bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning Predict Survivals of Spinal and Pelvic Ewing’s Sarcoma with the SEER Database
Authors: Fan Guoxin , Yang Sheng , Qin Jiaqi , Huang Longfei , Li Yufeng , Liu Huaqing , Liao Xiang 
Published: October 2022

Study Design Retrospective Cohort Study. Objectives This study aimed to develop survival prediction models for spinal Ewing’s sarcoma (EWS) based on machine learning (ML). Methods We extracted the SEER registry’s clinical data of EWS diagnosed between 1975 and 2016. Three feature selection methods extracted clinical features. Four ML algorithms (Cox, random survival forest (RSF), CoxBoost, DeepCox) were trained to predict the overall survival (OS) and cancer-specific survival (CSS) of spinal EWS. The concordance index (C-index), integrated Brier score (IBS) and mean area under the curves (AUC) were used to assess the prediction performance of different ML models. The top initial ML models with best performance from each evaluation index (C-index, IBS and mean AUC) were finally stacked to ensemble models which were compared with the traditional TNM stage model by 3-/5-/10-year Receiver Operating Characteristic (ROC) curves and Decision Curve Analysis (DCA). Results A total of 741 patients with spinal EWS were identified. C-index, IBS and mean AUC for the final ensemble ML model in predicting OS were .693/0.158/0.829 during independent testing, while .719/0.171/0.819 in predicting CSS. The ensemble ML model also achieved an AUC of .705/0.747/0.851 for predicting 3-/5-/10-year OS during independent testing, while .734/0.779/0.830 for predicting 3-/5-/10-year CSS, both of which outperformed the traditional TNM stage. DCA curves also showed the advantages of the ensemble models over the traditional TNM stage. Conclusion ML was an effective and promising technique in predicting survival of spinal EWS, and the ensemble models were superior to the traditional TNM stage model.
Communication barriers to education to referrals from the perspective of referrals to health centers and health care providers
Authors: Iranpour Abedin , Mirafzali Sedigheh , Borhaninejad Vahidreza , Alizadeh Somayeh 
Published: October 2022

Introduction: One of the most important factors affecting the increase of clients’ satisfaction is how health care providers (HCP) communicate with clients. On the other hand, different factors can hinder proper communication and thus education, which is one of the main tasks of HCP. Therefore, the purpose of this study was to investigate communication barriers to education to referrals from the perspective of referrals to health centers (RHC) and HCP. Method: This descriptive-analytical study was conducted on RHC and HCP in Kerman in 2021. Using a multi-stage sampling method, 162 HCP and 414 RHC were included in the study. The data collection tool was two researcher-made questionnaires. Data were analyzed using SPSS 16. Findings: From the perspective of RHC and HCP, most communication barriers were related to environmental and then socio-cultural factors. Among the demographic variables of HCP, level of education showed a significant relationship with the physical-psychological, verbal-non-verbal, and informational domains. And in relation to RHC, a significant relationship was found between education and job in the socio-cultural field and environmental barriers ( p < 0.05). Conclusion: HCP face a variety of barriers in educating people, most of which are related to environmental factors. Given the cost-effectiveness of education to the public, it is essential that planners and policymakers use strategies to eliminate environmental factors as well as the placement of indigenous HCP in health facilities to reduce communication barriers.
Cadaveric Biomechanical Evaluation of Capsular Constraint and Microinstability After Hip Capsulotomy and Repair
Authors: Donnelly Emma , Vakili Samira , Getgood Alan , Willing Ryan , Degen Ryan M. 
Published: October 2022

Background: It remains unclear if capsular management contributes to iatrogenic instability (microinstability) after hip arthroscopy. Purpose: To evaluate changes in torque, stiffness, and femoral head displacement after capsulotomy and repair in a cadaveric model. Study Design: Controlled laboratory study. Methods: A biomechanical analysis was performed using 10 cadaveric hip specimens. Each specimen was tested under the following conditions: (1) intact, (2) portals, (3) interportal capsulotomy (IPC), (4) IPC repair, (5) T-capsulotomy (T-cap), (6) partial T-cap repair, and (7) T-cap repair. Each capsular state was tested in neutral (0°) and then 30°, 60°, and 90° of flexion, with forces applied to achieve the displacement-controlled baseline limit of external rotation (ER), internal rotation (IR), abduction, and adduction. The resultant end-range torques and displacement were recorded. Results: For ER, capsulotomies significantly reduced torque and stiffness at 0°, 30°, and 60° and reduced stiffness at 90°; capsular repairs failed to restore torque and stiffness at 0°; and IPC repair failed to restore stiffness at 30° ( P < .05 for all). For IR, capsulotomies significantly reduced torque and stiffness at 0°, 30°, and 60° and reduced stiffness at 90°; and capsular repairs failed to restore torque or stiffness at 0°, 30°, and 60° and failed to restore stiffness at 90° ( P < .05 for all). For abduction, IPC significantly decreased torque at 60° and 90° and decreased stiffness at all positions; T-cap reduced torque and stiffness at all positions; IPC repair failed to restore stiffness at 0° and 90°; and T-cap repair failed at 0°, 60°, and 90° ( P < .05 for all). For adduction, IPC significantly reduced torque at 0° and reduced stiffness at 0° and 30°; T-cap reduced torque at 0° and 90° and reduced stiffness at all positions; IPC repair failed to restore stiffness at 0° and 90°; and T-cap repair failed at 0°, 60°, and 90° ( P < .05 for all). There were no statistically significant femoral head translations observed in any testing configurations. Conclusion: Complete capsular repair did not always restore intact kinematics, most notably at 0° and 30°. Despite this, there were no significant joint translations to corroborate concerns of microinstability. Clinical Relevance: Caution should be employed when applying rotational torques in lower levels of flexion (0° and 30°).
Improving Timeliness in Surgical Discharge Summary Distribution: A Quality Improvement Initiative
Authors: You Peng , Liu Jimmy , Moist Louise , Fung Kevin , Strychowsky Julie E. 
Published: October 2022

ObjectiveTo implement a quality improvement initiative to achieve an institutional targeted discharge summary distribution metric of 50% within 48 hours of patient discharge from hospital within an academic tertiary care otolaryngology–head and neck surgery department.MethodsA pre‐ and postintervention study was conducted. Process mapping was performed. Interventions included education and engagement, implementation of auto‐authentication (distribution immediately following transcription without review by the most responsible physician), and audit and feedback. The percentage of discharge summaries dictated with the auto‐authentication code was evaluated. Process measures were collected for 12 months pre‐ and postimplementation. Balancing measures included workload and revisions to auto‐authenticated notes. Analysis included summary statistics, statistical process control charting, and unpaired t tests.ResultsThe mean ± SD percentage of discharge summaries distributed within 48 hours increased from 19% ± 6.4% preintervention to 54% ± 20% postintervention (P <. 0001). Seventy‐four percent of discharge summaries were dictated via the auto‐authentication code. The target metric was met in 71% of discharges with the auto‐authentication codes as compared with 26% with non–auto‐authentication. The interventions did not result in any change to perceived workload, and the incidence of auto‐authentication revisions was <1%. The results were sustained with an increase of 72% the following quarter. For fiscal year 2021‐2022, performance remained sustained with an 85% completion rate.DiscussionOur surgical department exceeded and sustained the targeted metric for timely discharge summary distribution using a quality improvement approach.Implications for PracticeTimely distribution of discharge summaries optimizes patients’ transitions of care and can be achieved through stakeholder education and engagement, auto‐authentication, and audit with feedback.
Circulating small extracellular vesicle-encapsulated SEMA5A-IT1 attenuates myocardial ischemia–reperfusion injury after cardiac surgery with cardiopulmonary bypass
Authors: Wu Ting , Shi Guoning , Ji Zhenhua , Wang Shu , Geng Lizhu , Guo Zhigang 
Published: October 2022

AbstractCardiomyocyte injury is a common complication during cardiac surgery with cardiopulmonary bypass (CPB). Studies have shown that circulating small extracellular vesicles (sEVs) are involved in the pathological process of cardiovascular diseases via delivering signaling molecules. This study aims to investigate the relationship between circulating sEV-encapsulated long noncoding RNAs (lncRNAs) and cardiac injury after CPB. Here, we found that the expression of sEV SEMA5A-IT1 in serum samples of patients after CPB was higher than that of pre-CPB serum samples. Moreover, serum-derived sEV SEMA5A-IT1 levels were negatively correlated with creatine kinase-MB (CK-MB) levels in patients who underwent CPB operation. Notably, circulating sEVs packaged with SEMA5A-IT1 could be uptaken by cardiomyocyte-like cells AC16 and increased SEMA5A-IT1 expression in AC16 cells. Upregulated SEMA5A-IT1 protected cardiomyocytes against hypoxia/reoxygenation injury, confirmed by increased cell viability, reduced cell apoptosis, and inhibited ferroptosis in AC16 cells. Mechanistically, SEMA5A-IT1 regulated the expression of B-cell CLL/lymphoma 2 (BCL2) and solute carrier family 7 member 11 (SLC7A11) through sponging miR-143-3p. Transfection of miR-143-3p mimics,BCL2, orSLC7A11knockdown could attenuate the protective effect of SEMA5A-IT1 on cardiomyocytes. In conclusion, we propose that SEMA5A-IT1, which is transported to cardiomyocytes through circulating sEVs, is an important regulatory molecule that protects cardiomyocytes from ischemia–reperfusion injury, providing a target for the prevention and treatment of myocardial ischemia–reperfusion injury.
SumStatsRehab: an efficient algorithm for GWAS summary statistics assessment and restoration
Authors: Matushyn Mykyta , Bose Madhuchanda , Mahmoud Abdallah Amr , Cuthbertson Lewis , Tello Carlos , Bircan Karatuğ Ozan , Terpolovsky Andrew , Bamunusinghe Varuna , Khan Umar , Novković Biljana , Grabherr Manfred G. , Yazdi Puya G. 
Published: October 2022

Abstract
Background
Generating polygenic risk scores for diseases and complex traits requires high quality GWAS summary statistic files. Often, these files can be difficult to acquire either as a result of unshared or incomplete data. To date, bioinformatics tools which focus on restoring missing columns containing identification and association data are limited, which has the potential to increase the number of usable GWAS summary statistics files.

Results
SumStatsRehab was able to restore rsID, effect/other alleles, chromosome, base pair position, effect allele frequencies, beta, standard error, and p-values to a better extent than any other currently available tool, with minimal loss.

Conclusions
SumStatsRehab offers a unique tool utilizing both functional programming and pipeline-like architecture, allowing users to generate accurate data restorations for incomplete summary statistics files. This in turn, increases the number of usable GWAS summary statistics files, which may be invaluable for less researched health traits.
Combining denoising of RNA-seq data and flux balance analysis for cluster analysis of single cells
Authors: Galuzzi Bruno G. , Vanoni Marco , Damiani Chiara 
Published: October 2022

Abstract
Background
Sophisticated methods to properly pre-process and analyze the increasing collection of single-cell RNA sequencing (scRNA-seq) data are increasingly being developed. On the contrary, the best practices to integrate these data into metabolic networks, aiming at describing metabolic phenotypes within a heterogeneous cell population, have been poorly investigated. In this regard, a critical factor is the presence of false zero values in reactions essential for a fundamental metabolic function, such as biomass or energy production. Here, we investigate the role of denoising strategies in mitigating this problem.

Methods
We applied state-of-the-art denoising strategies - namely MAGIC, ENHANCE, and SAVER - on three public scRNA-seq datasets. We then associated a metabolic flux distribution with every single cell by embedding its noise-free transcriptomics profile in the constraints of the optimization of a core metabolic model. Finally, we used the obtained single-cell optimal metabolic fluxes as features for cluster analysis. We compared the results obtained with different techniques, and with or without the use of denoising. We also investigated the possibility of applying denoising directly on the Reaction Activity Scores, which are metabolic features extracted from the read counts, rather than on the read counts.

Results
We show that denoising of transcriptomics data improves the clustering of single cells. We also illustrate that denoising restores important metabolic properties, such as the correlation between cell cycle phase and biomass accumulation, and between the RAS scores of reactions belonging to the same metabolic pathway. We show that MAGIC performs better than ENHANCE and SAVER, and that, denoising applied directly on the RAS matrix could be an effective alternative in removing false zero values from essential metabolic reactions.

Conclusions
Our results indicate that including denoising as a pre-processing operation represents a milestone to integrate scRNA-seq data into Flux Balance Analysis simulations and to perform single-cell cluster analysis with a focus on metabolic phenotypes.
Effects of different depth of anesthesia on perioperative inflammatory reaction and hospital outcomes in elderly patients undergoing laparoscopic radical gastrectomy
Authors: Lv An-qing , Huang Li-cai , Lao Wei-long , Song Qi-liang , Zhou Qi-fu , Jiang Zong-ming , Chen Zhong-hua 
Published: October 2022

Abstract
Background
To investigate the effect of different depth of anesthesia on inflammatory factors and hospital outcomes in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer, in order to select an appropriate depth of anesthesia to improve the prognosis of patients undergoing surgery and improve the quality of life of patients.

Methods
A total of 80 elderly patients aged 65 and above who underwent laparoscopic radical gastrectomy in our hospital were by convenience sampling and randomly divided into two groups : 55 groups ( group H ) and 45 groups ( group L ), 40 cases in each group. The depth of anesthesia was maintained using a closed-loop target-controlled infusion system: the EEG bispectral index was set to 55 in the H group and 45 in the L group. Venous blood samples were collected 2 h (T2), 24 h (T3) and 72 h (T4) after the start of surgery. The intraoperative dosage of propofol and remifentanil, operation duration, postoperative PACU stay time, intraoperative consciousness occurrence, postoperative hospital stay and postoperative pulmonary inflammatory events were recorded.

Results
The patient characteristic of the two groups had no statistical difference and were comparable (P > 0.05). The intraoperative dosage of propofol in group H was lower than that in group L (P < 0.05). Compared with the L group, the plasma IL-6 and IL-10 concentrations in the H group were significantly increased at T2 (P < 0.05), and the plasma IL-10 concentration was significantly increased at T4 (P < 0.05). The plasma concentrations of IL-6 and IL-10 were higher in both groups at T2, T3 and T4 than at T1, while at T4, the concentration of TNF-α in group H was higher than at T1 (P < 0.05).

Conclusion
When the BIS value of the depth of anesthesia is 45, the perioperative release of inflammatory factors in elderly patients with laparoscopic radical gastrectomy for gastric cancer is less than BIS 55, and does not affect the prognosis.
Effect of glycopyrrolate on vasopressor requirements for non-elective cesarean section under spinal anesthesia: a randomized, double-blind, placebo-controlled trial
Authors: Deshar Rajesh , Subedi Asish , Pokharel Krishna , Sah Birendra Prasad , Prasad Jagat Narayan 
Published: October 2022

Abstract
Background
The study aimed to investigate whether prophylactic use of glycopyrrolate decreases the vasopressor requirements to prevent hypotension following spinal anesthesia during non-elective cesarean section.

Method
In this double-blind randomized clinical trial, 258 patients undergoing non-elective cesarean section were randomly assigned (1:1) to receive intravenous 0.2 mg glycopyrrolate or normal saline (placebo) before spinal anesthesia. The primary outcome was phenylephrine equivalent needed intraoperatively. Secondary outcomes included incidences of maternal hypotension, reactive hypertension, bradycardia, need for atropine, tachycardia, intraoperative nausea/vomiting, shivering, pruritus, dry mouth, dizziness; neonatal APGAR score at 1 min and 5 min, neonatal resuscitation needed, NICU admission and neonatal death.

Results
Three patients withdrew from the study due to failed spinal anesthesia. 128 patients in the glycopyrrolate group and 127 patients in the placebo group were analyzed. The mean phenylephrine equivalent needed was 1108.96 μg in the glycopyrrolate group and 1103.64 μg in the placebo group (mean difference, 5.32 μg [95% CI − 67.97 to 78.62]; P = 0.88). Hypotension occurred in 38 patients (30%) in the glycopyrrolate group as compared with 49 patients (39%) in the placebo group (P = 0.13). Tachycardia was reported in 70% of the participants in the glycopyrrolate group and 57% of those in the placebo group (P = 0.04). No statistically significant difference was noted in hypotensive episodes > 1, reactive hypertension, bradycardia, need for atropine, nausea, vomiting, shivering, and dry mouth between the two groups. Neonatal outcomes were similar in the two groups.

Conclusion
Prophylactic use of glycopyrrolate does not decrease the requirements of vasopressor to prevent hypotension in non-elective cesarean section under spinal anesthesia.

Trial registration
Registration number: NCT04401345. Date of registration: 26/05/2020. Website: https://clinicaltrials.gov
A comparison between the clinical frailty scale and the hospital frailty risk score to risk stratify older people with emergency care needs
Authors: Alshibani Abdullah , Coats Tim , Maynou Laia , Lecky Fiona , Banerjee Jay , Conroy Simon 
Published: October 2022

Abstract
Background
Older adults living with frailty who require treatment in hospitals are increasingly seen in the Emergency Departments (EDs). One quick and simple frailty assessment tool—the Clinical Frailty Scale (CFS)—has been embedded in many EDs in the United Kingdom (UK). However, it carries time/training and cost burden and has significant missing data. The Hospital Frailty Risk Score (HFRS) can be automated and has the potential to reduce costs and increase data availability, but has not been tested for predictive accuracy in the ED. The aim of this study is to assess the correlation between and the ability of the CFS at the ED and HFRS to predict hospital-related outcomes.

Methods
This is a retrospective cohort study using data from Leicester Royal Infirmary hospital during the period from 01/10/2017 to 30/09/2019. We included individuals aged + 75 years as the HFRS has been only validated for this population. We assessed the correlation between the CFS and HFRS using Pearson’s correlation coefficient for the continuous scores and weighted kappa scores for the categorised scores. We developed logistic regression models (unadjusted and adjusted) to estimate Odds Ratios (ORs) and Confidence Intervals (CIs), so we can assess the ability of the CFS and HFRS to predict 30-day mortality, Length of Stay (LOS) > 10 days, and 30-day readmission.

Results
Twelve thousand two hundred thirty seven individuals met the inclusion criteria. The mean age was 84.6 years (SD 5.9) and 7,074 (57.8%) were females. Between the CFS and HFRS, the Pearson correlation coefficient was 0.36 and weighted kappa score was 0.15. When comparing the highest frailty categories to the lowest frailty category within each frailty score, the ORs for 30-day mortality, LOS > 10 days, and 30-day readmission using the CFS were 2.26, 1.36, and 1.64 and for the HFRS 2.16, 7.68, and 1.19.

Conclusion
The CFS collected at the ED and the HFRS had low/slight agreement. Both frailty scores were shown to be predictors of adverse outcomes. More research is needed to assess the use of historic HFRS in the ED.
“Sometimes choices are not made, because we have ‘a’ choice, they’re made because they are ‘the’ choice”: Barriers to weight management for clients in rural general practice
Authors: Norman Kimberley , Burrows Lisette , Chepulis Lynne , Lawrenson Ross 
Published: October 2022

AbstractBackgroundObesity is an international health issue which currently affects over 34% of New Zealand adults and leads to further physical and psychosocial health complications. People living in rural communities experience health inequities and have a high-risk of becoming obese. The aim of this study was to explore and identify barriers to effective weight management in rural Waikato general practice.MethodsUsing semi-structured interviews, 16 rural Waikato participants shared their experiences with barriers to weight management. Interviews were transcribed and analysed using thematic analysis.ResultsFour themes were identified: resource constraints, rural locality barriers, rural sociocultural norms barriers, and participants’ understanding the solutions needed to overcome their specific barriers to effective weight management. For these participants, finding a feasible weight management strategy was a challenging first step in their weight management journey. A programme that would ‘work’ meant one that was economically viable for low-income persons, accessible, even if living rurally with less resources, and did not cause harm or jeopardise their social connections within family or community.ConclusionOverall, participants noted a lack of weight management strategy ‘choice’ because of income, isolation or accessibility of their rural location and/or the sociocultural norms of the community they lived in restricted options available to them. Future weight management initiatives may be better devised from within communities themselves and will need to be cognisant of the barriers specific to rural communities. Rural perspectives have much to offer in any such reconsideration of weight management initiatives.