bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multifunctional AIE gold cluster-based theranostic system: tumor-targeted imaging and Fenton reaction-assisted enhanced radiotherapy
Authors: Hua Yue , Wang Yuan , Kang Xue , Xu Fan , Han Zhen , Zhang Chong , Wang Zhao-Yang , Liu Jun-Qi , Zhao Xueli , Chen Xiaoyuan , Zang Shuang-Quan 
Published: December 2021

Abstract
Background
As cancer is one of the main leading causes of mortality, a series of monotherapies such as chemotherapy, gene therapy and radiotherapy have been developed to overcome this thorny problem. However, a single treatment approach could not achieve satisfactory effect in many experimental explorations.

Results
In this study, we report the fabrication of cyclic RGD peptide (cRGD) modified Au4-iron oxide nanoparticle (Au4-IO NP-cRGD) based on aggregation-induced emission (AIE) as a multifunctional theranostic system. Besides Au4 cluster-based fluorescence imaging and enhanced radiotherapy, iron oxide (IO) nanocluster could realize magnetic resonance (MR) imaging and Fenton reaction-based chemotherapy. Abundant toxic reactive oxygen species generated from X-ray irradiation and in situ tumor-specific Fenton reaction under acidic microenvironment leads to the apoptotic and necrotic death of cancer cells. In vivo studies demonstrated good biocompatibility of Au4-IO NP-cRGD and a high tumor suppression rate of 81.1% in the synergistic therapy group.

Conclusions
The successful dual-modal imaging and combined tumor therapy demonstrated AIE as a promising strategy for constructing multifunctional cancer theranostic platform.

Graphical Abstract
Serum folate concentration and health-related quality of life among the elderly in South Korea
Authors: Lee Eunmi , Park Sangshin 
Published: December 2021

Abstract
Background
The purpose of this study was to investigate the association between serum folate concentration and health-related quality of life (HRQOL) among the elderly in South Korea.

Materials and methods
The data used in this study were drawn from 1,021 participants over 65 years old in the Korea National Health and Nutrition Examination Survey from 2016–2018. HRQOL was measured by the EQ-5D questionnaire. Participants were divided into tertiles of folate concentration (ranges 1.7–5.6, 5.7–9.4, and 9.5–31.9 ng/mL). We performed multivariable linear regression to examine the relationship between folate and HRQOL, and multivariable logistic regression to examine the relationship between folate and the dimensional problem of HRQOL.

Results
Higher folate concentrations were significantly associated with higher HRQOL in the elderly. The average HRQOL score of the elderly in the highest tertile of the folate level was 0.0289 higher than that of the lowest tertile (coefficient: 0.0289; 95% CI 0.0016, 0.0563). The HRQOL score increased by 0.0174 points when the folate concentration increased by 100%. When analyzing specific dimensions, a significant association with folate concentration was found only for the self-care dimension of HRQOL (odds ratio for self-care problems: 0.63; 95% CI 0.41, 0.99).

Conclusions
The elderly with higher serum folate concentration tended to have higher HRQOL. Among HRQOL dimensions, self-care was only significantly associated with folate concentration.
Evaluation of health-related quality of life of Covid-19 patients: a hospital-based study in South Central Ethiopia
Authors: Kaso Abdene Weya , Agero Gebi , Hurisa Zewdu , Kaso Taha , Ewune Helen Ali , Hailu Alemayehu 
Published: December 2021

Abstract
Background
Covid-19 causes a wide range of symptoms in patients, ranging from mild manifestations to severe disease and death. This study assessed the health-related quality of life (HRQOL) and associated factors of Covid-19 patients using primary data from confirmed cases in South Central Ethiopia.

Methods
We employed a facility-based, cross-sectional study design and conducted the study at the Bokoji Hospital Covid-19 treatment centre. A structured questionnaire and the EQ-5D-3L scale were used to collect the data for analysis. The HRQOL results measured by the EQ-5D-3L tool were converted to a health state utility (HSU) using the Zimbabwe tariff. The average health utility index and HSU–visual analogue scale across diverse sociodemographic and clinical characteristics were compared using the Mann–Whitney U test or Kruskal–Wallis test. We employed a multiple linear regression to examine factors associated with HSU values simultaneously. The data were analysed using STATA version 15.

Results
The overall mean HSU score from the EQ-5D was 0.688 (SD: 0.285), and the median was 0.787 (IQR 0.596, 0.833). The mean HSU from the visual analogue scale score was 0.69 (SD: 0.129), with a median of 0.70 (IQR 0.60, 0.80). Those who received dexamethasone and intranasal oxygen supplement, those with comorbidity, those older than 55 years and those with a hospital stay of more than 15 days had significantly lower HSU scores than their counterparts (p < .001).

Conclusion
Covid-19 substantially impaired the HRQOL of patients in Ethiopia, especially among elderly patients and those with comorbidity. Therefore, clinical follow-up and psychological treatment should be encouraged for these groups. Moreover, the health utility values from this study can be used to evaluate quality adjusted life years for future cost-effectiveness analyses of prevention and treatment interventions against Covid-19.
Emotional dysregulation and health related quality of life in young adults with ADHD: a cross sectional study
Authors: Ben-Dor Cohen Maayan , Eldar Eran , Maeir Adina , Nahum Mor 
Published: December 2021

Abstract
Objective
Attention Deficit Hyperactivity Disorder (ADHD) is associated with emotional dysregulation (ED) and impaired health related quality of life (HRQoL). However, the role of ED in explaining the relationship between ADHD and HRQoL is unclear. The purpose of the present study was to do so in a sample of non-referred young adults with and without ADHD.

Method
The study design was cross-sectional. A non-clinical sample of 63 young adults with ADHD (mean age = 24.86 years, SD = 3.25, 78% university students) and 69 gender-matched controls (mean age = 23.84 years, SD = 2.59, 89% university students) were recruited. The Adult ADHD Quality-of-Life scale was used to measure HRQoL; The Self-Report Wender–Reimherr Adult Attention Deficit Disorder Scale and the Difficulties in Emotion Regulation Scale were used to measure ED. Group differences on all measures were tested using univariate and multivariate analyses of covariance, while controlling for age. Finally, a moderation analysis was used in order to examine the impact of ED on HRQoL beyond that accounted for by ADHD symptoms.

Results
Both HRQoL and ED were significantly worse for the ADHD group compared to the control group. The medication status of the ADHD group participants had no significant effect on the level of ADHD symptoms, ED or HRQoL. ED moderated the effect of ADHD symptoms on HRQoL for the ADHD group.

Conclusion
The findings support the centrality of ED in ADHD and its crucial influence on HRQoL. Young adults with ADHD and high levels of ED are at risk for aversive impact on their well-being regardless of their ADHD symptoms level.
Long-term oncologic safety of immediate reconstructive surgery in patients with invasive breast cancer: a retrospective matched-cohort study
Authors: Song Yanni , Sun Shanshan , Li Dalin , Han Jiguang , Niu Ming , Luo Sai , Xu Haiqian , Huang Rui , Zhang Sihang , Wu Yang , Wu Qiqi , Xiong Jing , Hao Lijun 
Published: December 2021

Abstract
Objective
Immediate reconstruction (IR) is a safe and effective surgical treatment for patients with breast cancer. We aimed to assess the prognosis, aesthetic outcomes, and patient satisfaction of IR compared with breast conservation surgery (BCS) and total mastectomy (TM).

Methods
This retrospective matched-cohort study was conducted between May 2005 and December 2014. We established two cohorts according to the tumor (T) size of breast cancer. In the T≤3cm group, cases (IR) and controls (BCS or TM) were matched for age, pathological tumor size, and pathologic nodal status in a 1:1:1 ratio. In the T>3cm group, cases (IR) and controls (TM) were matched with the same factors and ratio. The primary outcome was the 5-year disease-free survival (DFS). The secondary outcome was patient satisfaction and quality of life.

Results
A total of 12,678 breast cancer patients were assessed for eligibility, of which 587 were included (T≤3 cm group: 155 IR vs 155 BCS vs 155 TM; T>3cm group: 61 IR vs 61 TM). In the T≤3 cm cohort, patients who underwent IR had no difference compared with those who underwent BCS or TM regarding the 5-year DFS (P=0.539); however, an improved aesthetic satisfaction, psychosocial, and sexual well-being were achieved in the IR group (P<0.001). In the T>3 cm cohort, the IR group had a worse median 5-year DFS (P=0.044), especially for Her2+ or triple-negative breast carcinoma (TNBC) subtypes compared with the TM group.

Conclusions
IR improves aesthetic satisfaction, psychosocial, and sexual well-being for breast cancer patients with T≤3 cm. For patients with T > 3 cm invasive breast cancer, TM is superior to IR as it predicts a better 5-year DFS.
Framework for assessing the performance of the Ghanaian health system: study protocol
Authors: Kumah Emmanuel , Ankomah Samuel E. , Fusheini Adam , Agyei-Baffour Peter , Ayanore Martin A. , Asravor Richard K. , Kesse Felix O. , Mwini Emmanuel , Otchere Godfred 
Published: December 2021

Abstract
Background
Assessing the performance of health systems through quantitative and qualitative methods is recognized as an effective approach to strengthening national health systems. However, while many high-income countries have institutionalized health system performance assessment (HSPA) as an integral component of their respective health systems, few studies on HSPA have been documented in low- and middle-income countries, including Ghana. This study aims at providing a comprehensive framework for periodic assessment of the performance of the entire health system in Ghana.

Methods
The study will have four work packages. First, a structured review will be conducted to identify both international and national HSPA frameworks that could be applied to the Ghanaian context. Second, based on the structured review, an assessment framework tailored to the Ghanaian health system context will be developed. Third, the draft framework will be presented and discussed with experts and stakeholders for its appropriateness, feasibility and acceptability. Finally, the framework will be piloted to assess its effectiveness and suitability for full-scale implementation.

Discussion
Currently, Ghana does not have a full-fledged HSPA tool that provides a holistic health sector-wide approach to assessing health system performance. Thus, developing this HSPA framework for the country will provide a tool for periodic and comprehensive assessment of the performance of the health system, which can be compared with that of other countries. Such a comparison will offer the opportunity for mutual learning and for exploring new options for formulating more effective national health policies. As this is expected to be the first attempt to develop a comprehensive HSPA framework in Ghana, this study will provide a basis for future discussions on how to further develop and implement HSPA programmes in the country.
Detecting prognostic biomarkers of breast cancer by regularized Cox proportional hazards models
Authors: Li Lingyu , Liu Zhi-Ping 
Published: December 2021

AbstractBackgroundThe successful identification of breast cancer (BRCA) prognostic biomarkers is essential for the strategic interference of BRCA patients. Recently, various methods have been proposed for exploring a small prognostic gene set that can distinguish the high-risk group from the low-risk group.MethodsRegularized Cox proportional hazards (RCPH) models were proposed to discover prognostic biomarkers of BRCA from gene expression data. Firstly, the maximum connected network with 1142 genes by mapping 956 differentially expressed genes (DEGs) and 677 previously BRCA-related genes into the gene regulatory network (GRN) was constructed. Then, the 72 union genes of the four feature gene sets identified by Lasso-RCPH, Enet-RCPH,$$L_{0}$$L0-RCPH and SCAD-RCPH models were recognized as the robust prognostic biomarkers. These biomarkers were validated by literature checks, BRCA-specific GRN and functional enrichment analysis. Finally, an index of prognostic risk score (PRS) for BRCA was established based on univariate and multivariate Cox regression analysis. Survival analysis was performed to investigate the PRS on 1080 BRCA patients from the internal validation. Particularly, the nomogram was constructed to express the relationship between PRS and other clinical information on the discovery dataset. The PRS was also verified on 1848 BRCA patients of ten external validation datasets or collected cohorts.ResultsThe nomogram highlighted that the importance of PRS in guiding significance for the prognosis of BRCA patients. In addition, the PRS of 301 normal samples and 306 tumor samples from five independent datasets showed that it is significantly higher in tumors than in normal tissues ($$P<0.05$$P<0.05). The protein expression profiles of the three genes, i.e.,ADRB1,SAV1andTSPAN14, involved in the PRS model demonstrated that the latter two genes are more strongly stained in tumor specimens. More importantly, external validation illustrated that the high-risk group has worse survival than the low-risk group ($$P<0.05$$P<0.05) in both internal and external validations.ConclusionsThe proposed pipelines of detecting and validating prognostic biomarker genes for BRCA are effective and efficient. Moreover, the proposed PRS is very promising as an important indicator for judging the prognosis of BRCA patients.
An artificial neural-network approach to identify motor hotspot for upper-limb based on electroencephalography: a proof-of-concept study
Authors: Choi Ga-Young , Han Chang-Hee , Lee Hyung-Tak , Paik Nam-Jong , Kim Won-Seok , Hwang Han-Jeong 
Published: December 2021

Abstract
Background
To apply transcranial electrical stimulation (tES) to the motor cortex, motor hotspots are generally identified using motor evoked potentials by transcranial magnetic stimulation (TMS). The objective of this study is to validate the feasibility of a novel electroencephalography (EEG)-based motor-hotspot-identification approach using a machine learning technique as a potential alternative to TMS.

Methods
EEG data were measured using 63 channels from thirty subjects as they performed a simple finger tapping task. Power spectral densities of the EEG data were extracted from six frequency bands (delta, theta, alpha, beta, gamma, and full) and were independently used to train and test an artificial neural network for motor hotspot identification. The 3D coordinate information of individual motor hotspots identified by TMS were quantitatively compared with those estimated by our EEG-based motor-hotspot-identification approach to assess its feasibility.

Results
The minimum mean error distance between the motor hotspot locations identified by TMS and our proposed motor-hotspot-identification approach was 0.22 ± 0.03 cm, demonstrating the proof-of-concept of our proposed EEG-based approach. A mean error distance of 1.32 ± 0.15 cm was measured when using only nine channels attached to the middle of the motor cortex, showing the possibility of practically using the proposed motor-hotspot-identification approach based on a relatively small number of EEG channels.

Conclusion
We demonstrated the feasibility of our novel EEG-based motor-hotspot-identification method. It is expected that our approach can be used as an alternative to TMS for motor hotspot identification. In particular, its usability would significantly increase when using a recently developed portable tES device integrated with an EEG device.
Classification of Parkinson’s disease with freezing of gait based on 360° turning analysis using 36 kinematic features
Authors: Park Hwayoung , Shin Sungtae , Youm Changhong , Cheon Sang-Myung , Lee Myeounggon , Noh Byungjoo 
Published: December 2021

AbstractBackgroundFreezing of gait (FOG) is a sensitive problem, which is caused by motor control deficits and requires greater attention during postural transitions such as turning in people with Parkinson’s disease (PD). However, the turning characteristics have not yet been extensively investigated to distinguish between people with PD with and without FOG (freezers and non-freezers) based on full-body kinematic analysis during the turning task. The objectives of this study were to identify the machine learning model that best classifies people with PD and freezers and reveal the associations between clinical characteristics and turning features based on feature selection through stepwise regression.MethodsThe study recruited 77 people with PD (31 freezers and 46 non-freezers) and 34 age-matched older adults. The 360° turning task was performed at the preferred speed for the inner step of the more affected limb. All experiments on the people with PD were performed in the “Off” state of medication. The full-body kinematic features during the turning task were extracted using the three-dimensional motion capture system. These features were selected via stepwise regression.ResultsIn feature selection through stepwise regression, five and six features were identified to distinguish between people with PD and controls and between freezers and non-freezers (PD and FOG classification problem), respectively. The machine learning model accuracies revealed that the random forest (RF) model had 98.1% accuracy when using all turning features and 98.0% accuracy when using the five features selected for PD classification. In addition, RF and logistic regression showed accuracies of 79.4% when using all turning features and 72.9% when using the six selected features for FOG classification.ConclusionWe suggest that our study leads to understanding of the turning characteristics of people with PD and freezers during the 360° turning task for the inner step of the more affected limb and may help improve the objective classification and clinical assessment by disease progression using turning features.
Viral metagenomics reveals two novel anelloviruses in feces of experimental rats
Authors: Ning Song-Yi , Zhou Ming-Ming , Yang Jie , Zeng Jian , Wang Jia-Ping 
Published: December 2021

Abstract
Background
Rodents are widely distributed and are the natural reservoirs of a diverse group of zoonotic viruses. Thus, analyzing the viral diversity harbored by rodents could assist efforts to predict and reduce the risk of future emergence of zoonotic viral diseases. Rodents are commonly used in animal testing, particularly mice and rats. Experimental rats are important animal models, and a history of pathogenic infections in these animals will directly affect the animal trial results. The pathogenicity of Anellovirus (AV) remains poorly understood due to the lack of a suitable model cell line or animal to support the viral cycle. This study aimed to discover possible anelloviruses from the virome in feces of experimental rats by viral metagenomic technique.

Methods
Fecal samples were collected from 10 commercial SD rats and pooled into a sample pool and then subjected to libraries construction which was then sequenced on Illumina MiSeq platform. The sequenced reads were analyzed using viral metagenomic analysis pipeline and two novel anelloviruses (AVs) were identified from fecal sample of experimental rats. The prevalence of these two viruses was investigated by conventional PCR.

Results
The complete genomic sequence of these two AVs were determined and fully characterized, with strain name ratane153-zj1 and ratane153-zj2. The circular genomes of ratane153-zj1 and ratane153-zj2 are 2785 nt and 1930 nt in length, respectively, and both include three ORFs. Ratane153-zj1 closely clustered with members within the genus Wawtorquevirus and formed a separate branch based on the phylogenetic tree constructed over the amino acid sequence of ORF1 of the two AVs identified in this study and other related AVs. While the complete amino acid sequences of ORF1 of ratane153-zj2 (nt 335 to 1390) had the highest sequence identity with an unclassified AV (GenBank No. ATY37438) from Chinchilla lanigera, and they clustered with one AV (GenBank No. QYD02305) belonging to the genus Etatorquevirus from Lynx rufus. Conventional PCR with two sets of specific primers designed based on the two genomes, respectively, showed that they were detectable at a low frequency in cohorts of experimental rats.

Conclusion
Our study expanded the genome diversity of AVs and provided genetic background information of viruses existed in experimental rats.
Simulation study reveals factors that affect the predominance of SARS-CoV-2 novel variant
Authors: Furuse Yuki 
Published: December 2021

AbstractThe novel variants of the SARS-CoV-2 are a great global concern for the ongoing COVID-19 pandemic. However, how the novel variants predominate and replace existing strains remains elusive. In this study, I simulated the infection spread to investigate what kinds of viral, immunological, and epidemiological factors affect the predominance of SARS-CoV-2 novel variants. The results showed that the increase of the transmissibility of the novel variant substantially enhanced the predominance probability. In addition, the increasing trend of the infection spread, the large case number of the epidemic, and the ability of immune escape of the novel variant increased the predominance probability. A small number of cases and a decreasing trend of an entire epidemic, including not only the novel variant but also earlier strains, are especially important to reduce the chance of the predominance of the novel variant and delay the process. Good control of the COVID-19 epidemic could make the disease burden small and sequester the spread of the SARS-CoV-2 novel variants.