bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting risk of obesity in overweight adults using interpretable machine learning algorithms
Authors: Lin Wei , Shi Songchang , Huang Huibin , Wen Junping , Chen Gang 
Published: November 2023

ObjectiveTo screen for predictive obesity factors in overweight populations using an optimal and interpretable machine learning algorithm.MethodsThis cross-sectional study was conducted between June 2011 and January 2012. The participants were randomly selected using a simple random sampling technique. Seven commonly used machine learning methods were employed to construct obesity risk prediction models. A total of 5,236 Chinese participants from Ningde City, Fujian Province, Southeast China, participated in this study. The best model was selected through appropriate verification and validation and suitably explained. Subsequently, a minimal set of significant predictors was identified. The Shapley additive explanation force plot was used to illustrate the model at the individual level.ResultsMachine learning models for predicting obesity have demonstrated strong performance, with CatBoost emerging as the most effective in both model validity and net clinical benefit. Specifically, the CatBoost algorithm yielded the highest scores, registering 0.91 in the training set and an impressive 0.83 in the test set. This was further corroborated by the area under the curve (AUC) metrics, where CatBoost achieved 0.95 for the training set and 0.87 for the test set. In a rigorous five-fold cross-validation, the AUC for the CatBoost model ranged between 0.84 and 0.91, with an average AUC of ROC at 0.87 ± 0.022. Key predictors identified within these models included waist circumference, hip circumference, female gender, and systolic blood pressure.ConclusionCatBoost may be the best machine learning method for prediction. Combining Shapley’s additive explanation and machine learning methods can be effective in identifying disease risk factors for prevention and control.
Olink proteomics analysis uncovers the landscape of inflammation-related proteins in patients with acute compartment syndrome
Authors: Wang Tao , Yang Shuo , Long Yubin , Li Yiran , Wang Ting , Hou Zhiyong 
Published: November 2023

PurposeOur primary purpose was to explore the landscape of inflammation-related proteins, and our second goal was to investigate these proteins as potential biomarkers of acute compartment syndrome (ACS), which is a serious complication of tibial fractures.MethodsWe collected sera from 15 healthy subjects (control group, CG) and 30 patients with tibial fractures on admission day, comprising 15 patients with ACS (ACS group, AG) and 15 patients without ACS (fracture group, FG). Ten samples in each group were analyzed by the inflammation panel of Olink Proteomics Analysis, and all samples were verified by an ELISA. Receiver-operating characteristic (ROC) curve analysis was performed to identify the diagnostic ability and cutoff values of potential biomarkers.ResultsOur findings showed that the levels of IL6, CSF-1, and HGF in the FG were significantly higher than those in the CG. Similar results were found between the AG and CG, and their cutoff values for predicting ACS compared with the CG were 9.225 pg/ml, 81.04 pg/ml, and 0.3301 ng/ml, respectively. Furthermore, their combination had the highest diagnostic accuracy. Notably, compared with FG, we only found a higher expression of CCL23 in the AG. Additionally, we identified 35.75 pg/ml as the cutoff value of CCL23 for predicting ACS in patients with tibial fractures.ConclusionWe identified CCL23 as a potential biomarker of ACS in comparison with tibial fracture patients and the significance of the combined diagnosis of IL6, CSF-1, and HGF for predicting ACS compared with healthy individuals. Furthermore, we also found their cutoff values, providing clinicians with a new method for rapidly diagnosing ACS. However, we need larger samples to verify our results.
Factors associated with urinary tract infection in the early phase after performing intermittent catheterization in individuals with spinal cord injury: a retrospective study
Authors: Xing Huayi , Dai Hongyue , Li Baohua , Yuan Xiaoning , Liu Xiaoxuan , Cui Guoqing , Liu Nan , Biering-Sørensen Fin 
Published: November 2023

ObjectivesTo investigate the occurrence rate of urinary tract infections (UTIs) in the early phase after performing intermittent catheterization (IC) and to explore the possible factors associated with UTIs after performing IC among people with spinal cord injury (SCI).SettingAn inpatient rehabilitation department of a teaching hospital in China.DesignRetrospective chart review.MethodsA retrospective chart review was carried out for traumatic and non-traumatic SCI patients after performing IC during their inpatient stay. Demographic information, comorbidity of diabetes, urine analysis results before IC, method of IC (sterile or clean), use of bladder irrigation, cessation of IC and its reasons, and UTI events were collected.ResultsA total of 183 adult individuals were included, of which 60 (32.8%) of them were women. The median age was 49.0 years. The median time post-injury was 2 months. The overall occurrence rate of UTI after performing IC was 1.31 (95% confidence intervals: 0.96–1.77) events per 100 days. Sixty-nine (37.7%) patients discontinued IC during hospitalization, and UTIs were the leading reason for cessation (50.7%). Female sex, use of antibiotics for infections other than UTI, and use of bladder irrigation were found to be associated with a lower occurrence rate of UTI in the early phase after performing IC, with an odds ratio of 0.38 (p = 0.019), 0.20 (p = 0.022), and 0.24 (p &lt; 0.001), respectively.ConclusionUTI after performing IC is prevalent among people with SCI. The study indicated that antibiotic prophylaxis and routine bladder irrigation might be associated with the reduction in UTI in the early phase after performing IC. Further research is needed to provide more evidence.
Somatic comorbidity and the progression of cognitive impairment
Authors: Bidzan Leszek , Jurek Paweł , Olech Michał , Bidzan-Wiącek Monika , Bidzan-Bluma Ilona , Bidzan Mariola 
Published: November 2023

BackgroundThere are usually multiple factors underlying dementia in old age. Somatic comorbidity is one important element that influences the progression of cognitive impairment.ObjectiveThe goal of this study was to assess the relationship between the progression of cognitive impairment and the presence and severity of comorbidities based on a four-year observation.MaterialOut of 128 patients from the Clinic for Outpatients in Gdansk, who were recruited into the study based on the criteria of the Working Group on Mild Cognitive Impairment, a total of 93 participants completed the four-year observation. Only the data from participants who completed the full period of observations were analysed. The mean age of the group was M = 75.93 (SD = 9.43). The level of progression of cognitive impairment was measured using the Clinical Dementia Rating Scale – Sum of Boxes, the severity of comorbidities was measured using the modified Cumulative Illness Rating Scale, and, additionally, at the time of inclusion in the study, participants were assessed using the MMSE scale and the Activity Scale, and sociodemographic data were collected. The Generalized Estimating Equations method was employed to fit a marginal model for analyzing the data collected in a repeated measures design. The tested model elucidated the role of the overall severity of comorbidities in explaining the progression of cognitive impairment, while controlling for everyday activity and basic demographic variables.ResultsDuring the four-year observation, a significant decline in cognitive function (B = 1.86, p &lt; 0.01) was observed in the examined sample. The statistical analysis revealed that individuals with higher overall severity of comorbidities exhibited significantly more pronounced progression of cognitive impairment over time. Regarding particular comorbidities, metabolic diseases were found to be associated with a poorer prognosis (rho = 0.41, p &lt; 0.05). Furthermore, a time physical activity interaction was identified as predicting cognitive impairment, indicating that individuals who were more physically active at the beginning of the study exhibited significantly less pronounced progression of cognitive impairment over the course of the 4 years.ConclusionThis study suggests the important roles of comorbidities and physical activity for the prognosis of mild cognitive impairment.
Case report: Ultrasound-guided median nerve electrical stimulation on functional recovery of hemiplegic upper limb after stroke
Authors: Li Rui , Zhang Ping , Lu Jingyi , Zhuang Jianlin , Wang Meiqi , Fang Hongmei , Zhang Xiaowei , Gao Ying , Yang Zhufen , Chin Kai Ling 
Published: November 2023

BackgroundFunctional restoration of hemiplegic upper limbs is a difficult area in the field of neurological rehabilitation. Electrical stimulation is one of the treatments that has shown promising advancements and functional improvements. Most of the electrical stimulations used in clinical practice are surface stimulations. In this case, we aimed to investigate the feasibility of a minimally invasive, ultrasound-guided median nerve electrical stimulation (UG-MNES) in improving the upper limb motor function and activity of a patient with right-sided hemiparesis.Case presentationA 65-year-old male recovering from a left massive intracerebral hemorrhage after open debridement hematoma removal had impaired right limb movement, right hemianesthesia, motor aphasia, dysphagia, and complete dependence on his daily living ability. After receiving 3 months of conventional rehabilitation therapy, his cognitive, speech, and swallowing significantly improved but the Brunnstrom Motor Staging (BMS) of his right upper limb and hand was at stage I-I. UG-MNES was applied on the right upper limb for four sessions, once per week, together with conventional rehabilitation. Immediate improvement in the upper limb function was observed after the first treatment. To determine the effect of UG-MNES on long-term functional recovery, assessments were conducted a week after the second and fourth intervention sessions, and motor function recovery was observed after 4-week of rehabilitation. After completing the full rehabilitation course, his BMS was at stage V-IV, the completion time of Jebsen Hand Function Test (JHFT) was shortened, and the scores of Fugl-Meyer Assessment for upper extremity (FMA-UE) and Modified Barthel Index (MBI) were increased. Overall, the motor function of the hemiplegic upper limb had significantly improved, and the right hand was the utility hand. Electromyography (EMG) and nerve conduction velocity (NCV) tests were normal before and after treatment.ConclusionThe minimally invasive, UG-MNES could be a new alternative treatment in stroke rehabilitation for functional recovery of the upper limbs.
Sudden unexpected death in epilepsy disclosure causes anxiety in patients with epilepsy: a Chinese questionnaire survey
Authors: Pan Yuanhang , Hu Gengyao , Wang Zezhi , Yuan Na , Wei Zihan , Li Xia , Hou Xiaohua , Wang Jian , Zhang Xinbo , Chen Ze , Qu Shuyi , Bao Junxiang , Liu Yonghong 
Published: November 2023

Background and objectiveSudden unexpected death in epilepsy (SUDEP) has been regarded as a leading cause of premature death in patients with epilepsy (PWE). Although patients, relatives and caregivers have the right to be informed of SUDEP, neurologists prefer not to release the facts for fear of associated anxiety. In the study, a Chinese questionnaire survey was carried out to elucidate effect of SUDEP disclosure on anxiety in PWE and variables determining the anxiety of patients and provided suggestions for SUDEP disclosure.MethodsA survey study in China was conducted. We recruited 305 PWE from 3 tertiary epilepsy centers who attended outpatient clinic from December 2021 to February 2022. Two hundred and thirty-two PWE completed the screening evaluation, survey and Hamilton anxiety rating scale (HAMA) twice with 171 PWE completing third HAMA at follow-up. HAMA scores at baseline, T1, T2 were compared using analysis of variance and dependent samples t-test. The variables related to anxiety were screened out by univariate analysis and used for multivariate logistic regression.ResultWe found 127 (54.7%) among the 232 participants experienced anxiety after SUDEP disclosure. HAMA scores at T1 were significantly higher than at baseline and T2, while there was no statistical difference between baseline and T2. Medical insurance, seizure severity, and whether the PWE supported SUDEP being disclosed to their relatives and caregivers only were associated with the occurrence of anxiety.ConclusionSUDEP disclosures may cause short-term acute anxiety, but have no long-term effects in PWE. Acute anxiety caused by SUDEP disclosure may be more common in PWE with NCMI and severe seizures. Meanwhile, compared with indirect SUDEP disclosure to their relatives and caregivers, direct SUDEP disclosure to PWE reduces the risk of anxiety. Recommendations are provided to avoid anxiety caused by SUDEP disclosure.
Do multiple physiological OCT biomarkers indicate age-related decline in rod mitochondrial function in C57BL/6J mice?
Authors: Goodman Cole , Podolsky Robert H. , Childers Karen Lins , Roberts Robin , Katz Ryan , Waseem Rida , Paruchuri Anuhya , Stanek Josh , Berkowitz Bruce A. 
Published: November 2023

PurposeTo test the hypothesis that rod photoreceptor mitochondria function in vivo progressively declines over time.Methods2, 12, and 24 month-old dark- and light-adapted C57BL/6J (B6J) mice were examined by OCT. We measured (i) an index of mitochondrial configuration within photoreceptors measured from the profile shape aspect ratio (MCP/AR) of the hyperreflective band posterior to the external limiting membrane (ELM), (ii) a proxy for energy-dependent pH-triggered water removal, the thickness of the ELM-retinal pigment epithelium (ELM-RPE), and its correlate (iii) the hyporeflective band (HB) signal intensity at the photoreceptor tips. Visual performance was assessed by optokinetic tracking.ResultsIn 2 and 24 month-old mice, MCP/AR in both inferior and superior retina was smaller in light than in dark; no dark–light differences were noted in 12 month-old mice. Dark-adapted inferior and superior, and light-adapted superior, ELM-RPE thickness increased with age. The dark–light difference in ELM-RPE thickness remained constant across all ages. All ages showed a decreased HB signal intensity magnitude in dark relative to light. In 12 month-old mice, the dark–light difference in HB magnitude was greater than in younger and older mice. Anatomically, outer nuclear layer thickness decreased with age. Visual performance indices were reduced at 24 month-old compared to 2 month-old mice.ConclusionWhile the working hypothesis was not supported herein, the results raise the possibility of a mid-life adaptation in rod mitochondrial function during healthy aging in B6J mice based on OCT biomarkers, a plasticity that occurred prior to declines in visual performance.
Impact of healthcare inequities on survival in Mexican patients with metastatic renal cell carcinoma
Authors: Bourlon Maria T. , Remolina-Bonilla Yuly A. , Acosta-Medina Aldo A. , Saldivar-Oviedo Bruno I. , Perez-Silva Antonio , Martinez-Ibarra Nayeli , Castro-Alonso Francisco Javier , Martín-Aguilar Ana E. , Rivera-Rivera Samuel , Mota-Rivero Fernando , Pérez-Pérez Perla , Díaz-Alvarado María G. , Ruiz-Morales José M. , Campos-Gómez Saúl , Martinez-Cannon Bertha Alejandra , Lam Elaine T. , Sobrevilla-Moreno Nora 
Published: November 2023

IntroductionThe survival of patients with metastatic renal cell carcinoma (mRCC) has improved dramatically due to novel systemic treatments. However, mRCC mortality continues to rise in Latin America.MethodsA retrospective, multicenter study of patients diagnosed with mRCC between 2010-2018 in Mexico City was conducted. The aim of the study was to evaluate the impact of healthcare insurance on access to treatment and survival in patients with mRCC.ResultsAmong 924 patients, 55.4%, 42.6%, and 1.9% had no insurance (NI), social security, (SS) and private insurance (PI), respectively. De novo metastatic disease was more common in NI patients (70.9%) compared to SS (47.2%) and PI (55.6%) patients (p&lt;0.001). According to IMDC Prognostic Index, 20.2% were classified as favorable, 49% as intermediate, and 30.8% as poor-risk disease. Access to systemic treatment differed by healthcare insurance: 36.1%, 99.5%, and 100% for the NI, SS, and PI patients, respectively (p&lt;0.001). NI patients received fewer lines of treatment, with 24.8% receiving only one line of treatment (p&lt;0.001). Median overall survival (OS) was 13.9 months for NI, 98.9 months for SS, and 147.6 months for NI patients (p&lt;0.001). In multivariate analysis, NI status, brain metastases, sarcomatoid features, bone metastases, no treatment were significantly associated with worse OS.ConclusionOS in mRCC was affected by insurance availability in this resource-limited cohort of Mexican patients. These results underscore the need for effective strategies to achieve equitable healthcare access in an era of effective, yet costly systemic treatments.
Development and validation of a nomogram for predicting prostate cancer based on combining contrast-enhanced transrectal ultrasound and biparametric MRI imaging
Authors: Nong Wanxian , Huang Qun , Gao Yong 
Published: November 2023

ObjectivesThis study was to explore the feasibility of combining contrast-enhanced transrectal ultrasound (CE-TRUS) with biparametric MRI (CEUS-BpMRI) score for diagnosing prostate cancer (PCa).MethodsA total of 183 patients with suspected PCa who underwent multiparametric MRI (Mp-MRI) and CE-TRUS were included. CEUS-BpMRI score was developed based on the results of Mp-MRI and CE-TRUS. The diagnostic performance was evaluated by the area under the curve (AUC). The diagnostic efficacy of the CEUS-BpMRI score, BpMRI score, and PI-RADS v2.1 score were compared. Total patients were randomly assigned to a training cohort (70%) or validation cohort (30%). A nomogram was constructed based on univariate and multivariate logistic regression. The model was evaluated by AUC and calibration curve.ResultsThe diagnostic performance of CEUS-BpMRI score (AUC 0.857) was comparable to that of PI-RADS v2.1 (AUC 0.862) (P = 0.499), and both were superior to Bp-MRI score (AUC 0.831, P &lt; 0.05). In peripheral zone lesions with Bp-MRI score of 3, there was no statistically significant difference between PI-RADS v2.1 score (AUC 0.728) and CEUS-BpMRI score (AUC 0.668) (P = 0.479). Multivariate analysis showed that age, total prostate specific antigen/free prostate specific antigen (F/T), time to peak (TTP), and CEUS-BpMRI score were independent factors. The AUC of the nomogram was 0.909 in the training cohort and 0.914 in the validation cohort.ConclusionsCEUS-BpMRI score has high diagnostic efficacy for diagnosing PCa. A nomogram model established by combining age, F/T, TTP, and CEUS-BpMRI score can achieve the best predictive accuracy for PCa.
Longitudinal study of cross-reactive antigenemia in individuals with high Loa loa microfilarial density reveals promising biomarkers for distinguishing lymphatic filariasis from loiasis
Authors: Djune-Yemeli Linda , Hertz Marla , Nana-Djeunga Hugues C. , Rush Amy , Erdmann-Gilmore Petra , Sprung Robert , Bopda Jean Gabin , Townsend Reid , Netongo Palmer Masumbe , Kamgno Joseph , Budge Philip J. 
Published: November 2023

Background and methodsCirculating Loa loa antigens are often detected in individuals with heavy L. loa infections by diagnostic tests for lymphatic filariasis (LF) caused by Wuchereria bancrofti. This is a major challenge to LF mapping and elimination efforts in loiasis co-endemic areas. However, it also provides an opportunity to identify antigen biomarkers for loiasis. To determine which L. loa antigens might be promising biomarkers for distinguishing true LF from loiasis, we screened for L. loa antigens in a group of individuals with heavy L. loa infections living in the Okola Health District of Cameroon. In this longitudinal study, participants were tested for cross-reactive antigenemia by filariasis test strip (FTS), ELISA, and western blot, and were monitored for FTS status at 6, 9, 12, and 15 months post-enrollment. We then identified specific circulating L. loa antigens by liquid chromatography-tandem mass spectrometry (LC-MS/MS) from baseline and 15-month plasma samples.Principal findings and conclusionsAmong 73 FTS-positive (FTS+) and 13 FTS-negative (FTS-) participants with high L. loa microfilarial loads, 83% maintained their FTS status over the course of the study, while 17% experienced at least one FTS conversion event (from FTS+ to FTS- or vice versa). Cross-reactive antigens were detected in both FTS+ and FTS- sera by western blot, and there was poor agreement in antigen detection by FTS, western blot, and ELISA methods. One protein family, a group of Nas-14 metalloproteases, was detected by LC MS/MS in &gt;80% of tested samples, including FTS- samples. These data identify Nas-14 as a promising loiasis biomarker potentially capable of distinguishing loiasis from lymphatic filariasis.
Comparison of pharmacokinetics and safety between CE-fosphenytoin sodium, fosphenytoin sodium, and phenytoin sodium after intravenous and intramuscular administration in healthy volunteers
Authors: Li Xiaojiao , Wu Min , Sun Jixuan , Jin Weili , Han Lei , Xu Jia , Liu Jingrui , Zhang Hong , Wang Jing , Wang Daidi , Zhang Hanyi , Zhang Qing , Liu Nini , Ding Yanhua 
Published: November 2023

Background: Captisol®-enabled-fosphenytoin sodium (CE-fosphenytoin sodium) injection is a modified formulation of fosphenytoin sodium.Objective: We aim to compare the intravenous and intramuscular bioavailability and safety between CE-fosphenytoin sodium, fosphenytoin sodium (Cerebyx®), and phenytoin sodium (intravenous injection only).Methods: In pivotal study 1, 54 subjects were divided into three sequence groups that receive intravenous injection of 250 mg of phenytoin sodium equivalent (PE), CE-fosphenytoin sodium (T), or fosphenytoin sodium (R1) and 250 mg of phenytoin sodium (R2) in period 1. After a 14-day washout period, 36 subjects were randomized to two treatment sequence groups (T-R1 or R1-T, n = 18 per group) in period 2, in which the subjects who received R2 in period 1 were removed, those who received T in period 1 used R1 (T-R1), while those who previously received R1 used T (R1-T). In pivotal study 2, a single intramuscular dose of T (400 mg PE) or R1 (400 mg PE) was administered according to the individual sequential treatment assignment in each period. There was a washout (14 days) period before receiving the next period study drug.Results: T and R1 have similar pharmacokinetic characteristics regarding total and free phenytoin, showing bioequivalence of both drugs in the intravenous and intramuscular administration. The geometric mean ratio was close to 1 (0.98–1.06). The AUC of total and free phenytoin in subjects who intravenously received T and R1 was very similar to those who received R2, although their Cmax was lower than that of the subjects who received R2. Overall, treatment with T and R1 was safe and well-tolerated, without serious adverse events (SAEs) or grade III adverse events (AEs). With intravenous (i.v.) or intramuscular (i.m.) treatment, the incidence of drug-related AEs using T was similar to that using R1. Treatment with T and R1 had clearly superior tolerability than that with R2.Conclusion: CE-fosphenytoin sodium is a promising substitute for fosphenytoin sodium.Clinical Trial Registration:http://www.chinadrugtrials.org.cn/, CTR20202154 (11 November 2020).