bluuebunny/crossref_metadata_2025_split huggingface dataset:
“PrEP”ing for a PrEP demonstration project: understanding PrEP knowledge and attitudes among cisgender women
Authors: Pasipanodya Elizabeth C. , Stockman Jamila , Phuntsog Thupten , Morris Sheldon , Psaros Christina , Landovitz Raphael , Amico K. Rivet , Moore David J. , Blumenthal Jill 
Published: May 2021

Abstract
Background
Prior to implementing a pre-exposure prophylaxis (PrEP) demonstration study, we sought to explore cisgender women’s experiences with HIV prevention, PrEP knowledge and attitudes, and anticipated barriers and facilitators for PrEP uptake and adherence in Southern California.

Methods
Three focus groups were held with cisgender women of mixed HIV serostatus in San Diego and Los Angeles between November 2015 and January 2016. Women were recruited through local testing sites, community-based organizations, and social media. Focus groups were audio-recorded and transcripts were analyzed using thematic analysis.

Results
Twenty-two women participated in focus groups, with median age 44 (IQR 30–53) and 6 identifying as non-Hispanic Black, 7 non-Hispanic White, 8 Latina and 1 mixed race. Despite limited prior PrEP knowledge and no PrEP experience, participants expressed interest in taking PrEP. Anticipated benefits were freedom from worry about HIV and control over sexual health; however, these were tempered by concerns including the possibility of increased HIV risk behaviors and potential side effects. Cisgender women reported potential barriers to PrEP uptake and adherence barriers, like competing priorities and poor PrEP access. Conversely, PrEP facilitators included utilizing practical tools such as phone apps and pill boxes as well as receiving encouragement from loved ones and support from other cisgender women on PrEP, women living with HIV and their medical providers.

Conclusions
Although PrEP awareness was low, participants recognized the importance of PrEP and ways to facilitate adherence. Exploring perspectives of cisgender women is integral to developing effective interventions to support PrEP uptake and adherence for women at elevated risk for HIV.
Deregulation and pricing of medical services: a policy experiment based in China
Authors: Zang Wenbin , Zhou Mei , Zhao Shaoyang 
Published: May 2021

Abstract
Background
Price regulation is a common constraint in Chinese hospitals. Based on a policy experiment conducted in China on the price deregulation of private nonprofit hospitals, this study empirically examines the impact of medical service price regulation on the pricing of medical services by hospitals.

Methods
Using the claim data of insured inpatients residing in a major Chinese city for the period 2010–2015, this study constructs a DID (difference-in-differences) model to compare the impact of price deregulation on medical expenditure and expenditure structure between public and private nonprofit hospitals.

Results
The empirical results based on micro data reveal that, price deregulated significantly increased the total expenditure per inpatient visit by 10.5%. In the itemized expenditure, the diagnostic test and drug expenditure per inpatient visit of private nonprofit hospitals decreased significantly, whereas the physician service expenditure per inpatient visit increased significantly. For expenditure structure, the proportions of drug expenditure and diagnostic test expenditure per inpatient visit significantly decreased by 5.7 and 3.1%, respectively. Furthermore, this paper also found that hospitals had larger price changes for dominant diseases than for non-dominant diseases.

Conclusions
Under price regulation, medical service prices generally become lower than their costs. Therefore, after price deregulation, private nonprofit hospitals increase medical service prices above their cost and achieve the service premium increasing physician medical services. Further, although price deregulation causes patient expenditure to increase to a certain level, it optimizes the expenditure structure, as well.
The long shadow of childhood cancer: a qualitative study on insurance hardship among survivors of childhood cancer
Authors: Hendriks Manya Jerina , Harju Erika , Roser Katharina , Ienca Marcello , Michel Gisela 
Published: May 2021

AbstractBackgroundThe long-term consequences of childhood cancer have received increasing attention due to the growing number of survivors over the past decades. However, insurance hardships of survivors are mostly unknown. This study explored qualitatively, in a sample of childhood cancer survivors (CCS), (i) the experiences and needs of CCS living in Switzerland with a special focus on hardships related to insurance; and (ii) the views of insurance and law experts with experience on childhood cancer.MethodsSemi-structured interviews were conducted with 28 childhood cancer survivors and 3 experts (one legal expert, two insurance experts). Data was analysed using qualitative content analysis.ResultsThree key themes emerged from the interviews with the CCS: 1) experiences with insurance, 2) perception of discrimination, and 3) needs and barriers for support. The interviewed experts provided further detailed clarification of CCS’ concerns. Our findings indicated that some CCS can move past their cancer history, while others continue to face hardships. CCS reported confusion about the opportunities and services within the social security system and most relied on their personal contacts for guidance. Finally, CCS expressed a strong need for socio-economic and legal support for social insurance questions, especially related to disability insurance.ConclusionsWith the growing population of CCS, it is essential to further assess the interplay between medical and psychosocial health and socio-economic hardship. Supportive psychosocial services should aim to ameliorate insurance hardships. Better understanding of the relationship between childhood cancer and insurance hardships during survivorship will inform efforts to improve long-term financial security and health outcomes for survivors. We call for the public, lawmakers, researchers, insurers, and patient organizations to come together and discuss future perspectives to avoid the risk of discrimination for cancer survivors.
Identification of collagen genes related to immune infiltration and epithelial-mesenchymal transition in glioma
Authors: Yin Wen , Zhu Hecheng , Tan Jun , Xin Zhaoqi , Zhou Quanwei , Cao Yudong , Wu Zhaoping , Wang Lei , Zhao Ming , Jiang Xingjun , Ren Caiping , Tang Guihua 
Published: May 2021

AbstractBackgroundGliomas account for the majority of fatal primary brain tumors, and there is much room for research in the underlying pathogenesis, the multistep progression of glioma, and how to improve survival. In our study, we aimed to identify potential biomarkers or therapeutic targets of glioma and study the mechanism underlying the tumor progression.MethodsWe downloaded the microarray datasets (GSE43378 and GSE7696) from the Gene Expression Omnibus (GEO) database. Then, we used weighted gene co-expression network analysis (WGCNA) to screen potential biomarkers or therapeutic targets related to the tumor progression. ESTIMATE (Estimation of STromal and Immune cells in MAlignant Tumors using Expression data) algorithm and TIMER (Tumor Immune Estimation Resource) database were used to analyze the correlation between the selected genes and the tumor microenvironment. Real-time reverse transcription polymerase chain reaction was used to measure the selected gene. Transwell and wound healing assays were used to measure the cell migration and invasion capacity. Western blotting was used to test the expression of epithelial-mesenchymal transition (EMT) related markers.ResultsWe identified specific module genes that were positively correlated with the WHO grade but negatively correlated with OS of glioma. Importantly, we identified that 6 collagen genes (COL1A1, COL1A2, COL3A1, COL4A1, COL4A2, and COL5A2) could regulate the immunosuppressive microenvironment of glioma. Moreover, we found that these collagen genes were significantly involved in the EMT process of glioma. Finally, taking COL3A1 as a further research object, the results showed that knockdown of COL3A1 significantly inhibited the migration, invasion, and EMT process of SHG44 and A172 cells.ConclusionsIn summary, our study demonstrated that collagen genes play an important role in regulating the immunosuppressive microenvironment and EMT process of glioma and could serve as potential therapeutic targets for glioma management.
Genetic variation at the Cyp6m2 putative insecticide resistance locus in Anopheles gambiae and Anopheles coluzzii
Authors:   The Anopheles gambiae 1000 Genomes Consortium, Wagah Martin G. , Korlević Petra , Clarkson Christopher , Miles Alistair , Lawniczak Mara K. N. , Makunin Alex 
Published: May 2021

Abstract
Background
The emergence of insecticide resistance is a major threat to malaria control programmes in Africa, with many different factors contributing to insecticide resistance in its vectors, Anopheles mosquitoes. CYP6M2 has previously been recognized as an important candidate in cytochrome P450-mediated detoxification in Anopheles. As it has been implicated in resistance against pyrethroids, organochlorines and carbamates, its broad metabolic activity makes it a potential agent in insecticide cross-resistance. Currently, allelic variation within the Cyp6m2 gene remains unknown.

Methods
Here, Illumina whole-genome sequence data from Phase 2 of the Anopheles gambiae 1000 Genomes Project (Ag1000G) was used to examine genetic variation in the Cyp6m2 gene across 16 populations in 13 countries comprising Anopheles gambiae and Anopheles coluzzii mosquitoes. To identify whether these alleles show evidence of selection either through potentially modified enzymatic function or by being linked to variants that change the transcriptional profile of the gene, hierarchical clustering of haplotypes, linkage disequilibrium, median joining networks and extended haplotype homozygosity analyses were performed.

Results
Fifteen missense biallelic substitutions at high frequency (defined as > 5% frequency in one or more populations) are found, which fall into five distinct haplotype groups that carry the main high frequency variants: A13T, D65A, E328Q, Y347F, I359V and A468S. Despite consistent reports of Cyp6m2 upregulation and metabolic activity in insecticide resistant Anophelines, no evidence of directional selection is found occurring on these variants or on the haplotype clusters in which they are found.

Conclusion
These results imply that emerging resistance associated with Cyp6m2 is potentially driven by distant regulatory loci such as transcriptional factors rather than by its missense variants, or that other genes are playing a more significant role in conferring metabolic resistance.
Therapeutic efficacy of artemether–lumefantrine and artesunate–amodiaquine for the treatment of uncomplicated Plasmodium falciparum malaria in Mali, 2015–2016
Authors: Diarra Youssouf , Koné Oumar , Sangaré Lansana , Doumbia Lassina , Haidara Dade Bouye Ben , Diallo Mouctar , Maiga Ababacar , Sango Hamadoun A. , Sidibé Halidou , Mihigo Jules , Nace Douglas , Ljolje Dragan , Talundzic Eldin , Udhayakumar Venkatachalam , Eckert Erin , Woodfill Celia J. , Moriarty Leah F. , Lim Pharath , Krogstad Donald J. , Halsey Eric S. , Lucchi Naomi W. , Koita Ousmane A. 
Published: May 2021

Abstract
Background
The current first-line treatments for uncomplicated malaria recommended by the National Malaria Control Programme in Mali are artemether–lumefantrine (AL) and artesunate–amodiaquine (ASAQ). From 2015 to 2016, an in vivo study was carried out to assess the clinical and parasitological responses to AL and ASAQ in Sélingué, Mali.

Methods
Children between 6 and 59 months of age with uncomplicated Plasmodium falciparum infection and 2000–200,000 asexual parasites/μL of blood were enrolled, randomly assigned to either AL or ASAQ, and followed up for 42 days. Uncorrected and PCR-corrected efficacy results at days 28 and 42. were calculated. Known markers of resistance in the Pfk13, Pfmdr1, and Pfcrt genes were assessed using Sanger sequencing.

Results
A total of 449 patients were enrolled: 225 in the AL group and 224 in the ASAQ group. Uncorrected efficacy at day 28 was 83.4% (95% CI 78.5–88.4%) in the AL arm and 93.1% (95% CI 89.7–96.5%) in the ASAQ arm. The per protocol PCR-corrected efficacy at day 28 was 91.0% (86.0–95.9%) in the AL arm and 97.1% (93.6–100%) in the ASAQ arm. ASAQ was significantly (p < 0.05) better than AL for each of the aforementioned efficacy outcomes. No mutations associated with artemisinin resistance were identified in the Pfk13 gene. Overall, for Pfmdr1, the N86 allele and the NFD haplotype were the most common. The NFD haplotype was significantly more prevalent in the post-treatment than in the pre-treatment isolates in the AL arm (p < 0.01) but not in the ASAQ arm. For Pfcrt, the CVIET haplotype was the most common.

Conclusions
The findings indicate that both AL and ASAQ remain effective for the treatment of uncomplicated malaria in Sélingué, Mali.
Automated laryngeal mass detection algorithm for home-based self-screening test based on convolutional neural network
Authors: Kim Gun Ho , Sung Eui-Suk , Nam Kyoung Won 
Published: May 2021

Abstract
Background
Early detection of laryngeal masses without periodic visits to hospitals is essential for improving the possibility of full recovery and the long-term survival ratio after prompt treatment, as well as reducing the risk of clinical infection.

Results
We first propose a convolutional neural network model for automated laryngeal mass detection based on diagnostic images captured at hospitals. Thereafter, we propose a pilot system, composed of an embedded controller, a camera module, and an LCD display, that can be utilized for a home-based self-screening test. In terms of evaluating the model’s performance, the experimental results indicated a final validation loss of 0.9152 and a F1-score of 0.8371 before post-processing. Additionally, the F1-score of the original computer algorithm with respect to 100 randomly selected color-printed test images was 0.8534 after post-processing while that of the embedded pilot system was 0.7672.

Conclusions
The proposed technique is expected to increase the ratio of early detection of laryngeal masses without the risk of clinical infection spread, which could help improve convenience and ensure safety of individuals, patients, and medical staff.
Circulating angiopoietin-like proteins in metabolic-associated fatty liver disease: a systematic review and meta-analysis
Authors: Ke Yani , Liu Shan , Zhang Zheyuan , Hu Jie 
Published: May 2021

Abstract
Background
Angiopoietin-like proteins (ANGPTLs) are closely related to insulin resistance and lipid metabolism, and may be a key in metabolic syndrome. Non-alcoholic fatty liver disease (NAFLD) (newly named metabolic-associated fatty liver disease (MAFLD)) is based on metabolic dysfunction. There may be some correlation between ANGPTLs and MAFLD, but the specific correlation is unclear. This study aims to explore the predictive role of ANGPTLs in MAFLD and its progression.

Methods
Seven databases (PubMed, EMBASE, Cochrane Library, CNKI, WANFANG, CBM and Clinicaltrials.gov) were searched with free terms and MeSH terms. The random-effects model was used to pool the data, and Standardized Mean Difference (SMD) and 95% confidence intervals (CI) were taken as the overall outcome. No language restrictions existed in the article selection. RevMan 5.3, Stata 16 and MetaXL software were applied to analyse the data and the GRADE system was utilized to assess the certainty of evidence.

Results
After reviewing 823 related articles, 13 studies (854 cases and 610 controls) met the inclusion criteria, and contributed to this meta-analysis. The results showed that circulating ANGPTL8 level was significantly elevated in the MAFLD group than in the healthy control group (SMD = 0.97 pg/mL, 95%CI: 0.77, 1.18). Conversely, there was no significant difference in the ANGPTL4 (SMD = 0.11 ng/mL, 95%CI: − 0.32, 0.54) and ANGPTL3 (SMD = − 0.95 ng/mL, 95%CI: − 4.38, 2.48) between the two groups. Subgroup analysis showed that: 1) the MAFLD group had significantly higher ANGPTL8 levels than the healthy control group in Asian and other races; 2) the ANGPTL8 levels in Body Mass Index (BMI) > 25 kg/m2 patients with MAFLD were higher than those in the healthy control group; 3) the higher ANGPTL8 levels were observed in moderate to severe MAFLD group than the healthy control group. Meta-regression demonstrated that BMI might effectively explain the high heterogeneity. No significant publication bias existed (P > 0.05). The certainty of evidence was assessed as very low by the GRADE system.

Conclusions
The ANGPTLs may be related to MAFLD. The increased ANGPTL8 level may be positively correlated with different situations of MAFLD, which may act as a potential indicator to monitor the development trends.
A compact system for simultaneous stimulation and recording for closed-loop myoelectric control
Authors: Garenfeld Martin A. , Jorgovanovic Nikola , Ilic Vojin , Strbac Matija , Isakovic Milica , Dideriksen Jakob L. , Dosen Strahinja 
Published: May 2021

Abstract
Background
Despite important advancements in control and mechatronics of myoelectric prostheses, the communication between the user and his/her bionic limb is still unidirectional, as these systems do not provide somatosensory feedback. Electrotactile stimulation is an attractive technology to close the control loop since it allows flexible modulation of multiple parameters and compact interface design via multi-pad electrodes. However, the stimulation interferes with the recording of myoelectric signals and this can be detrimental to control.

Methods
We present a novel compact solution for simultaneous recording and stimulation through dynamic blanking of stimulation artefacts. To test the system, a feedback coding scheme communicating wrist rotation and hand aperture was developed specifically to stress the myoelectric control while still providing meaningful information to the subjects. Ten subjects participated in an experiment, where the quality of closed-loop myoelectric control was assessed by controlling a cursor in a two degrees of freedom target-reaching task. The benchmark performance with visual feedback was compared to that achieved by combining visual feedback and electrotactile stimulation as well as by using electrotactile feedback only.

Results
There was no significant difference in performance between visual and combined feedback condition with regards to successfully reached targets, time to reach a target, path efficiency and the number of overshoots. Therefore, the quality of myoelectric control was preserved in spite of the stimulation. As expected, the tactile condition was significantly poorer in completion rate (100/4% and 78/25% for combined and tactile condition, respectively) and time to reach a target (9/2 s and 13/4 s for combined and tactile condition, respectively). However, the performance in the tactile condition was still good, with no significant difference in path efficiency (38/8%) and the number of overshoots (0.5/0.4 overshoots), indicating that the stimulation was meaningful for the subjects and useful for closed-loop control.

Conclusions
Overall, the results demonstrated that the developed system can provide robust closed-loop control using electrotactile stimulation. The system supports different encoding schemes and allows placing the recording and stimulation electrodes next to each other. This is an important step towards an integrated solution where the developed unit will be embedded into a prosthetic socket.
Vil Du?! incorporation of a serious game in therapy for sexually abused children and adolescents
Authors: Endendijk Joyce J. , Tichelaar Henny K. , Deen Menno , Deković Maja 
Published: May 2021

Abstract
Background
Talking about experiences of sexual abuse in therapy is difficult for children and adolescents, amongst others due to a lack of vocabulary to describe the situation, avoidance, or feelings of shame, fear, and self-blame. The serious game Vil Du?! was developed to help children open up about sexual experiences. Vil Du?! is a non-verbal communication game, which resembles a dress-up game, in which children can show the therapist what happened to them. The current study examined how and for which therapy components Vil Du?! was used by therapists.

Methods
We used a mixed-methods triangulation design. Therapists filled out online surveys about the use of Vil Du?! with 23 clients (Mage = 11.38 years, SD = 3.96; 61 % female). We also conducted semi-structured interviews with 10 therapists. The data were analyzed in SPSS (quantitative) and Nvivo (qualitative) following the stepwise guidelines of Zhang and Wildemuth.

Results
Merged qualitative and quantitative data revealed that therapists acknowledged the usefulness of Vil Du?! mostly for the therapy components trauma narration and processing, and psycho-education about sexuality. In addition, Vil Du?! might be most useful for clients who have difficulty with disclosing sexual abuse experiences, due to limited verbal abilities or feelings of guilt, shame, avoidance, and tension.

Conclusions
Recommendations from this study were incorporated in a user manual as a first step toward more systematic and broad implementation of Vil Du?! in the treatment of young sexual abuse victims. A next step is to test whether implementing Vil Du?! in therapy is effective in reducing the negative mental health consequences of sexual abuse for children and adolescents.
Tailored modulation of the inflammatory balance in COVID-19 patients admitted to the ICU?—a viewpoint
Authors: Kuindersma Marnix , Diaz Rocio Ramos , Spronk Peter E. 
Published: May 2021

AbstractA growing consensus seems to be emerging that dexamethasone is a crucial component in the treatment of COVID-19-associated oxygen-dependent respiratory failure. Although dexamethasone has an undeniably beneficial effect on the inflammatory response in a subgroup of patients, the potential negative effects of corticosteroids must also be considered. In view of these negative effects, we argue that a one-size-fits-all dexamethasone approach may be potentially harmful in specific subsets of patients with COVID-19-associated ARDS. We propose a different individually tailored treatment strategy based on the patient’s inflammatory response.
Characterization of structural variation in Tibetans reveals new evidence of high-altitude adaptation and introgression
Authors: Quan Cheng , Li Yuanfeng , Liu Xinyi , Wang Yahui , Ping Jie , Lu Yiming , Zhou Gangqiao 
Published: May 2021

Abstract
Background
Structural variation (SV) acts as an essential mutational force shaping the evolution and function of the human genome. However, few studies have examined the role of SVs in high-altitude adaptation and little is known of adaptive introgressed SVs in Tibetans so far.

Results
Here, we generate a comprehensive catalog of SVs in a Chinese Tibetan (n = 15) and Han (n = 10) population using nanopore sequencing technology. Among a total of 38,216 unique SVs in the catalog, 27% are sequence-resolved for the first time. We systematically assess the distribution of these SVs across repeat sequences and functional genomic regions. Through genotyping in additional 276 genomes, we identify 69 Tibetan-Han stratified SVs and 80 candidate adaptive genes. We also discover a few adaptive introgressed SV candidates and provide evidence for a deletion of 335 base pairs at 1p36.32.

Conclusions
Overall, our results highlight the important role of SVs in the evolutionary processes of Tibetans’ adaptation to the Qinghai-Tibet Plateau and provide a valuable resource for future high-altitude adaptation studies.