bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Selenium Intake and Development of Depression in Brazilian Farmers
Authors: Ferreira de Almeida Tatiana Lourençoni , Petarli Glenda Blaser , Cattafesta Monica , Zandonade Eliana , Bezerra Olivia Maria de Paula Alves , Tristão Kelly Guimães , Salaroli Luciane Bresciani 
Published: May 2021

Introduction:Depression and deficiency in the consumption of micronutrients are a public health problem, especially in the rural population. The deficiency in selenium consumption affects mental health, contributing to the development of major depressive disorders. Thus, this study aimed to evaluate selenium intake and its association with depressive symptoms in farmers in southeastern Brazil.Material and Methods:Epidemiological, cross-sectional, and analytical study with 736 farmers aged between 18 and 59. A semistructured questionnaire was used to collect sociodemographic, lifestyle and clinical condition data. For evaluation of food intake, three 24-h recalls were applied, and for identification of depressive episodes, the Mini-International Neuropsychiatric Interview was conducted.Results:A total of 16.1% (n= 119) of the farmers presented symptoms of major depressive episodes, 5.8% (n= 43) presented symptoms of current depressive episodes, and 10.3% (n= 76) presented symptoms of recurrent major depressive episodes. Sociodemographic factors associated with depression were gender (p&lt; 0.001), marital status (p= 0.004), and socioeconomic class (p= 0.015). The consumption of high doses of selenium was associated with a reduction of ~54% in the chances of occurrence of depression (OR = 0.461; 95% CI = 0.236–0.901).Conclusion:High selenium intake is associated with a lower prevalence of depression even after adjusting for sociodemographic variables, lifestyle, and pesticide intoxication. The findings of this study contributed to highlighting the high prevalence of depression in rural areas and its relationship with selenium intake.
Learning Curve for Lymph Node Dissection Around the Recurrent Laryngeal Nerve in McKeown Minimally Invasive Esophagectomy
Authors: Zhu Zi-Yi , Luo Rao-Jun , He Zheng-Fu , Xu Yong , Xu Shao-Hua , Zhang Qiang 
Published: May 2021

BackgroundCompared to open esophagectomy (OE), minimally invasive esophagectomy (MIE) is associated with lower morbidity and mortality. However, lymph node (LN) dissection around the recurrent laryngeal nerve (RLN) is still an important factor that affects the length of the learning curve of MIE. This study aims to evaluate the surgical outcomes of the first nearly 5-year period and explore the learning curve for LN dissection around the RLN in McKeown MIE by a new single surgical team.MethodsA total of 285 consecutive patients who underwent McKeown MIE between March 2016 and September 2020 were included at our institution. According to the cumulative sum (CUSUM) analysis of LN dissection around the RLN, the patients were divided into three groups: exploration period, adjustment period, and stable period. We assessed the impact of surgical proficiency on postoperative outcomes and explored the learning curve for LN dissection around the RLN in McKeown MIE.ResultsThe CUSUM graph showed that a point of upward inflection for LN dissection around the RLN was observed in 151 cases. After 151 cases, LNs around the right and left RLNs were dissected thoroughly compared to the exploration and adjustment period (P = 0.010 and P = 0.012, respectively), and the postoperative incidence of hoarseness significantly decreased from 11.1 to 1.5% (P&lt;0.001).ConclusionsOur study results revealed that not only are the LN, around the RLN, sufficiently dissected but also the incidence of hoarseness significantly decreased in the stable phase. Consequently, the learning curve length was approximately 151 cases for LN dissection around the RLN in McKeown MIE.
Factors Influencing Mood Disorders and Health Related Quality of Life in Adults With Glioma: A Longitudinal Study
Authors: Leonetti Antonella , Puglisi Guglielmo , Rossi Marco , Viganò Luca , Conti Nibali Marco , Gay Lorenzo , Sciortino Tommaso , Howells Henrietta , Fornia Luca , Riva Marco , Cerri Gabriella , Bello Lorenzo 
Published: May 2021

ObjectiveAt present, it is not clear whether Mood Disorders (MD) and poor Health Related Quality of Life (HRQoL) in the glioma population correlate with features of the tumor, or rather with secondary symptoms associated with treatment. The aim of this study was to assess the prevalence of MD and decline in HRQoL in glioma patients, and to determine the main factors associated with these two variables.Methods80 patients affected by lower-grade gliomas (LGGs) and 65 affected by high-grade gliomas (HGGs) were evaluated, from admission up to 12 months after surgery, for MD, HRQoL, clinical characteristics, and cognitive functions. Independent factors associated with MD and low HRQoL were identified by using bivariate analysis.ResultsData showed that prevalence of low HRQoL was comparable in both groups during all the time points assessed (pre, 1, 3, 6 and 12 months after surgery). In contrast at 6 months following surgery, HGGs showed a higher prevalence of MD compared to LGGs;. Bivariate analysis revealed that factors associated with MD and HRQoL in LGGs and HGGs were different over the course of the disease. In LGGs, from the pre-operative period to one year post surgery, MD and low HRQOL were associated with the occurrence of cognitive deficits and, from the third month after surgery onward, they were also associated with the effect exerted by adjuvant treatments. In HGGs, MD were associated with cognitive deficits at 3 and 6 months after surgery, along with older age (65-75 years); HRQoL, in its Physical component in particular, was associated with older age only from 6 months after surgery.ConclusionFactors associated with MD and low HRQoL were different in LGGs and HGGs over the course of the disease. In LGGs the effect of adjuvant treatments was prominent in determining the prevalence of both MD and poor HRQoL from the third month after surgery onward. In HGGs, MD and HRQoL were associated with age, at 3 and 6 months after surgery. In both, the occurrence of cognitive deficits was significantly associated with MD.
Melanotic Neuroectodermal Tumor of Infancy: A Clinicopathological and BRAF V600E Mutation Study of 11 Cases
Authors: Xia Rong-Hui , Zhang Chun-Ye , Wang Li-Zhen , Hu Yu-Hua , Sun Jing-Jing , Tian Zhen , Li Jiang 
Published: May 2021

PurposeTo investigate the clinicopathological features and BRAF V600E mutation of melanotic neuroectodermal tumor of infancy (MNTI).Materials and MethodsEleven cases of MNTI diagnosed at the Department of Oral Pathology were collected. Clinicopathological characteristics were obtained from the medical records. Immunostaining was performed by immunohistochemistry (IHC). Amplification-Refractory Mutation System-qPCR (ARMS-qPCR) and Sanger Sequencing were used to detect BRAF V600E mutation.ResultsOf the 11 cases, 3 cases were female and 8 cases were male. The mean age of the first symptoms was 3.2 months (range: 1 to 6 months). Ten cases (90.9%) located in maxilla but only one (9.1%) in mandible. Most of the cases demonstrated well-defined mass with lytic bone destruction and tooth germ affecting radiologically. Histologically, MNTI was consisted of large polygonal melanin-producing epithelioid cells and small round neuroblast-like cells which arranged in irregular alveolar, tubuloglandular and fissured architecture. The epithelioid cells expressed Vim, Pan-CK, NSE and HMB45, while the smalls cells expressed Syn, NSE and scattered Vim. Most cases showed low Ki-67 index (range: &lt;1% to 50%). None of the MNTI cases showed BRAF V600E mutation. Most cases were treated with enucleation (45.4%) or curettage (36.4%). Among the 11 cases, 6 cases had follow-up information, and 2 cases had recurrence lesions after surgery.ConclusionMNTI, an extremely rare tumor, mainly affects male infants with strong preference for maxilla. Distinct histopathological features and immunohistochemical profile are helpful to distinguish from other melanin-containing tumors and small round cell tumors. No BRAF V600E mutation in MNTI is detected in the present study and needs further investigations. The factors that contribute to the local recurrence of MNTI are controversial, but the close follow-up for the patients is recommended.
Treatments Outcomes in Histological Variants and Non-Urothelial Bladder Cancer: Results of a Multicenter Retrospective Study
Authors: Epaillard Nicolas , Parent Pauline , Loriot Yohann , Lavaud Pernelle , Vera-Cea E-B. , Martinez-Chanza Nieves , Rodriguez-Vida Alejo , Dumont Clement , Lozano Rebeca , Llácer Casilda , Ratta Raffaele , Oudard Stephane , Thibault Constance , Auclin Edouard 
Published: May 2021

IntroductionLess than one-third of bladder cancers are non-pure urothelial carcinoma [with variant histological (VH) or non-urothelial carcinoma (non-UC)] for which no treatment guidelines are available. We aim to evaluate the efficacy of systemic treatments in VH or non-UC bladder cancers.MaterialsMulticenter retrospective analysis of patients treated for advanced or metastatic VH or non-UC bladder cancers. Primary endpoint was overall response rate (ORR) according to treatment line, regimen and histology subtype. Secondary endpoints were progression-free survival (PFS) and overall survival (OS).ResultsBetween 2005 and 2020, 46 patients from seven centers were included. The median age was 66 years (58.75; 74.75), 65.2% were male and 67.2% presented VH. At first line, the ORR for the entire population was 54.4% and median OS was 21.6 months (95% confidence interval [CI]: 14.2-38.6). The ORR of the 37 patients treated with chemotherapy at first line was 62.2% with median PFS and OS of 7.3 (95% CI: 4.5-8.6) and 21.6 months (95% CI: 14.2-35.7), respectively. Dose dense MVAC and platinum doublet chemotherapy had the highest ORR (71.4% and 65.2%). The 9 patients treated with immunotherapy at first line had an ORR of 22.2%, a median PFS of 3.3 months (95% CI:2.3-NR) and the median OS was not reached (95% CI:13.8-NR). Response to treatment varied depending on the histological sub-types and on the treatment type.ConclusionChemotherapy and immunotherapy have shown to be effective in VH or non-UC cancers, a rare histological subtype for which we currently have very little data in the literature.
Asphyxia and Neonatal Respiratory Distress Syndrome Are Independent Predictors of the Non-response to Inhaled Nitric Oxide in the Newborns With PPHN
Authors: Zhao Yuwei , Liang Lei , Liu Guanghui , Zheng Hong , Dai Liying , Wang Yan , Wang Lei , Sheng Weiting 
Published: May 2021

Aim: Not all the neonates respond with improvement in oxygenation following inhaled nitric oxide treatment (iNO) treatment. The aim of this study was to assess the independent risk factors associated with non-response to iNO during the 2 weeks of postnatal treatment in neonates diagnosed with persistent pulmonary hypertension (PPHN).Materials and Methods: This retrospective cohort study included all newborns with PPHN who received iNO treatment for more than 24 h. Demographic, obstetric, perinatal data and clinical complications were extracted from the hospitalization records. Subjects were divided into two groups according to their response to iNO inspiration during the first 24 h of iNO treatment. No response was defined as an increase in SpO2 &lt; 5% or the inability to sustain saturation levels in the first 24 h of iNO treatment. For descriptive statistics, χ2 and t-test analysis were used to compare categorical and continuous variables between the two groups. To evaluate independent risk factors of non-responsiveness to iNO treatment, binary logistic regression analysis were performed.Results: A total of 75 newborns were included in the study. Sixty-two cases were in the responders group, and 13 cases were in the non-responders group. Univariate analysis showed that asphyxia, neonatal respiratory distress syndrome (NRDS), pulmonary surfactant administration, meconium aspiration syndrome (MAS), the severity of pulmonary hypertension (PH), and high-frequency oscillatory ventilation (HFOV) therapy were the high-risk factors affecting the response to iNO treatment in the newborns with PPHN. The binary logistic regression analysis indicated that asphyxia and NRDS incidence were independent predictors of non-responsiveness to iNO treatment [asphyxia: OR 4.193, 95% CI 1.104–15.927, P = 0.035; NRDS: OR 0.154, 95% CI 0.036–0.647, P = 0.011]. The patients in the non-responders group had shorter iNO inspiration followed by MV duration, supplemental oxygen and hospital stay, and higher mortality. There were no significant differences in IVH, PVL, and BPD between two groups.Conclusion: In the newborns with PPHN, asphyxia and NRDS resulted as the independent risk factors of non-responsiveness to iNO therapy. Asphyxia in the newborns with PPHN is detrimental to the response to iNO treatment, while NRDS is beneficial.
Efficacy of Mudan Granule (Combined With Methylcobalamin) on Type 2 Diabetic Peripheral Neuropathy: Study Protocol for a Double-Blind, Randomized, Placebo-Controlled, Parallel-Arm, Multi-Center Trial
Authors: Zhang Yuehong , Jin De , Duan Yingying , Hao Rui , Chen Keyu , Yu Tongyue , Lian Fengmei , Tong Xiaolin 
Published: May 2021

Background: Diabetic peripheral neuropathy (DPN) characterized by nerve damage is a common and disabling chronic microvascular complication in patients with type 2 diabetic mellitus (T2DM), affecting at least half of patients diagnosed with T2DM. Unfortunately, the current treatment for DPN is not ideal. Traditional Chinese medicine (TCM), with a unique theoretical system, has made outstanding contributions in the treatment of T2DM and related complications. Mudan granule, a Chinese patent medicine, has been previously validated that could ameliorate the symptoms, promote nerve tissue repair, increase nerve conduction velocity (NCV) in patients with DPN. However, the previous studies are of variable quality, which limits the clinical application of Mudan granule. Therefore, we designed a double-blind, randomized, placebo-controlled, parallel-arm, multi-center trial to estimate the safety and efficacy of Mudan granule in conjunction with methylcobalamin in individuals suffering from type 2 diabetic peripheral neuropathy.Methods: This work is conducted as a 14-center, double-blind, randomized, placebo-controlled, parallel-arm trial. In all, 402 subjects (aged 30–70 years) will be recruited and randomized in a 1:1 ratio to an intervention group (n = 201; Mudan granule + methylcobalamin) and a control group (n = 201; placebo + methylcobalamin). Treatment is administered in 24 weeks cycles without any treatment interruption between cycles. Michigan Diabetic Neuropathy Score (MDNS) as the primary outcome will be evaluated at baseline, 12 weeks during the intervention period, and after 24 weeks of the intervention. Adverse events and safety assessments will be also documented. The analysis of all data will be carried out based on a predefined statistical analysis plan.Discussion: The outcomes from this study will offer important evidence regarding the safety and efficacy that Mudan granule can be used as an alternative and complementary therapeutic intervention in patients with type 2 diabetic peripheral neuropathy.Clinical trial registration: Registered at https://clinicaltrials.gov/. Trial registration number: NCT04711980. Registered January 2021.
Development and Internal Validation of a Novel Model to Identify Inflammatory Biomarkers of a Response to Escitalopram in Patients With Major Depressive Disorder
Authors: Zhou Jingjing , Zhou Jia , Sun Zuoli , Feng Lei , Zhu Xuequan , Yang Jian , Wang Gang 
Published: May 2021

Objective: The aim of our study was to identify immune- and inflammation-related factors with clinical utility to predict the clinical efficacy of treatment for depression.Study Design: This was a follow-up study. Participants who met the entry criteria were administered with escitalopram (5–10 mg/day) as an initial treatment. Self-evaluation and observer valuations were arranged at the end of weeks 0, 4, 8, and 12, with blood samples collected at baseline and during weeks 2 and 12. Multivariable logistic regression analysis was then carried out by incorporating three cytokines selected by the Least Absolute Shrinkage and Selection Operator (LASSO) regression model. Internal validation was estimated using the bootstrap method with 1,000 repetitions.Results: A total of 85 patients with Major Depressive Disorder (MDD), including 62 responders and 23 non-responders, were analyzed. Monocyte chemoattractant protein-1 (MCP-1), vascular cell adhesion molecule-1 (VCAM-1), and lipocalin-2 were selected by the LASSO regression model. The area under the curve (AUC) from the logistic model was 0.811 and was confirmed as 0.7887 following bootstrapping validation.Conclusions: We established and validated a good prediction model to facilitate the individualized prediction of escitalopram treatment for MDD and created a personalized approach to treatment for patients with depression.
Family Dynamics and Grandparents' Anxiety and Depression in Intergenerational Rearing Families: A Correlational Study
Authors: Yang Chun-Yan , Xu Hong-Jiao , Liu Shan-Shan , Wu Yue-Jing , Long Yun , Liu Hong-Sheng , Chen Yao-Pian , Li Xia 
Published: May 2021

Background: In China, intergenerational rearing is a ubiquitous phenomenon based on unique national conditions. This study aimed to explore family dynamics in intergenerational rearing families as well as their correlation with older household members' anxiety and depression.Methods: The elderly from intergenerational (n = 141) and non-intergenerational rearing families (n = 266) were investigated using the following scales: the general information questionnaire, Self-Rating Scale of Systemic Family Dynamics, Geriatric Depression Scale, and Self-Rating Anxiety Scale.Results: Scores from the four dimensions (family atmosphere, system logic, individuation, and the concept of disease) of the structure of family dynamics were computed. The comparison of these dimensions scores and the total scores of grandparents' anxiety and depression for the two groups were not statistically significant (p &gt; 0.05). In Pearson's correlation analysis, no significant correlation between the family atmosphere dimension and the total score of the grandparents' depression and anxiety scales was observed. The system logic aspect was negatively correlated with depression and anxiety scale scores. The individual dimension was positively correlated with the anxiety scale scores. The disease concept dimension was positively correlated with depression and anxiety scale scores. Hence, the results were statistically significant.Conclusion: There were no significant differences in terms of family dynamics and risk of anxiety and depression among grandparents between the two family types. The system logic, individuation, and disease concept dimensions were correlated with their anxiety and depression.
Factors Influencing Mental Health Among Chinese Medical and Non-medical Students in the Early Stage of the COVID-19 Pandemic
Authors: Xiong Peng , Ming Wai-kit , Zhang Caiyun , Bai Jian , Luo Chaohua , Cao Wenyuan , Zhang Fan , Tao Qian 
Published: May 2021

Background: The 2019 coronavirus disease (COVID-19) pandemic is a public health emergency of international concern. This study aimed to assess the psychological outcomes and their influencing factors among medical and non-medical University students during the COVID-19 pandemic in China.Methods: A cross-sectional online survey using structured questionnaires was conducted from February 20 to March 20, 2020. Psychological outcomes were assessed according to the Depression, Anxiety, and Stress Scale (DASS-21). Influencing factors were assessed by COVID-19 knowledge, mindful coping scale, and sense of control scale.Results: Our sample is comprised of 563 University students (male = 172, mean age = 21.52). Among them, 382 are medical students. Among the participants, 12.26, 18.47, and 8.53% have moderate to severe levels of depression, anxiety, and stress symptoms, respectively. Compared with the non-medical students, the medical students had a higher knowledge level of COVID-19, a higher sense of awareness, and fewer mental health symptoms. After controlling the covariance, perceived constraints of sense of control were negatively associated with depression, anxiety, and stress among both medical and non-medical students. Prevention of negative emotions by mindful coping was negatively associated with depression and anxiety among non-medical students. Knowledge of COVID-19 is not associated with mental distress among medical and non-medical students.Conclusions: During the COVID-19 pandemic in China, the mental health of University students was affected. Our findings suggested that a sense of control is a protective factor for both medical and non-medical students, while mindful coping is a protective factor for only non-medical students.
Short Report: Using Targeted Urine Metabolomics to Distinguish Between Manganese Exposed and Unexposed Workers in a Small Occupational Cohort
Authors: Carter Kayla A. , Simpson Christopher D. , Raftery Daniel , Baker Marissa G. 
Published: May 2021

Objectives: Despite the widespread use of manganese (Mn) in industrial settings and its association with adverse neurological outcomes, a validated and reliable biomarker for Mn exposure is still elusive. Here, we utilize targeted metabolomics to investigate metabolic differences between Mn-exposed and -unexposed workers, which could inform a putative biomarker for Mn and lead to increased understanding of Mn toxicity.Methods: End of shift spot urine samples collected from Mn exposed (n = 17) and unexposed (n = 15) workers underwent a targeted assay of 362 metabolites using LC-MS/MS; 224 were quantified and retained for analysis. Differences in metabolite abundances between exposed and unexposed workers were tested with a Benjamini-Hochberg adjusted Wilcoxon Rank-Sum test. We explored perturbed pathways related to exposure using a pathway analysis.Results: Seven metabolites were significantly differentially abundant between exposed and unexposed workers (FDR ≤ 0.1), including n-isobutyrylglycine, cholic acid, anserine, beta-alanine, methionine, n-isovalerylglycine, and threonine. Three pathways were significantly perturbed in exposed workers and had an impact score &gt;0.5: beta-alanine metabolism, histidine metabolism, and glycine, serine, and threonine metabolism.Conclusion: This is one of few studies utilizing targeted metabolomics to explore differences between Mn-exposed and -unexposed workers. Metabolite and pathway analysis showed amino acid metabolism was perturbed in these Mn-exposed workers. Amino acids have also been shown to be perturbed in other occupational cohorts exposed to Mn. Additional research is needed to characterize the biological importance of amino acids in the Mn exposure-disease continuum, and to determine how to appropriately utilize and interpret metabolomics data collected from occupational cohorts.