Boosting Machine, KNN, and Extreme Gradient Boosting, Categorical Boosting, Artificial Neural Network and Deep Forest. The model performance was evaluated using Bootstrap ROC curves and calibration curves, with the optimal model selected and further interpreted using the SHAP explainability algorithm.ResultsTen significantly correlated important variables were identified through Lasso regression, validated by 1000 Bootstrap resamplings, and represented through Bootstrap ROC curves. The Logistic Regression model achieved the highest AUC (AUC=0.99, 95% CI=0.97–0.99). The explainable machine learning algorithm revealed that the distance walked on the third day post-surgery was the most important variable for the LR model.ConclusionThis study successfully constructed a model predicting postoperative hospital stay duration using patients’ clinical data. This model promises to provide healthcare professionals with a more precise prediction tool in clinical practice, offering a basis for personalized nursing interventions, thereby improving patient prognosis and quality of life and enhancing the efficiency of medical resource utilization.
Risk of immune system and skin and subcutaneous tissue related adverse events associated with oxaliplatin combined with immune checkpoint inhibitors: a pharmacovigilance study
Authors: Zhang Chunhong , Li Furong , Dai Ying , Zeng Yifan , Yu Xuben , Shi Dawei 
Published: June 2024

BackgroundFew studies have analysed oxaliplatin-induced adverse events (ADEs) in the immune system and skin and subcutaneous tissues through pharmacovigilance. We used this approach to analyse the risk of such ADEs when oxaliplatin combined with immune checkpoint inhibitors (ICIs).MethodsWe evaluated the association between oxaliplatin and ADEs in the immune system and skin and subcutaneous tissues using the reporting odd ratio (ROR) for mining the ADE report signals in the FDA Adverse Event Reporting System database. Risk factors were analyzed using a binary logistic regression analysis using the sex and age of the patients.ResultsThere were 40,474 reports of oxaliplatin as primary suspect drug or second suspect drug. The signal intensities of ADEs such as type II hypersensitivity, type I hypersensitivity, type III immune complex–mediated reaction, anaphylactoid shock and cytokine release syndrome were high in PTs classified by SOC as immune system disorders; in the PTs classified as skin and subcutaneous tissue disorders by SOC, the signal intensities of ADEs such as skin toxicity, skin reaction, rash maculo-papular and skin fissures were higher. In the risk assessment between the two groups, rash showed an increased risk in the oxaliplatin-ICI group, with an OR of 1.96. Nivolumab in combination with oxaliplatin had an OR of 2.196 and an adjusted OR of 2.231. Combined with pembrolizumab, OR was 2.762 and the adjusted OR was 2.678.ConclusionType II hypersensitivity shows a stronger pharmacovigilance signal. Oxaliplatin in combination with nivolumab or pembrolizumab has been shown to increase the risk of rash.
Comparing the acute responses between a manual and automated blood flow restriction system
Authors: Carter Daphney M. , Chatlaong Matthew A. , Miller William M. , Benton J. Barnes , Jessee Matthew B. 
Published: June 2024

The purpose of this study was to compare acute responses between manual and automated blood flow restriction (BFR) systems.MethodsA total of 33 individuals completed this study. On visit 1, arterial occlusion pressure (AOP, mm Hg), cardiovascular responses, and discomfort (RPE-D) were measured with each BFR system at rest. On visit 2, unilateral bicep curls were completed [30% one-repetition maximum; 50% AOP] with one system per arm. Muscle thickness (MT, cm) and maximal force (N) were assessed before (pre), immediately (post-0), 5 min (post-5), and 10 min (post-10) post-exercise. Ratings of perceived exertion (RPE-E) and ratings of perceived discomfort (RPE-D) were assessed throughout the exercise. AOP and repetitions were compared with Bayesian paired t-tests. Other outcomes were compared with Bayesian RMANOVAs. BF10 represents the likelihood of the best model vs. the null. The results are presented as mean ± SD.ResultsSupine cardiovascular responses and RPE-D were similar for manual and automated (all BF10 ≤ 0.2). Supine AOP for manual (157 ± 20) was higher than that of automated (142 ± 17; BF10 = 44496.0), but similar while standing (manual: 141 ± 17; automated: 141 ± 22; BF10 = 0.2). MT (time, BF10 = 6.047e + 40) increased from Pre (3.9 ± 0.7) to Post-0 (4.4 ± 0.8; BF10 = 2.969e + 28), with Post-0 higher than Post-5 (4.3 ± 0.8) and Post-10 (4.3 ± 0.8; both BF10 ≥ 275.2). Force (time, BF10 = 1.246e + 29) decreased from Pre (234.5 ± 79.2) to Post-0 (149.8 ± 52.3; BF10 = 2.720e + 22) and increased from Post-0 to Post-5 (193.3 ± 72.7; BF10 = 1.744e + 13), with Post-5 to Post-10 (194.0 ± 70.6; BF10 = 0.2) being similar. RPE-E increased over sets. RPE-D was lower for manual than automated. Repetitions per set were higher for manual (Set 1: 37 ± 18; Set 4: 9 ± 5) than automated (Set 1: 30 ± 7; Set 4: 7 ± 3; all BF10 ≥ 9.7).ConclusionUnder the same relative pressure, responses are mostly similar between BFR systems, although a manual system led to lower exercise discomfort and more repetitions.
Cognitive styles and psi: psi researchers are more similar to skeptics than to lay believers
Authors: Pehlivanova Marieta , Weiler Marina , Greyson Bruce 
Published: June 2024

IntroductionBelief in psi, which includes psychic phenomena such as extra-sensory perception and post-mortem survival, is widespread yet controversial. According to one of the leading and perhaps most tested hypotheses, high belief in psi can be explained by differences in various aspects of cognition, including cognitive styles. Most of this research has been conducted with lay individuals. Here, we tested the hypothesis that academic researchers who investigate psi may exhibit different cognitive styles than lay individuals interested in psi, and are more similar to skeptics.MethodsWe measured two cognitive styles—actively open-minded thinking (AOT) and the need for closure (NFC)—and assessed differences among four heterogeneous groups regarding belief in psi and involvement in related research. Specifically, our study included academic psi researchers (N = 44), lay individuals who believe in psi (N = 32), academics who are skeptics of psi (N = 35), and lay individuals who are skeptics (N = 33).ResultsWe found group differences in AOT (p = 0.003) but not in NFC scores (p = 0.67). Post hoc tests showed no significant difference in AOT scores between academics who conduct psi research (4.5 ± 0.3) and academic skeptics (4.5 ± 0.3; p = 0.91) or lay skeptics (4.5 ± 0.4; p = 0.80). The lay psi group had significantly lower AOT scores (4.2 ± 0.4) than the other three groups (ps: 0.005–0.04), indicating a decreased willingness to consider a range of evidence when forming an opinion, including evidence that challenges their beliefs. AOT was negatively associated with psi belief in the two skeptic groups combined (r = −0.29, p = 0.01), but not in the psi groups (r = −0.03, p = 0.78).DiscussionOur research shows that academics who work with psi differ from lay psi individuals, but not from skeptics, in actively open-minded thinking. In other words, despite their high belief in psi phenomena, psi researchers demonstrate a commitment to sound reasoning about evidence that is no different from that of skeptics.
Efficacy of polygenic risk scores and digital technologies for INNOvative personalized cardiovascular disease PREVention in high-risk adults: protocol of a randomized controlled trial
Authors: Pastorino Roberta , Pezzullo Angelo Maria , Agodi Antonella , de Waure Chiara , Mazzucco Walter , Russo Luigi , Bianchi Martina , Maio Alessandra , Farina Sara , Porcelli Martina , Tona Diego Maria , Di Pumpo Matteo , Amore Rosarita , Wachocka Malgorzata , Pasciuto Tina , Barchitta Martina , Magnano San Lio Roberta , Favara Giuliana , Tuttolomondo Antonino , Tramuto Fabio , Morello Gaia , De Bella Daniele Domenico , Fruscione Santo , Severino Anna , Liuzzo Giovanna , Boccia Stefania 
Published: June 2024

BackgroundCardiovascular diseases (CVDs) pose a significant global health challenge, necessitating innovative approaches for primary prevention. Personalized prevention, based on genetic risk scores (PRS) and digital technologies, holds promise in revolutionizing CVD preventive strategies. However, the clinical efficacy of these interventions requires further investigation. This study presents the protocol of the INNOPREV randomized controlled trial, aiming to evaluate the clinical efficacy of PRS and digital technologies in personalized cardiovascular disease prevention.MethodsThe INNOPREV trial is a four-arm RCT conducted in Italy. A total of 1,020 participants, aged 40–69 with high 10-year CVD risk based on SCORE 2 charts, will be randomly assigned to traditional CVD risk assessment, genetic testing (CVD PRS), digital intervention (app and smart band), or a combination of genetic testing and digital intervention. The primary objective is to evaluate the efficacy of providing CVD PRS information, measured at baseline, either alone or in combination with the use of an app and a smart band, on two endpoints: changes in lifestyle patterns, and modification in CVD risk profiles. Participants will undergo a comprehensive assessment and cardiovascular evaluation at baseline, with follow-up visits at one, five, and 12 months. Lifestyle changes and CVD risk profiles will be assessed at different time points beyond the initial assessment, using the Life's Essential 8 and SCORE 2, respectively. Blood samples will be collected at baseline and at study completion to evaluate changes in lipid profiles. The analysis will employ adjusted mixed-effect models for repeated measures to assess significant differences in the data collected over time. Additionally, potential moderators and mediators will be examined to understand the underlying mechanisms of behavior change.DiscussionAs the largest trial in this context, the INNOPREV trial will contribute to the advancement of personalized cardiovascular disease prevention, with the potential to positively impact public health and reduce the burden of CVDs on healthcare systems. By systematically examining the clinical efficacy of PRS and digital interventions, this trial aims to provide valuable evidence to guide future preventive strategies and enhance population health outcomes.
Unraveling diarrheal disease knowledge, understanding, and management practices among climate change vulnerable coastal communities in Ghana
Authors: Boafo Yaw Agyeman , Ohemeng Fidelia N. A. , Ayivor Jesse , Ayitiah Joseph Armah , Yirenya-Tawiah Dzidzo , Mensah Adelina , Datsa Cecilia , Annang Ted Yemoh , Adom Lois 
Published: June 2024

IntroductionDiarrheal disease is a global public health concern, particularly in low-income countries. In Ghana, widespread issues like inadequate sanitation, unsafe drinking water, malnutrition, and poor hygiene practices contribute to the high incidence of diarrhea. Climate change exacerbates these challenges by increasing the frequency and severity of conditions that spread diarrheal diseases. This study explores households’ knowledge, understanding, and management practices for diarrhea in climate change-vulnerable coastal communities.MethodsThe study is set in Ghana’s central (Mumford, Opetekwei) and eastern (Anyako, Anyanui-Atiteti) coastlines. Using a cross-sectional study design, a structured questionnaire was administered to randomly sampled households (n = 419) to collect quantitative data. The study collected qualitative data from focus group discussions (n = 8), with groups separated into men and women, key informant interviews, and observations of food, water, and sanitation conditions across the studied communities.Results and discussionThe study found significant variations between the studied communities and socio-demographic variables except for the respondents’ gender. Multivariate regression analyses identified significant associations between socio-demographic variables (especially gender and educational status) and perceptions of diarrhea causes. The most used first management action against diarrhea is ‘over-the-counter drugs’, followed by home-made traditional remedies. Significant differences were observed in the usage of management practices across the studied communities. Trust, affordability, and availability were identified as the main factors influencing households’ use of approved pharmaceutical drugs and traditional herbal remedies for managing behavior, with significant differences being observed across communities. The study recommends a multi-sectoral approach, including improved access to regularly flowing, safe water and sanitation facilities, education on preventing diarrhea, and adequate healthcare services. Community-based interventions such as promoting good hygiene practices at homes and community settings such as schools, lorry parks, funeral grounds, and recreational areas can also effectively reduce the burden of diarrhea.
Association between machine learning-assisted heavy metal exposures and diabetic kidney disease: a cross-sectional survey and Mendelian randomization analysis
Authors: Zhao Ruiqi , Lin Sen , Han Mengyao , Lin Zhimei , Yu Mengjiao , Zhang Bei , Ma Lanyue , Li Danfei , Peng Lisheng 
Published: June 2024

Background and objectiveHeavy metals, ubiquitous in the environment, pose a global public health concern. The correlation between these and diabetic kidney disease (DKD) remains unclear. Our objective was to explore the correlation between heavy metal exposures and the incidence of DKD.MethodsWe analyzed data from the NHANES (2005–2020), using machine learning, and cross-sectional survey. Our study also involved a bidirectional two-sample Mendelian randomization (MR) analysis.ResultsMachine learning reveals correlation coefficients of −0.5059 and − 0.6510 for urinary Ba and urinary Tl with DKD, respectively. Multifactorial logistic regression implicates urinary Ba, urinary Pb, blood Cd, and blood Pb as potential associates of DKD. When adjusted for all covariates, the odds ratios and 95% confidence intervals are 0.87 (0.78, 0.98) (p = 0.023), 0.70 (0.53, 0.92) (p = 0.012), 0.53 (0.34, 0.82) (p = 0.005), and 0.76 (0.64, 0.90) (p = 0.002) in order. Furthermore, multiplicative interactions between urinary Ba and urinary Sb, urinary Cd and urinary Co, urinary Cd and urinary Pb, and blood Cd and blood Hg might be present. Among the diabetic population, the OR of urinary Tl with DKD is a mere 0.10, with a 95%CI of (0.01, 0.74), urinary Co 0.73 (0.54, 0.98) in Model 3, and urinary Pb 0.72 (0.55, 0.95) in Model 2. Restricted Cubic Splines (RCS) indicate a linear linkage between blood Cd in the general population and urinary Co, urinary Pb, and urinary Tl with DKD among diabetics. An observable trend effect is present between urinary Pb and urinary Tl with DKD. MR analysis reveals odds ratios and 95% confidence intervals of 1.16 (1.03, 1.32) (p = 0.018) and 1.17 (1.00, 1.36) (p = 0.044) for blood Cd and blood Mn, respectively.ConclusionIn the general population, urinary Ba demonstrates a nonlinear inverse association with DKD, whereas in the diabetic population, urinary Tl displays a linear inverse relationship with DKD.
Defining a screening tool for post-traumatic stress disorder in East Africa: a penalized regression approach
Authors: Meffert Susan M. , Mathai Muthoni A. , Ongeri Linnet , Neylan Thomas C. , Mwai Daniel , Onyango Dickens , Akena Dickens , Rota Grace , Otieno Ammon , Obura Raymond R. , Wangia Josline , Opiyo Elizabeth , Muchembre Peter , Oluoch Dennis , Wambura Raphael , Mbwayo Anne , Kahn James G. , Cohen Craig R. , Bukusi David E. , Aarons Gregory A. , Burger Rachel L. , Jin Chengshi , McCulloch Charles E. , Njuguna Kahonge Simon 
Published: June 2024

BackgroundScalable PTSD screening strategies must be brief, accurate and capable of administration by a non-specialized workforce.MethodsWe used PTSD as determined by the structured clinical interview as our gold standard and considered predictors sets of (a) Posttraumatic Stress Checklist-5 (PCL-5), (b) Primary Care PTSD Screen for the DSM-5 (PC-PTSD) and, (c) PCL-5 and PC-PTSD questions to identify the optimal items for PTSD screening for public sector settings in Kenya. A logistic regression model using LASSO was fit by minimizing the average squared error in the validation data. Area under the receiver operating characteristic curve (AUROC) measured discrimination performance.ResultsPenalized regression analysis suggested a screening tool that sums the Likert scale values of two PCL-5 questions—intrusive thoughts of the stressful experience (#1) and insomnia (#21). This had an AUROC of 0.85 (using hold-out test data) for predicting PTSD as evaluated by the MINI, which outperformed the PC-PTSD. The AUROC was similar in subgroups defined by age, sex, and number of categories of trauma experienced (all AUROCs&gt;0.83) except those with no trauma history- AUROC was 0.78.ConclusionIn some East African settings, a 2-item PTSD screening tool may outperform longer screeners and is easily scaled by a non-specialist workforce.