bluuebunny/crossref_metadata_2025_split huggingface dataset:
Locked and lonely? A longitudinal assessment of loneliness before and during the COVID-19 pandemic in Norway
Authors: Hansen Thomas , Nilsen Thomas S. , Yu Baeksan , Knapstad Marit , Skogen Jens Christoffer , Vedaa Øystein , Nes Ragnhild Bang 
Published: March 2021

Aims: There are concerns that lockdown measures taken during the current COVID-19 pandemic lead to a rise in loneliness, especially in vulnerable groups. We explore trends in loneliness before and during the pandemic and differences across population subgroups. Methods: Data were collected via online questionnaires in June 2020 and four to eight months prior in two Norwegian counties ( N=10,740; 54% women; age 19–92 years). Baseline data come from the Norwegian Counties Public Health Survey (participation rate 46%, of which 59% took part in a COVID-19 follow-up study). Results: Overall loneliness was stable or falling during the lockdown. However, some subgroups, single individuals and older women, reported slightly increased loneliness during lockdown. Interestingly, individuals with low social support and high levels of psychological distress and loneliness before the pandemic experienced decreasing loneliness during the pandemic. Conclusions: Although data limitations preclude strong conclusions, our findings suggest that, overall, Norwegians seem to have managed the lockdown without alarming increases in loneliness. It is important to provide support and to continue investigating the psychological impact of the pandemic over time and across regions differentially affected by the pandemic.
Perceived stress among adolescents as a marker for future mental disorders: A prospective cohort study
Authors: Lindholdt Louise , Labriola Merete , Andersen Johan H. , Kjeldsen Mette-Marie Z. , Obel Carsten , Lund Thomas 
Published: March 2021

Aim: The mental health problems of adolescents are important in relation to their future health and life course. The aim of this study was to investigate perceived stress in adolescence as a marker for later mental disorders. Methods: The data consisted of a combination of questionnaire and register data for 11,929 adolescents. Perceived stress was measured using Cohen’s Perceived Stress Scale divided into low, moderate and high perceived stress. Mental disorder was identified using the ICD-10 codes for Mental and Behavioural Disorders classified into whether the adolescents were diagnosed or not. Logistic regression was used to examine the prospective association between perceived stress and mental disorders during about 12 months of follow-up, including the adolescents self-rated health, sex and parental education. Results: In total, 247 adolescents (2.1%) were diagnosed with a mental disorder during follow-up. The perceived stress of the adolescents was associated with mental disorders, yielding two-fold higher odds of developing a mental disorder for adolescents reporting moderate perceived stress and six-fold higher odds among adolescents reporting high perceived stress in the adjusted model. Conclusions: Adolescents with high levels of perceived stress were more likely to develop a mental disorder. Interventions to reduce perceived stress among adolescents could therefore potentially help to identify groups at high risk for later mental disorders.
A New Meal Absorption Model for Artificial Pancreas Systems
Authors: Diamond Travis , Cameron Faye , Bequette B. Wayne 
Published: March 2021

Background: Artificial pancreas (AP) systems reduce the treatment burden of Type 1 Diabetes by automatically regulating blood glucose (BG) levels. While many disturbances stand in the way of fully closed-loop (automated) control, unannounced meals remain the greatest challenge. Furthermore, different types of meals can have significantly different glucose responses, further increasing the uncertainty surrounding the meal. Methods: Effective attenuation of a meal requires quick and accurate insulin delivery because of slow insulin action relative to meal effects on BG. The proposed Variable Hump (VH) model adapts to meals of varying compositions by inferring both meal size and shape. To appropriately address the uncertainty of meal size, the model divides meal absorption into two disjoint regions: a region with coarse meal size predictions followed by a fine-grain region where predictions are fine-tuned by adapting to the meal shape. Results: Using gold-standard triple tracer meal data, the proposed VH model is compared to three simpler second-order response models. The proposed VH model increased model fit capacity by 22% and prediction accuracy by 12% relative to the next best models. A 47% increase in the accuracy of uncertainty predictions was also found. In a simple control scenario, the controller governed by the proposed VH model provided insulin just as fast or faster than the controller governed by the other models in four out of the six meals. While the controllers governed by the other models all delivered at least a 25% excess of insulin at their worst, the VH model controller only delivered 9% excess at its worst. Conclusions: The VH Model performed best in accuracy metrics and succeeded over the other models in providing insulin quickly and accurately in a simple implementation. Use in an AP system may improve prediction accuracy and lead to better control around mealtimes.
Corporate Social Responsibility Measures: A Brief Review
Authors: Shukla Akanksha , Geetika  , Shukla Nimesh 
Published: March 2021

Studies are being conducted to measure the impact of corporate social responsibility (CSR) on different dimensions of performance of the firm. Therefore, it becomes imperative to measure CSR activities undertaken by the firms. The measures used to assess CSR range from quantitative to perceptual; hence, the study proposes to present an analytical profile of various methods used to measure CSR. The article reviews studies that span over the time period from the 1980s to 2016 to determine the relationship between CSR and performance of the firm. Various measures of CSR used in studies are broadly categorized as rating-based measures, financial measures, perceptual measures, and disclosure-based measures. The study revealed that perceptual and rating-based measures are the most commonly used measures. Also, it has been found that the operationalization of CSR using these two measures has been used in the studies that are conducted mainly in developed countries. However, disclosure of CSR and expenditure made on social responsibility can be more comprehensive measures as they are more objective in nature and are not influenced by the biases. Also, expenditure on CSR can be a useful measure while conducting a cost-benefit analysis of CSR activities performed by the organizations.
Percutaneous spinal endoscopy with unilateral interlaminar approach to perform bilateral decompression for central lumbar spinal stenosis: radiographic and clinical assessment
Authors: Xue Jingbo , Chen Haoxiang , Zhu Bin , Li Xuelin , Ouyang Zhihua , Li Shan , Xu Zhun , Xie Yong , Yan Yiguo 
Published: March 2021

Abstract
Background
Recently, a percutaneous spinal endoscopy unilateral posterior interlaminar approach to perform bilateral decompression has been proposed for use in treatment of lumbar spinal stenosis, As a development and supplement to traditional surgery, its advantages regarding therapeutic effects and prognosis, such as minor soft tissue damage, little intraoperative blood loss, and a quick return to daily life. However, there are few analyses of this surgery with a follow-up of more than 1 year,we conducted this study in order to quantitatively investigate radiographic and clinical efficacies of this surgery for central lumbar spinal stenosis.

Materials and methods
Forty-six patients with central lumbar spinal stenosis were enrolled from January 2017 to July 2018. The visual analog scale (VAS) for back pain and leg pain, Oswestry disability index (ODI), modified MacNab criteria were used to evaluate clinical efficiency at preoperative and postoperative time points. The intervertebral height index (IHI), cross-sectional area of the spinal canal (CSAC), calibrated disc signal (CDS) and spinal stability were examined to assess radiographic decompression efficiency via magnetic resonance imaging and X-ray at preoperative and postoperative time points.

Results
The VAS score for lower back pain and leg pain improved from 7.50 ± 0.78 to 1.70 ± 0.66 and from 7.30 ± 0.79 to 1.74 ± 0.68, respectively, and the ODI improved from 72.35 ± 8.15 to 16.15 ± 4.51. In terms of modified MacNab criteria, 91.3% of the patients achieved good or excellent outcomes. Furthermore, significant changes after surgery were observed for the percentage of CSAC, increasing from 125.3 ± 53.9 to 201.4 ± 78 mm2; however, no significant differences were observed for the remaining measurement indicators.

Conclusions
The clinical and radiographic efficacies of this surgery for central lumbar spinal stenosis were good in short-term follow-up, and this surgery did not cause meaningful changes in IHI, CDS, and spine stability in short-term follow-up. The effect of long-term follow-up needs further investigation.
Mining of two novel aldehyde dehydrogenases (DHY-SC-VUT5 and DHY-G-VUT7) from metagenome of hydrocarbon contaminated soils
Authors: Baburam Cindy , Feto Naser Aliye 
Published: March 2021

Abstract
Background
Aldehyde dehydrogenases are vital for aerobic hydrocarbon degradation and is involved in the last step of catalysing the oxidation of aldehydes to carboxylic acids. With the global increase in hydrocarbon pollution of different environments, these enzymes have the potential to be used in enzymatic bioremediation applications.

Results
Fifteen fosmid clones with hydrocarbon degrading potential were functionally screened to identify dehydrogenase enzymes. Accordingly, the fosmid insert of the positive clones were sequenced using PacBio next generation sequencing platform and de novo assembled using CLC Genomic Work Bench. The 1233 bp long open reading frame (ORF) for DHY-SC-VUT5 was found to share a protein sequence similarity of 97.7% to short-chain dehydrogenase from E. coli. The 1470 bp long ORF for DHY-G-VUT7 was found to share a protein sequence similarity of 23.9% to glycine dehydrogenase (decarboxylating) (EC 1.4.4.2) from Caulobacter vibrioides (strain NA1000 / CB15N) (Caulobacter crescentus). The in silico analyses and blast against UNIPROT protein database with the stated similarity show that the two dehydrogenases are novel. Biochemical characterization revealed, that the highest relative activity was observed at substrate concentrations of 150 mM and 50 mM for DHY-SC-VUT5 and DHY-G-VUT7, respectively. The Km values were found to be 13.77 mM with a Vmax of 0.009135 μmol.min− 1 and 2.832 mM with a Vmax of 0.005886 μmol.min− 1 for DHY-SC-VUT5 and DHY-G-VUT7, respectively. Thus, a potent and efficient enzyme for alkyl aldehyde conversion to carboxylic acid.

Conclusion
The microorganisms overexpressing the novel aldehyde dehydrogenases could be used to make up microbial cocktails for biodegradation of alkanes. Moreover, since the discovered enzymes are novel it would be interesting to solve their structures by crystallography and explore the downstream applications.
Factors associated with delay in seeking treatment among women with pelvic organ prolapse at selected general and referral hospitals of Southern Ethiopia, 2020
Authors: Borsamo Asfaw , Oumer Mohammed , Asmare Yared , Worku Ayanaw 
Published: March 2021

AbstractBackgroundPelvic organ prolapse (POP) is the descent of the vaginal wall, cervix, uterus, bladder, and rectum downward into the vaginal canal. Its prevalence is higher among women in developing countries because women are more prone to risk factors. In Ethiopia, women with prolapse seek treatments at advanced stages of prolapse; hence, surgical management has been widely practicing. Therefore, it was found to be very important to conduct research that assesses factors hindering early treatments in Southern Ethiopia. This study aimed to find out factors associated with the delay in seeking treatment of pelvic organ prolapse among patients at selected general and referral hospitals of Southern Ethiopia.MethodsCross-sectional study design was employed in 123 participants of seven randomly selected General and Referral Hospitals of Southern Ethiopia from February 01 to April 30, 2020, by using a structured questionnaire. Pre-trained two midwives in each center were deployed to collect data. Physicians performed diagnosis and physical examination. Data were entered and coded using EPI INFO version 7 and exported into SPSS version 25 for analysis. Bivariate and multivariable logistic regression analyses were performed. The goodness of fit was assessed by using the Hosmer and Lemeshow goodness test.ResultsIn this study, out of 123 clinically diagnosed POP cases, nearly half of them were stage III, and over one-third were stage IV. Therefore, 84.6% (104 participants) of the respondents were delayed for the treatment of POP. The mean length of delay for POP treatments was 36.41 ± 3.95 months. After adjusting for covariates, lack of supports [AOR (Adjusted Odds Ratio) = 5.2 (95% CI 1.4–19.5)], low-income [AOR = 5.8 (95% CI 1.1–19.66)], and fear of social stigma [AOR = 4.7 (95% CI 1.2–18.59)] were significant factors for delayed treatments.ConclusionsMost of the POP patients were delayed for POP treatments. Factors like lack of support, low-income, and fear of losing social value/stigma were associated with treatment delay. Screening for the POP cases, educating (making awareness) the community about this devastating disease to facilitate early treatment and to avoid social stigma, and raising access to treatment by making the nearby hospitals equipped with facilities to treat POP are recommended.
Willingness to volunteer and readiness to practice of undergraduate medical students during the COVID-19 pandemic: a cross-sectional survey in Indonesia
Authors: Lazarus Gilbert , Findyartini Ardi , Putera Azis Muhammad , Gamalliel Nico , Nugraha David , Adli Imam , Phowira Jason , Azzahra Lyanna , Ariffandi Bagas , Widyahening Indah Suci 
Published: March 2021

Abstract
Background
The question to involve or restrict medical students’ involvement in the coronavirus disease 2019 (COVID-19) pandemic response remains contentious. As their state of preparation and perceptions in volunteering during this pandemic have yet to be investigated, this study aims to evaluate Indonesian medical students’ willingness to volunteer and readiness to practice during the COVID-19 pandemic.

Methods
A web-based survey was conducted among undergraduate medical students throughout Indonesia. Socio-demographic and social interaction information, in addition to willingness to volunteer and readiness to practice, were obtained using a self-reported questionnaire. The significance level was set at 5%.

Results
Among 4870 participants, 2374 (48.7%) expressed their willingness to volunteer, while only 906 (18.6%) had adequate readiness to practice. Male students, students with prior volunteering experience in health or non-health sectors, and students from public universities or living in Central Indonesia (vs Java) had higher scores of willingness and readiness to volunteer. Students from Sumatra also had better preparedness (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.15–2.12, p = 0.004), while the opposite occurred for students from Eastern Indonesia (OR 0.63, 95% CI: 0.44–0.89, p = 0.002)–when compared to students from Java. In addition, compared to students with high family income, students from lower-middle income families were less willing to volunteer (OR 0.76, 95% CI: 0.59–0.98, p = 0.034), though those with low family income had better readiness (OR 1.51, 95% CI: 1.10–2.08, p = 0.011). Shortage of medical personnel, sense of duty, and solicitation by stakeholders were the main reasons increasing the students’ willingness to volunteer; whereas contrarily fear for own’s health, absence of a cure, and fear of harming patients were the primary factors diminishing their willingness to volunteer.

Conclusion
Our findings indicated that many Indonesian medical students are willing to volunteer, yet only few of them were ready to practice, indicating that further preparations are required to maximize their potentials and minimize their exposure to hazards. We suggest that their potentials as a firm support system during the pandemic should not be overlooked, and that the integration of relevant courses to the medical curricula are imperative to prepare for future public health emergencies.
Disclosure of clinically actionable genetic variants to thoracic aortic dissection biobank participants
Authors: Beil Adelyn , Hornsby Whitney , Uhlmann Wendy R. , Aatre Rajani , Arscott Patricia , Wolford Brooke , Eagle Kim A. , Yang Bo , McNamara Jennifer , Willer Cristen , Roberts J. Scott 
Published: March 2021

AbstractBackgroundDisclosure of pathogenic variants to thoracic aortic dissection biobank participants was implemented. The impact and costs, including confirmatory genetic testing in a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory, were evaluated.MethodsWe exome sequenced 240 cases with thoracic aortic dissection and 258 controls, then examined 11 aortopathy genes. Pathogenic variants in 6 aortopathy genes (COL3A1,FBN1,LOX,PRKG1,SMAD3, andTGFBR2)were identified in 26 participants, representing 10.8% of the cohort (26/240). A second research sample was used to validate the initial findings. Mailed letters to participants disclosed that a potentially disease causing DNA alteration had been identified (neither the gene nor variant was disclosed). Participants were offered clinical genetic counseling and confirmatory genetic testing in a CLIA laboratory.ResultsExcluding 6 participants who were deceased or lost to follow-up, 20 participants received the disclosure letter, 10 of whom proceeded with genetic counseling, confirmatory genetic testing, and enrolled in a survey study. Participants reported satisfaction with the letter (4.2 ± 0.7) and genetic counseling (4.4 ± 0.4; [out of 5, respectively]). The psychosocial impact was characterized by low decisional regret (11.5 ± 11.6) and distress (16.0 ± 4.2, [out of 100, respectively]). The average cost for 26 participants was $400, including validation and sending letters. The average cost for those who received genetic counseling and CLIA laboratory confirmation was $605.ConclusionsParticipants were satisfied with the return of clinically significant biobank genetic results and CLIA laboratory testing; however, the process required significant time and resources. These findings illustrate the trade-offs involved for researchers considering returning research genetic results.
Differential ketogenic diet-induced shift in CSF lipid/carbohydrate metabolome of pediatric epilepsy patients with optimal vs. no anticonvulsant response: a pilot study
Authors: Masino Susan A. , Ruskin David N. , Freedgood Natalie R. , Lindefeldt Marie , Dahlin Maria 
Published: March 2021

Abstract
Background
The low carbohydrate, high fat ketogenic diet can be an effective anticonvulsant treatment in some pediatric patients with pharmacoresistant epilepsy. Its mechanism(s) of action, however, remain uncertain. Direct sampling of cerebrospinal fluid before and during metabolic therapy may reveal key changes associated with differential clinical outcomes. We characterized the relationship between seizure responsiveness and changes in lipid and carbohydrate metabolites.

Methods
We performed metabolomic analysis of cerebrospinal fluid samples taken before and during ketogenic diet treatment in patients with optimal response (100% seizure remission) and patients with no response (no seizure improvement) to search for differential diet effects in hallmark metabolic compounds in these two groups. Optimal responders and non-responders were similar in age range and included males and females. Seizure types and the etiologies or syndromes of epilepsy varied but did not appear to differ systematically between responders and non-responders.

Results
Analysis showed a strong effect of ketogenic diet treatment on the cerebrospinal fluid metabolome. Longitudinal and between-subjects analyses revealed that many lipids and carbohydrates were changed significantly by ketogenic diet, with changes typically being of larger magnitude in responders. Notably, responders had more robust changes in glucose and the ketone bodies β-hydroxybutyrate and acetoacetate than non-responders; conversely, non-responders had significant increases in fructose and sorbose, which did not occur in responders.

Conclusions
The data suggest that a differential and stronger metabolic response to the ketogenic diet may predict a better anticonvulsant response, and such variability is likely due to inherent biological factors of individual patients. Strategies to boost the metabolic response may be beneficial.
Sialolithiasis: retrospective analysis of the effect of an escalating treatment algorithm on patient-perceived health-related quality of life
Authors: Lommen Julian , Schorn Lara , Roth Benjamin , Naujoks Christian , Handschel Jörg , Holtmann Henrik , Kübler Norbert R. , Sproll Christoph 
Published: March 2021

Abstract
Background
Gland preserving techniques in the treatment of sialolithiasis have continuously replaced radical surgery. The aim of this study was to evaluate a multimodal treatment algorithm in the therapy of sialolithiasis and assess improvement of HRQoL perceived by patients.

Methods
Patients with sialolithiasis were treated by a multimodal treatment algorithm based on multiplicity of stones, stone size, affected gland, and stone position. The therapeutic spectrum ranged from conservative measures, extracorporeal shockwave lithotripsy, interventional sialendoscopy, combined endoscopic-surgical procedures to surgical gland removal as ultima ratio. Outcomes were evaluated by surgeons by means of the electronic patient record and by patients themselves using a standardized questionnaire.

Results
87 patients treated for sialolithiasis were comprised in this study. The submandibular gland (SMG) was affected in 58.6% and the parotid gland (PG) in 41.4% of cases. Mean patient age was 41.67 years for SMG and 48.91 years for PG. In over 80% of cases sialolithiasis was associated with classic meal-related pain and swelling. Type and intensity of symptomatic sialolithiasis were not dependent on patient age or gender, nor could a relation between the affected gland and the occurrence of symptoms be demonstrated. Overall, 86.2% of cases were reported as cured using the multimodal step-by-step treatment algorithm. Resection of the affected gland could be dispensed in 98.9% of cases. According to patients pain could be reduced in 94.3% of cases.

Conclusions
The analyzed treatment algorithm of increasing invasiveness is a favorable and effective tool to successfully treat sialolithiasis in > 86% of cases. For the first time, the present study shows that patient-perceived improvement of HRQoL due to ease of symptoms has an even higher success rate of > 94%.