bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characterization and application of a lactate and branched chain amino acid metabolism related gene signature in a prognosis risk model for multiple myeloma
Authors: Yu Zhengyu , Qiu Bingquan , Zhou Hui , Li Linfeng , Niu Ting 
Published: August 2023

Abstract
Background
About 10% of hematologic malignancies are multiple myeloma (MM), an untreatable cancer. Although lactate and branched-chain amino acids (BCAA) are involved in supporting various tumor growth, it is unknown whether they have any bearing on MM prognosis.

Methods
MM-related datasets (GSE4581, GSE136337, and TCGA-MM) were acquired from the Gene Expression Omnibus (GEO) database and the Cancer Genome Atlas (TCGA) database. Lactate and BCAA metabolism-related subtypes were acquired separately via the R package “ConsensusClusterPlus” in the GSE4281 dataset. The R package “limma” and Venn diagram were both employed to identify lactate-BCAA metabolism-related genes. Subsequently, a lactate-BCAA metabolism-related prognostic risk model for MM patients was constructed by univariate Cox, Least Absolute Shrinkage and Selection Operator (LASSO), and multivariate Cox regression analyses. The gene set enrichment analysis (GSEA) and R package “clusterProfiler"were applied to explore the biological variations between two groups. Moreover, single-sample gene set enrichment analysis (ssGSEA), Microenvironment Cell Populations-counter (MCPcounte), and xCell techniques were applied to assess tumor microenvironment (TME) scores in MM. Finally, the drug’s IC50 for treating MM was calculated using the “oncoPredict” package, and further drug identification was performed by molecular docking.

Results
Cluster 1 demonstrated a worse prognosis than cluster 2 in both lactate metabolism-related subtypes and BCAA metabolism-related subtypes. 244 genes were determined to be involved in lactate-BCAA metabolism in MM. The prognostic risk model was constructed by CKS2 and LYZ selected from this group of genes for MM, then the prognostic risk model was also stable in external datasets. For the high-risk group, a total of 13 entries were enriched. 16 entries were enriched to the low-risk group. Immune scores, stromal scores, immune infiltrating cells (except Type 17 T helper cells in ssGSEA algorithm), and 168 drugs’IC50 were statistically different between two groups. Alkylating potentially serves as a new agent for MM treatment.

Conclusions
CKS2 and LYZ were identified as lactate-BCAA metabolism-related genes in MM, then a novel prognostic risk model was built by using them. In summary, this research may uncover novel characteristic genes signature for the treatment and prognostic of MM.
Looking at maternal health of Asháninka communities from the conceptual framework of the accessibility of care
Authors: Lazo-Gonzales Angel Oswaldo , Sarmiento-Casavilca Tania , Espinosa-Henao Olga Elena , Ruelas-González Maria Guadalupe , Alcalde-Rabanal Jacqueline Elizabeth 
Published: August 2023

AbstractBackgroundPeru is one of the 20 countries that has significantly reduced maternal mortality before the pandemic due to implementing policies to strengthen maternal health care, mainly in rural areas with greater poverty. However, the implementation of these policies has been different across the territory; such is the case of the indigenous communities of the Peruvian Amazon that are characterized by the inaccessibility of their territory and continue to face severe problems in accessing maternity care in health services.ObjectiveAnalyze the main dimensions of accessibility for maternal care in public health services for women of the Asháninka community of Peru between 2016 and 2018.MethodsQualitative research was carried out in the Asháninka community of the Tambo River. Key informants involved in maternal health care were selected, and 60 in-depth interviews were conducted that explored geographical, financial, cultural, and organizational accessibility. The interviews were recorded and transcribed into a word processor; then, a content analysis was performed to classify the texts according to the dimensions of specified accessibility.ResultsGeographical accessibility: health units in the territory do not have the resolution capacity to attend maternal health problems. Financial accessibility: the programs implemented by the government have not been able to finance the indirect costs of care, such as transportation, which has high costs that a family cannot afford, given their subsistence economy. Cultural: there are efforts for cultural adaptation of maternal care, but its implementation needs to be improved, and the community cannot recognize it due to the lack of continuity of the model and the high personnel turnover. Organizational: health units are characterized by insufficient human resources, supplies, and medicines that fail to offer continuous and quality care.ConclusionsThe poor geographical, financial, cultural, and organizational accessibility that women from the Asháninka community face for maternal care in public health services are evident. So, the Peruvian government must review the implementation processes of its models of care and maternal health programs in these communities and propose strategies to improve the coverage, quality and continuity of maternal care.
Temporal trends of sepsis-related mortality in China, 2006–2020: a population-based study
Authors: Dong Run , Liu Wei , Weng Li , Yin Peng , Peng Jinmin , Chen Yan , Li Shan , Wang Chunyao , Jiang Wei , Hu Xiaoyun , Du Bin , Zhou Maigeng ,   for the China Critical Care Clinical Trials Group (CCCCTG)
Published: August 2023

Abstract
Background
The scarcity of sepsis epidemiologic data from most low- and middle-income countries (LMICs) hampered estimation of regional and global burden of the disease, and provided limited guidance for policy makers. We aimed to characterize and analyze the temporal trends of sepsis-related mortality in China, by population groups, underlying causes of death, geographic regions, and sociodemographic index (SDI) levels.

Methods
Sepsis-related deaths were identified from the National Mortality Surveillance System (NMSS) of China from 2006 to 2020. Trends of sepsis-related mortality and years of life lost (YLLs), stratified by age, sex, underlying diseases, and regions were analyzed using the Jointpoint regression analysis. We investigated the association of SDI with trends of sepsis-related mortality.

Results
In 2020, sepsis was estimated to be responsible for 986,929 deaths and 17.1 million YLLs in China. Age-standardized sepsis-related mortality significantly declined from 130.2 (95%CI, 129.4–131) per 100,000 population in 2006 to 76.6 (76.3–76.9) in 2020. Age-standardized YLLs decreased from 2172.7 (2169.4–2176) per 100,000 population in 2006 to 1271 (1269.8–1272.2) in 2020. Substantial variations of sepsis-related mortality and YLLs were observed between population groups and regions, with higher burden in males, the elderly, and western China. An inverse relation was noted between SDI and sepsis-related mortality or YLLs.

Conclusions
Despite declining trends of age-standardized mortality and YLLs of sepsis in China, significant disparities between population groups and regions highlight a need for targeted policies and measures to close the gaps and improve the outcome of sepsis.
Enterotypes of the human gut mycobiome
Authors: Lai Senying , Yan Yan , Pu Yanni , Lin Shuchun , Qiu Jian-Ge , Jiang Bing-Hua , Keller Marisa Isabell , Wang Mingyu , Bork Peer , Chen Wei-Hua , Zheng Yan , Zhao Xing-Ming 
Published: August 2023

Abstract
Background
The fungal component of the human gut microbiome, also known as the mycobiome, plays a vital role in intestinal ecology and human health. However, the overall structure of the gut mycobiome as well as the inter-individual variations in fungal composition remains largely unknown. In this study, we collected a total of 3363 fungal sequencing samples from 16 cohorts across three continents, including 572 newly profiled samples from China.

Results
We identify and characterize four mycobiome enterotypes using ITS profiling of 3363 samples from 16 cohorts. These enterotypes exhibit stability across populations and geographical locations and significant correlation with bacterial enterotypes. Particularly, we notice that fungal enterotypes have a strong age preference, where the enterotype dominated by Candida (i.e., Can_type enterotype) is enriched in the elderly population and confers an increased risk of multiple diseases associated with a compromised intestinal barrier. In addition, bidirectional mediation analysis reveals that the fungi-contributed aerobic respiration pathway associated with the Can_type enterotype might mediate the association between the compromised intestinal barrier and aging.

Conclusions
We show that the human gut mycobiome has stable compositional patterns across individuals and significantly correlates with multiple host factors, such as diseases and host age.
Recovery from (treatment-resistant) depression after lifestyle changes and micronutrient precision supplementation: a preliminary field study in patients
Authors: Mader Isabella M. 
Published: August 2023

Abstract
Background and purpose
The incidence of depression is increasing, despite continued advances in psychological and pharmacological interventions. New treatment approaches are urgently needed. Here we assess the effects on depression of individualized micronutrient supplementation, in concert with a standard set of lifestyle changes.

Methods
We conducted a small field-study with 17 participants in Austria. Patients with depression (n = 11) and healthy volunteers (n = 6) underwent laboratory serum analysis and filled out the DASS-21 and a questionnaire about their medical history and condition. The list of parameters to be tested in the serum analysis was derived from an expert heuristic compilation of factors known to influence depression, narrowed down to a workable list to be tested in this initial study. On the basis of the results, the participants (n = 17) received individualized recommendations for micronutrient supplementation, in collaboration with their treating physician. Participants followed the individual supplementation regime for two months, along with a standard set of lifestyle changes. After two months the laboratory serum analyses, the DASS-21, and the questionnaire were repeated.

Results
All patients with micronutrient deficiencies were in the patient group; none of the healthy volunteers showed any micronutrient deficiencies. After two months of precision supplementation and lifestyle changes, all but one patient had recovered from their depression or had considerably improved. The one patient who didn’t recover was the only one with a known trigger of their depression (trauma). Of 11 patients with depression, the trigger was unknown for the other ten.

Conclusions
These results have promising implications for further research, treatment, drug development, and public health. We propose that systematic screening of patients with symptoms of depression be developed for future research, medical care, and practice. Psychiatry and psychotherapy may see improved results once they no longer have to push against the underlying constraints of existing micronutrient deficiencies.
Comparison of dislocation rates of Teflon and Titanium stapes prostheses: A retrospective survival analysis on 855 patients
Authors: Gargula Stéphane , Daval Mary , Lecoeuvre Adrien , Ayache Denis 
Published: August 2023

Background Stapes prosthesis dislocation is the first cause of revision stapes surgery. To our knowledge, there is no data about stability of the incus attachment of manual crimped prosthesis of different materials. This study aimed to compare the dislocation incidence between titanium and fluoroplastic stapes prostheses. Method A monocentric retrospective cohort study was conducted between January 2013 and June 2022 in a tertiary-care center. All patients that underwent a primary stapes surgery with manually crimped fluoroplastic or titanium prostheses were included. Prosthesis dislocation from the incus was identified intraoperatively or with CT scan. The incidence of stapedial prosthesis dislocation over time was estimated using the Kalbfleisch and Prentice survival analysis method. Other indications for revision surgery prior to prosthesis dislocation were considered as competing events. Differences in the cumulative incidence functions between the fluoroplastic group and the titanium group was assessed using the Gray's test. Results Eight hundred and fifty-five patients underwent primary stapes surgery during the study period. Fluoroplastic prosthesis was used in 758 (88.7%) cases and titanium prosthesis in 97 (11.3%) cases. Median follow-up was 51.7 months (28.4–80.1). Dislocation was observed in 23 (3.0%) patients with fluoroplastic prosthesis and none (0.0%) in the titanium group. The probability of prosthesis dislocation at two years after surgery was 3.5% in the Teflon group and 0.0% in the Titanium group. No significant difference was found in the cumulative incidence of prosthesis dislocation between the fluoroplastic group and the titanium group (p = 0.12). Conclusions Despite lack of statistical power, our results suggest a trend in a more stable incus attachment of manually crimped titanium stapes prosthesis compared to fluoroplastic over time. Further prospective randomized studies could be valuable to assess our findings. Graphical Abstract
Practical aspects of multiaxial classification: a clinically useful biopsychosocial framework for child and adolescent psychiatry
Authors: Mayall Mark , McDermott Brett , Sadhu Raja , Teoh Yvonne , Bosanquet Margot , Nundeekasen Sunaina 
Published: August 2023

SUMMARYMultiaxial classification system development (organising important and relevant clinical factors under multiple headings or ‘axes’) has a long history stretching back to the 1940s. The World Health Organization supported the development of a multiaxial system of classification for children from the 1960s and in the 1990s produced a comprehensive multiaxial system which could be used with ICD-10. Using the multiaxial approach provides for an atheoretical framework that can integrate factors from within the child and the environmental influences on the child. This article presents a variety of ways in which the ICD-10 multiaxial framework can be extended from its classic usage to provide clinicians with valuable tools to assist in a biopsychosocial clinical assessment. Using the multiaxial system in an extended format allows a more comprehensive diagnosis and planning of treatments and is helpful in the training and teaching of juniors. It is also useful in evaluating responses to medication when it is combined with a chronological analysis and can provide other useful ways of integrating information relevant to understanding clinical cases.
Evolution of Breast Cancer Recurrence Risk Prediction: A Systematic Review of Statistical and Machine Learning–Based Models
Authors: El Haji Hasna , Souadka Amine , Patel Bhavik N. , Sbihi Nada , Ramasamy Gokul , Patel Bhavika K. , Ghogho Mounir , Banerjee Imon 
Published: August 2023

PURPOSE Selection of appropriate adjuvant therapy to ultimately reduce the risk of breast cancer (BC) recurrence is a challenge for medical oncologists. Several automated risk prediction models have been developed using retrospective clinical data and have evolved significantly over the years in terms of predictors of recurrence, data usage, and predictive techniques (statistical/machine learning [ML]). METHODS Following PRISMA guidelines, we performed a systematic literature review of the aforementioned statistical and ML models published between January 2008 and December 2022 through searching five digital databases—PubMed, ScienceDirect, Scopus, Cochrane, and Web of Science. The comprehensive search yielded a total of 163 papers and after a screening process focusing on papers that dealt exclusively with statistical/ML methods, only 23 papers were deemed appropriate for further analysis. We benchmarked the studies on the basis of development, evaluation metrics, and validation strategy with an added emphasis on racial diversity of patients included in the studies. RESULTS In total, 30.4% of the included studies use statistical techniques, while 69.6% are ML-based. Among these, traditional ML models (support vector machines, decision tree, logistic regression, and naïve Bayes) are the most frequently used (26.1%) along with deep learning (26.1%). Deep learning and ensemble learning provide the most accurate predictions (AUC = 0.94 each). CONCLUSION ML-based prediction models exhibit outstanding performance, yet their practical applicability might be hindered by limited interpretability and reduced generalization. Moreover, predictive models for BC recurrence often focus on limited variables related to tumor, treatment, molecular, and clinical features. Imbalanced classes and the lack of open-source data sets impede model development and validation. Furthermore, existing models predominantly overlook African and Middle Eastern populations, as they are trained and validated mainly on Caucasian and Asian patients.
Predictors of mortality for major trauma patients in intensive care: A retrospective cohort study
Authors: Jennings Michael , Booker James , Addison Amy , Egglestone Rebecca , Dushianthan Ahilanandan 
Published: August 2023

Background: Major trauma places substantial demand on critical care services, is a leading cause of death in under 40-year-olds and causes significant morbidity and mortality across all age groups. Various factors influence patient outcome and predefining these could allow prognostication. The aim of this study was to identify predictors of mortality from major trauma in intensive care. Methods: This was a retrospective study of adult trauma patients admitted to general intensive care between January 2018 and December 2019. We assessed the impact on mortality of patient demographics, patterns of injury, injury scores (Glasgow Coma Score (GCS), Charlson’s comorbidity index (CCI), Acute Physiology and Health Evaluation II (APACHE II), Injury Severity Score (ISS) and Probability of Survival Score (Ps19)), number of surgeries and mechanism of injury using logistic regression. Results: A total of 414 patients were included with a median age of 54 years (IQR 34–72). Overall mortality was 18.6%. The most common mechanism of injury was traffic collision (46%). Non-survivors were older, had higher ISS scores with lower GCS on admission and probability of survival scores. Factors independently predictive of mortality were increasing age (OR 1.06, p <0.001) and GCS <15 on admission (OR 7.21, p <0.001). Ps19 was the best predictor of mortality (p <0.001 for each score category), with an AUROC of 0.90. Conclusions: The significant mortality predictors were age, fall from <2 metres, injury of head or limbs, GCS <15 and Ps19. Contrary to previous studies CCI and APACHE II did not significantly predict mortality. Although Ps19 was found to be the best current prognostic score, trauma prognostication would benefit from a single validated scoring system incorporating both physiological variables and injury patterns.
Identification of high-risk factors for recurrence of colon cancer following complete mesocolic excision: An 8-year retrospective study
Authors: Liu Yuan , Du Wenyi , Guo Yi , Tian Zhiqiang , Shen Wei 
Published: August 2023

Background
Colon cancer recurrence is a common adverse outcome for patients after complete mesocolic excision (CME) and greatly affects the near-term and long-term prognosis of patients. This study aimed to develop a machine learning model that can identify high-risk factors before, during, and after surgery, and predict the occurrence of postoperative colon cancer recurrence.

Methods
The study included 1187 patients with colon cancer, including 110 patients who had recurrent colon cancer. The researchers collected 44 characteristic variables, including patient demographic characteristics, basic medical history, preoperative examination information, type of surgery, and intraoperative information. Four machine learning algorithms, namely extreme gradient boosting (XGBoost), random forest (RF), support vector machine (SVM), and k-nearest neighbor algorithm (KNN), were used to construct the model. The researchers evaluated the model using the k-fold cross-validation method, ROC curve, calibration curve, decision curve analysis (DCA), and external validation.

Results
Among the four prediction models, the XGBoost algorithm performed the best. The ROC curve results showed that the AUC value of XGBoost was 0.962 in the training set and 0.952 in the validation set, indicating high prediction accuracy. The XGBoost model was stable during internal validation using the k-fold cross-validation method. The calibration curve demonstrated high predictive ability of the XGBoost model. The DCA curve showed that patients who received interventional treatment had a higher benefit rate under the XGBoost model. The external validation set’s AUC value was 0.91, indicating good extrapolation of the XGBoost prediction model.

Conclusion
The XGBoost machine learning algorithm-based prediction model for colon cancer recurrence has high prediction accuracy and clinical utility.
Youths’ perceptions and behaviors on COVID-19 testing
Authors: Arthur Caleb , Abenes Kathleen , Waselewski Marika , Chuisano Samantha A. , Chang Tammy 
Published: August 2023

Background
Social gatherings are frequent sources of COVID-19 infections, especially among youth. However, little is known about youth testing behaviors before and after gatherings. Our aim was to assess behaviors and perceptions of youth related to testing for COVID-19 before or after social gatherings in order to inform efforts to reduce disease spread.

Methods
Five open-ended questions were texted to participants aged 14–24 throughout the United States via MyVoice. Using a content analysis approach, two investigators reviewed responses by question, developed a codebook, and independently applied codes. Discrepancies were resolved via discussion. Code frequency and demographic data were summarized using descriptive statistics.

Results
Of 1204 participants, 989 responded to at least one question (RR = 94.1%). The mean age was 20.2 years (SD: 2.4 years). Most participants (80.7%) reported testing for COVID-19 at least once. Most (70.6%) were likely to test following an event, especially “[i]f someone at the gathering tested positive,” while a smaller number (50.9%) endorsed testing prior to a gathering. Of youth who would not get tested, being vaccinated was the highest reported.

Conclusion
Youth in our nationwide sample are likely to test for COVID-19 after an event, though less likely if they are vaccinated. Their desire to test is primarily driven by symptoms, exposures, and requirements. Youth are interested in increased access to home testing. Youth-centered communications regarding testing recommendations and increased test availability for youth may reduce COVID-19 spread among young people and inform future pandemic recommendations.
Ernest Lehman: The Sweet Smell of Success, Jon Krampner (2022)
Authors: Weisz Craig 
Published: August 2023

Review of: Ernest Lehman: The Sweet Smell of Success, Jon Krampner (2022)
Lexington, KY: The University Press of Kentucky, 396 pp.,
ISBN 978-0-81319-595-7, h/bk, $27.73