bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences in Psychiatric Outpatients: A Before and During COVID-19 Pandemic Study in General Hospitals From China
Authors: He Wenli , Xu Danhong , Wang Jiafeng , Shen Yuze , Lin Zheng , Ruan Liemin , Chen Qiaozhen 
Published: September 2021

Abstract
BackgroundLittle is known about the gender characteristics and the Corona Virus Disease 2019(COVID-19) impact on psychiatric department outpatients in general hospitals in China. MethodsWe retrospectively collected 225,947 outpatient clinic records before and during COVID-19 pandemic from January 1, 2019 to December 31, 2020 in the psychiatric clinic of 3 general hospitals, gender composition of patients was analyzed in different five age groups and nine diagnostic categories at three levels: total patient visits, number of patients and number of first-visit patients. ResultsThe total male-to-female ratio of psychiatric outpatient records in 3 general hospitals from 2019 to 2020 was 1:1.69. Women were more common in all age groups and the male-to-female ratio of 2020 was expanded compared to that of 2019, especially in age group below 34 years old and anxiety disorders category. Most mental disorders showed higher demands for females than that for males except Mental and behavioral disorders due to psychoactive substance use with the male-to-female ratio was 1:0.05. Compared to 2019, the proportions of women were expanded especially in age group below 34 years old, and anxiety disorder and undetermined diagnosis categories were significantly increased in 2020. ConclusionsThe demand for female psychiatric outpatient services is obviously higher than that for males. It is necessary to pay more attention to explore targeted mechanism or psychosocial service strategy for female patients with mental disorders. Trial registration: ChiCTR2100044894, March 31,2021 retrospectively registered.
Safety and Efficacy of Procarbazine and Lomustine Chemotherapy as a Salvage Treatment for Recurrent Adult Glioma
Authors: Ahn Stephen , Kim Young Il , Shin Ja Young , Park Jae-Sung , Yoo Changyoung , Lee Youn Soo , Hong Yong-Kil , Jeun Sin-Soo , Yang Seung-Ho 
Published: September 2021

Abstract
PurposeWhile procarbazine, lomustine, and vincristine (PCV) chemotherapy is considered a salvage option for adult glioma, whether vincristine included in this regimen is beneficial is uncertain due to its potential toxicity and uncertain efficacy. In this study, we evaluated the safety and efficacy of PC chemotherapy in contrast with those of PCV chemotherapy. MethodsUsing electronic medical records, all patient with adult recurrent glioma who received PC or PCV chemotherapy between 2009 and 2020 at Seoul St. Mary’s Hospital or St. Vincent’s Hospital were examined retrospectively. A total of 59 patients met our eligibility criteria. Among them, 15 patients received PC chemotherapy (PC group) and 44 patients received PCV chemotherapy (PCV group). ResultsThe PC group presented a significantly lower hematology toxicity (anemia: 6.7% vs. 45.5%; p = 0.02 and thrombocytopenia: 20.0% vs. 70.4%; p < 0.001). Also, the clinical impacts of PC chemotherapy, including delay of a cycle, dose reduction, discontinuation of drug(s), or total cessation of chemotherapy, were significantly less frequent (26.7% vs. 68.2%; p = 0.012). The overall survival of PC group was significantly longer than that of PCV group (396 vs. 232 days; p = 0.042), while there was no significant difference in progression-free survival between two groups (284.5 vs. 131 days; p = 0.077). ConclusionThis is the first comparative study to suggest that PC chemotherapy leads to less toxicity than PCV chemotherapy without loss of clinical efficacy in patients with recurrent adult glioma. Further prospective and larger studies are needed to validate our findings.
Better Than Maximum Likelihood Estimation of Model-Based And Model-Free Learning Style
Authors: Yazdani Sadjad , Vahabie Abdol-Hossein , Araabi Babak Nadjar , Ahmadabadi Majid Nili 
Published: September 2021

Abstract
Various decision-making systems work together to shape human behavior. Habitual and goal-directed systems are the two most important ones that are studied by reinforcement learning (RL), using model-free and model-based learning methods, respectively. Human behavior resembles the weighted combination of these two systems. Such a combination is modeled by the weighted sum of action values of the model-based and model-free systems. The weighting parameter has been mostly extracted by "maximum likelihood" or "maximum a-posteriori" estimation methods. In this study, we show these two well-known methods bring many challenges, and their respective extracted values are less reliable, especially in the case of limited sample size or at the proximity of extremes values. We propose that using k‑nearest neighbor, as a free format estimate, can improve the estimation error. k-nn uses global information extracted from the behavior such as stay probability, along with fitted values. The proposed method is examined by simulated experiments, where obtained results indicate the advantage of our method in reducing both bias and variance of the error. Investigation of the human behavior data from previous studies shows that the proposed method results in more statistically robust estimates in predicting other behavioral indices such as the number of gaze directions toward each target or symptoms of some psychiatric disorders. In brief, the proposed method increases the reliability of the estimated parameters and enhances the applicability of reinforcement learning paradigms in clinical trials.
CRISPR-Cas9 bends and twists DNA to read its sequence
Authors: Doudna Jennifer , Cofsky Joshua , Soczek Katarzyna , Knott Gavin , Nogales Eva 
Published: September 2021

Abstract
In bacterial defense and genome editing applications, the CRISPR-associated protein Cas9 searches millions of DNA base pairs to locate a 20-nucleotide, guide-RNA-complementary target sequence that abuts a protospacer-adjacent motif (PAM). Target capture requires Cas9 to unwind DNA at candidate sequences using an unknown ATP-independent mechanism. Here we show that Cas9 sharply bends and undertwists DNA at each PAM, thereby flipping DNA nucleotides out of the duplex and toward the guide RNA for sequence interrogation. Cryo-electron-microscopy (EM) structures of Cas9:RNA:DNA complexes trapped at different states of the interrogation pathway, together with solution conformational probing, reveal that global protein rearrangement accompanies formation of an unstacked DNA hinge. Bend-induced base flipping explains how Cas9 “reads” snippets of DNA to locate target sites within a vast excess of non-target DNA, a process crucial to both bacterial antiviral immunity and genome editing. This mechanism establishes a physical solution to the problem of complementarity-guided DNA search and shows how interrogation speed and local DNA geometry may influence genome editing efficiency.
Evaluating the relevance of sequence conservation in the prediction of pathogenic missense variants
Authors: Capriotti Emidio , Fariselli Piero 
Published: September 2021

Abstract
Evolutionary information is the primary tool for detecting functional conservation in nucleic acid and protein. This information has been extensively used to predict structure, interactions and functions in macromolecules. Pathogenicity prediction models rely on multiple sequence alignment information at different levels. However, most accurate genome-wide variant deleteriousness ranking algorithms consider different features to assess the impact of variants. Here, we analyze three different ways of extracting evolutionary information from sequence alignments in the context of pathogenicity predictions at DNA and protein levels. We showed that protein sequence-based information is slightly more informative in the annotation of Clinvar missense variants than those obtained at the DNA level. Furthermore, to achieve the performance of state-of-the-art methods, such as CADD, the conservation of reference and variant, encoded as frequencies of reference/alternate alleles or wild-type/mutant residues, should be included. Our results on a large set of missense variants show that a basic method based on three input features derived from the protein sequence profile performs similarly to the CADD algorithm which uses hundreds of genomic features. This observation indicates that for missense variants, evolutionary information, when properly encoded, plays the primary role in ranking pathogenicity.
Highly Enhanced Adsorption For The Removal of Hg (II) From Aqueous Solution By Co-Polymerized Al2O3 Nanocomposites Fabricated By Improved Sol-Gel Combustion Route: Synthesis, Adsorption Kinetics &amp; Isotherm Modelling
Authors: El-Feky Hesham H. , Amin Alaa S. , Nassar Mostafa Y. 
Published: September 2021

Abstract
The synthesis, characterization and capacity studies of co-polymerized Al2O3 nanocomposites capable of adsorbing with Hg(II) ions are reported. Al2O3 nanoparticles was fabricated with combustion synthesis using inexpensive mixed fuels. Nanocomposite of poly (aniline-CO-O-anthranilic acid) (PANAA/ Al2O3) was synthesized by chemical oxidative polymerization of anthranilic acid and aniline co-monomers at equimolar ratios (1:1) with the Al2O3 nanostructure. The product was characterized by FT-IR, XRD, SEM and TEM techniques. The adsorption behaviors of the toxic Hg(II) were studied. The equilibrium isotherm, kinetics parameters and the thermodynamics investigations of the adsorption process were calculated. Thermodynamics investigations also confirmed that the adsorption capacity of Hg(II) on each adsorbent was spontaneous and exothermic.
Optical polarizers based on graphene oxide integrated with waveguides and ring resonators
Authors: Moss David 
Published: September 2021

Abstract
Integrated waveguide polarizers and polarization-selective micro-ring resonators (MRRs) incorporated with graphene oxide (GO) films are experimentally demonstrated. CMOS-compatible doped silica waveguides and MRRs with both uniformly coated and patterned GO films are fabricated based on a large-area, transfer-free, layer-by-layer GO coating method that yields precise control of the film thickness. Photolithography and lift-off processes are used to achieve photolithographic patterning of GO films with precise control of the placement and coating length. Detailed measurements are performed to characterize the performance of the devices versus GO film thickness and coating length as a function of polarization, wavelength and power. A high polarization dependent loss of ~ 53.8 dB is achieved for the waveguide coated with 2-mm-long patterned GO films. It is found that intrinsic film material loss anisotropy dominates the performance for less than 20 layers whereas polarization dependent mode overlap dominates for thicker layers. For the MRRs, the GO coating length is reduced to 50 µm, yielding a ~ 8.3-dB polarization extinction ratio between TE and TM resonances. These results offer interesting physical insights and trends of the layered GO films and demonstrate the effectiveness of introducing GO films into photonic integrated devices to realize high-performance polarization selective components.
Parasitism-evoked horizontal gene transfer between plants as a novel trigger for specialized metabolism evolution
Authors: Ono Eiichiro , Shimizu Kohki , Murata Jun , Shiraishi Akira , Yokoyama Ryusuke , Toyonaga Hiromi , Kutsumi Yuka , Yamamoto Shota , Takagaki Yusuke , Takada Rika , Horikawa Manabu , Hoshino Atsushi , Aoki Koh 
Published: September 2021

Abstract
Recent genomic studies of parasitic plants have revealed that there are numerous footprints indicative of horizontal gene transfer (HGT) to the parasites from their host plants. However, the molecular mechanisms and biological impacts of this phenomenon have remained largely unknown. Here, we made the striking observation that two parasitic dodders, Cuscuta campestris and C. australis, have functional homologues of Si_CYP81Q1, which encodes piperitol/sesamin synthase (PSS) in the phylogenetically remote plant Sesamum indicum (sesame). The apparent lack of sequence similarity between the regions flanking PSS in Sesamum and Cuscuta spp. suggests the occurrence of HGT tightly associated with the PSS gene. Upon parasitism, C. campestris induced expression of the host Si_CYP81Q1 at the parasitic interface and mature and intron-retained Si_CYP81Q1 mRNA was transferred to C. campestris, suggesting that CYP81Q1 was translocated via RNA-mediated HGT. Thus, parasitism-evoked HGT might have had an unexpected role in the metabolic evolution of plants.
Runoff-associated nitrogen and phosphorus losses under natural rainfall events in purple soil area: the role of land disturbance and slope length
Authors: Liang Ke , He Xiaorong , He Binghui , Guo Xiaomeng , Li Tianyang 
Published: September 2021

Abstract
Land disturbance and slope length play key roles in affecting runoff-associated nitrogen (N) and phosphorus (P) losses in different forms under natural rainfall. Field monitoring was conducted in nine plots located parallel on a 15° purple slope in southwest China. Three slope lengths (20-, 40-, 60-m) combined with measures of artificial disturbance and natural restoration were implemented. The highest N concentration was observed in soft rainfall events across all plots. The highest P concentration was recorded in heavy rainfall events for the artificially disturbed plots and in soft rainfall events for the naturally restored plots. Land disturbance caused orthophosphate concentration to differ in the 20-m plot, and affected N and P loss amounts in different forms. Slope length caused total dissolved phosphorus concentration to differ in naturally restored plots, and also caused the loss amounts of total dissolved nitrogen and orthophosphate to differ in artificially disturbed plots. Natural restoration reduced loss amounts of total nitrogen and total phosphorus by 62.14–79.05% and 79.28–83.43% relative to artificial disturbance, respectively. Concentrations of nitrate-nitrogen, total phosphorus and dissolved phosphorus were closely correlated with rainfall and runoff variables, respectively, in artificially disturbed plots. Our results highlight the dominant role of natural restoration in reducing erosion and nutrient loss in sloping land.
Water quality analysis and health risk assessment of the Lanzhou section of the Yellow River
Authors: Ma Kai , Ren Hao , Zhou Tianhong , Wu Fuping , Zhang Guozhen 
Published: September 2021

Abstract
The Yellow River flows through Lanzhou city and is the only drinking water source for 3.6 million people. However, people are not clear about the water environmental quality and safety in Lanzhou. To address this problem. Water samples were collected from different sites within this section during the high water period, normal water period and dry water period, and the environmental quality and health risk of the surface water were evaluated using the Nemerow index and health risk assessment method. The results are as follows: first, none of the pollutants exceeded the standard, except for total nitrogen; second, the highest comprehensive evaluation score was 1.04, so the water quality level was good; third, the health risk assessment showed that health risk value of water quality in the Lanzhou section of the Yellow River is on the high side, which is mainly caused by Chromium(Cr); fourth, the carcinogenic risk is five orders of magnitude higher than the non-carcinogenic risk, and the total carcinogenic risk is higher than the maximum acceptable risk level (10−5 a−1), while the total non-carcinogenic risk is lower than the acceptable health risk level (10−6 a−1). Therefore, to ensure the safety of its drinking water, Cr pollutants in the Lanzhou section of the Yellow River should be properly treated and controlled.
A Web-Based Cognitive Behavioral Therapy, Mindfulness Meditation, and Yoga Intervention for Posttraumatic Stress Disorder: Single-Arm Experimental Clinical Trial
Authors: Kirk Megan A , Taha Bilal , Dang Kevin , McCague Hugh , Hatzinakos Dimitrios , Katz Joel , Ritvo Paul 
Published: September 2021

BackgroundPosttraumatic stress disorder (PTSD) is a debilitating, undertreated condition. The web-based delivery of cognitive behavioral therapy supplemented with mindfulness meditation and yoga is a viable treatment that emphasizes self-directed daily practice.ObjectiveThis study aims to examine the effectiveness of a web-based cognitive behavioral therapy, mindfulness, and yoga (CBT-MY) program designed for daily use.MethodsWe conducted an 8-week, single-arm, experimental, registered clinical trial on adults reporting PTSD symptoms (n=22; aged 18-35 years). Each participant received web-based CBT-MY content and an hour of web-based counseling each week. Pre-post outcomes included self-reported PTSD symptom severity, depression, anxiety, chronic pain, and mindfulness. Pre-post psychophysiological outcomes included peak pupil dilation (PPD) and heart rate variability (HRV). HRV and PPD were also compared with cross-sectional data from a non-PTSD comparison group without a history of clinical mental health diagnoses and CBT-MY exposure (n=46).ResultsPre-post intention-to-treat analyses revealed substantial improvements in PTSD severity (d=1.60), depression (d=0.83), anxiety (d=0.99), and mindfulness (d=0.88). Linear multilevel mixed models demonstrated a significant pre-post reduction in PPD (B=−0.06; SE=0.01; P<.001; d=0.90) but no significant pre-post change in HRV (P=.87). Overall, participants spent an average of 11.53 (SD 22.76) min/day on self-directed mindfulness practice.ConclusionsWeb-based CBT-MY was associated with clinically significant symptom reductions and significant PPD changes, suggesting healthier autonomic functioning. Future randomized controlled trials are needed to further examine the gains apparent in this single-arm study.Trial RegistrationClinicalTrials.gov NCT03684473; https://clinicaltrials.gov/ct2/show/NCT03684473
Initial Outcomes of CardioClick, a Telehealth Program for Preventive Cardiac Care: Observational Study
Authors: Kalwani Neil M , Johnson Austin N , Parameswaran Vijaya , Dash Rajesh , Rodriguez Fatima 
Published: September 2021

Background
Telehealth use has increased in specialty clinics, but there is limited evidence on the outcomes of telehealth in primary cardiovascular disease (CVD) prevention.

Objective
The objective of this study was to evaluate the initial outcomes of CardioClick, a telehealth primary CVD prevention program.

Methods
In 2017, the Stanford South Asian Translational Heart Initiative (a preventive cardiology clinic focused on high-risk South Asian patients) introduced CardioClick, which is a clinical pathway replacing in-person follow-up visits with video visits. We assessed patient engagement and changes in CVD risk factors in CardioClick patients and in a historical in-person cohort from the same clinic.

Results
In this study, 118 CardioClick patients and 441 patients who received in-person care were included. CardioClick patients were more likely to complete the clinic’s CVD prevention program (76/118, 64.4% vs 173/441, 39.2%, respectively; P<.001) and they did so in lesser time (mean, 250 days vs 307 days, respectively; P<.001) than the patients in the historical in-person cohort. Patients who completed the CardioClick program achieved reductions in CVD risk factors, including blood pressure, lipid concentrations, and BMI, which matched or exceeded those observed in the historical in-person cohort.

Conclusions
Telehealth can be used to deliver care effectively in a preventive cardiology clinic setting and may result in increased patient engagement. Further studies on telehealth outcomes are needed to determine the optimal role of virtual care models across diverse preventive medicine clinics.
Problems in Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year (the PUPPY Study): Protocol for a Longitudinal Mixed Methods Study
Authors: Marshall Emily Gard , Breton Mylaine , Cossette Benoit , Isenor Jennifer , Mathews Maria , Ayn Caitlyn , Smithman Mélanie Ann , Stock David , Frymire Eliot , Edwards Lynn , Green Michael 
Published: September 2021

Background
The COVID-19 pandemic has significantly disrupted primary care in Canada, with many walk-in clinics and family practices initially closing or being perceived as inaccessible; pharmacies remaining open with restrictions on patient interactions; rapid uptake of virtual care; and reduced referrals for lab tests, diagnostics, and specialist care.

Objective
The PUPPY Study (Problems in Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year) seeks to understand the impact of the COVID-19 pandemic across the quadruple aims of primary care, with particular focus on the effects on patients without attachment to a regular provider and those with chronic health conditions.

Methods
The PUPPY study builds on an existing research program exploring patients’ access and attachment to a primary care practice, pivoted to adapt to the emerging COVID-19 context. We intend to undertake a longitudinal mixed methods study to understand critical gaps in primary care access and coordination, as well as compare prepandemic and postpandemic data across 3 Canadian provinces (Quebec, Ontario, and Nova Scotia). Multiple data sources will be used such as a policy review; qualitative interviews with primary care policymakers, providers (ie, family physicians, nurse practitioners, and pharmacists), and patients (N=120); and medication prescriptions and health care billing data.

Results
This study has received funding by the Canadian Institutes of Health Research COVID-19 Rapid Funding Opportunity Grant. Ethical approval to conduct this study was granted in Ontario (Queens Health Sciences & Affiliated Teaching Hospitals Research Ethics Board, file 6028052; Western University Health Sciences Research Ethics Board, project 116591; University of Toronto Health Sciences Research Ethics Board, protocol 40335) in November 2020, Québec (Centre intégré universitaire de santé et de services sociaux de l'Estrie, project 2020-3446) in December 2020, and Nova Scotia (Nova Scotia Health Research Ethics Board, file 1024979) in August 2020.

Conclusions
To our knowledge, this is the first study of its kind to explore the effects of the COVID-19 pandemic on primary care systems, with particular focus on the issues of patient’s attachment and access to primary care. Through a multistakeholder, cross-jurisdictional approach, the findings of the PUPPY study will inform the strengthening of primary care during and beyond the COVID-19 pandemic, as well as have implications for future policy and practice.

International Registered Report Identifier (IRRID)
DERR1-10.2196/29984
Greatly Exaggerated in Canada: Diverging Data and Media Bailouts
Authors: Edge Marc 
Published: September 2021

Background: The Canadian government allocated $595 million in subsidies over five years to news media in 2019, but the bailout was based on questionable data. Financial losses were exaggerated; a think tank report was criticized for using data selectively; data from a university research project differed sharply from annual industry counts; and job loss figures were disputed. Analysis: Hard data can diverge markedly from soft data accepted in pursuit of policy outcomes. Conclusions and implications: A second campaign under way on behalf of entertainment industries could yield a bailout several times larger than the first. Closer scrutiny should be exercised of media narratives and offered data. An independent media research centre should collect and verify data for policy purposes.