bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of Same-Day Discharge Posterior Lumbar Decompression and/or Discectomy: An Observational Study Using Administrative Data From England
Authors: Gray William K. , Day Jamie , Briggs Tim W. R. , Hutton Mike 
Published: October 2022

Study design Retrospective cohort study. Objectives Same-day discharge is widely used in many surgical specialities. If carefully planned, it can improve patient outcomes whilst using resources efficiently. We aimed to investigate the safety of same-day discharge following a posterior lumbar decompression and/or discectomy (PLDD). Methods This was a retrospective analysis of administrative data. We extracted data from the Hospital Episodes Statistics database for the 5 years from 1st April 2014 to 31st March 2019. Patients undergoing an elective one or two level PLDD aged 19-54 years during the index stay were included. The primary exposure variable was same-day discharge or post-surgery overnight stay and the primary outcome was emergency hospital readmission within 90 days post-discharge. Results Data were available for 45,814 PLDD performed across 103 hospital trusts of which 7914 (17.3%) were performed as same-day discharge. Same-day discharge rates varied from 87.7% to 0% across the 90 hospital trusts that operated on more than 50 patients during the study period. Fourteen (15.6%) trusts had same-day discharge rates above 30% and 57 (63.3%) trusts had same-day discharge rates below 10%. The odds of emergency hospital readmission within 90 days were lower for same-day discharge patients (odds ratio .72 (95% confidence interval .61 to .85). There was no difference in outcomes for patients seen at trusts with a same-day discharge rate of ≥30% compared to trusts with a same-day discharge rate of ≤10%. Conclusions Same-day discharge low-complexity elective PLDD is safe in adult patients below the age of 55 years. There is potential for many providers to substantially increase their rates of same-day discharge.
Barriers to Access: The Unencumbered Client in Private Food Assistance
Authors: Haynes Stein Alana 
Published: October 2022

The private food assistance network has expanded amidst a receding welfare state, signaling the privatization of food assistance and other social services. Simultaneously, the cultural association of poverty with morality characterizes some individuals as more “deserving” of assistance than others. As people seek social services, they must navigate programs embedded with these ideas of deservingness. I use data from 21 in-depth, semi-structured interviews with food bank clients and over 225 hours of participant observation at a California food bank and its partner agencies to examine how clients experience barriers to accessing private food assistance. I find that nonprofit program structures are designed to serve an unencumbered client, yet even populations characterized as “deserving” do not meet the characteristics of the unencumbered client. This nearly unattainable status of unencumbered client contributes to inequity emerging from the structural level that manifests as individuals try to access and use private food assistance. These structural barriers manifest in four ways at the food bank: material resources, nonprofit infrastructure and coordination, communication channels, and policing. Based on these findings, organizational practices of nonprofits are of key importance when considering the reproduction of inequality in society.
Proportions of Biologic Discontinuation Among Psoriasis Patients With Metabolic Comorbidities
Authors: Enos Clinton W. , Ramos Vanessa L. , McLean Robert R. , Lin Tin-Chi , Foster Nicole , Dube Blessing , Van Voorhees Abby S. 
Published: October 2022

Background Among psoriasis patients, the presence of metabolic comorbidities associates with poorer response to biologics. How the presence of comorbidity impacts treatment patterns with biologics is not fully understood. Methods Adult patients in the CorEvitas Psoriasis Registry were included if they initiated biologic therapy between 5/2015–12/2019 and had a 6-month follow-up visit. The frequency of biologic discontinuations by 6-months were calculated by metabolic comorbidity status (current obesity and histories of hypertension [HTN], diabetes [DM], and hyperlipidemia [HLD]) for all patients and by drug class (tumor necrosis factor inhibitors [TNFi], interleukin-17i [IL-17i], and IL-23i or IL-12/23i). Results Among the 2924 participants, discontinuations were more frequent in those with obesity (17%, P < .01) or DM (20%, P < .001) compared to those without these (13% and 14%, respectively). Discontinuations were similar for those with and without histories of HTN or HLD. Frequencies of discontinuation for each biologic class were: TNFi (26%), IL-17i (16%), and IL-23i or IL-12/23i (9%). Among TNFi initiators, the proportions of discontinuations were greater in the presence of obesity (30%, P < .05), DM (34%, P < .05), or HTN (34%, P < .01) compared to those without (22%, 24%, and 22%, respectively). Of the IL-23i or IL-12/23i initiators, discontinuations were more frequent in those with obesity (11%, P < .01) or with DM (13%, P < .05) compared to those without (7% and 8%, respectively). Discontinuations did not statistically differ between comorbidity groups in IL-17i initiators. Conclusion Comorbid disease status, especially obesity and DM, should be assessed at biologic initiation as it may predict a less optimal clinical outcome.
Interactions of CDKAL1 rs7747752 polymorphism and serum levels of L-carnitine and choline are related to increased risk of gestational diabetes mellitus
Authors: Wang Hui , Li Jing , Liu Jinnan , Leng Junhong , Li Weiqin , Yu Zhijie , Tam Claudia H. T. , Hu Gang , Ma Ronald C. W. , Fang Zhongze , Wang Ying , Yang Xilin 
Published: October 2022

Abstract
Background
Interactions between genetic, metabolic, and environmental factors lead to gestational diabetes mellitus (GDM). We aimed to examine interactive effects of cyclin-dependent kinase 5 regulatory subunit-associated protein1-like 1(CDKAL1) rs7747752 polymorphism with low serum levels of L-carnitine, choline, and betaine for GDM.

Methods
A nested case-control study of 207 GDM women and their one-to-one, age-matched controls was organized from a prospective cohort of pregnant women in Tianjin, China. Conditional logistic regressions were used to test associations between CDKAL1 rs7747752 and serum levels of L-carnitine, choline, and betaine, and the risk of GDM. Additive interactions were performed to examine interactive effects of rs7747752 and low serum levels of L-carnitine, choline, and betaine on the risk of GDM.

Results
The CDKAL1 rs7747752 G > C was associated with GDM in additive, dominant, and recessive model (P <0.05). The rs7747752 CC genotype enhanced the OR of L-carnitine ≤ vs. > 150 nmol/mL for GDM from 6.14 (2.61–14.4) to 19.6 (5.65–68.1) and the OR of choline ≤ vs. > 110 nmol/mL from 2.37 (1.07–5.28) to 12.1 (3.22–45.6), with significant additive interactions. Similarly, CG genotype also enhanced the OR of L-carnitine ≤ vs. > 150 nmol/mL for GDM from 4.70 (2.01–11.0) to 11.4 (3.98–32.9), with a significant additive interaction. However, the additive interaction between rs7747752 and betaine ≤ 200 nmol/mL on the risk of GDM was not significant.

Conclusions
The CC or CG genotype carriers in rs7747752 of CDKAL1 who have a low serum level of L-carnitine or choline are at a particular high risk of GDM. Randomized controlled trials are warranted to test the effect of supplement of L-carnitine or choline on the risk of GDM in the high-risk group.
Breast cancer prediction with transcriptome profiling using feature selection and machine learning methods
Authors: Taghizadeh Eskandar , Heydarheydari Sahel , Saberi Alihossein , JafarpoorNesheli Shabnam , Rezaeijo Seyed Masoud 
Published: October 2022

Abstract
Background
We used a hybrid machine learning systems (HMLS) strategy that includes the extensive search for the discovery of the most optimal HMLSs, including feature selection algorithms, a feature extraction algorithm, and classifiers for diagnosing breast cancer. Hence, this study aims to obtain a high-importance transcriptome profile linked with classification procedures that can facilitate the early detection of breast cancer.

Methods
In the present study, 762 breast cancer patients and 138 solid tissue normal subjects were included. Three groups of machine learning (ML) algorithms were employed: (i) four feature selection procedures are employed and compared to select the most valuable feature: (1) ANOVA; (2) Mutual Information; (3) Extra Trees Classifier; and (4) Logistic Regression (LGR), (ii) a feature extraction algorithm (Principal Component Analysis), iii) we utilized 13 classification algorithms accompanied with automated ML hyperparameter tuning, including (1) LGR; (2) Support Vector Machine; (3) Bagging; (4) Gaussian Naive Bayes; (5) Decision Tree; (6) Gradient Boosting Decision Tree; (7) K Nearest Neighborhood; (8) Bernoulli Naive Bayes; (9) Random Forest; (10) AdaBoost, (11) ExtraTrees; (12) Linear Discriminant Analysis; and (13) Multilayer Perceptron (MLP). For evaluating the proposed models' performance, balance accuracy and area under the curve (AUC) were used.

Results
Feature selection procedure LGR + MLP classifier achieved the highest prediction accuracy and AUC (balanced accuracy: 0.86, AUC = 0.94), followed by an LGR + LGR classifier (balanced accuracy: 0.84, AUC = 0.94). The results showed that achieved AUC for the LGR + LGR classifier belonged to the 20 biomarkers as follows: TMEM212, SNORD115-13, ATP1A4, FRG2, CFHR4, ZCCHC13, FLJ46361, LY6G6E, ZNF323, KRT28, KRT25, LPPR5, C10orf99, PRKACG, SULT2A1, GRIN2C, EN2, GBA2, CUX2, and SNORA66.

Conclusions
The best performance was achieved using the LGR feature selection procedure and MLP classifier. Results show that the 20 biomarkers had the highest score or ranking in breast cancer detection.
Novel lipometabolism biomarker for chemotherapy and immunotherapy response in breast cancer
Authors: Zhang Lei , She Risheng , Zhu Jianlin , Lu Jin , Gao Yuan , Song Wenhua , Cai Songwang , Wang Lu 
Published: October 2022

AbstractEmerging proof shows that abnormal lipometabolism affects invasion, metastasis, stemness and tumor microenvironment in carcinoma cells. However, molecular markers related to lipometabolism have not been further established in breast cancer. In addition, numerous studies have been conducted to screen for prognostic features of breast cancer only with RNA sequencing profiles. Currently, there is no comprehensive analysis of multiomics data to extract better biomarkers. Therefore, we have downloaded the transcriptome, single nucleotide mutation and copy number variation dataset for breast cancer from the TCGA database, and constructed a riskScore of twelve genes by LASSO regression analysis. Patients with breast cancer were categorized into high and low risk groups based on the median riskScore. The high-risk group had a worse prognosis than the low-risk group. Next, we have observed the mutated frequencies and the copy number variation frequencies of twelve lipid metabolism related genes LMRGs and analyzed the association of copy number variation and riskScore with OS. Meanwhile, the ESTIMATE and CIBERSORT algorithms assessed tumor immune fraction and degree of immune cell infiltration. In immunotherapy, it is found that high-risk patients have better efficacy in TCIA analysis and the TIDE algorithm. Furthermore, the effectiveness of six common chemotherapy drugs was estimated. At last, high-risk patients were estimated to be sensitive to six chemotherapeutic agents and six small molecule drug candidates. Together, LMRGs could be utilized as a de novo tumor biomarker to anticipate better the prognosis of breast cancer patients and the therapeutic efficacy of immunotherapy and chemotherapy.
Isolated traumatic aniridia with full and partial iris expulsion in pseudophakic eyes
Authors: Ichioka Sho , Ishida Akiko , Sugihara Kazunobu , Sano Ichiya , Tanito Masaki 
Published: October 2022

Abstract
Background
Total aniridia after ocular trauma without disruption of the intraocular lens (IOL) has been reported in patients with a history of small-incisional cataract surgery. We report one case each of total and partial aniridia after accidental falls experienced by two elderly Japanese women.

Case presentations
Case 1. A 76-year-old woman with a history of small-incisional cataract surgery more than 10 years previously fell onto concrete and had a contusion that affected the left side of her face. At the initial visit, the best-corrected visual acuity (BCVA) was hand motions and the intraocular pressure (IOP) was 38 mmHg in her left eye (OS). A blood clot was present in the well-formed anterior chamber and expulsed iris tissue was seen beneath the conjunctiva. Exploratory surgery showed no scleral laceration other than the previous sclerocorneal tunnel. After hyphema removal, total aniridia and an intact in-the-bag fixed IOL were seen. By 4 months, the BCVA was 1.2 and the IOP was 13 mmHg OS. Case 2. An 88-year-old woman with a history of small-incisional cataract surgery more than 10 years previously had a fall that resulted in right-sided zygomatic and maxillary bone fractures. The BCVA was light perception and the IOP was 29 mmHg in her right eye (OD). Exploratory surgery showed no scleral laceration and the previous sclerocorneal tunnel was found; iris strand prolapsing from the sclerocorneal tunnel was seen. After hyphema removal, partial iris loss and an intact lens position were seen. By 1 week postoperatively, the BCVA was 0.05 OD and the IOP was 12 mmHg OD.

Conclusions
It has been postulated that previously created small-incision tunnels can function as release valves during blunt trauma by preventing further global rupture and limiting IOL prolapse or retinal injury. Our cases suggested this can happen even long periods after cataract surgery. The case with partial aniridia demonstrated the process of the expulsive aniridia, and its findings do not contradict the postulated mechanisms.
Relationship between sperm NAD + concentration and reproductive aging in normozoospermia men:A Cohort study
Authors: Bai Xueyan , Wang Peng 
Published: October 2022

Abstract
Background
The mechanisms of age-dependent reproductive decline in men are largely overlooked. An age-dependent reduction in nicotinamide adenine dinucleotide (NAD+) levels has been reported in multiple somatic and female reproductive tissues, including oocytes and ovarian tissue. However, the relationship between NAD + levels and male reproduction has not yet been studied. In the current study, the association between sperm NAD + level and paternal age was investigated. In addition, we also investigated whether sperm NAD + levels were related to semen quality.

Methods
In this pilot observational cohort study, semen samples from 51 male subjects who visited a university-affiliated reproductive medical center for preconception consultation (< 30 years: n = 13, 30–40 years: n = 19, > 40 years: n = 19) were recruited. Their anthropometric characteristics were recorded, and semen analysis was performed. Their sperm NAD + levels were evaluated spectrophotometrically.

Results
There were significant differences among the three age groups in the major parameters of semen quality. The sperm NAD + level was, however, similar among the three groups (< 30 years: 91.61 ± 15.59 nmol/106 sperm, 30–40 years: 125.60 ± 16.28 nmol/106 sperm, > 40 years: 115.59 ± 16.55 nmol/106 sperm). Additionally, linear regression also revealed no correlation between sperm NAD + concentration and the age of the participants (r2 = 0.018, p = 0.35). Noticeably, a negative correlation was found between the sperm NAD + concentrations and the sperm quality parameters, including sperm concentration (r2 = 0.78, p < 0.0001), sperm count (r2 = 0.47, p < 0.0001), mobile sperm number (r2 = 33, p < 0.0001), and DFI (r2 = 0.35, p < 0.0001). The semen volume and mobility rate were not related to the sperm NAD + concentration.

Conclusion
Unlike the age-related decrease of NAD + levels in oocytes and ovarian tissue, the sperm NAD + concentration is not age dependent. Sperm NAD + levels are negatively correlated with sperm quality, suggesting a unique role of NAD + in spermatogenesis, which warrants further study and opens opportunities for pharmaceutical interventions for oligozoospermia.
Correlation study on serum miR-222-3p and glucose and lipid metabolism in patients with polycystic ovary syndrome
Authors: Wang Qin , Fang Chuanxiang , Zhao Ying , Liu Zhaoxia 
Published: October 2022

Abstract
Objective
microRNAs (miRNAs) play pivotal roles in polycystic ovary syndrome (PCOS), an endocrine and metabolic disorder that commonly occurs in women of childbearing age. This paper aimed to measure miR-222-3p expression in sera of PCOS patients and to explore its clinical value on PCOS diagnosis and prediction of diabetic and cardiovascular complications.

Methods
Totally 111 PCOS patients and 94 healthy people were recruited and assigned to the overweight (ow) group and non-overweight (non-ow) group, followed by determination of serum miR-222-3p expression. The diagnostic efficiency of miR-222-3p on PCOS ow and non-ow patients was analyzed. Correlations between miR-222-3p and glycolipid metabolic indicators and diabetic and cardiovascular complications in PCOS were analyzed. The downstream target of miR-222-3p was predicted and their binding relationship was verified. The correlation between PGC-1α and miR-222-3p was analyzed.

Results
miR-222-3p was highly-expressed in PCOS patients (p < 0.001), in especially PCOS ow patients. The area under the curve (AUC) of miR-222-3p diagnosing PCOS non-ow patients was 0.9474 and cut-off value was 1.290 (89.06% sensitivity, 98.11% specificity), indicating that non-ow people with serum miR-222-3p > 1.290 could basically be diagnosed with PCOS. AUC of miR-222-3p diagnosing PCOS ow patients was 0.9647 and cut-off value was 2.425 (85.11% sensitivity, 100% specificity), suggesting that ow people with serum miR-222-3p > 2.425 could basically be diagnosed with PCOS. miR-222-3p was positively-correlated with fasting plasma glucose (FPG), fasting insulin (FINS), homeostatic model assessment–insulin resistance (HOMA-IR), and low-density lipoprotein cholesterol (LDL-C) and negatively-correlated with high-density lipoprotein cholesterol (HDL-C). miR-222-3p was independently-correlated with diabetic and cardiovascular complications in PCOS (p < 0.05). High expression of miR-222-3p predicted high risks of diabetic and cardiovascular complications in PCOS. miR-222-3p targeted PGC-1α and was negatively-correlated with PGC-1α (r = − 0.2851, p = 0.0224; r = − 0.3151, p = 0.0310).

Conclusion
High expression of miR-222-3p assisted PCOS diagnosis and predicted increased risks of diabetic and cardiovascular complications. miR-222-3p targeted PGC-1α and was negatively-correlated with PGC-1α.
Prediction of successful aging using ensemble machine learning algorithms
Authors: Asghari Varzaneh Zahra , Shanbehzadeh Mostafa , Kazemi-Arpanahi Hadi 
Published: October 2022

AbstractBackgroundAging is a chief risk factor for most chronic illnesses and infirmities. The growth in the aged population increases medical costs, thus imposing a heavy financial burden on families and communities. Successful aging (SA) is a positive and qualitative view of aging. From a biomedical perspective, SA is defined as the absence of diseases or disability disorders. This is distinct from normal aging, which is associated with age-related deterioration in physical and cognitive functions. From a social perspective, SA highlights life satisfaction and individual well-being, usually attained through socialization. It is an abstract and multidimensional concept surrounded by imprecision about its definition and measurement. Our study attempted to find the most effective features of SA as defined by Rowe and Kahn's theory. The determined features were used as input parameters of six machine learning (ML) algorithms to create and validate predictive models for SA.MethodsIn this retrospective study, the raw data set was first pre-processed; then, based on the data of a sample of 983, five basic ML techniques including artificial neural network, decision tree, support vector machine, Naïve Bayes, and k-nearest neighbors (K-NN) with one ensemble method (that gathers 30 K-NN algorithms as weak learners) were trained. Finally, the prediction result was yielded using the majority vote method based on the output of the generated base models.ResultsThe experimental results revealed that the predictive system has been more successful in predicting SA with a 93% precision, 92.40% specificity, 87.80% sensitivity, 90.31% F-measure, 89.62% accuracy, and a ROC of 96.10%, using a five-fold cross-validation procedure.ConclusionsOur results showed that ML techniques potentially have satisfactory performance in supporting the SA-related decisions of social and health policymakers. The KNN-based ensemble algorithm is superior to the other ML models in classifying people into SA and non-SA classes.
Rational design of an essential diagnostics network to support Universal Health Coverage: a modeling analysis
Authors: Schroeder Lee F. , Dei-Adomakoh Yvonne , DeStigter Kristen , Idigbe Emmanuel O. , Flanigan John , Ekpale Priscilla Mawuli Awo , Adjei Ernest , Roa Lina , Wilson Michael L. , Horton Susan 
Published: October 2022

Abstract
Background
Diagnostic investigations, including pathology and laboratory medicine (PALM) and radiology, have been largely absent from international strategies such as the Sustainable Development Goals. Further, there is little international guidance on which health system tiers different diagnostics should be placed, a critical step in developing a country-level diagnostics network. We describe a modeling strategy to produce tier-specific diagnostic recommendations based on disease burden, current treatment pathways, and existing infrastructure in a country.

Methods
The relational model assumes that diagnostics should be available at the lowest tier where patients might receive medical management. Using Ghana as an exemplar, the 20 diseases forecasted by 2030 and 2040 to cause the greatest burden in low- and middle-income countries were mapped to three generalized tiers in the Ghanaian health system (Primary, Secondary, and Tertiary care) for three levels of each disease (triage, uncomplicated, and complicated). The lowest tier at which a diagnostic could potentially be placed was restricted by existing infrastructure, though placement still required there be a medical justification for the diagnostic at that tier.

Results
The model recommended 111 unique diagnostic investigations with 17 at Primary tier, an additional 45 at Secondary tier and a further 49 at Tertiary tier. Estimated capital costs were $8,330 at Primary tier and between $571,000 to $777,000 at Secondary tier. Twenty-eight different laboratory tests were recommended as send-outs from Primary to Secondary tier, and twelve as send-outs to Tertiary tier.

Conclusions
This model provides a transparent framework within which countries can customize diagnostic planning to local disease priorities, health system patient treatment pathways, and infrastructural limitations to best support Universal Health Coverage.