bluuebunny/crossref_metadata_2025_split huggingface dataset:
A promising Prognostic risk model for advanced renal cell carcinoma (RCC) with immune-related genes
Authors: Cao Peng , Wu Ji-Yue , Zhang Jian-Dong , Sun Ze-Jia , Zheng Xiang , Yu Bao-Zhong , Cao Hao-Yuan , Zhang Fei-Long , Gao Zi-Hao , Wang Wei 
Published: June 2022

Abstract
Background
Renal cell carcinoma (RCC) is a third most common tumor of the urinary system. Nowadays, Immunotherapy is a hot topic in the treatment of solid tumors, especially for those tumors with pre-activated immune state.

Methods
In this study, we downloaded genomic and clinical data of RCC samples from The Cancer Genome Atlas (TCGA) database. Four immune-related genetic signatures were used to predict the prognosis of RCC by Cox regression analysis. Then we established a prognostic risk model consisting of the genes most related to prognosis from four signatures to value prognosis of the RCC samples via Kaplan–Meier (KM) survival analysis. An independent data from International Cancer Genome Consortium (ICGC) database were used to test the predictive stability of the model. Furthermore, we performed landscape analysis to assess the difference of gene mutant in the RCC samples from TCGA. Finally, we explored the correlation between the selected genes and the level of tumor immune infiltration via Tumor Immune Estimation Resource (TIMER) platform.

Results
We used four genetic signatures to construct prognostic risk models respectively and found that each of the models could divide the RCC samples into high- and low-risk groups with significantly different prognosis, especially in advanced RCC. A comprehensive prognostic risk model was constructed by 8 candidate genes from four signatures (HLA-B, HLA-A, HLA-DRA, IDO1, TAGAP, CIITA, PRF1 and CD8B) dividing the advanced RCC samples from TCGA database into high-risk and low-risk groups with a significant difference in cancer-specific survival (CSS). The stability of the model was verified by independent data from ICGC database. And the classification efficiency of the model was stable for the samples from different subgroups. Landscape analysis showed that mutation ratios of some genes were different between two risk groups. In addition, the expression levels of the selected genes were significantly correlated with the infiltration degree of immune cells in the advanced RCC.

Conclusions
Sum up, eight immune-related genes were screened in our study to construct prognostic risk model with great predictive value for the prognosis of advanced RCC, and the genes were associated with infiltrating immune cells in tumors which have potential to conduct personalized treatment for advanced RCC.
A novel pyroptosis-related lncRNA prognostic signature associated with the immune microenvironment in lung squamous cell carcinoma
Authors: Zhou Wei , Zhang Wenxiong 
Published: June 2022

Abstract
Background
A growing body of evidence suggests that pyroptosis-related lncRNAs (PRncRNAs) are associated with the prognoses of tumor patients and their tumor immune microenvironments. However, the function of PRlncRNAs in lung squamous cell carcinoma (LUSC) remains unclear.

Methods
We downloaded the transcriptome and clinical information of 551 LUSC samples from the The Cancer Genome Atlas (TCGA) database and randomly separated patients with complete information into two cohorts. Based on the training cohort, we developed a pyroptosis-related signature. We then examined the signature in the test cohort and all retained patients. We also clustered two risk groups in each cohort according to the signature and performed survival analysis, functional analysis, tumor immune microenvironment analysis and drug sensitivity analysis.

Results
A prognostic signature containing five PRlncRNAs (AP001189.1, PICART1, LINC02555, AC010422.4, and AL606469.1) was developed. A principal component analysis (PCA) indicated better differentiation between patients with different risk scores. Kaplan–Meier (K–M) analysis demonstrated poorer survival among patients with higher risk scores (P < 0.001). A receiver operating characteristic (ROC) curve analysis provided evidence confirming the accuracy of the signature, and univariate (p = 0.005) and multivariate (p = 0.008) Cox regression analyses confirmed the independent value of the risk score in prognoses. Clinical subgroup validation indicated that the signature was more suitable for patients with early-stage LUSC. We also created a nomogram to increase the accuracy of the prediction. Moreover, functional analysis revealed that pathways related to tumor development and pyroptosis were enriched in the high-risk group. Furthermore, the prognostic signature was proven to be a predictor of sensitivity to immunotherapy and chemotherapy.

Conclusions
We developed a novel pyroptosis-associated signature with independent value for the prognosis of LUSC patients. PRlncRNAs are closely associated with the tumor immune microenvironment in LUSC and might offer new directions for immunotherapy.
Decriminalizing suicide attempt in the 21st century: an examination of suicide rates in countries that penalize suicide, a critical review
Authors: Lew Bob , Lester David , Mustapha Feisul Idzwan , Yip Paul , Chen Ying-Yeh , Panirselvam Ravivarma Rao , Hassan Astrid Sinarti , In Serena , Chan Lai Fong , Ibrahim Norhayati , Chan Caryn Mei Hsien , Siau Ching Sin 
Published: June 2022

Abstract
Background
Decriminalizing suicide may decrease overall suicide rates because then individuals who are at risk of suicide would be more willing to seek help from the community and from mental health professionals, therefore enabling early interventions for preventing suicidality. We aimed to examine the suicide trends over the last 20 years in 20 countries that still criminalize attempted suicide, and to compare the suicide rates of these 20 countries against the global average suicide rate and to a comparison sample of 20 countries that do not criminalize suicide, matched according to region and majority religion.

Methods
Age-standardized suicide rates were extracted from the WHO Global Health Estimates, available for the period 2000-2019. Population data were extracted from the World Bank. We analyzed only countries which criminalize attempted suicide under its criminal justice system. Countries were further categorized according to their membership in the Commonwealth of Nations and countries in Africa. Countries from the same region and with the same majority religion were chosen as a matching group. Joinpoint analysis was used to compare the trends of the two groups with the global average.

Results
Based on the 2019 WHO Global Health Estimates data, there is a large range in the suicide rates of the countries that criminalize attempted suicide, from 2.5 (Brunei) to 40.9 (Guyana) per 100,000 population. The mean suicide rate was 8.3 (Standard Deviation = 10.6). Out of the 20 countries, seven have suicide rates higher than the global average, covering a total population of about 387.3 million. Of these seven countries, five are in the African region. The other thirteen countries have suicide rates between 2.5 to 8.2. Mean scores of the countries which criminalized attempted suicide was lower than the global average and 20 comparison countries over the 20 years, but average annual percentage in the decrease of suicide was greater for countries in which attempted suicide was not criminalized.

Conclusions
Based on our review, there was no substantial evidence here to indicate that countries which criminalized attempted suicide had consistently lower suicide rates compared to the global average. There is a need to acknowledge that the currently available evidence is inadequate to definitively claim that criminalizing suicide is beneficial or harmful for the reduction of suicide rate for the entire populations. Future studies should continue to evaluate the unique effects of decriminalizing attempted suicide while controlling for other key associated factors.
Community gardens and their effects on diet, health, psychosocial and community outcomes: a systematic review
Authors: Hume Clare , Grieger Jessica A. , Kalamkarian Anna , D’Onise Katina , Smithers Lisa G. 
Published: June 2022

Abstract
Background
We systematically reviewed the effects of community gardens on physical and psychosocial health, health behaviors and community outcomes.

Methods
Quantitative studies that examined associations of health, psychosocial or community outcomes with community gardens were included in the review. Studies up to December 2020 were captured from searches of Medline, Web of Science, PsycInfo, EBSCOHost and CAB Abstracts. Data were extracted and study quality including risk of bias was examined.

Results
There were 53 studies that met the inclusion criteria. Studies examining associations between community gardens and nutrition or food security were most frequently reported (k = 23). Other factors examined for associations with community gardens were health (k = 16), psychosocial (k = 16) and community outcomes (k = 7). Effects appeared positive for fruit and vegetable intake, some psychosocial and community outcomes, but mixed for physical health outcomes. Evidence quality overall was low.

Conclusions
Community gardening was associated with higher fruit and vegetable intake, positive psychosocial and community outcomes, but poor evidence quality suggests the effects of community gardening may be overestimated.
“This Group is Like a Home to Me:” understandings of health of LGBTQ refugees in a Swedish health-related integration intervention: a qualitative study
Authors: Pelters Pelle , Hertting Krister , Kostenius Catrine , Lindgren Eva-Carin 
Published: June 2022

AbstractBackgroundWhen large numbers of asylum seekers immigrate to a country, civil society is encouraged to contribute to their integration. A subgroup of asylum seekers comprising lesbian, gay, bisexual, transgender, or queer (LGBTQ) refugees are specifically deemed vulnerable to developing health and integration problems due to the double stigma of being a sexual/gender minority and a refugee. The Swedish Federation for LGBTQ Rights (RFSL) is a civil societal organization that has established the support group “RFSL Newcomers,” a health-related integration intervention that targets such refugees. The aim of the present study is reconstructing the subjective understanding of health of LGBTQ refugees.MethodsEleven participants in Newcomers and eight organizers were interviewed about LGBTQ refugees’ experiences of migrating and participating in RFSL Newcomers. Qualitative content analysis was used to reconstruct subjective understandings of health that were constructed in these narratives. As the data did not originally concentrate on exploring understandings of health, a broad theoretical approach was used as a heuristic for the analysis, which focused on the common everyday approach of conceptualizing health as wellbeing.ResultsThe narratives revealed three interconnected, interdependent categories of understanding health in which tensions occur between wellbeing and ill-being: belonging versus alienation, security and safety versus insecurity, and recognition versus denial. The categories contribute to an overarching theme of health as framed freedom – i.e., freedom framed by conditions of society.ConclusionsFor our participants, belonging, recognition, and security/safety are conceptual elements of understanding health, not its social determinants. Thus, these understandings emphasize relational and existential meanings of health (theoretical implication). As for practical implications, the understandings of health were connected to being either inside or outside the Newcomers group and a new society, depending on whether LGBTQ refugees comply with social requirements. As a significant actor that is representative of the cultural majority and a facilitator of LGBTQ refugees’ resettlement process, RFSL provides LGBTQ refugees with crucial orientations for becoming a “good migrant” and a “good LGBTQ person,” yet a “bad bio-citizen.” Generally, organizers of interventions may enhance the effectiveness of their interventions when relational, existential, and biomedical understandings of health are all incorporated.
Podotimod in pediatric recurrent respiratory tract infections: a cost-utility analysis
Authors: Buendía Jefferson Antonio , Guerrero Patiño Diana , Lindarte Erika Fernanda 
Published: June 2022

Abstract
Introduction
Despite the growing evidence on efficacy, few economic evaluations have evaluated the cost-utility of Pidotimod (PDT) supplementation to decrease the probability of recurrent respiratory tract infections in children. This study aimed to determine the cost-utility of PDT to reduce the incidence rate of recurrent respiratory tract infections in children.

Methods
A decision tree model was used to estimate the cost and quality-adjusted life-years (QALYs) of PDT in a patient aged 1–6 with a history of recurrent respiratory tract infections. Multiple sensitivity analyses were conducted to evaluate the robustness of the model. Cost-effectiveness was evaluated at a willingness-to-pay (WTP) value of US$5180.

Results
The base-case analysis showed that compared with placebo, PDT was associated with lower costs and higher QALYs. The expected annual cost per patient with PDT was US$797 (CI 95% US$794- US$801) and with placebo was US$1175 (CI 95% US$1169- US$1181). The QALYs per person estimated with PDT was 0.95 (CI 95% 0.94–0.95) and with placebo was 0.94 (CI 95% 0.94–0.94). The NMB with PDT was US$ 4121 (CI 95% 4114–4127) and with placebo was US$ 3710 (CI 95% 3700–3720). This position of absolute dominance (PDT has lower costs and higher QALYs than placebo) of PDT it is unnecessary to estimate the incremental cost-effectiveness ratio.

Conclusion
In conclusion our study shows that PDT is a cost-effective strategy to reduce the incidence rate of recurrent respiratory tract infections in children. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines.
A cross-sectional study of student empathy across four medical schools in Denmark—associations between empathy level and age, sex, specialty preferences and motivation
Authors: Assing Hvidt Elisabeth , Søndergaard Jens , Wehberg Sonja , Hvidt Niels Christian , Andersen Christina Maar 
Published: June 2022

AbstractBackgroundProfessional empathy has been associated with a range of positive patient- and clinician outcomes and is therefore considered important to develop for future physicians. Measuring changes in empathy scores among medical students by using the Jefferson Scale of Empathy (Student version) (JSE-S) has led to mixed results. So far, no investigation of Danish medical students’ empathy development has been conducted. The aim of this study was therefore to examine the associations between empathy scores among Danish medical students and medical school, year of curriculum, age, sex, co-habitation, and parental status, specialty preferences and motivations for choosing medicine as a future profession.MethodsThis was a cross-sectional questionnaire study. All medical students from four medical schools in Denmark in their first, third and sixth year (N = 4,178) were invited to participate in the study in October 2020. The associations between JSE-S sum score and the above explanatory factors were analysed by uni- and multivariable linear regression models.ResultsThe JSE-S was completed by 672 medical students. The overall mean score was 112.7. There were no statistically significant differences in empathy between medical schools, first, third- and sixth- year medical students, age groups or parental status. Female students and students living with a spouse or partner scored higher on JSE-S than male students or students living alone, and the sex difference remained statistically significant in the multivariable regression. In both the univariable and multivariable setting, preference for future medical specialty was statistically significant, with a decrease in scores for students choosing surgery-specialties. Motivational factors were not statistically significantly associated with empathy, although there was a slight upwards trend for one of the motivational categories, named “personal experiences”.ConclusionsOverall, our results showed neither decrease nor increase but instead rather stable empathy scores across years of curriculum of medical students in Denmark, adding to the mixed picture of empathy development among medical students. Our findings are consistent with positive associations found in international studies between empathy scores and higher age, female sex, specialty preferences for psychiatry and general practice and altruistic motivations for choosing to enroll. Although specialty preferences are changing during medical education, they may be used meaningfully as predictors of individual student empathy levels.
The objectives and instructional design of undergraduate endodontic program: multicenter cross-sectional study in Saudi Arabia
Authors: Algahtani Fahda N. , Barakat Reem M. , Almohareb Rahaf A. , Alqarni Lujain , Alqabbani Alanoud , Almadi Ebtisam 
Published: June 2022

AbstractBackgroundIdentify the objectives and the instructional design of undergraduate endodontics in dental schools in Saudi Arabia.MethodsThe online questionnaire was developed from an original survey conducted in the United Kingdom. The questionnaire was modified for purpose of the study and the region of interest. Then it was directed and emailed to the undergraduate endodontic program directors in twenty-six dental schools in Saudi Arabia. The results were analyzed using descriptive statistics and the Chi-square and Fisher’s exact tests.ResultsThe response rate was 96.15%. The number of credit hours for preclinical endodontic courses was up to four credit hours (84%). Students were clinically trained to do vital pulp therapies (92%), root canal treatment (100%), and root canal retreatment (68%). The majority of dental schools define the minimum clinical requirements (92%). Practical and clinical competency exams were used to evaluate students' performance (92% and 84% respectively). The students were trained to treat cases of minimal (52%) to moderate complexity (48%). Endodontic treatment consent and difficulty assessment form were used by 32% and 60% of dental schools respectively. There was no significant difference in the instructional design between public and private dental schools (P > 0.05).ConclusionThe endodontic undergraduate objectives were to graduate competent clinicians who acquired basic science of endodontics and who know their limitations as it is necessary for a safe general dental practice. The use of endodontic treatment consent and case difficulty assessment should be wisely considered in clinical training.
Using machine learning to predict subsequent events after EMS non-conveyance decisions
Authors: Paulin Jani , Reunamo Akseli , Kurola Jouni , Moen Hans , Salanterä Sanna , Riihimäki Heikki , Vesanen Tero , Koivisto Mari , Iirola Timo 
Published: June 2022

Abstract
Background
Predictors of subsequent events after Emergency Medical Services (EMS) non-conveyance decisions are still unclear, though patient safety is the priority in prehospital emergency care. The aim of this study was to find out whether machine learning can be used in this context and to identify the predictors of subsequent events based on narrative texts of electronic patient care records (ePCR).

Methods
This was a prospective cohort study of EMS patients in Finland. The data was collected from three different regions between June 1 and November 30, 2018. Machine learning, in form of text classification, and manual evaluation were used to predict subsequent events from the clinical notes after a non-conveyance mission.

Results
FastText-model (AUC 0.654) performed best in prediction of subsequent events after EMS non-conveyance missions (n = 11,846). The model and manual analyses showed that many of the subsequent events were planned before, EMS guided the patients to visit primary health care facilities or ED next or following days after non-conveyance. The most frequent signs and symptoms as subsequent event predictors were musculoskeletal-, infection-related and non-specific complaints. 1 in 5 the EMS documentation was inadequate and many of these led to a subsequent event.

Conclusion
Machine learning can be used to predict subsequent events after EMS non-conveyance missions. From the patient safety perspective, it is notable that subsequent event does not necessarily mean that patient safety is compromised. There were a number of subsequent visits to primary health care or EDs, which were planned before by EMS. This demonstrates the appropriate use of limited resources to avoid unnecessary conveyance to the ED. However, further studies are needed without planned subsequent events to find out the harmful subsequent events, where EMS non-conveyance puts patient safety at risk.
Preliminary exploration of theory and practice training of 5G ultrasonic remote consultation in grassroot hospitals
Authors: Wang Ceng , Zheng Yi , Xiong Cui , Sun Litao , Wang Jing 
Published: June 2022

Abstract
Background
With the rapid development of science and technology, telemedicine diagnosis and treatment systems have gradually attracted increased attention and applications.5G ultrasound is an important branch of telemedicine, connecting grassroots hospitals at one end and provincal hospitals at the other, which provides remote guidance to grassroots doctors for ultrasound examination and image diagnosis. It is convenient for villagers obtaining diagnosis and advice from provincial ultrasound experts, saving time and economic costs, as well as benefiting from high-quality ultrasound medical resources. In this study, taishun County community grassroot hospitals were selected as the pilot study of 5G ultrasound application, to explore the effectiveness of their theory and practice, and gradually improve the remote ultrasound diagnosis and treatment standards, so as to improve their quality of grassroots hospitals and benefit grassroots people.

Methods
This is a descriptive study. The Provincal Hospital will conduct ultrasonic theory and practice training for grassroot hospitals. The training subjects included 43 doctors in grassroots hospitals who were willing to carry out ultrasound examinations. Theories, skills training scores and trainees' questionnaires on teaching content were collected and analyzed. After passing theoretical and practical training, they will conduct ultrasound examinations in their respective communities and collect relevant cases. There are 148 cases thus far for analysis. It mainly included the type of disease, whether the patient was out-patient or inpatient, frequency of ultrasound visits in recent 5 years, and follow-up treatment measures.

Results
It mainly included three aspects: (1) Through theoretical and practical training, the ultrasonic diagnosis level of grassroot doctors was significantly improved. The difference in scores between the two practical trainings was statistically significant. (2) Forty-three questionnaires were sent out, feedback from trainees was very high. Most of them was very satisfied with our training. The total score of the questionnaire was 10, and 97.67% of them score more than 8. (3) In total, there were 148 remote consultation cases, including 67 males and 81 females, who were aged 21 to 101 years old (62.40 ± 15.73).mainly abdominal ultrasound, and typical cases involve fatty liver, hepatic cyst, gallbladder stone, kidney stone and so on. We analyzed case data and provided follow-up treatment recommendations.

Conclusion
As a “visual apparatus”, 5G ultrasound can be routinely carried out in grassroot hospitals, which can provide mutual benefit between doctors and patients and comprehensively promote healthy villages.