bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Insomnia, Depressive Disorders, and Mood Disorders as Risk Factors With Breast Cancer: A Nationwide Population-Based Cohort Study of 232,108 Women in Taiwan
Authors: Liu Hui-Pu , Wei James Cheng-Chung , Yip Hei-Tung , Yeh Ming-Hsin 
Published: October 2021

BackgroundInsomnia, depressive disorders, and to a more general view, mood disorders are raising people’s concerns and causing disability of life. Herein, we try to seek the association of such illnesses with subsequent breast cancer.MethodsThis population-based, retrospective cohort study used data from the Taiwan National Health Insurance Research Database. This study included 232,108 women diagnosed with insomnia, depressive disorders, and mood disorders from January 1, 2000 to December 31, 2013. Physician diagnosed insomnia, depressive disorders, or mood disorders using outpatient and inpatient records before diagnosis of breast cancer. Cox proportional hazards regression analysis is adjusted for women with insomnia, depressive disorders, mood disorders, and other factors like insured amount, urbanization, and comorbidities such as having subsequent breast cancer.ResultsSleep medication was associated with a significantly increased incidence rate of breast cancer (aHR = 1.23 (95% CI = 1.13, 1.35), p &lt; 0.001). Insomnia was associated with significant increased hazard of breast cancer (aHR = 1.16 (95% CI = 1.07, 1.27), p &lt; 0.001). Annual insured amount &gt;20,000 (TWD), high urbanization area, and hyperlipidemia were associated with increased hazard of breast cancer (aHR = 1.13 (95% CI = 1.01, 1.27), p = 0.04; aHR = 1.41 (95% CI = 1.17, 1.71), p &lt; 0.001; aHR = 1.14 995% CI = 1.02, 1.29), p = 0.02, respectively). There was a positive correlation between depressive disorders and increased incidence rate of breast cancer but not statistically significant (aHR = 1.11 (95% CI = 0.99, 1.25), p = 0.08). Mood disorders were not associated with increased hazard (aHR = 1.11 (95% CI = 0.91, 1.34), p = 0.31).ConclusionIn this study, women with insomnia had increased risk of breast cancer, particularly those in high urbanization or with high insured amounts. Sleep medication (benzodiazepine (BZD) or non-BZD) and hyperlipidemia were independently associated with a higher hazard ratio of breast cancer. Insomnia along with sleep medication did not yield more hazards than each alone. Mood disorders appeared to be not associated with subsequent breast cancer. However, depressive disorders, the subgroups of mood disorders, could possibly increase the incidence rate of breast cancer though not statistically significant.
Platelet Count Might Be Associated With the Closure of Hemodynamically Significant Patent Ductus Arteriosus
Authors: Zhong Junyan , Lin Binchun , Fu Yongping , Yu Yanliang , Zhao Jie , Zhao Depeng , Yang Chuanzhong , Chen Xueyu 
Published: October 2021

Background: Platelet-rich thrombosis leads to the occlusion of arteries. Whether the association between platelet count and closure of hemodynamically significant patent ductus arteriosus (hsPDA) exists remains inconclusive. Given that neonatal platelet count is significantly affected by infection, this study aims to evaluate the association of platelet parameters before ibuprofen treatment with the closure of hsPDA in very low birth weight (VLBW) infants without concurrent infection.Methods: A retrospective study was conducted at the NICU of Shenzhen Maternity and Child Healthcare Hospital from January 2016 to August 2020. VLBW infants diagnosed with hsPDA, treated with oral ibuprofen and without concurrent infection were included in this study. The platelet parameters were retrieved from the whole-blood test routinely performed within 24 h before starting treatment of oral ibuprofen. A multiple regression model was built to evaluate the association between platelet parameters before ibuprofen treatment and successful closure of hsPDA.Results: A total of 129 premature infants with hsPDA were analyzed in this study. After oral ibuprofen treatment, successful closure of hsPDA was achieved in 70 (54.3%) infants. The gestational age at birth and birth weight in infants with successful or failed closure of hsPDA after ibuprofen treatment were 28.3 vs. 27.6 weeks (p = 0.016) and 1,120 vs. 960 g (p = 0.043), respectively. The rate of mechanical ventilation in infants with successful closure of hsPDA was significantly lower compared to those with failed closure of hsPDA, 31.4 vs. 54.2%, p = 0.014. The platelet count in infants with successful closure of hsPDA after ibuprofen treatment was significantly higher compared to those with failed closure of hsPDA, 212 vs. 183 (in a unit of 109/L), respectively (p = 0.024). Multivariate logistic regression analysis showed that a higher platelet count (≥181 × 109/L) before ibuprofen treatment was independently associated with successful closure of hsPDA [odds ratio 2.556, 95% confidence interval (1.101–5.932), p = 0.029].Conclusion: The findings in this study suggest that a higher platelet count before oral ibuprofen treatment may predict the probability of successful closure of hsPDA in VLBW infants.
Functional Profiling Reveals Altered Metabolic Activity in Divers’ Oral Microbiota During Commercial Heliox Saturation Diving
Authors: Monnoyer Roxane , Eftedal Ingrid , Hjelde Astrid , Deb Sanjoy , Haugum Kjersti , Lautridou Jacky 
Published: October 2021

Background: The extreme environment in saturation diving affects all life forms, including the bacteria that reside on human skin and mucosa. The oral cavity alone is home to hundreds of different bacteria. In this study, we examined the metabolic activity of oral bacteria from healthy males during commercial heliox saturation diving. We focused on environmentally induced changes that might affect the divers’ health and fitness.Methods: We performed pathway abundance analysis using PICRUSt2, a bioinformatics software package that uses marker gene data to compute the metabolic activity of microbial communities. The analysis is based on 16S rRNA metagenomic data generated from the oral microbiota of 23 male divers before, during, and after 4weeks of commercial heliox saturation diving. Environmentally induced changes in bacterial metabolism were computed from differences in predicted pathway abundances at baseline before, versus during, and immediately after saturation diving.Results and Conclusion: The analysis predicted transient changes that were primarily associated with the survival and growth of bacteria in oxygenated environments. There was a relative increase in the abundance of aerobic metabolic pathways and a concomitant decrease in anaerobic metabolic pathways, primarily comprising of energy metabolism, oxidative stress responses, and adenosylcobalamin biosynthesis. Adenosylcobalamin is a bioactive form of vitamin B12 (vitB12), and a reduction in vitB12 biosynthesis may hypothetically affect the divers’ physiology. While host effects of oral bacterial vitamin metabolism are uncertain, this is a finding that concurs with the existing recommendations for vitB12 supplements as part of the divers’ diet, whether to boost antioxidant defenses in bacteria or their host or to improve oxygen transport during saturation diving.
Prevalence and Risk Factors of Post-traumatic Stress Disorder Symptoms in Students Aged 8–18 in Wuhan, China 6 Months After the Control of COVID-19
Authors: Chen Yue , Zhu Zhuohong , Lei Fei , Lei Shulan , Chen Jing 
Published: October 2021

Objectives: To explore the prevalence of post-traumatic stress disorder (PTSD) symptoms and the factors influencing mental health symptoms in students aged 8–18 in Wuhan, China at 6 months after the COVID-19 pandemic was controlled.Methods: Questionnaires were distributed to students aged 8–18 in Wuhan through an online platform from September to October 2020, and 15,993 valid surveys were returned, resulting in a response rate of 75.4%. The data related to symptoms of PTSD, anxiety, depression, stress and psychological inflexibility levels, as well as demographic information about the population. Hierarchical multiple regression analyses were performed to examine the predictive effects.Results: In total, 11.5% of the students met the criteria for clinically concerning PTSD symptoms. Psychological inflexibility was associated with PTSD symptoms, depression, anxiety, and stress symptoms (β = 0.45, 0.63, 0.65 and 0.69, respectively, with ΔR2 = 0.16, 0.32, 0.34 and 0.39, respectively, p &lt; 0.001) in children and adolescents.Conclusion: This study investigated the impacts of COVID-19 on the mental health status among students aged 8–18 in Wuhan. Even at 6 months after the outbreak was brought under control, some students were still affected. Psychological inflexibility was correlated with psychological symptoms in students. Therefore, methods to reduce psychological inflexibility may help improve the mental health states of students as part of psychological interventions.
Is the Severity of the Clinical Expression of Anorexia Nervosa Influenced by an Anxiety, Depressive, or Obsessive-Compulsive Comorbidity Over a Lifetime?
Authors: Riquin Elise , Raynal Agathe , Mattar Lama , Lalanne Christophe , Hirot France , Huas Caroline , Duclos Jeanne , Berthoz Sylvie , Godart Nathalie ,   EVHAN group
Published: October 2021

Purpose: The relationship between anxiety or depressive comorbidities, their chronology of onset, and the severity of anorexia nervosa (AN) is not well-studied. We hypothesize that the existence of a comorbidity, particularly before the onset of AN, is associated with greater severity of AN.Methods: One hundred seventy-seven subjects were assessed. The prevalence of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), and social phobia (SP) as well as their chronology of onset were studied. The assessment criteria of AN severity were the overall clinical condition, body mass index (BMI) on admission, lowest BMI, intensity of the eating symptoms, age at the onset of AN, illness duration, number of hospitalizations, and quality of life.Results: Patients with AN had the greatest clinical severity when they had a comorbid disorder over their lifetime, such as MDD, GAD, or SP. These comorbidities along with OCD were associated with a higher level of eating symptoms and a more altered quality of life. A profile of maximum severity was associated with a higher prevalence of MDD and GAD. Concerning the chronology of onset, the age at the start of AN was later in cases of MDD or GAD prior to AN.Conclusion: There seems to be an association between severity of AN and both MDD and GAD. The chronology of onset of the comorbidity did not seem to be associated with the severity.
Machine Learning-Based Electroencephalographic Phenotypes of Schizophrenia and Major Depressive Disorder
Authors: Jang Kuk-In , Kim Sungkean , Kim Soo Young , Lee Chany , Chae Jeong-Ho 
Published: October 2021

Background: Psychiatric diagnosis is formulated by symptomatic classification; disease-specific neurophysiological phenotyping could help with its fundamental treatment. Here, we investigated brain phenotyping in patients with schizophrenia (SZ) and major depressive disorder (MDD) by using electroencephalography (EEG) and conducted machine-learning-based classification of the two diseases by using EEG components.Materials and Methods: We enrolled healthy controls (HCs) (n = 30) and patients with SZ (n = 34) and MDD (n = 33). An auditory P300 (AP300) task was performed, and the N1 and P3 components were extracted. Two-group classification was conducted using linear discriminant analysis (LDA) and support vector machine (SVM) classifiers. Positive and negative symptoms and depression and/or anxiety symptoms were evaluated.Results: Considering both the results of statistical comparisons and machine learning-based classifications, patients and HCs showed significant differences in AP300, with SZ and MDD showing lower N1 and P3 than HCs. In the sum of amplitudes and cortical sources, the findings for LDA with classification accuracy (SZ vs. HCs: 71.31%, MDD vs. HCs: 74.55%), sensitivity (SZ vs. HCs: 77.67%, MDD vs. HCs: 79.00%), and specificity (SZ vs. HCs: 64.00%, MDD vs. HCs: 69.67%) supported these results. The SVM classifier showed reasonable scores between SZ and HCs and/or MDD and HCs. The comparison between SZ and MDD showed low classification accuracy (59.71%), sensitivity (65.08%), and specificity (54.83%).Conclusions: Patients with SZ and MDD showed deficiencies in N1 and P3 components in the sum of amplitudes and cortical sources, indicating attentional dysfunction in both early and late sensory/cognitive gating input. The LDA and SVM classifiers in the AP300 are useful to distinguish patients with SZ and HCs and/or MDD and HCs.
Fischer Linear Discrimination and Quadratic Discrimination Analysis–Based Data Mining Technique for Internet of Things Framework for Healthcare
Authors: Hasan Mohammad Kamrul , Ghazal Taher M. , Alkhalifah Ali , Abu Bakar Khairul Azmi , Omidvar Alireza , Nafi Nazmus S. , Agbinya Johnson I. 
Published: October 2021

The internet of reality or augmented reality has been considered a breakthrough and an outstanding critical mutation with an emphasis on data mining leading to dismantling of some of its assumptions among several of its stakeholders. In this work, we study the pillars of these technologies connected to web usage as the Internet of things (IoT) system's healthcare infrastructure. We used several data mining techniques to evaluate the online advertisement data set, which can be categorized as high dimensional with 1,553 attributes, and the imbalanced data set, which automatically simulates an IoT discrimination problem. The proposed methodology applies Fischer linear discrimination analysis (FLDA) and quadratic discrimination analysis (QDA) within random projection (RP) filters to compare our runtime and accuracy with support vector machine (SVM), K-nearest neighbor (KNN), and Multilayer perceptron (MLP) in IoT-based systems. Finally, the impact on number of projections was practically experimented, and the sensitivity of both FLDA and QDA with regard to precision and runtime was found to be challenging. The modeling results show not only improved accuracy, but also runtime improvements. When compared with SVM, KNN, and MLP in QDA and FLDA, runtime shortens by 20 times in our chosen data set simulated for a healthcare framework. The RP filtering in the preprocessing stage of the attribute selection, fulfilling the model's runtime, is a standpoint in the IoT industry.Index Terms: Data Mining, Random Projection, Fischer Linear Discriminant Analysis, Online Advertisement Dataset, Quadratic Discriminant Analysis, Feature Selection, Internet of Things.
Bioethical Concerns During the COVID-19 Pandemic: What Did Healthcare Ethics Committees and Institutions State in Spain?
Authors: Ruiz-Hornillos Javier , Hernández Suárez Pilar , Marín Martínez Juana María , Miguel Beriain Íñigo de , Nieves Vázquez María Auxiliadora , Albert Marta , Herrera Abián María , Pacheco-Martínez Pedro A. , Trasmontes Victoria , Guillén-Navarro Encarna 
Published: October 2021

Objectives: Each new wave of the COVID-19 pandemic invites the possible obligation to prioritize individuals' access to vital resources, and thereby leads to unresolved and important bioethical concerns. Governments have to make decisions to protect access to the health system with equity. The prioritization criteria during a pandemic are both a clinical and legal-administrative decision with ethical repercussion. We aim to analyse the prioritization protocols used in Spain during the pandemic which, in many cases, have not been updated.Method: We carried out a narrative review of 27 protocols of prioritization proposed by healthcare ethics committees, scientific societies and institutions in Spain for this study. The review evaluated shared aspects and unique differences and proffered a bioethical reflection.Results: The research questions explored patient prioritization, the criteria applied and the relative weight assigned to each criterion. There was a need to use several indicators, being morbidity and mortality scales the most commonly used, followed by facets pertaining to disease severity and functional status. Although age was initially considered in some protocols, it cannot be the sole criterion used when assigning care resources.Conclusions: In COVID-19 pandemic there is a need for a unified set of criteria that guarantees equity and transparency in decision-making processes. Establishing treatment indications is not the aim of such criteria, but instead prioritizing access to care resources. In protocols of prioritization, the principle of efficiency must vary according to the principle of equity and the criteria used to guarantee such equity.
Upfront Brain Treatments Followed by Lung Surgery Improves Survival for Stage IV Non-small Cell Lung Cancer Patients With Brain Metastases: A Large Cohort Analysis
Authors: He Xiaopeng , Yin Shen , Liu Hongyu , Lu Rong , Kernstine Kemp , Gerber David E. , Xie Yang , Yang Donghan M. 
Published: October 2021

Background: Current treatment guidelines for stage IV non-small cell lung cancer (NSCLC) with brain metastases recommend brain treatments, including surgical resection and radiotherapy (RT), in addition to resection of the primary lung tumor. Here, we investigate the less-studied impact of treatment sequence on the overall survival.Methods: The National Cancer Database was queried for NSCLC patients with brain metastases who underwent surgical resection of the primary lung tumor (n = 776). Kaplan-Meier survival curves with log-rank test and propensity score stratified Cox regression with Wald test were used to evaluate the associations between various treatment plans and overall survival (OS).Results: Compared to patients who did not receive any brain treatment (median OS = 6.05 months), significantly better survival was observed for those who received brain surgery plus RT (median OS = 26.25 months, p &lt; 0.0001) and for those who received brain RT alone (median OS = 14.49 months, p &lt; 0.001). Patients who received one upfront brain treatment (surgery or RT) before lung surgery were associated with better survival than those who received lung surgery first (p &lt; 0.05). The best survival outcome (median OS 27.1 months) was associated with the sequence of brain surgery plus postoperative brain RT followed by lung surgery.Conclusions: This study shows the value of performing upfront brain treatments followed by primary lung tumor resection for NSCLC patients with brain metastases, especially the procedure of brain surgery plus postoperative brain RT followed by lung surgery.
Awareness of HPV-associated oropharyngeal cancers among GPs in The Netherlands: a cross-sectional study
Authors: Demers Imke , Verhees Femke , Schouten Leo J , Muris Jean WM , Kremer Bernd , Speel Ernst Jan M 
Published: October 2021

BackgroundThe incidence of human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) is increasing in high income countries. HPV-associated OPC generally presents as an invasive disease, often with lymph node involvement, in relatively young patients with minimal or no history of smoking and alcohol consumption. Knowledge on HPV-associated OPC among primary care professionals is essential for disease recognition and early start of treatment.AimTo examine the knowledge on HPV-associated OPC among GPs in the Netherlands.Design & settingA cross-sectional postal survey among GPs in the Netherlands.MethodA 12-item questionnaire was sent to 900 randomly selected general practices. Outcome measures included awareness of the link between HPV and OPC, epidemiological trends, and patient characteristics. Data were statistically analysed for sex, years after graduation, and self-rated knowledge of OPC.ResultsA total of 207 GPs participated in this study. Seventy-two per cent recognised HPV as a risk factor for OPC and 76.3% were aware of the increasing incidence rate of HPV-associated OPC. In contrast, 35.7% of participants knew that patients with HPV-associated OPC are more often male, and just over half (53.6%) of the participants were aware of the younger age of these patients.ConclusionMore than one-quarter of GPs in the Netherlands are unaware of HPV as a causative factor for OPC. Furthermore, there is a gap in knowledge on characteristics of patients with HPV-associated OPC . Further training on these topics could improve disease recognition and, ultimately, patient survival.
Diagnostic accuracy of Fever-PAIN and Centor criteria for bacterial throat infection in adults with sore throat: a secondary analysis of a randomised controlled trial
Authors: Seeley Anna , Fanshawe Thomas , Voysey Merryn , Hay Alastair , Moore Michael , Hayward Gail 
Published: October 2021

BackgroundSore throat is a common and self-limiting condition. There remains ambiguity in stratifying patients to immediate, delayed, or no antibiotic prescriptions. The National Institute for Health and Care Excellence (NICE) recommends two clinical prediction rules (CPRs), FeverPAIN and Centor, to guide decision making.AimTo describe the diagnostic accuracy of CPRs in identifying streptococcal throat infections.Design & settingAdults presenting to UK primary care with sore throat, who did not require immediate antibiotics.MethodAs part of the Treatment Options without Antibiotics for Sore Throat (TOAST) trial, 565 participants, aged ≥18 years, were recruited on day of presentation to general practice. Physicians could opt to give delayed prescriptions. CPR scores were not part of the trial protocol but were calculated post hoc from baseline assessments. Diagnostic accuracy was calculated by comparing scores with throat swab cultures.ResultsIt was found that 81/502 (16.1%) patients had group A, C, or G streptococcus cultured on throat swab. Overall diagnostic accuracy of both CPRs was poor: area under receiver operating characteristics (ROC) curve 0.62 for Centor; and 0.59 for FeverPAIN. Post-test probability of a positive or negative test was 27.3% (95% confidence interval [CI] = 6.0% to 61.0%) and 84.1% (95% CI = 80.6% to 87.2%) for FeverPAIN ≥4; versus 25.7% (95% CI = 16.2% to 37.2%) and 85.5% (95% CI = 81.8% to 88.7%) for Centor ≥3. Higher CPR scores were associated with increased delayed antibiotic prescriptions (χ2 = 8.42, P = 0.004 for FeverPAIN ≥4; χ2 = 32.0, P<0.001 for Centor ≥3).ConclusionIn those who do not require immediate antibiotics in primary care, neither CPR provides a reliable way of diagnosing streptococcal throat infection. However, clinicians were more likely to give delayed prescriptions to those with higher scores.
Les oiseaux (Aves) du gisement pléistocène moyen des Abîmes de la Fage à Noailles (Corrèze)
Authors: Mourer-Chauviré Cécile 
Published: October 2021

Les oiseaux sont extrêmement abondants dans le gisement de la Fage. Au point de vue systématique, des études statistiques ont permis de mettre en évidence des différences de taille entre les populations de la Fage et les populations actuelles et de définir un certain nombre d'espèces ou de sous-espèces nouvelles.
La faune comporte un certain nombre d'espèces qui indiquent un climat plus froid que le climat actuel mais ces espèces sont toujours peu nombreuses par rapport à l'en¬ semble des oiseaux. La majorité des formes identifiées correspondent à un milieu de type steppique.