bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anhedonia difference between major depressive disorder and bipolar disorder II
Authors: Fang Xinyu , Wang Dandan , Tang Wei , Liu Hongyang , Zhang Xiangrong , Zhang Chen 
Published: October 2021

Abstract
Objective
This study aims to explore the difference in anhedonia between Major Depressive Disorder (MDD) and Bipolar Disorder II (BD-II), and attempt to distinguish the two diseases through Snaith-Hamilton Pleasure Scale (SHAPS).

Methods
A total of 164 drug-free depressive patients (98 MDD patients, 66 BD-II patients) completed the investigation. 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA) and SHAPS were assessed in all participants.

Results
Our results showed that BD-II patients had higher SHAPS scores than MDD patients. The stepwise logistic regression analysis further revealed that SHAPS score, drinking habit, and extroversion as influencing factors for the identification of BD-II. The ROC curve analysis indicated that SHAPS could differentiate BD-II from MDD patients (AUC = 0.655, P = 0.001, 95% CI = 0.568 to 0.742), with the best screening cutoff at 26, and the corresponding sensitivity and specificity was 0.788 and 0.520, respectively.

Conclusion
Our results suggest that BD-II patients had more severe anhedonia compared to MDD patients, and the difference in anhedonia may help clinicians preliminary identify BD patients from MDD patients. The preliminary findings are worthly of further exploration.
Crosstalk between autophagy inhibitors and endosome-related secretory pathways: a challenge for autophagy-based treatment of solid cancers
Authors: Raudenska Martina , Balvan Jan , Masarik Michal 
Published: October 2021

AbstractAutophagy is best known for its role in organelle and protein turnover, cell quality control, and metabolism. The autophagic machinery has, however, also adapted to enable protein trafficking and unconventional secretory pathways so that organelles (such as autophagosomes and multivesicular bodies) delivering cargo to lysosomes for degradation can change their mission from fusion with lysosomes to fusion with the plasma membrane, followed by secretion of the cargo from the cell. Some factors with key signalling functions do not enter the conventional secretory pathway but can be secreted in an autophagy-mediated manner.Positive clinical results of some autophagy inhibitors are encouraging. Nevertheless, it is becoming clear that autophagy inhibition, even within the same cancer type, can affect cancer progression differently. Even next-generation inhibitors of autophagy can have significant non-specific effects, such as impacts on endosome-related secretory pathways and secretion of extracellular vesicles (EVs). Many studies suggest that cancer cells release higher amounts of EVs compared to non-malignant cells, which makes the effect of autophagy inhibitors on EVs secretion highly important and attractive for anticancer therapy. In this review article, we discuss how different inhibitors of autophagy may influence the secretion of EVs and summarize the non-specific effects of autophagy inhibitors with a focus on endosome-related secretory pathways. Modulation of autophagy significantly impacts not only the quantity of EVs but also their content, which can have a deep impact on the resulting pro-tumourigenic or anticancer effect of autophagy inhibitors used in the antineoplastic treatment of solid cancers.
Waist-to-height ratio, an optimal anthropometric indicator for metabolic dysfunction associated fatty liver disease in the Western Chinese male population
Authors: Cai Jinwei , Lin Cuiting , Lai Shuiqing , Liu Yingshan , Liang Min , Qin Yingfen , Liang Xinghuan , Tan Aihua , Gao Yong , Lu Zheng , Wu Chunlei , Huang Shengzhu , Yang Xiaobo , Zhang Haiying , Kuang Jian , Mo Zengnan 
Published: October 2021

Abstract
Background
Non-alcoholic fatty liver disease (NAFLD) has been entitled as metabolic-dysfunction associated fatty liver disease (MAFLD). Therefore anthropometric indicators of adiposity may provide a non-invasive predictive and diagnostic tool for this disease. This study intended to validate and compare the MAFLD predictive and diagnostic capability of eight anthropometric indicators.

Methods
The study involved a population-based retrospective cross-sectional design. The Fangchenggang area male health and examination survey (FAMHES) was used to collect data of eight anthropometric indicators, involving body mass index (BMI), waist-to-height ratio (WHtR), waist-hip ratio (WHR), body adiposity index (BAI), cardiometabolic index (CMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and abdominal volume index (AVI). Receiver operating characteristics (ROC) curves and the respective areas under the curves (AUCs) were utilized to compare the diagnostic capacity of each indicator for MAFLD and to determine the optimal cutoff points. Binary logistic regression analysis was applied to identify the odds ratios (OR) with 95% confidence intervals (95% CI) for all anthropometric indicators and MAFLD. The Spearman rank correlation coefficients of anthropometric indicators, sex hormones, and MAFLD were also calculated.

Results
All selected anthropometric indicators were significantly associated with MAFLD (P < 0.001), with an AUC above 0.79. LAP had the highest AUC [0.868 (95% CI, 0.853–0.883)], followed by WHtR [0.863 (95% CI, 0.848–0.879)] and AVI [0.859 (95% CI, 0.843–0.874)]. The cutoff values for WHtR, LAP and AVI were 0.49, 24.29, and 13.61, respectively. WHtR [OR 22.181 (95% CI, 16.216–30.340)] had the strongest association with MAFLD, regardless of potential confounders. Among all the anthropometric indicators, the strongest association was seen between LAP and sex hormones.

Conclusion
All anthropometric indicators were associated with MAFLD. WHtR was identified as the strongest predictor of MAFLD in young Chinese males, followed by LAP and AVI. The strongest association was found between LAP and sex hormones.
SquiggleNet: real-time, direct classification of nanopore signals
Authors: Bao Yuwei , Wadden Jack , Erb-Downward John R. , Ranjan Piyush , Zhou Weichen , McDonald Torrin L. , Mills Ryan E. , Boyle Alan P. , Dickson Robert P. , Blaauw David , Welch Joshua D. 
Published: October 2021

AbstractWe present SquiggleNet, the first deep-learning model that can classify nanopore reads directly from their electrical signals. SquiggleNet operates faster than DNA passes through the pore, allowing real-time classification and read ejection. Using 1 s of sequencing data, the classifier achieves significantly higher accuracy than base calling followed by sequence alignment. Our approach is also faster and requires an order of magnitude less memory than alignment-based approaches. SquiggleNet distinguished human from bacterial DNA with over 90% accuracy, generalized to unseen bacterial species in a human respiratory meta genome sample, and accurately classified sequences containing human long interspersed repeat elements.
Treatment response and several patient-reported outcomes are early determinants of future self-efficacy in rheumatoid arthritis
Authors: Doumen Michaël , De Cock Diederik , Pazmino Sofia , Bertrand Delphine , Joly Johan , Westhovens René , Verschueren Patrick 
Published: October 2021

AbstractBackgroundSelf-efficacy, or patients’ confidence in their ability to control disease and its consequences, was recently prioritised in EULAR recommendations for inflammatory arthritis self-management strategies. However, it remains unclear which factors influence self-efficacy in early rheumatoid arthritis (RA).MethodsData were analysed from the 2-year RCT Care in early RA (CareRA), which studied remission-induction treatment regimens for early RA. Participants completed the Arthritis Self-Efficacy Scale (ASES), Short-Form 36 (SF-36), Revised Illness Perception Questionnaire (IPQ-R), Utrecht Coping List (UCL), RAQoL and Health Assessment Questionnaire (HAQ). Depending on time to first remission (DAS28-CRP < 2.6) and persistence of remission, treatment response was defined as persistent response, secondary failure, delayed response, late response or non-response. The association between ASES scores and clinical/psychosocial factors was explored with Spearman correlation and multivariate linear mixed models. Baseline predictors of week 104 ASES were identified with exploratory linear regression followed by multiple regression of significant predictors adjusted for DAS28-CRP, HAQ, treatment arm, treatment response, cumulative CRP/SJC28 and demographic/serologic confounders.ResultsAll 379 patients had a recent diagnosis of RA and were DMARD-naïve at study initiation. Most patients were women (69%) and RF/ACPA-positive (66%), and the mean (SD) age was 52 (13) years. For all tested outcome measures, better perceived health correlated with higher self-efficacy. While patient-reported factors (HAQ, SF-36, RAQoL, IPQ-R, pain, fatigue and patient’s global assessment) showed moderate/strong correlations with ASES scores, correlations with physician-reported factors (physician’s global assessment, SJC28), TJC28 and DAS28-CRP were weak.Only more favourable outcomes on patient-reported factors and DAS28-CRP were associated with higher ASES scores at each time point.An earlier, persistent treatment response predicted higher ASES scores at both weeks 52 and 104. Significant baseline predictors of week 104 ASES included HAQ; SF-36 mental component score, vitality, mental health and role emotional; IPQ-R illness coherence, treatment control, emotional representations and consequences; UCL Passive reacting; and the RAQoL.ConclusionsPatient-reported outcomes and treatment response were early determinants of long-term self-efficacy in an early RA trial. These results provide further relevance for the window of opportunity in an early treat-to-target strategy and could help to timely identify patients who might benefit from self-management interventions.Trial registrationEudraCT2008-007225-39
Life-threatening diarrhea in neuroendocrine tumors: two case reports
Authors: Gordon Emma , Chan David L. , Arena Jennifer , Bernard Elizabeth , Carr-Boyd Emily , Clarke Stephen J. , Itchins Malinda , Learoyd Diana , Sandanayake Neomal , Pavlakis Nick 
Published: October 2021

Abstract
Background
Neuroendocrine tumors are rare, heterogeneous neoplasms that produce a wide variety of clinical symptoms. Diarrhea in neuroendocrine tumors is incredibly common and is usually benign in nature. We report two extreme cases of diarrhea in metastatic neuroendocrine tumors that threatened fatality and provide evidence for steroids as a novel agent in the management of vasoactive intestinal peptide tumors.

Case presentation
A 63-year-old Caucasian male with a grade 2 (Ki-67 17%) metastatic small bowel neuroendocrine tumor, and a 43-year-old female with a grade 2 (Ki-67 5%) metastatic pancreatic vasoactive intestinal peptide tumor. Both patients suffered life-threatening diarrhea despite extensive treatment modalities, including new systemic agents. This case explains how a lack of compliance and patient under-reporting of symptoms contributed to their challenging clinical course. Only steroids had a significant sustained effect on the diarrhea of the patient with vasoactive intestinal peptide tumor.

Conclusions
This report discusses two rare cases of life-threatening diarrhea in neuroendocrine tumors and stresses the importance of accurate clinical history taking, patient education, and compliance for symptom control. The report suggests steroids as a potential novel pharmaceutical option in the management of vasoactive intestinal peptide tumors; this is of great significance as it may provide a new approach to their management and potentially act as a life-saving agent in other oncology patients.
Applicability and validation of the Reaction to Tests Scale (RTT) in a sample of Portuguese medical students
Authors: Pereira Daniela S. M. , Pereira Ana Mónica , Castanho Teresa Costa , Silva Gabriela A. , Falcão Filipe , Costa Patrício , Pêgo José Miguel 
Published: October 2021

Abstract
Background
Test anxiety is a crucial factor in determining academic outcomes, and it may lead to poor cognitive performance, academic underachievement, and psychological distress, interfering specifically with their ability to think and perform during tests. The main objective of this study was to explore the applicability and psychometric properties of a Portuguese version of the Reactions to Tests scale (RTT) in a sample of medical students.

Method
A sample of 672 medical students completed the RTT. The sample was randomly split in half to allow for independent Exploratory Factor Analysis (EFA) and to test the best fit model—Confirmatory Factor Analysis (CFA). CFA was used to test both the first-order factor structure (four subscales) and second-order factor structure, in which the four subscales relate to a general factor, Test Anxiety. The internal consistency of the RTT was assessed through Cronbach’s alpha, Composite reliability (CR) and Average Variance Extracted (AVE) for the total scale and each of the four subscales. Convergent validity was evaluated through the correlation between RTT and the State-Trait Anxiety Inventory (STAI-Y).To explore the comparability of measured attributes across subgroups of respondents, measurement invariance was also studied.

Results
Results from exploratory and confirmatory factor analyses showed acceptable fits for the Portuguese RTT version. Concerning internal consistency, results indicate that RTT was found to be reliable to measure test anxiety in this sample. Convergent validity of the RTT with both state and trait anxiety STAI-Y’s subscales was also shown. Moreover, multigroup analyses showed metric invariance across gender and curriculum phase.

Conclusion
Our results suggest that the RTT scale is a valid and reliable instrument for the measurement of test anxiety among Portuguese Medical Students.
Immune and hormonal modulation in the postprandial period of bullfrogs (Lithobates catesbeianus)
Authors: de Figueiredo Aymam C. , Titon Stefanny C. M. , Cyrino João C. , Nogueira Letícia A. K. , Gomes Fernando R. 
Published: October 2021

ABSTRACT
Mammals show immune up-regulation and increased plasma and local (gastrointestinal tract) concentrations of some immunoregulatory hormones, such as corticosterone and melatonin, after feeding. However, little is known about the endocrine and immune modulation in the postprandial period of ectothermic animals. This study investigated the effects of feeding on endocrine and immune responses in the bullfrog (Lithobates catesbeianus). Frogs were fasted for 10 days and divided into two groups: fasted and fed with fish feed (5% of body mass). Blood and gastrointestinal tract tissues (stomach and intestine) were collected at 6, 24, 48, 96 and 168 h to measure neutrophil/lymphocyte ratio, plasma bacterial killing ability, phagocytosis of blood leukocytes, plasma corticosterone and melatonin, and stomach and intestine melatonin. Feeding increased plasma corticosterone at 24 h and decreased it at 168 h, and increased neutrophil/lymphocyte ratio at 6, 24 and 96 h. We also observed decreased bacterial killing ability 48 h after feeding. Stomach melatonin increased after 17 days of fasting. We show that feeding activates the hypothalamic–pituitary–interrenal axis and promotes transient immunosuppression, without stimulating an inflammatory response. Increased corticosterone may mobilize energy to support digestive processes and melatonin may protect the stomach during fasting. We conclude that feeding modulates secretion of immunoregulatory hormones, initially increasing plasma corticosterone levels, followed by a decrease at the end of meal digestion, and causes systemic immune cell redistribution, increasing neutrophil/lymphocyte ratio for almost the entire period of meal digestion in bullfrogs. Also, fasting modulates secretion of melatonin in the stomach.
МОРФОМЕТРИЧЕСКИЙ АНАЛИЗ ПРИМЕНИМОСТИ УРАВНЕНИЙ MURRAY C.D. ДЛЯ ЧИСЛЕННОГО МОДЕЛИРОВАНИЯ СОСУДИСТЫХ ДИХОТОМИЙ ПОЧКИ ЧЕЛОВЕКА
Authors: Zenin Oleg K. , Miltykh Ilia S. , Dmitriev Andrey V. , Iurchenko Olga O. 
Published: October 2021

Цель. Провести анализ применимости уравнений Murray C.D. для расчёта значений углов дихотомий внутриорганного артериального и венозного русел почки человека.
Материал и методы. Были исследованы внутриорганные артерии и вены почек. Почки полученны на аутопсии у людей (возраст от 36 до 74 лет; 9 человек мужского пола, 8 – женского), изготовлены 17 коррозионных препаратов: 9 препаратов артериальное русло, 8 – венозное. Визуализацию проводили с помощь микротомографа BRUNKER SkyScan 1178. Для морфометрии использовали программный пакет blender с надстройкой NeuroMorph Measuring tools. Измеряли диаметры сегментов (D, dmax, dmin) и углы между ними (αmax, αmin). Для расчетов углов дихотомии пользовались уравнениями Murray C.D.
Результаты. Установлено наличие четырех структурно-различных типов дихотомий, составляющих внутриорганное сосудистое русло почки. Показано, что применять уравнение Murray C.D. для расчетов величины угла αmax можно для любых структурно-различных типов сосудистых дихотомий почки человека. Однако использовать уравнение Murray C.D. для расчетов значений угла αmin нельзя для артериальных и венозных дихотомий 1-го структурно-различного типа и для 2-го типа венозных дихотомий.
Заключение. Применение уравнений Murray C.D. для численного моделирования сосудистых дихотомий почки человека носит ограниченный характер. Это необходимо учитывать при создании структурных математических моделей сосудистого русла почки человека.
Using Machine Learning to Predict Patterns of Employment and Day Program Participation
Authors: Broda Michael D. , Bogenschutz Matthew , Dinora Parthenia , Prohn Seb M. , Lineberry Sarah , Ross Erica 
Published: October 2021

Abstract
In this article, we demonstrate the potential of machine learning approaches as inductive analytic tools for expanding our current evidence base for policy making and practice that affects people with intellectual and developmental disabilities (IDD). Using data from the National Core Indicators In-Person Survey (NCI-IPS), a nationally validated annual survey of more than 20,000 nationally representative people with IDD, we fit a series of classification tree and random forest models to predict individuals' employment status and day activity participation as a function of their responses to all other items on the 2017–2018 NCI-IPS. The most accurate model, a random forest classifier, predicted employment outcomes of adults with IDD with an accuracy of 89 percent on the testing sample, and 80 percent on the holdout sample. The most important variable in this prediction was whether or not community employment was a goal in this person's service plan. These results suggest the potential machine learning tools to examine other valued outcomes used in evidence-based policy making to support people with IDD.
Healthcare spending in U.S. emergency departments by health condition, 2006–2016
Authors: Scott Kirstin Woody , Liu Angela , Chen Carina , Kaldjian Alexander S. , Sabbatini Amber K. , Duber Herbert C. , Dieleman Joseph L. 
Published: October 2021

Background
Healthcare spending in the emergency department (ED) setting has received intense focus from policymakers in the United States (U.S.). Relatively few studies have systematically evaluated ED spending over time or disaggregated ED spending by policy-relevant groups, including health condition, age, sex, and payer to inform these discussions. This study’s objective is to estimate ED spending trends in the U.S. from 2006 to 2016, by age, sex, payer, and across 154 health conditions and assess ED spending per visit over time.

Methods and findings
This observational study utilized the National Emergency Department Sample, a nationally representative sample of hospital-based ED visits in the U.S. to measure healthcare spending for ED care. All spending estimates were adjusted for inflation and presented in 2016 U.S. Dollars. Overall ED spending was $79.2 billion (CI, $79.2 billion-$79.2 billion) in 2006 and grew to $136.6 billion (CI, $136.6 billion-$136.6 billion) in 2016, representing a population-adjusted annualized rate of change of 4.4% (CI, 4.4%-4.5%) as compared to total healthcare spending (1.4% [CI, 1.4%-1.4%]) during that same ten-year period. The percentage of U.S. health spending attributable to the ED has increased from 3.9% (CI, 3.9%-3.9%) in 2006 to 5.0% (CI, 5.0%-5.0%) in 2016. Nearly equal parts of ED spending in 2016 was paid by private payers (49.3% [CI, 49.3%-49.3%]) and public payers (46.9% [CI, 46.9%-46.9%]), with the remainder attributable to out-of-pocket spending (3.9% [CI, 3.9%-3.9%]). In terms of key groups, the majority of ED spending was allocated among females (versus males) and treat-and-release patients (versus those hospitalized); those between age 20–44 accounted for a plurality of ED spending. Road injuries, falls, and urinary diseases witnessed the highest levels of ED spending, accounting for 14.1% (CI, 13.1%-15.1%) of total ED spending in 2016. ED spending per visit also increased over time from $660.0 (CI, $655.1-$665.2) in 2006 to $943.2 (CI, $934.3-$951.6) in 2016, or at an annualized rate of 3.4% (CI, 3.3%-3.4%).

Conclusions
Though ED spending accounts for a relatively small portion of total health system spending in the U.S., ED spending is sizable and growing. Understanding which diseases are driving this spending is helpful for informing value-based reforms that can impact overall health care costs.
Facilitators and barriers to physicians’ entrepreneurial ventures in major Japanese cities: A qualitative study
Authors: Yashiro Daichi , Nawa Nobutoshi , Okada Eriko , Kato Hiroaki , Yonemori-Matsumoto Sarara , Kashimada Ayako , Itsui Yasuhiro , Tanaka Yujiro 
Published: October 2021

Background
The Japanese healthcare system currently faces numerous challenges, including a super-aging society and an excessive burden on medical workers; therefore, the need for innovative solutions from healthcare ventures to tackle these issues has increased. Meanwhile, as physicians play important roles in healthcare ventures, the need for Japanese physician entrepreneurs is more important than ever. Given the lack of research examining barriers to physicians starting ventures and what skills, knowledge, and surrounding environments act as facilitators, this study aimed to identify the facilitators and barriers faced by physicians to start ventures.

Methods
Between September and November 2019 and in May 2021, qualitative interviews were conducted with 33 participants, which included eight physician entrepreneurs; two administrative officers at the Ministry of Health, Labour and Welfare and the Ministry of Economy, Trade and Industry; three faculty members at Tokyo Medical and Dental University (in-depth interviews); and 20 medical students (focus group discussions). The interviews were deductively coded based on the social ecological model. The inductive approach was applied to coding any knowledge necessary to start a business. We conducted member checking with three physician entrepreneurs and seven medical students to improve our results’ credibility.

Results
The factors influencing a physician’s decision to launch a new business include their willingness to contribute to society, the unique environment in which an individual is placed while in medical school and afterward, negative aspects of the lack of diversity in physicians’ careers, the financial stability provided by a medical license, and self-efficacy.

Conclusions
Our study revealed facilitators and barriers to physicians’ entrepreneurial ventures. Knowledge about these factors might be useful in supporting physicians to launch or become involved in healthcare ventures.