bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and testing of a random forest-based machine learning model for predicting events among breast cancer patients with a poor response to neoadjuvant chemotherapy
Authors: Jin Yudi , Lan Ailin , Dai Yuran , Jiang Linshan , Liu Shengchun 
Published: September 2023

Abstract
Background
Breast cancer (BC) is the most common malignant tumor around the world. Timely detection of the tumor progression after treatment could improve the survival outcome of patients. This study aimed to develop machine learning models to predict events (defined as either (1) the first tumor relapse locally, regionally, or distantly; (2) a diagnosis of secondary malignant tumor; or (3) death because of any reason.) in BC patients post-treatment.

Methods
The patients with the response of stable disease (SD) and progressive disease (PD) after neoadjuvant chemotherapy (NAC) were selected. The clinicopathological features and the survival data were recorded in 1 year and 5 years, respectively. Patients were randomly divided into the training set and test set in the ratio of 8:2. A random forest (RF) and a logistic regression were established in both of 1-year cohort and the 5-year cohort. The performance was compared between the two models. The models were validated using data from the Surveillance, Epidemiology, and End Results (SEER) database.

Results
A total of 315 patients were included. In the 1-year cohort, 197 patients were divided into a training set while 87 were into a test set. The specificity, sensitivity, and AUC were 0.800, 0.833, and 0.810 in the RF model. And 0.520, 0.833, and 0.653 of the logistic regression. In the 5-year cohort, 132 patients were divided into the training set while 33 were into the test set. The specificity, sensitivity, and AUC were 0.882, 0.750, and 0.829 in the RF model. And 0.882, 0.688, and 0.752 of the logistic regression. In the external validation set, of the RF model, the specificity, sensitivity, and AUC were 0.765, 0.812, and 0.779. Of the logistics regression model, the specificity, sensitivity, and AUC were 0.833, 0.376, and 0.619.

Conclusion
The RF model has a good performance in predicting events among BC patients with SD and PD post-NAC. It may be beneficial to BC patients, assisting in detecting tumor recurrence.
Factors associated with anxiety and depression in men undergoing fertility investigations: a cross-sectional study
Authors: Kooli Rim , Sallem Amira , Chebil Dhekra , Boussabbeh Manel , Mohamed Bochra Ben , Ajina Tesnim , Boughzela Ines , Mougou Soumaya , Mehdi Meriem 
Published: September 2023

Abstract
Background
Infertility is a real public health issue because of its medical, socio-cultural, and financial impact. It does also have heavy psychological consequences on both partners. This study aimed to assess levels of anxiety and depression among men undergoing infertility investigation and to identify their associated factors.

Methods
We conducted a cross-sectional study in the Laboratory of Cytogenetics and Reproductive Biology of Fattouma Bourguiba University Teaching Hospital (Monastir, Tunisia) between August 30th, 2020, and March 16th, 2021. Anxiety and depression levels were assessed using the valid Arab version of the Hospital Anxiety and Depression scale (HAD). Semen parameters were analyzed and interpreted according to 2021 World Health Organization (WHO) guidelines.

Results
A total of 282 men were included in the current study. The mean HAD-D (depression) and HAD-A (anxiety) scores were of 6.56 ± 3.07 (IQR [4–8]) and 7.94 ± 3.73 (IQR[5–10]) respectively. Univariate analysis showed that patients having two or more comorbidities were nearly five times more likely to be anxious than those without or with only one comorbidity (ORc = 4.71; p = 0.007). Furthermore, single patients were about four times more anxious than those in couple having primary or secondary infertility (ORc = 3.85; p = 0.027). With regards to semen parameters, patients having hypospermia were more than two times anxious compared with those with normal semen volume (ORc = 2.33; p = 0.034). As for depression, we observed that patients with an infertility history lasting for a year or more have a nine times greater risk of depression (ORc = 9.848; p = 0.007). With regards to semen parameters, patients exhibiting two or more semen abnormalities, teratozoospermia and increased MAI were more depressed (ORc = 2.478; p = 0.036; ORc = 2.549: p = 0.023; ORc = 2.762; p = 0.036). Furthermore, we found a negative correlation between HAD-A scores and patient’s age.

Conclusions
We pointed out through the current study the associated factors with anxiety and depression in patients under fertility management to precociously identify those who need psychological counseling and hence to better manage infertility issues.
Reappraisal of intra-abdominal candidiasis: insights from peritoneal fluid analysis
Authors: Novy Emmanuel , Esposito Mathieu , Birckener Julien , Germain Adeline , Losser Marie-Reine , Machouart Marie-Claire , Guerci Philippe 
Published: September 2023

Abstract
Background
The understanding of high mortality associated with intra-abdominal candidiasis (IAC) remains limited. While Candida is considered a harmless colonizer in the digestive tract, its role as a true pathogen in IAC is still debated. Evidence regarding Candida virulence in the human peritoneal fluid are lacking. We hypothesized that during IAC, Candida albicans develops virulence factors to survive to new environmental conditions. The objective of this observational exploratory monocentric study is to investigate the influence of peritoneal fluid (PF) on the expression of C. albicans virulence using a multimodal approach.

Materials and methods
A standardized inoculum of a C. albicans (3.106 UFC/mL) reference strain (SC5314) was introduced in vitro into various PF samples obtained from critically ill patients with intra-abdominal infection. Ascitic fluids (AFs) and Sabouraud medium (SBD) were used as control groups. Optical microscopy and conventional culture techniques were employed to assess the morphological changes and growth of C. albicans. Reverse transcriptase qPCR was utilized to quantify the expression levels of five virulence genes. The metabolic production of C. albicans was measured using the calScreener™ technology.

Results
A total of 26 PF samples from patients with secondary peritonitis were included in the study. Critically ill patients were mostly male (73%) with a median age of 58 years admitted for urgent surgery (78%). Peritonitis was mostly hospital-acquired (81%), including 13 post-operative peritonitis (50%). The infected PF samples predominantly exhibited polymicrobial composition. The findings revealed substantial variability in C. albicans growth and morphological changes in the PF compared to ascitic fluid. Virulence gene expression and metabolic production were dependent on the specific PF sample and the presence of bacterial coinfection.

Conclusions
This study provides evidence of C. albicans virulence expression in the peritoneal fluid. The observed variability in virulence expression suggests that it is influenced by the composition of PF and the presence of bacterial coinfection. These findings contribute to a better understanding of the complex dynamics of intra-abdominal candidiasis and advocate for personalized approach for IAC patients.
Trial registrationhttps://clinicaltrials.gov/ (NCT05264571; February 22, 2022)

Graphical Abstract
Behind the Curtain: Prevalence of Symptoms of Depression, Generalised Anxiety and Eating Disorders in 147 Professional Dancers from Six Opera Houses or State Theatres
Authors: Junge Astrid , Hauschild Anja 
Published: September 2023

Abstract
Background
Mental health problems cover a wide spectrum. Depression and anxiety disorders are the most frequent mental health problem in the general population and in elite athletes. The aim of the present study was to assess the prevalence of symptoms of depression, generalised anxiety disorder and eating disorders in professional dancers, to compare the results between genders and to the general population and to analyse potential determinants.

Methods
During a pre-season health screening, professional dancers of six German companies answered a comprehensive questionnaire on personal and dancer-specific characteristics, medical history and the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Questionnaire (GAD-7) and Eating-Disorder-Examination-Questionnaire (EDE-QS).

Results
A total of 82 (55.8%) female and 65 (44.2%) male dancers answered the questionnaire. One in five (20.8%) dancers had at least moderate symptoms of either depression, generalised anxiety disorder or eating disorders. The prevalence of at least moderate symptoms of depression was 11.1% in female and 6.4% in male dancers, of generalised anxiety disorder 16.0% in female and 6.4% in male dancers and of eating disorders 14.8% in female and 6.1% in male dancers. Compared to the general population of the same gender and similar age, the prevalence of at least moderate symptoms of generalised anxiety disorder was significantly higher in both genders. About one in four dancers (26.9%) reported a subjective need for support from a psychotherapist at the time of the screening. The PHQ-9, GAD-7 and EDE-QS sum scores were not related to the size or type of the companies, the age or rank of the dancers, but the PHQ-9 and GAD-7 sum score were significantly related to severity of musculoskeletal pain in the past seven days and to chronic or recurrent symptoms of low mood and generalised anxiety.

Conclusion
The prevalence of symptoms of depression, generalised anxiety and eating disorders was high in professional dancers. Routine screening and low-threshold interventions to improve mental health of professional dancers are recommended.
Dementia resources for eating, activity, and meaningful inclusion (DREAM) toolkit co-development: process, output, and lessons learned
Authors: Middleton Laura E. , Freeman Shannon , Pelletier Chelsea , Regan Kayla , Donnelly Rachael , Skinner Kelly , Wei Cindy , Rossnagel Emma , Nasir Huda Jamal , Albisser Tracie , Ajwani Fatim , Aziz Sana , Heibein William , Holmes Ann , Johannesson Carole , Romano Isabella , Sanchez Louisa , Butler Alexandra , Doggett Amanda , Buchan M. Claire , Keller Heather 
Published: September 2023

AbstractPromoting wellbeing of persons with dementia and their families is a priority of research and practice. Engaging diverse partners, including persons with dementia and their families, to co-develop interventions promotes relevant and impactful solutions. We describe the process, output, and lessons learned from the dementia resources for eating, activity, and meaningful inclusion (DREAM) project, which co-developed tools/resources with persons with dementia, care partners, community service providers, health care professionals, and researchers with the aim of increasing supports for physical activity, healthy eating, and wellbeing of persons with dementia. Our process included: (1) Engaging and maintaining the DREAM Steering Team; (2) Setting and navigating ways of engagement; (3) Selecting the priority audience and content; (4) Drafting the toolkit; (5) Iterative co-development of tools and resources; (6) Usability testing; and (7) Implementation and evaluation. In virtual meetings, the DREAM Steering Team confirmed the toolkit audiences (primary: community service providers; secondary: persons with dementia and care partners) and identified and evolved content areas. An environmental scan identified few existing, high-quality resources aligned with content areas. The Steering Team, additional multi-perspective partners, and external contractors iteratively co-developed new tools/resources to meet gaps over a 4-month virtual process that included virtual meetings, email exchange of documents and feedback, and one-on-one calls by telephone or email. The final DREAM toolkit includes a website with seven learning modules (on the diversity of dementia, rights and inclusion of persons living with dementia, physical activity, healthy eating, dementia-inclusive practices), a learning manual, six videos, nine handouts, and four wallet cards (www.dementiawellness.ca). Our co-development participants rated the process highly in relation to the principles and enablers of authentic partnership even though all engagement was virtual. Through use of the co-developed DREAM toolkit, we anticipate community service providers will gain the knowledge and confidence needed to provide dementia-inclusive wellness programs and services that benefit persons with dementia and their families.
Youth and family involvement in the development of a plain language trial results communication tool: CommuniKIDS
Authors: Baba Ami , Richards Dawn P. , Smith Maureen , Pallone Nicole , Vanderhout Shelley , Prebeg Matthew , Elsman Ellen B. M. , Potter Beth K. , Offringa Martin , Butcher Nancy J. 
Published: September 2023

Abstract
Background
Pediatric trials are possible through voluntary participation of children, youth (age ≤ 18 years), and their families. Despite important arguments for trialists to provide trial progress or results, and evidence that participants desire it, this information remains rarely shared with youth and their families. Little guidance exists on how trialists can best communicate trial results back to participants and their families. Guided by Liabo et al.’s framework, we describe how we developed a pediatric-specific, “plain language summary” clinical trial results template called CommuniKIDS with an adult patient partner, family partner (parent), youth advisors, and parent advisors, taking into account their unique knowledge needs and preferences.

Main text
Patient and Public Involvement (PPI) was integrated in the development of the CommuniKIDS template. In collaboration with Clinical Trials Ontario, we used a generic trial results template as a starting point. The core project leadership team included a patient partner and a family partner from project inception to completion. Five youth (ages 13–18 years) and eight parent advisors were consulted at each point of the development process through three virtual workshops conducted separately; youth workshops were led by a youth facilitator. During these workshops, advisors agreed on the importance and value of sharing trial results, and expressed their preferences on content, format, and timing of sharing trial results. PPI-led improvements included the addition of three new sections to the CommuniKIDS template: “at a glance,” “side effects,” and “next steps.” We reflect on our PPI strategy in the context of five “values” and six “practicalities” identified as good PPI principles, and summarize lessons learned when collaborating with youth and families from this project.

Conclusion
Involvement of a patient partner, a family partner, youth advisors, and parent advisors in the development of CommuniKIDS was critical to create a clinical trial results template that is useful and relevant to its end-users. To our knowledge, CommuniKIDS is the first to meaningfully engage youth and parents as advisors and partners in developing a plain language summary results template for pediatric trial participants and their families. Our experience of co-developing CommuniKIDS demonstrates that meaningful PPI can be achieved in trial results communication and knowledge translation practices. This report provides resources for those seeking to involve youth and families in their initiatives and in meaningfully sharing trial results.
Effect of intradialytic exercise on fall occurrences in older patients undergoing hemodialysis: a single-center non-randomized study
Authors: Yabe Hiroki , Yamaguchi Tomoya , Kono Kenichi , Sakakibara Aiko , Sugimoto Hiroko , Ishikawa Yumiko , Yamaguchi Yoshiko , Azekura Hisanori 
Published: September 2023

Abstract
Background
Given rapid aging of the global population, preventing adverse events such as falls is essential for preserving functional capacity and quality of life among older adults, especially those at high risk due to hemodialysis (HD) treatment. We aimed to investigate the effects of a 3-year intradialytic exercise intervention on fall occurrence and physical performance in older patients undergoing HD.

Methods
Sixty-one patients were non-randomly assigned to the exercise (n = 31) and control groups (n = 30). The exercise group performed aerobic and resistance training during HD three times per week for 3 years. Handgrip strength, lower extremity muscle strength, 10-m walking speed, and Short Physical Performance Battery (SPPB) scores were assessed at baseline. Physical function was reassessed every year in the exercise group. All participants were followed up until the first fall or the end of the study period.

Results
There were no significant between-group differences in baseline data. Over a median follow-up of 35 months, 10 (16.3%) falls occurred, including 1 (3.2%) in the exercise group and 9 (30%) in the control group. Kaplan–Meier analysis revealed that the exercise intervention significantly reduced the occurrence of falls. No significant differences in physical function were observed among four time points in patients who completed the 3-year program.

Conclusion
Intradialytic exercise may represent an essential intervention for preventing falls in older patients undergoing HD.
Trial registration: This study was retrospectively registered with the University Hospital Medical Information Network (UMIN 00044821, February 4, 2021).
Suicidal cut-throat with medico-legal masquerades: case illustration and review of the literature
Authors: Singh Bajrang K. , Tomar Jitendra S. , Sharma Lokesh , Chauhan M. 
Published: September 2023

Abstract
Background
Furnishing an opinion about the manner may be challenging for a forensic pathologist in cases of spot deaths with isolated cut-throat injury.

Case presentation
This fatality in a young male is elucidated for it to be found markedly deviant with reference to the factors described for suicidal cut-throat injuries, including (1) medical history; (2) death circumstances (non-home); (3) type of object that produced injury; (4) injury pattern in relation to dexterity, lack of old and fresh hesitation cuts at neck and elsewhere, predisposition (horizontal), and extent (superficiality); (5) autopsy findings (non-pale organs); (6) scene evidence/s; (7) findings at viscera examination; and (8) cause of death (choking). The deceased was a cannabis addict, practiced black magic, and lived separated from his wife. There was no lead of the event, and thus an inquest proceeding was initiated.

Conclusion
The possibility of suicide by cut throat by razor blade was considered in the light of the pragmatic comprehension of the post-mortem and scene findings. A case of suicide cut-throat without hesitation cuts, but with venous outpour, and not-so-deep injuries caused by a razor blade, has not been reported. This unprecedented review aims to add to the virtually non-existent literature about medico-legal masquerades rarely seen in suicide cut-throat injuries. It is an endeavor to guide the deduction of the most qualified opinion with a guide to analyzing often undermined and neglected variables in cases of isolated cut-throat injuries. The causative association of marital conflicts that put young males at an increased risk of suicide is highlighted here.
Evaluation of general public awareness, knowledge and attitude about common rheumatic diseases in Egypt: a multicenter study
Authors: Elsabae Ola Eltabey Mahmoud , Habib Hisham Mohammed , Abady Wael Abdelmohsen , Radwan Ahmed Roshdy , Shaat Reham Magdy , Gharbia Ola Mohammad 
Published: September 2023

Abstract
Background
Rheumatic diseases are the diseases of the connective tissue and medical disorders of the musculoskeletal system, with pain and/or stiffness as main manifestations, and which may or may not be accompanied by other organ system involvement. Public and patient’s awareness is needed as the number of patients of various forms of arthritis and other musculoskeletal diseases is constantly on rise.

Objective
The aim of our multicenter study is to evaluate awareness, knowledge, and attitude of general populations regarding common rheumatic diseases in Egypt.

Subjects and methods
This was a multicenter study included 3000 subjects from 4 Egyptian governorates (750 subjects from each): Lower Egypt: Dakahlia and Damietta and Upper Egypt: Sohag and Qena. Entire cases completed the Awareness, Knowledge, and Attitude of Egyptian people towards four of the common rheumatic diseases (Rheumatoid arthritis, Systemic lupus erythematosus, Crystal-induced arthritis, and Osteoarthritis): AKARSCO questionnaire that included basic information, general knowledge, and attitude about rheumatic diseases.

Results
The knowledge and awareness of rheumatic diseases are significantly higher among females. Regarding education level, there is a steady increase in the awareness with the rise of education level, with a highly significant correlation. Non-working and married participants had significantly higher knowledge compared to working and non-married ones. The attitude towards rheumatic diseases is significantly satisfactory among females. Regarding education level, there is a steady increase in the attitude with the rise of education level, with a highly significant correlation. Non-working and married participants had significant satisfactory attitude compared to working and non-married ones. The main sources of information about rheumatic diseases are media and Internet.

Conclusion
The overall awareness, knowledge, and attitude of population towards rheumatic diseases are limited in Egypt. The participants’ total score regarding the general knowledge level of rheumatic diseases, rheumatoid arthritis, SLE, gout, and osteoarthritis is bad. The participants’ overall level regarding the attitude towards rheumatic diseases is unsatisfactory. The level of knowledge and attitude is affected by many factors like sex, work, education, residence, marital status, and family history of rheumatic diseases. The main sources of information about rheumatic diseases are media and Internet.
Bacterial lipoprotein plays an important role in the macrophage autophagy and apoptosis induced by Salmonella typhimurium and Staphylococcus aureus
Authors: Jiang Shanshan , He Jinyao , Zhang Lijie , Zhao Qiaojiajie , Zhao Shuqi 
Published: September 2023

Abstract
This study aimed to determine the role of bacterial lipoprotein (BLP) in autophagy and apoptosis. Western blot was used to examine autophagy biomarkers in mouse bone marrow-derived macrophages (BMDMs) after infection with Salmonella typhimurium (S. typhimurium) and Staphylococcus aureus (S. aureus) and BLP stimulation. In BMDMs, enhanced protein expression of LC3-II was observed after S. typhimurium or S. aureus infection (P < 0.05) and BLP stimulation (P < 0.05). Autophagy inhibition by chloroquine resulted in increased levels of LC3-Ⅱ and p62 protein (P < 0.05). Persistently upregulated expressions of Atg3 and Atg7 were observed following BLP stimulation (P < 0.05), and knockdown of Atg3 or Atg7 significantly attenuated BLP-enhanced protein expression of LC3-Ⅱ in BMDMs. Furthermore, we found that the autophagy inhibitor 3-methyladenine prevented BLP- and infection-induced macrophage apoptosis. BLP is not only required for autophagy and apoptosis activation in macrophages but also for regulating the balance between autophagy and apoptosis.