bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Anxiety and Depression Among Medical Students During the Covid-19 Pandemic: A Cross-Sectional Study
Authors: Halperin Scott J , Henderson Matthew N , Prenner Sofia , Grauer Jonathan N 
Published: February 2021

Purpose: The Covid-19 pandemic is a public health emergency with both physical and mental health risks. Medical students have baseline elevated rates of anxiety, depression and burnout. As such, they may be especially susceptible to the psychological stresses of Covid-19. The current study aimed to evaluate the prevalence of anxiety and depression among United States medical students during the Covid-19 pandemic. Methods: A cross-sectional, survey-based study collected demographic data as well as the 7-item Generalized Anxiety Disorder (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) to assess anxiety and depression symptoms, respectively. The survey was administered from April 13, 2020 to April 28, 2020 amidst the height of the Covid-19 pandemic. Results: A total of 1,428 students from 40 US medical schools completed the survey. From those surveyed, 30.6% and 24.3% of respondents screened positive for anxiety and depression, respectively. Median GAD-7 scores were higher among females (7.0 vs 5.0, P < .00001), pre-clinical students (7.0 vs 6.0, P < .00004), and those with a friend or relative diagnosed with Covid-19 (7.0 vs 6.0, P=.001). Median PHQ-9 scores were higher among females (6.0 vs 4.0, P < .00001) and pre-clinical students (6.0 vs 4.0, P < .00001). Conclusion: When compared to previous medical student studies, these results are 61% higher for anxiety and 70% higher for depression during the Covid-19 era. The current study suggests that there should be a heightened awareness of and sensitivity to student’s mental health during the Covid-19 pandemic with certain cohorts at greater potential risk.
The Clinical Significance of Promoter Methylation of Fluoropyrimidine Metabolizing and Cyclooxygenase Genes in Colorectal Cancer
Authors: Fouad Mariam Ahmed , Salem Salem Eid , Hussien Marwa M. , Badr Doaa Mohamed , Zekri Abdelrahman N. , Hafez Hafez Farouk , Shouman Samia A. 
Published: February 2021

Aims: This study investigated the impact of promoter methylation of flouropyrimidine (FP) metabolizing and cyclooxygenase 2 (COX2) genes on their mRNA expression and on the clinical outcome of colorectal cancer (CRC) patients. Methods: Methylation specific-PCR and real time-PCR of thymidylate synthase (TS), thymidine phosphorylase (TP), dihydropyrimidine dehydrogenase (DPD) and COX2 were performed at baseline and after 3 and 6 months of FP therapy. Pairwise comparisons were conducted between the subgroups of CRC patients. The event free survival (EFS) and the hazard of progression were estimated by univariate and multivariate analyses. Results: At baseline CRC patients, both TS and TP were overexpressed, in spite of the unmethylation of TS and the full methylation of TP genes. Significant downexpression of DPD and COX2 were associated their promoter’s methylation. At the end of FP therapy, TS, DPD and COX2 were overexpressed by 7.52, 2.88 and 3.45 folds, respectively, while TP was downexpressed by 0.54 fold. However, no change was observed in the methylation status of genes with FP therapy. Pairwise comparisons revealed significant difference in the expression and the methylation status of genes according to the clinicopathological characters of CRC patients either at baseline or after FP therapy. The overexpression of DPD and COX2 genes were indicators for a poor EFS of CRC patients. Also, the high level of COX2 expression was found to be significantly correlated with the hazard of progression (HR = 1.73, 95% CI = 1.02-3.03). Conclusion: The promoter methylation of FP metabolizing and COX2 genes has significant impact on the expression and the treatment outcome of CRC patients.
Instalment of the margarosanite group, and data on walstromite–margarosanite solid solutions from the Jakobsberg Mn–Fe deposit, Värmland, Sweden
Authors: Holtstam Dan , Cámara Fernando , Karlsson Andreas 
Published: February 2021

AbstractThe margarosanite group (now officially confirmed by IMA-CNMNC) consists of triclinic Ca-(Ba, Pb) cyclosilicates with three-membered [Si3O9]6–rings (3R), with the general formulaAB2Si3O9, whereA= Pb, Ba and Ca andB= Ca. A closest-packed arrangement of O atoms parallel to (101) hosts Si andBcations in interstitial sites in alternating layers. The 3R layer has three independent Si sites in each ring. Divalent cations occupy three independent sites: Ca inBoccupies two nonequivalent sites,Ca1 (8-fold coordinated), andCa2 (6-fold coordinated).A(=Ca3) is occupied by Pb2+(or Ba2+) in 6+4 coordination, or 6+1 when occupied by Ca; this third site occurs within the 3R-layer in a peripheral position. Three minerals belong to this group: margarosanite (ideally PbCa2Si3O9), walstromite (BaCa2Si3O9) and breyite (CaCa2Si3O9). So far, no solid solutions involving theCa1 andCa2 sites have been described. Therefore, root names depend on the composition of theCa3 site only. Isomorphic replacement at theCa3 sites has been noted. We here report data on a skarn sample from the Jakobsberg Mn–Fe oxide deposit, in Värmland, Sweden, representing intermediate compositions on the walstromite–margarosanite binary, in the rangeca.50–70% mol.% BaCa2Si3O9. The Pb-rich walstromite is associated closely with celsian, phlogopite, andradite, vesuvianite, diopside and nasonite. A crystal-structure refinement (R1= 4.8%) confirmed the structure type, and showed that theCa3 (Ba, Pb) site is split into two positions separated by 0.39 Å, with the Ba atoms found slightly more peripheral to the 3R-layers.
Recovery trajectories over six weeks in patients selected for a high-intensity physiotherapy program after Total knee Arthroplasty: a latent class analysis
Authors: Harmelink K. E. M. , Dandis R. , der Van der Wees PJ P. J. , Zeegers A. V. C. M. , der Sanden M. W. Nijhuis-van , Staal J. B. 
Published: February 2021

Abstract
Background
Recovery trajectories differ between individual patients and it is hypothesizes that they can be used to predict if an individual patient is likely to recover earlier or later. Primary aim of this study was to determine if it is possible to identify recovery trajectories for physical functioning and pain during the first six weeks in patients after TKA. Secondary aim was to explore the association of these trajectories with one-year outcomes.

Methods
Prospective cohort study of 218 patients with the following measurement time points: preoperative, and at three days, two weeks, six weeks, and one year post-surgery (no missings). Outcome measures were performance-based physical functioning (Timed Up and Go [TUG]), self-reported physical functioning (Knee injury and Osteoarthritis Outcome Score-Activities of Daily Living [KOOS-ADL]), and pain (Visual Analogue Scale [VAS]). Latent Class Analysis was used to distinguish classes based on recovery trajectories over the first six weeks postoperatively. Multivariable regression analyses were used to identify associations between classes and one year outcomes.

Results
TUG showed three classes: “gain group” (n = 203), “moderate gain group” (n = 8) and “slow gain group” (n = 7), KOOS showed two classes: “gain group” (n = 86) and “moderate gain group” (n = 132), and VAS-pain three classes: “no/very little pain” (n = 151), “normal decrease of pain” (n = 48) and “sustained pain” (n = 19). The” low gain group” scored 3.31 [95% CI 1.52, 5.09] seconds less on the TUG than the “moderate gain group” and the KOOS “gain group” scored 11.97 [95% CI 8.62, 15.33] points better than the “moderate gain group” after one year.
Patients who had an early trajectory of “sustained pain” had less chance to become free of pain at one year than those who reported “no or little pain” (odds ratio 0.11 [95% CI 0.03,0.42].

Conclusion
The findings of this study indicate that different recovery trajectories can be detected. These recovery trajectories can distinguish outcome after one year.
Lipoprotein-associated phospholipase A2 levels, endothelial dysfunction and arterial stiffness in patients with stable coronary artery disease
Authors: Mourouzis Konstantinos , Siasos Gerasimos , Oikonomou Evangelos , Zaromitidou Marina , Tsigkou Vicky , Antonopoulos Alexis , Bletsa Evanthia , Stampouloglou Panagiota , Vlasis Konstantinos , Vavuranakis Manolis , Tousoulis Dimitris 
Published: February 2021

Abstract
Background
Lipoprotein-associated Phospholipase A2 (Lp-PLA2), can exert proinflammatory as well as proatherogenic properties on the vascular wall. The current study sought to evaluate the influence of high Lp-PLA2 levels on indices of arterial wall properties in patients with stable coronary artery disease (CAD).

Methods
Three hundred seventy-four consecutive patients with stable CAD (mean age 61 ± 11 years, 89% males) were enrolled in this single-center cross-sectional study. Flow-mediated dilation (FMD) was used to assess endothelial function and augmentation index (AIx) of the central aortic pressure was used to assess reflected waves. ELISA was used to determine Lp-PLA2 serum levels.

Results
After dividing the participants in 3 equal groups based on the tertiles of circulating Lp-PLA2 values, no significant differences were demonstrated between those in the 3rd tertile with Lp-PLA2 values > 138 μg/L, in the 2nd tertile with Lp-PLA2 values between 101 and 138 μg/L and in the 1st tertile (Lp-PLA2 values < 101 μg/L) regarding age, male gender, smoking habits, family history of CAD or history of a previous myocardial infarction, diabetes mellitus, arterial hypertension, hyperlipidemia, duration of CAD and treatment with relevant medication. Importantly, subjects with Lp-PLA2 values in the highest tertile, had significantly reduced FMD values compared to the middle and lower tertile (4.43 ± 2.37% vs. 4.61 ± 1.97% vs. 5.20 ± 2.52% respectively, P = 0.03). Patients in the highest tertile of Lp-PLA2 values had significantly higher AIx values (24.65 ± 8.69% vs. 23.33 ± 9.65%, P = 0.03), in comparison to the lowest tertile, with Lp-PLA2 values < 101 μg/L. A linear regression analysis showed that Lp-PLA2 values > 138 μg/L negatively correlated to FMD [b = − 0.45 (95% CI: − 0.79 – -0.11), P = 0.01] and AIx values [b = 1.81 (95% CI: 0.57–3.05), P < 0.001] independently of cofounders like gender, age, diabetes mellitus, arterial hypertension, dyslipidemia, smoking habits, family history of CAD, history of previous myocardial infarction, serum glucose, circulating lipid levels, duration of CAD, antihypertensive medication, antidiabetic drugs, statin therapy and treatment with β-blockers.

Conclusions
Elevated Lp-PLA2 levels relate to endothelial dysfunction and arterial stiffness in patients with stable CAD independently from classical risk factors for CAD, statin use, antihypertensive treatment, and duration of the disease.
Pre- and postoperative left atrial and ventricular volumetric and deformation analyses in severe aortic regurgitation
Authors: Jenner Jonas , Ilami Ali , Petrini Johan , Eriksson Per , Franco-Cereceda Anders , Eriksson Maria J. , Caidahl Kenneth 
Published: February 2021

AbstractBackgroundThe impact of volume overload due to aortic regurgitation (AR) on systolic and diastolic left ventricular (LV) indices and left atrial remodeling is unclear. We assessed the structural and functional effects of severe AR on LV and left atrium before and after aortic valve replacement.MethodsPatients with severe AR scheduled for aortic valve replacement (n = 65) underwent two- and three-dimensional echocardiography, including left atrial strain imaging, before and 1 year after surgery. A control group was selected, and comprised patients undergoing surgery for thoracic aortic aneurysm without aortic valve replacement (n = 20). Logistic regression analysis was used to assess predictors of impaired left ventricular functional and structural recovery, defined as a composite variable of diastolic dysfunction grade ≥ 2, EF < 50%, or left ventricular end-diastolic volume index above the gender-specific normal range.ResultsDiastolic dysfunction was present in 32% of patients with AR at baseline. Diastolic LV function indices and left atrial strain improved, and both left atrial and LV volumes decreased in the AR group following aortic valve replacement. Preoperative left atrial strain during the conduit phase added to left ventricular end-systolic volume index for the prediction of impaired LV functional and structural recovery after aortic valve replacement (modelp < 0.001, accuracy 70%; addition of left atrial strain during the conduit phase to end-systolic volume indexp = 0.006).ConclusionsOne-third of patients with severe AR had signs of diastolic dysfunction. Aortic valve surgery reduced LV and left atrial volumes and improved diastolic indices. Left atrial strain during the conduit phase added to the well-established left ventricular end-diastolic dimension for the prediction of impaired left ventricular functional and structural recovery at follow-up. However, long-term follow-up studies with hard endpoints are needed to assess the value of left atrial strain as predictor of myocardial recovery in aortic regurgitation.
Surgical drainage after limb salvage surgery and endoprosthetic reconstruction: is 30 mL/day critical?
Authors: Liu Jiayong , Fan Zhengfu , El Beaino Marc , Lewis Valerae O. , Moon Bryan S. , Satcher Robert L. , Bird Justin E. , Frink Spencer J. , Lin Patrick P. 
Published: February 2021

AbstractBackgroundPeriprosthetic infection is a major cause of failure after segmental endoprosthetic reconstruction. The purpose of this study is to determine whether certain aspects of drain output affect infection risk, particularly the 30 mL/day criterion for removal.MethodsTwo hundred and ninety-five patients underwent segmental bone resection and lower limb endoprosthetic reconstruction at one institution. Data on surgical drain management and occurrence of infection were obtained from a retrospective review of patients’ charts and radiographs. Univariate and multivariate Cox regression analyses were performed to identify factors associated with infection.ResultsThirty-one of 295 patients (10.5%) developed infection at a median time of 13 months (range 1–108 months).Staphylococcus aureuswas the most common organism and was responsible for the majority of cases developing within 1 year of surgery. Mean output at the time of drain removal was 72 mL/day. Ten of 88 patients (11.3%) with ≤ 30 mL/day drainage and 21 of 207 patients (10.1%) with > 30 mL/day drainage developed infection (p= 0.84). In multivariate analysis, independent predictive factors for infection included sarcoma diagnosis (HR 4.13, 95% CI 1.4–12.2,p= 0.01) and preoperative chemotherapy (HR 3.29, 95% CI 1.1–9.6,p= 0.03).ConclusionWaiting until drain output is < 30 mL/day before drain removal is not associated with decreased risk of infection for segmental endoprostheses of the lower limb after tumor resection. Sarcoma diagnosis and preoperative chemotherapy were independent predictors of infection.
Review of the impact of heat stress on reproductive performance of sheep
Authors: van Wettere William H. E. J. , Kind Karen L. , Gatford Kathryn L. , Swinbourne Alyce M. , Leu Stephan T. , Hayman Peter T. , Kelly Jennifer M. , Weaver Alice C. , Kleemann David O. , Walker Simon K. 
Published: February 2021

AbstractHeat stress significantly impairs reproduction of sheep, and under current climatic conditions is a significant risk to the efficiency of the meat and wool production, with the impact increasing as global temperatures rise. Evidence from field studies and studies conducted using environmental chambers demonstrate the effects of hot temperatures (≥ 32 °C) on components of ewe fertility (oestrus, fertilisation, embryo survival and lambing) are most destructive when experienced from 5 d before until 5 d after oestrus. Temperature controlled studies also demonstrate that ram fertility, as measured by rates of fertilisation and embryo survival, is reduced when mating occurs during the period 14 to 50 d post-heating. However, the contribution of the ram to heat induced reductions in flock fertility is difficult to determine accurately. Based primarily on temperature controlled studies, it is clear that sustained exposure to high temperatures (≥ 32 °C) during pregnancy reduces lamb birthweight and will, therefore, decrease lamb survival under field conditions. It is concluded that both ewe and ram reproduction is affected by relatively modest levels of heat stress (≥ 32 °C) and this is a concern given that a significant proportion of the global sheep population experiences heat stress of this magnitude around mating and during pregnancy. Despite this, strategies to limit the impacts of the climate on the homeothermy, behaviour, resource use and reproduction of extensively grazed sheep are limited, and there is an urgency to improve knowledge and to develop husbandry practices to limit these impacts.
Bilateral scrotoshisis a rare entity: case report
Authors: Perveen Shazia , Shaikh Mishraz , Ali Sajid 
Published: February 2021

Abstract
Background
Scrotoschisis is a rare anomaly in which the testis is lying outside scrotum congenitally. Only few cases have been reported in literature under different names most of which are unilateral. We have found only one case of bilateral scrotoschisis in literature.

Case presentation
Newborn presented to us after normal term twin delivery as a case of bilateral scrotoschisis in which both testes were lying outside the scrotum congenitally. Baby underwent uneventful bilateral orchiopexy and was discharged home the next day.

Conclusion
Scrotoschisis is a very rare genital anomaly with only a few cases reported in literature. This report would add to the literature which would help in studying the exact mechanism and embryopathogenesis of this anomaly which is not known yet.
Improving attitudes toward electroconvulsive therapy
Authors: Cheung Oakley , Baker Marc , Tabraham Paul 
Published: February 2021

Aims and method
Electroconvulsive therapy (ECT) often causes fear in the general public because of media representation and negative reported side-effects. This study evaluates a new video focusing on experiences of ECT and how this can aid communicating medical information to the public. Knowledge and attitudes toward ECT after watching the video were compared with a group that received no information and a group that read the current NHS leaflet on ECT. The role of empathy was also considered as a covariate.

Results
The video was the only condition found to positively affect knowledge and attitudes toward ECT. The video was especially beneficial to those that possessed low perspective-taking trait empathy.

Clinical implications
These findings demonstrate the video improved knowledge and attitudes toward ECT compared with current material or no information. We suggest that the addition of personal experiences to public information adds perspective, improving overall attitudes toward health treatments.
Contribution of birth weight to mental health, cognitive and socioeconomic outcomes: two-sample Mendelian randomisation
Authors: Orri Massimiliano , Pingault Jean-Baptiste , Turecki Gustavo , Nuyt Anne-Monique , Tremblay Richard E. , Côté Sylvana M. , Geoffroy Marie-Claude 
Published: February 2021

BackgroundLow birth weight is associated with adult mental health, cognitive and socioeconomic problems. However, the causal nature of these associations remains difficult to establish owing to confounding.AimsTo estimate the contribution of birth weight to adult mental health, cognitive and socioeconomic outcomes using two-sample Mendelian randomisation, an instrumental variable approach strengthening causal inference.MethodWe used 48 independent single-nucleotide polymorphisms as genetic instruments for birth weight (genome-wide association studies’ total sample: n = 264 498) and considered mental health (attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive–compulsive disorder, post-traumatic stress disorder (PTSD), schizophrenia, suicide attempt), cognitive (intelligence) and socioeconomic (educational attainment, income, social deprivation) outcomes.ResultsWe found evidence for a contribution of birth weight to ADHD (OR for 1 s.d. unit decrease (~464 g) in birth weight, 1.29; 95% CI 1.03–1.62), PTSD (OR = 1.69; 95% CI 1.06–2.71) and suicide attempt (OR = 1.39; 95% CI 1.05–1.84), as well as for intelligence (β = −0.07; 95% CI −0.13 to −0.02) and socioeconomic outcomes, i.e. educational attainment (β = −0.05; 95% CI −0.09 to −0.01), income (β = −0.08; 95% CI −0.15 to −0.02) and social deprivation (β = 0.08; 95% CI 0.03–0.13). However, no evidence was found for a contribution of birth weight to the other examined mental health outcomes. Results were consistent across a wide range of sensitivity analyses.ConclusionsThese findings support the hypothesis that birth weight could be an important element on the causal pathway to mental health, cognitive and socioeconomic outcomes.
Proteomic Profile of Urinary Extracellular Vesicles Identifies AGP1 as a Potential Biomarker of Primary Aldosteronism
Authors: Barros Eric R , Rigalli Juan Pablo , Tapia-Castillo Alejandra , Vecchiola Andrea , Young Morag J , Hoenderop Joost G J , Bindels René J M , Fardella Carlos E , Carvajal Cristian A 
Published: February 2021

AbstractContextPrimary aldosteronism (PA) represents 6% to 10% of all essential hypertension patients and is diagnosed using the aldosterone-to-renin ratio (ARR) and confirmatory studies. The complexity of PA diagnosis encourages the identification of novel PA biomarkers. Urinary extracellular vesicles (uEVs) are a potential source of biomarkers, considering that their cargo reflects the content of the parent cell.ObjectiveWe aimed to evaluate the proteome of uEVs from PA patients and identify potential biomarker candidates for PA.MethodsSecond morning spot urine was collected from healthy controls (n = 8) and PA patients (n = 7). The uEVs were isolated by ultracentrifugation and characterized. Proteomic analysis on uEVs was performed using LC-MS Orbitrap.ResultsIsolated uEVs carried extracellular vesicle markers, showed a round shape and sizes between 50 and 150 nm. The concentration of uEVs showed a direct correlation with urinary creatinine (r = 0.6357; P = 0.0128). The uEV size mean (167 ± 6 vs 183 ± 4nm) and mode (137 ± 7 vs 171 ± 11nm) was significantly smaller in PA patients than in control subjects, but similar in concentration. Proteomic analysis of uEVs from PA patients identified an upregulation of alpha-1-acid glycoprotein 1 (AGP1) in PA uEVs, which was confirmed using immunoblot. A receiver operating characteristic curve analysis showed an area under the curve of 0.92 (0.82 to 1; P = 0.0055).ConclusionProteomic and further immunoblot analyses of uEVs highlights AGP1 as potential biomarker for PA.