bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Predictors of Loneliness Among Youth During the Time of COVID-19: A Multinational Study
Authors: Al Omari Omar , Al Sabei Sulaiman , Al Rawajfah Omar , Abu Sharour Loai , Al-Hashmi Iman , Al Qadire Mohammad , Khalaf Atika 
Published: May 2021

BACKGROUND: Given the restrictions associated with COVID-19, feelings of loneliness among youth may increase. AIMS: The aims of the current study were to assess the prevalence of loneliness among young people at the time of COVID-19 and to identify whether selected variables related to the pandemic predicted the level of loneliness. METHOD: A cross-sectional study using WhatsApp and Facebook social media platforms was conducted to survey 1,057 young people aged 15 to 24 years from six Middle Eastern countries. Participants completed survey items including demographic and COVID-19-related questions; the Depression, Anxiety and Stress Scale (DASS); the Satisfaction With Life Scale (SWLS); and the UCLA Loneliness Scale. RESULTS: The prevalence of experienced loneliness was 1 (0.1%), 625 (59.1%), 429 (40.6%), and 2 (0.2%), reflecting low, moderate, moderately high, and high experiences for loneliness, respectively. History of depression or anxiety, being dissatisfied with life, and having depression at the time of COVID-19 were significant predictors of loneliness among youth. The model was significant ( F = 44.95, p < .05) and accounted for 29.8% of the variance in UCLA Loneliness Scale scores. CONCLUSIONS: We found that the high prevalence rate of loneliness during the COVID-19 pandemic was correlated with depression and impaired life satisfaction among Middle Eastern youth. Thus, special attention and interventional action plans need to be developed taking into consideration the youths’ special situation during COVID-19.
Safe Zones for Spinopelvic Screws in Patients With Lumbosacral Transitional Vertebra
Authors: Becker Luis , Schömig Friederike , Haffer Henryk , Ziegeler Katharina , Diekhoff Torsten , Pumberger Matthias 
Published: May 2021

Study Design: Retrospective matched-pair analysis. Objectives: Lumbosacral transitional vertebrae (LSTV) have a reported prevalence of 4-36% in the population. The safe zones for screw placement for spinopelvic fusion in adult spinal deformity surgery for patients with LSTV have not been described in the literature. Our study aimed to assess the safety of S1-pedicle screw (S1PS), S2-alar screw (S2AS), S2-alar-iliac screw (S2AIS), and iliac screw (IS) placement in patients with LSTV. Methods: Out of the 819 examined patients, 49 patients with LSTV were included in our retrospective analysis with a matched pair control group. We used the 3-dimensional planning tool mediCAD for screw placement of S1PS, S2AS, S2AIS, IS with different angles, length and diameters. Results: We evaluated a total of 10 192 screw trajectories. No serious complications occurred due to the trajectories used for S1PS. LSTV increased the risk of vessel injury for S2AS trajectories ( P = .001) but not for S2AIS ( P = .526). Besides the presence of an LSTV, the screw trajectory had a major influence on the frequency of serious complications. Conclusions: Sacral anchoring of long spinal constructions using S1PS, S2AS, S2AIS and IS is also possible in the presence of LSTV. For S2AS the trajectory with 30° lateral and caudal angulation of 10° showed the least vascular injuries and the least sacro-iliac-joint violations in patients with LSTV. S2AIS trajectories with 40° lateral and 0° sagittal angulation reduced the risk of serious complications in our patients collective with LSTV.
Liquid biopsy in extranodal NK/T-cell lymphoma: a prospective analysis of cell-free DNA genotyping and monitoring
Authors: Qi Fei , Cao Zheng , Chen Bo , Chai Yue , Lin Jing , Ye Junyi , Wei Yuce , Liu Hao , Han-Zhang Han , Mao Xinru , Feng Xiaoli , Dong Mei 
Published: May 2021

Abstract
Satisfactory tumor material is often hard to obtain for molecular analysis in extranodal natural killer (NK)/T-cell lymphoma (NKTCL) at present. However, the accuracy and utility of circulating cell-free DNA (cfDNA) genotyping have not been adequately assessed in NKTCL. We therefore performed targeted next-generation sequencing on tumor tissues and a series of longitudinal plasma samples prospectively collected from a cohort of high-risk NKTCL patients. Concordance of genotyping results of paired baseline tumor and cfDNA and the predictive value of dynamic cfDNA monitoring were evaluated. At baseline, 59 somatic variants in 31 genes were identified in tumor and/or plasma cfDNA among 19 out of 24 high-risk NKTCL patients (79.2%). Plasma cfDNA had a sensitivity of 72.4% for detection of somatic variants identified in tumor biopsies before treatment. Plasma cfDNA also allowed the identification of mutations that were undetectable in tumor biopsies. These results were also verified in a validation cohort of an additional 23 high-risk NKTCL patients. Furthermore, longitudinal analysis showed that patients with rapid clearance of NKTCL-related mutations from plasma had higher complete remission rates (80.0% vs 0%; P = .004) and more favorable survival (1-year progression-free survival [PFS] rate, 79.0% vs 20.0%; P = .002) compared with those with persisting or emerging mutations in plasma. In addition, low cfDNA concentration before treatment was associated with favorable survival outcome for patients with NKTCL (1-year PFS, 90.0% vs 36.4%; P = .012). In conclusion, cfDNA mirrors tumor biopsy for detection of genetic alterations in NKTCL and noninvasive dynamic plasma cfDNA monitoring might be a promising approach for tracking response and survival outcome for patients with NKTCL.
Fibroblasts positive for meflin have anti-fibrotic properties in pulmonary fibrosis
Authors: Nakahara Yoshio , Hashimoto Naozumi , Sakamoto Koji , Enomoto Atsushi , Adams Taylor S. , Yokoi Toyoharu , Omote Norihito , Poli Sergio , Ando Akira , Wakahara Keiko , Suzuki Atsushi , Inoue Masahide , Hara Akitoshi , Mizutani Yasuyuki , Imaizumi Kazuyoshi , Kawabe Tsutomu , Rosas Ivan O. , Takahashi Masahide , Kaminski Naftali , Hasegawa Yoshinori 
Published: May 2021

The prognosis of elderly individuals with idiopathic pulmonary fibrosis (IPF) remains poor. Fibroblastic foci, in which aggregates of proliferating fibroblasts and myofibroblasts are involved, are the pathological hallmark lesions in IPF to represent focal areas of active fibrogenesis. Fibroblast heterogeneity in fibrotic lesions hampers the discovery of the pathogenesis of pulmonary fibrosis. Therefore, to determine the pathogenesis of IPF, identification of functional fibroblasts is warranted. The aim of this study was to determine the role of fibroblasts positive for meflin, identified as a potential marker for mesenchymal stromal cells, during the development of pulmonary fibrosis.We characterised meflin-positive cells in a single-cell atlas established by single-cell RNA sequencing (scRNA-seq)-based profiling of 243 472 cells from 32 IPF lungs and 29 normal lung samples. We determined the role of fibroblasts positive for meflin using bleomycin (BLM)-induced pulmonary fibrosis.scRNA-seq combined within situRNA hybridisation identified proliferating fibroblasts positive for meflin in fibroblastic foci, not dense fibrosis, of fibrotic lungs in IPF patients. A BLM-induced lung fibrosis model for meflin-deficient mice showed that fibroblasts positive for meflin had anti-fibrotic properties to prevent pulmonary fibrosis. Although transforming growth factor-β-induced fibrogenesis and cell senescence with the senescence-associated secretory phenotype were exacerbated in fibroblastsviathe repression or lack of meflin, these were inhibited in meflin-deficient fibroblasts with meflin reconstitution.These findings provide evidence to show the biological importance of meflin expression on fibroblasts and myofibroblasts in the active fibrotic region of pulmonary fibrosis.
AICAR decreases acute lung injury by phosphorylating AMPK and upregulating heme oxygenase-1
Authors: Ahmad Israr , Molyvdas Adam , Jian Ming-Yuan , Zhou Ting , Traylor Amie M. , Cui Huachun , Liu Gang , Song Weifeng , Agarwal Anupam , Jilling Tamas , Aggarwal Saurabh , Matalon Sadis 
Published: May 2021

AimWe investigated the mechanisms by which N1-(β-d-ribofuranosyl)-5-aminoimidazole-4-carboxamide ribonucleotide (AICAR), an activator of AMP-activated protein kinase (AMPK), decreases lung injury and mortality when administered to mice post exposure to bromine gas (Br2).MethodsWe exposed male C57BL/6 mice and heme oxygenase-1 (HO-1)-deficient (HO-1−/−) and corresponding wild-type (WT) littermate mice to Br2(600 ppm for 45 or 30 min, respectively) in environmental chambers and returned them to room air. AICAR was administered 6 h post exposure (10 mg·kg−1, intraperitoneal). We assessed survival, indices of lung injury, high mobility group box 1 (HMGB1) in the plasma, HO-1 levels in lung tissues and phosphorylation of AMPK and its upstream liver kinase B1 (LKB1). Rat alveolar type II epithelial (L2) cells and human club-like epithelial (H441) cells were also exposed to Br2(100 ppm for 10 min). After 24 h we measured apoptosis and necrosis, AMPK and LKB1 phosphorylation, and HO-1 expression.ResultsThere was a marked downregulation of phosphorylated AMPK and LKB1 in lung tissues and in L2 and H441 cells post exposure. AICAR increased survival in C57BL/6 but not in HO-1−/−mice. In WT mice, AICAR decreased lung injury and restored phosphorylated AMPK and phosphorylated LKB1 to control levels and increased HO-1 levels in both lung tissues and cells exposed to Br2. Treatment of L2 and H441 cells with small interfering RNAs against nuclear factor erythroid 2-related factor 2 or HO-1 abrogated the protective effects of AICAR.ConclusionsOur data indicate that the primary mechanism for the protective action of AICAR in toxic gas injury is the upregulation of lung HO-1 levels.
SMILE: systems metabolomics using interpretable learning and evolution
Authors: Sha Chengyuan , Cuperlovic-Culf Miroslava , Hu Ting 
Published: May 2021

Abstract
Background
Direct link between metabolism and cell and organism phenotype in health and disease makes metabolomics, a high throughput study of small molecular metabolites, an essential methodology for understanding and diagnosing disease development and progression. Machine learning methods have seen increasing adoptions in metabolomics thanks to their powerful prediction abilities. However, the “black-box” nature of many machine learning models remains a major challenge for wide acceptance and utility as it makes the interpretation of decision process difficult. This challenge is particularly predominant in biomedical research where understanding of the underlying decision making mechanism is essential for insuring safety and gaining new knowledge.

Results
In this article, we proposed a novel computational framework, Systems Metabolomics using Interpretable Learning and Evolution (SMILE), for supervised metabolomics data analysis. Our methodology uses an evolutionary algorithm to learn interpretable predictive models and to identify the most influential metabolites and their interactions in association with disease. Moreover, we have developed a web application with a graphical user interface that can be used for easy analysis, interpretation and visualization of the results. Performance of the method and utilization of the web interface is shown using metabolomics data for Alzheimer’s disease.

Conclusions
SMILE was able to identify several influential metabolites on AD and to provide interpretable predictive models that can be further used for a better understanding of the metabolic background of AD. SMILE addresses the emerging issue of interpretability and explainability in machine learning, and contributes to more transparent and powerful applications of machine learning in bioinformatics.
Plastome structure and phylogenetic relationships of Styracaceae (Ericales)
Authors: Cai Xiu-Lian , Landis Jacob B. , Wang Hong-Xin , Wang Jian-Hua , Zhu Zhi-Xin , Wang Hua-Feng 
Published: May 2021

AbstractBackgroundThe Styracaceae are a woody, dicotyledonous family containing 12 genera and an estimated 160 species. Recent studies have shown thatStyraxandSinojackiaare monophyletic,AlniphyllumandBruinsmiacluster into a clade with an approximately 20-kb inversion in the Large Single-Copy (LSC) region.HalesiaandPterostyraxare not supported as monophyletic, whileMelliodendronandChangiostyraxalways form sister clades.PerkinsiodendronandChangiostyraxare newly established genera of Styracaceae. However, the phylogenetic relationship of Styracaceae at the generic level needs further research.ResultsWe collected 28 complete plastomes of Styracaceae, including 12 sequences newly reported here and 16 publicly available sequences, comprising 11 of the 12 genera of Styracaceae. All species possessed the typical quadripartite structure of angiosperm plastomes, with sequence differences being minor, except for a large 20-kb (14 genes) inversion found inAlniphyllumandBruinsmia. Seven coding sequences (rps4,rpl23,accD,rpoC1,psaA,rpoAandndhH) were identified to possess positively selected sites. Phylogenetic reconstructions based on seven data sets (i.e., LSC, SSC, IR, Coding, Non-coding, combination of LSC + SSC and concatenation of LSC + SSC + one IR) produced similar topologies. In our analyses, all genera were strongly supported as monophyletic.Styraxwas sister to the remaining genera.AlniphyllumandBruinsmiaform a clade.Halesia dipteradoes not cluster withPerkinsiodendron, whilePerkinsiodendronandRehderodendronform a clade.Changiostyraxis sister to a clade ofPterostyraxandSinojackia.ConclusionOverall, our results demonstrate the power of plastid phylogenomics in improving estimates of phylogenetic relationships among genera. This study also provides insight into plastome evolution across Styracaceae.
Three-dimensional visualization improves the endoscopic diagnosis of superficial gastric neoplasia
Authors: Higuchi Kazutoshi , Kaise Mitsuru , Noda Hiroto , Kirita Kumiko , Koizumi Eriko , Umeda Takamitsu , Akimoto Teppei , Omori Jun , Akimoto Naohiko , Goto Osamu , Tatsuguchi Atsushi , Iwakiri Katsuhiko 
Published: May 2021

Abstract
Background
Three-dimensional (3D) technology has been used in many fields, including flexible endoscopy. We evaluated the usefulness of 3D visualization for endoscopically diagnosing superficial gastric neoplasia.

Methods
Twelve participants (4 novices, 4 trainees and 4 experts) evaluated two-dimensional (2D) and 3D endoscopic still images of 28 gastric neoplasias, obtained before ESD with white-light imaging (WLI) and narrow-band imaging (NBI). Assessments of the delineation accuracy of tumor extent and tumor morphology under 2D and 3D visualization were based on the histopathological diagnosis of ESD specimens. Participants answered visual analog scale (VAS) questionnaires (0–10, worst to best) concerning the (a) ease of recognition of lesion morphology, (b) lesion extent and (c) comprehensive endoscopic cognition under 2D and 3D visualization. The endpoints were the accuracy of tumor extent and morphology type and the degree of confidence in assessing (a)–(c).

Results
The delineation accuracy of lesion extent [mean (95% confidence interval)] with WLI under 3D visualization [60.2% (56.1–64.3%)] was significantly higher than that under 2D visualization [52.3% (48.2–56.4%)] (P < 0.001). The accuracy with NBI under 3D visualization [70.3% (66.8–73.7%)] was also significantly higher than that under 2D visualization [64.2% (60.7–67.4%)] (P < 0.001). The accuracy of the morphology type with NBI under 3D visualization was significantly higher than that under 2D visualization (P = 0.004). The VAS for all aspects of endoscopic recognition under 3D visualization was significantly better than that under 2D visualization (P < 0.01).

Conclusions
Three-dimensional visualization can enhance the diagnostic quality for superficial gastric tumors.
Pure retroperitoneal laparoscopic radical nephrectomy and thrombectomy with delayed occlusion of the proximal inferior vena cava (DOPI) technique for renal tumor with level II-III venous tumor thrombus
Authors: Liu Zhuo , Hong Peng , Zhu Guodong , Zhang Li , Zhao Xun , Tang Shiying , Yang Feilong , Tian Xiaojun , Wang Guoliang , Zhang Shudong , Zhang Hongxian , Huang Yi , Liu Chunxia , Liu Cheng , Ma Lulin 
Published: May 2021

Abstract
Purpose
To explore the safety and effectiveness of delayed occlusion of the proximal inferior vena cava (DOPI) technique in retroperitoneal laparoscopic radical nephrectomy (LRN) and thrombectomy for renal tumor with level II-III venous tumor thrombus (VTT).

Materials and methods
From August 2016 to October 2018, a total of 145 patients with renal tumor and VTT were admitted to our centre. Seventy-five patients underwent laparoscopic surgery, and 70 patients underwent open surgery. Among these patients, 17 patients underwent retroperitoneal LRN and thrombectomy with the DOPI technique. Clinical data were collected retrospectively, and a descriptive statistical analysis was conducted.

Results
All the patients successfully underwent retroperitoneal laparoscopic surgery. The mean operation time was 345.9 ± 182.9 min, the mean estimated blood loss was 466.7 ± 245.5 ml. Postoperative complications occurred in three patients, including two patients of Clavien grading system level IVa and one patient of level II. There were no complications related to carbon dioxide pneumoperitoneum, such as gas embolism, acidosis, and subcutaneous emphysema. During 21 months of median follow-up time, no local recurrence was found, and distant metastasis occurred in four patients. Cancer-specific death occurred in two patients.

Conclusions
The DOPI technique is safe and feasible in the treatment of renal tumor and level II-III VTT. With the DOPI technique, the procedures of dissociating and exposing proximal inferior vena cava are simplified.
Mental health education in undergraduate medical curricula across Nepalese universities
Authors: Marahatta Kedar , Pant Sagun Ballav , Basnet Madhur , Sharma Pawan , Risal Ajay , Ojha Saroj Prasad 
Published: May 2021

Abstract
Background
Mental and substance use disorders account for 30 % of the non-fatal disease burden and 10 % of the overall disease burden but the treatment gap is daunting. With just one psychiatrist per 200,000 populations in Nepal, the only convincing way to improve access to the services quickly is by mobilizing non-specialized medical practitioner. A robust mental health component within the training curriculum of general medical doctors could produce medical graduates with adequate knowledge and skills to deliver basic mental health service. We reviewed the mental health curricula for medical students of all the medical universities in Nepal.

Methods
Information on existing mental health curricula was collected from the faculty of the respective universities with respect to content coverage, teaching methods and evaluation patterns. The mental health curricula were described in relation to teaching duration, duration of clinical rotation, duration of internship, and the relative weight of mental health in examination marks. Teaching methods were classified broadly as passive and active. Assessment methods were documented. Content coverage of the curricula was evaluated with respect to history taking and general physical examination, the priority mental health conditions, topics on behavioural sciences, and child mental health or other topics.

Results
The duration of teaching on mental health in general medical doctor training in Nepalese medical universities ranges from 25 to 92 h. All medical universities have a relative focus on the priority mental neurological and substance use disorders. The clinical rotation on mental health is mostly two weeks, except in one university where it can be extended up to 4 weeks with an elective clinical rotation. The relative weight of summative assessment ranges from 0.21 to 2.5 % total marks of the entire training.

Conclusions
Considerable disparities exist in course content, teaching/learning modalities and assessments for mental health across Nepalese medical universities. The relative proportion of mental health in medical curricula as well as teaching/learning and assessments are far below ideal in these universities. These findings suggest a need for increasing time allocation, adopting newer teaching learning methods, and also having a mandatory clinical rotation during training and during internship.
A cross-case analyses of laboratory professionals-patients interaction for patients accessing laboratory services at University of Cape Coast hospital and Ewim Polyclinic in the Cape Coast Metropolis, Ghana
Authors: Adu Patrick 
Published: May 2021

Abstract
Background
There is scarcity of data on experiences of patients who access laboratory services during hospital visits in sub-Saharan Africa. This study sought to evaluate the depth of laboratory professionals-patient interactions during pre- and post-sampling period at two hospitals in Ghana.

Methods
This study used real time observations of patient-laboratory staff interactions to collect first-hand data. Additionally, two separate sets of semi-structured questionnaires were used to collect data on the experiences of patients and laboratory professionals. Data were entered into Microsoft Excel and analysed using SPSS version 25.

Results
Inadequate laboratory space is a major factor limiting adequacy of patients-laboratory professionals’ interactions. Overall, even though the laboratory professionals (93.3%) overwhelmingly agreed to the need to inform patients about the turnaround time of the respective laboratory testing, this was not routinely done. Irrespective of patients’ educational attainment, patients were poorly informed about their respective laboratory tests. Although both patients and laboratory professionals (60.0% vs 63.6% respectively) indicated that the test requester has responsibility to inform patients about their laboratory testing, only 29.1% of patients indicated having received such explanations. Furthermore, although 28.1% of patients indicated knowing the specifics of their respective test requisition, only 15% could correctly identify their requested laboratory testing.

Conclusion
There is the need for standard operating protocols to standardize practitioner-patient interaction at the two facilities. Moreover, there is the need for laboratory staff-test requester engagement to clearly delineate who has what responsibilities regarding informing patients about laboratory testing.