bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of C-terminal p7 (NC)-p6 Gag genetic variants among HIV-1 non-B subtypes in a subset of Cameroonian patients
Authors: Teto Georges , Nka Alex Durand , Fokam Joseph , Bouba Yagai , Takou Désiré , Fabeni Lavinia , Carioti Luca , Armenia Daniele , Semengue Ezéchiel Ngoufack Jagni , Dambaya Béatrice , Sosso Samuel Martin , Colizzi Vittorio , Perno Carlo-Federico , Ceccherini-Silberstein Francesca , Santoro Maria Mercedes , Ndjolo Alexis 
Published: October 2021

Abstract
Response to ritonavir-boosted-protease inhibitors (PI/r)-based regimen is associated with some Gag mutations among HIV-1 B-clade. There is limited data on Gag variants and their covariation with mutations in protease among HIV-1 non-B-clades at PI/r-based treatment failure. Thus, we characterized Gag variants present in isolates from HIV-1 infected individuals treated to a PI/r-regimen (n=143) and compared them to those obtained from individuals not treated to PI/r (ART-naïve [n=101] or RTI-treated [n=118]). The most frequent HIV-1 subtypes were CRF02_AG (54.69%), A (13.53%), D (6.35%) and G (4.69%). Eighteen Gag variants (distributed in three groups) showed a significantly higher prevalence in PI/r-treated isolates compared to ART-naïve (p<0.05): Group 1 (prevalence <1% in drug-naïve): L449F, D480N, L483Q, Y484P, T487V; group 2 (prevalence 1%-5% in drug-naïve): S462L, I479G, I479K, D480E; group 3 (prevalence ≥5% in drug-naïve): P453L, E460A, R464G, S465F, V467E, Q474P, I479R, E482G, T487A. Five Gag variants (L449F, P453L, D480E, S465F, Y484P) positively correlated (Phi ≥0.2, p<0.05) with protease-resistance mutations. At PI/r-failure, no significant difference was observed between patients with and without these associated Gag variants in term of viremia or CD4 count. This analysis suggests that some Gag variants are significantly associated with an increased frequency at PI/r failure among HIV-1 non-B clades.
Coding and Noncoding RNA Expression Profiles of Spleen CD4+ T Lymphocytes in Mice With Echinococcosis
Authors: Yang Songhao , Du Xiancai , Wang Chan , Zhang Tingrui , Xu Shimei , Zhu Yazhou , Lv Yongxue , Zhao Yinqi , Zhu Mingxing , zhao wei 
Published: October 2021

Abstract
Background: Cystic echinococcosis (CE) is a severe and neglected zoonotic disease, which is caused by Echinococcus granulosus sensu lato and poses health and socioeconomic hazards. RNA molecules play important roles in genetic coding, translation, regulation, and gene expression and are classified into noncoding RNAs, such as long noncoding RNAs (lncRNAs), miRNAs, and circular RNAs (circRNAs), and coding RNAs (mRNAs) based on whether they encode proteins.Methods: Peripheral blood serum from E. granulosus-infected and uninfected female BALB/c mice was used to measure IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF-α levels using the cytometric bead array mouse Th1/Th2/Th17 cytokine kit. mRNA, lncRNA, miRNA, and circRNA profiles were analyzed in spleen CD4+ T cells from the two groups of mice using high-throughput sequencing.Results: The results showed that the levels of serum IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF-α were significantly higher in the CE mice than in the control group (P < 0. 01). A total of 1,758 known mRNAs, 37 miRNAs, 175 lncRNAs, and 22 circRNAs were differentially expressed between infected and uninfected mice (|fold change| ≥ 0.585, P < 0.05). These differentially expressed molecules were closely related to the JAK/STAT, mitogen-activated protein kinase, p53, and PI3K/Akt signaling pathways, cell cycle, and metabolic pathways.Conclusions: E. granulosus infection caused significant increases in the IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF-α levels in the peripheral blood of mice, as well as significant changes in the expression levels of a variety of coding and noncoding RNAs. A further study of these trends and pathways may help clarify the pathogenesis of CE and provide new insights into the prevention and treatment of this infection.
Rates and Risk Factors of Intrapedicular Accuracy and Cranial Facet Joint Violation Among Robot- Assisted, Fluoroscopy-Guided Percutaneous, and Freehand Techniques in Pedicle Screw Fixation of Thoracolumbar Fractures: A Comparative Cohort Study
Authors: Zhang Ren-Jie , Zhou Lu-Ping , Zhang Hua-Qing , Ge Peng , Jia Chong-Yu , Shen Cai-Liang 
Published: October 2021

Abstract
Background Robot-assisted (RA) technique has been increasingly applied in clinical practice, providing promising outcomes of inserting accuracy and cranial facet joint protection. However, studies comparing this novel method with other assisted methods are rare, and the controversy of the superiority between the insertion techniques remains. Thus, we compare the rates and risk factors of intrapedicular accuracy and cranial facet joint violation (FJV) of RA, fluoroscopy-guided percutaneous (FP), and freehand (FH) techniques in the treatment of thoracolumbar fractures. Methods A total of 90 patients with thoracolumbar fractures requiring pedicle screw instruments were retrospectively included and divided into RA, FP, and FH groups at 1:1:1 ratio from June 2016 to May 2020. The primary outcomes were the intrapedicular accuracy and cranial FJV. The factors that affected the intrapedicular accuracy and cranial FJV were assessed using multivariate analyses.Results The optimal intrapedicular accuracy of pedicle screw placement (Grade A) in the RA, FP, and FH groups was 94.3%, 79.3%, and 88.7%, respectively. This finding indicates no significant differences between RA and FH techniques (P =0.062), but significantly higher accuracies of RA over FP (P＜0.001), and FH over FP (P= 0.013). In addition, the rates of proximal FJV in RA, FP, and FH groups were 13.9%, 29.3%, and 22.7%, respectively. The RA had a significantly greater proportion of intact facet joints than the FP (P= 0.001) and FH (P= 0.035). However, FP and FH showed significantly similar outcomes with respect to the proximal FJV (P= 0.149). The logistic regression analysis showed that FP technique (OR= 2.791), pedicle angle (OR= 0.916), and L3 insertion (OR= 0.081) were independently associated with insertion accuracy. Meanwhile, the age (OR= 0.966), pedicle angle (OR= 0.940), mild facet joint osteoarthritis (OR= 5.906), moderate facet joint osteoarthritis (OR= 5.906), severe facet joint osteoarthritis (OR= 9.991), and distance from skin to insertion point (OR= 0.575) were independently associated with cranial FJV.Conclusion RA technique showed higher rate of intrapedicular accuracy and lower rate of cranial FJV than FH and FP techniques, and it might be a safe method for pedicle screw placement in thoracolumbar surgery.
Emotional distress in COVID-19 patients in Maldives
Authors: Dey Rajib Kumar , Mansoor Shanooha , Hilmy Abdullah Isneen , Moosa Sheena , Rahman Shiraany Abdul , Latheef Raishan , Rasheed Nihla , Hassan Fathimath Guraishaa , Zaadhee Ali , Ibrahim Afa , Usman Sofoora Kawsar 
Published: October 2021

Abstract
Background and objectives: Researchers are exploring the epidemiology, clinical characteristics, treatment, vaccination and the challenges faced by healthcare authorities. However less focus is being paid towards the impact of COVID-19 on mental health of the patients. This study is a cross-sectional study, measuring the prevalence of emotional distress among patients with COVID-19 in the Maldivian population.Methods: This study was conducted in Maldivian nations above 18 of age with COVID-19 who were admitted in isolation facilities. Patients who were on treatment for any other chronic medical conditions, severe and critical COVID-19 disease were excluded. This study was conducted over a period of 2months by administering a local translated version of DASS21 questionnaire.Results: The total of 195 patients were included in this study. The mean age of the patients was 40 (CI at 95% 38 - 42) years. The respondents were 48.7% men and 51.3% women. Overall, 9% of patients with COVID-19 had depression while 23% of patients had anxiety and 12% of the patients had stress. There was a statistically significant relationship between gender and depression, anxiety and stress (p<0.01). Symptomatic cases had a significantly higher level of stress than asymptomatic patients (p<0.05), but no significant association was observed with symptomatic status and anxiety or depression.Interpretations & conclusion: The management of patients with COVID-19 should be multi-disciplinary with special focus on the mental wellbeing of our patients. We should aim to establish proper communication with the patients in order to identify emotional distress and provide appropriate mental health care.
The Association Between Geographic Information System-Based Neighborhood Built Environmental Factors and Accelerometer-Derived Light-Intensity Physical Activity Across the Lifespan: A Cross-Sectional Study
Authors: Compernolle Sofie , Mertens Lieze , Cauwenberg Jelle Van , Maes Iris , Dyck Delfien Van 
Published: October 2021

Abstract
Background. Evidence on correlates of accelerometer-derived light-intensity physical activity (LPA) is scarce. The aim of this study was to examine associations between Geographic Information System (GIS)-based neighborhood built environmental factors and accelerometer-derived LPA, and to investigate the moderating effect of age group (adolescents, adults, older adults) on these associations. Methods. Objective data were used from three similar observational studies conducted in Ghent (Belgium) between 2007 and 2015. Accelerometer data were collected from 1652 participants, and GIS-based neighborhood built environmental factors (residential density, intersection density, park density, public transport density, entropy index) were calculated using sausage buffers of 500 m and 1000 m around the home addresses of all participants. Linear mixed models were performed to estimate the associations. Results. A small but significant association was observed between residential density (500 m buffer) and LPA in the total sample (B=-0.002; SE=0.0001; p=0.04), demonstrating that every decrease of 1000 dwellings per surface buffer was associated with a two minute increase in LPA. Intersection density, park density, public transport density and entropy index were not related to LPA, and moderating effects of age group were absent. Conclusions. The small association, in combination with other non-significant associations suggests that the neighborhood built environment, as classically measured in moderate-to-vigorous intensity physical activity research, is of limited importance for LPA. More research is needed to unravel how accelerometer-derived LPA is accumulated, and to gain insight into its determinants.
Performance Evaluation of GAA Nanosheet FET with Varied Geometrical and Process Parameters
Authors: Neelam Aruna Kumari , P Prithvi 
Published: October 2021

Abstract
Nanosheet Field Effect Transistor (NSFET) is a viable contender for future scaling in sub-7-nm technology. This paper provides insights into the variations of DC FOMs for different geometrical configurations of the NSFET. In this script, DC performance of 3D GAA NSFET is analyzed by varying the width, thickness of the device. Moreover, the gate length is scaled from 20 nm to 5 nm to check for the device suitability in logic applications. The thickness and width of each nanosheet are varied in the range of 5 to 9 nm, and 10 to 50 nm respectively to analyse the performance dependency on the geometry of the device. The impact of geometry of NSFET on various DC performance metrics like transfer characteristics, sub-threshold swing (SS), on current (ION), off current (IOFF), switching ratio (ION/IOFF), threshold voltage (Vth) and drain induced barrier lowering (DIBL) are studied. On top of that, the device’s electrical characteristics are analyzed for a wide range of temperatures from -43oC to 127oC to identify the temperature compensation point and is observed at VGS = 0.55 V and ID = 3.86 × 10−6 A. Furthermore, the important process parameter, work function variations on transfer characteristics of the device is analyzed. Moreover, the analyses tell that, for sub -7 nm, the NSFET is a potential device for high performance and good logic applications.
Upregulated heme biosynthesis increases obstructive sleep apnea severity: a pathway-based mendelian randomization study
Authors: Wang Heming , Kurniansyah Nuzulul , Cade Brian E. , Goodman Matthew O. , Chen Han , Gottlieb Daniel J. , Gharib Sina A. , Purcell Shaun M. , Lin Xihong , Saxena Richa , Zhu Xiaofeng , Durda Peter , Tracy Russel , Liu Yongmei , Taylor Kent D. , Johnson W. Craig , Gabriel Stacey , Smith Joshua D. , Aguet François , Ardlie Kirstin , Redline Susan , Sofer Tamar , Blackwell Tom , Reiner Alexander P , Rotter Jerome , Rich Stephen S 
Published: October 2021

Abstract
Obstructive sleep apnea (OSA) is a common disorder associated with increased risk of cardiovascular disease and mortality. Iron and heme metabolism, implicated in ventilatory control and OSA comorbidities, was associated with OSA phenotypes in recent admixture mapping and gene enrichment analyses. However, its causal contribution was unclear. In this study, we performed pathway-level transcriptional Mendelian randomization (MR) analysis to investigate the causal relationships between iron and heme related pathways and OSA. In primary analysis, we examined the expression level of four iron/heme Reactome pathways as exposures and four OSA traits as outcomes using cross-tissue cis-eQTLs from the Genotype-Tissue Expression portal and published genome-wide summary statistics of OSA. We identify a significant putative causal association between up-regulated heme biosynthesis pathway with higher sleep time percentage of hypoxemia (p=6.14×10−3). This association is supported by consistency of point estimates in one-sample MR in the Multi-Ethnic Study of Atherosclerosis using high coverage DNA and RNA sequencing data generated by the Trans-Omics for Precision Medicine project. Secondary analysis for 37 additional iron/heme Gene Ontology pathways did not reveal any significant causal associations. This study suggests a causal association between increased heme biosynthesis and OSA severity.
Characteristics of supination-external rotation Salter-Harris II ankle fractures in computed tomography
Authors: Zhen Yunfang 
Published: October 2021

Abstract
Background: Recent literature has shown that Salter-Harris (S-H)Ⅱfractures are the most common ankle fractures and carry a higher rate of growth disturbance. Recent literature has shown that Salter-Harris (S-H) Ⅱ fractures are the most common ankle fractures. CT characteristics of S-H Ⅱ ankle fractures are not well depicted. The purpose of this study was to evaluate supination-external rotation (SER) S-HⅡankle fractures by CT and to analyze the features of the associated fibular fracture to further determine the injury mechanism.Methods: The radiographs and CT with S-H Ⅱankle fractures were reviewed. Patients suffered from SER injury were included. The medial tibial cortex (MTC) of the distal tibia broken or intact, the metaphyseal fracture angle (MFA) 5-10mm proximal to the physis was documented in axial CT. The length of the metaphyseal fragment was measured in saggital CT. The correlation of the upper limits between fibular fracture and metaphyseal fragment was analyzed. In presence of the fibular fracture, the fracture pattern was classified based on the location and morphology of the fracture line.Results: Seventy-nine SER S-HⅡankle fractures were identified. Stage 1 was present in 35 and stage 2 in 44. In axial CT, the mean MFA was 11.2 degrees. MTC was fully broken in one case and 20, in stage 1 and stage 2, respectively (P=0.001). In saggital CT, the mean length of metaphyseal fragment was 35.3mm. The length of this fragment was 35.0mm, 35.5mm, in stage 1 and stage 2, respectively (P=0.868). The upper part of the fibular fracture line was located at the same level or higher than that of metaphyseal fragment. In 44 cases with associated fibular fracture, forty were in distal metaphysis with oblique fracture line for which 4 types were demonstrated with plantar flexion. Other 4 were in distal diaphysis with spiral fracture line.Conclusions: For SER S-H Ⅱ ankle fractures, MTC and orientation of the fracture plane can be shown in CT to help to make an appropriate preoperative plan. In addition to SER, majority of the concurrent fibular fracture was in the distal metaphysis with oblique fracture line and plantar flexion.
Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt
Authors: Rady Ahmed , Alamrawy Roa Gamal , Ramadan Ismail , El Raouf Mervat Abd 
Published: October 2021

Background:There is a high incidence of alexithymia in people who report medically unexplained symptoms. There have been limited studies on the prevalence of alexithymia in patients with medically unexplained physical symptoms (MUPS) in various ethnic and cultural backgrounds.Objective:This study aimed to estimate the prevalence of alexithymia in patients with MUPS and examine their socio-demographic data.Methods:In this cross-sectional study, 196 patients with MUPS were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. Patients completed a structured interview; socio-demographic and medical history data were collected. Somatic symptom severity was assessed using the Arabic version of the Patient Health Questionnaire (PHQ-15). Alexithymia was assessed using the Arabic version of the Toronto Alexithymia Scale.Results:General fatigue was the most common complaint observed, followed by headache and dyspepsia. In addition, 73.5% of patients had a high Patient Health Questionnaire score, 17.9% had somatic symptoms of medium severity, while 8% and 0.5% had low and marginal somatic symptoms, respectively. Alexithymia was presented in 49.5%, 22.9% had no alexithymia, and 27.6% had borderline/intermediate alexithymia.A weak positive correlation (r<0.4) was found between somatic symptom severity and alexithymic psychopathology (r=0.277;p<0.05). Only the ‘difficulty identifying feelings’ dimension of alexithymic psychopathology was positively correlated with the severity of somatic symptoms (r=0.271;p<0.05).Conclusion:Alexithymia is associated with the development of MUPS.
Machine Learning Algorithms to Detect Subclinical Keratoconus: Systematic Review
Authors: Maile Howard , Li Ji-Peng Olivia , Gore Daniel , Leucci Marcello , Mulholland Padraig , Hau Scott , Szabo Anita , Moghul Ismail , Balaskas Konstantinos , Fujinami Kaoru , Hysi Pirro , Davidson Alice , Liskova Petra , Hardcastle Alison , Tuft Stephen , Pontikos Nikolas 
Published: October 2021

Background
Keratoconus is a disorder characterized by progressive thinning and distortion of the cornea. If detected at an early stage, corneal collagen cross-linking can prevent disease progression and further visual loss. Although advanced forms are easily detected, reliable identification of subclinical disease can be problematic. Several different machine learning algorithms have been used to improve the detection of subclinical keratoconus based on the analysis of multiple types of clinical measures, such as corneal imaging, aberrometry, or biomechanical measurements.

Objective
The aim of this study is to survey and critically evaluate the literature on the algorithmic detection of subclinical keratoconus and equivalent definitions.

Methods
For this systematic review, we performed a structured search of the following databases: MEDLINE, Embase, and Web of Science and Cochrane Library from January 1, 2010, to October 31, 2020. We included all full-text studies that have used algorithms for the detection of subclinical keratoconus and excluded studies that did not perform validation. This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations.

Results
We compared the measured parameters and the design of the machine learning algorithms reported in 26 papers that met the inclusion criteria. All salient information required for detailed comparison, including diagnostic criteria, demographic data, sample size, acquisition system, validation details, parameter inputs, machine learning algorithm, and key results are reported in this study.

Conclusions
Machine learning has the potential to improve the detection of subclinical keratoconus or early keratoconus in routine ophthalmic practice. Currently, there is no consensus regarding the corneal parameters that should be included for assessment and the optimal design for the machine learning algorithm. We have identified avenues for further research to improve early detection and stratification of patients for early treatment to prevent disease progression.
Assessing Values and Preferences Toward SARS-CoV-2 Self-testing Among the General Population and Their Representatives, Health Care Personnel, and Decision-Makers: Protocol for a Multicountry Mixed Methods Study
Authors: Shilton Sonjelle , Ivanova Reipold Elena , Roca Álvarez Albert , Martínez-Pérez Guillermo Z 
Published: October 2021

Background
Accessible, safe, and client-centered SARS-CoV-2 testing services are an effective way to halt its transmission. Testing enables infected individuals to isolate or quarantine to prevent further transmission. In countries with limited health systems and laboratory capacity, it can be challenging to provide accessible and safe screening for COVID-19. Self-testing provides a convenient, private, and safe testing option; however, it also raises important concerns about lack of counseling and ensuring timely reporting of self-test results to national surveillance systems. Investigating community members’ views and perceptions regarding SARS-CoV-2 self-testing is crucial to inform the most effective and safe strategies for implementing said testing.

Objective
We aimed to determine whether SARS-CoV-2 self-testing was useful to diagnose and prevent the spread of SARS-CoV-2 for populations in low-resource settings and under which circumstances it would be acceptable.

Methods
This multisite, mixed methods, observational study will be conducted in 9 countries—Brazil, India, Indonesia, Kenya, Malawi, Nigeria, Peru, the Philippines, and South Africa—and will consists of 2 components: cross-sectional surveys and interviews (semistructured and group) among 4 respondent groupings: the general population, general population representatives, health care workers, and decision-makers. General population and health care worker survey responses will be analyzed separately from each other, using bivariate and multivariate inferential analysis and descriptive statistics. Semistructured interviews and group interviews will be audiorecorded, transcribed, and coded for thematic comparative analysis.

Results
As of November 19, 2021, participant enrollment is ongoing; 4364 participants have been enrolled in the general population survey, and 2233 participants have been enrolled in the health care workers survey. In the qualitative inquiry, 298 participants have been enrolled. We plan to complete data collection by December 31, 2021 and publish results in 2022 via publications, presentations at conferences, and dissemination events specifically targeted at local decision-makers, civil society, and patient groups.

Conclusions
The views and perceptions of local populations are crucial in the discussion of the safest strategies for implementing SARS-CoV-2 self-testing. We intend to identify sociocultural specificities that may hinder or accelerate the widespread utilization of SARS-CoV-2 self-testing.

International Registered Report Identifier (IRRID)
DERR1-10.2196/33088