bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediating effects of self-stigma and depression on the association between autistic symptoms and recovery in patients with schizophrenia-spectrum disorders: a cross-sectional study
Authors: Komatsu Hiroshi , Ono Takashi , Onoguchi Goh , Tomita Hiroaki , Kakuto Yoshihisa 
Published: September 2021

Abstract
Background
Several studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders. More recently, an association between autistic symptoms and self-stigma was found in schizophrenia-spectrum patients. This study aimed to investigate the association between self-stigma, autistic and depressive symptoms, and recovery in patients with schizophrenia.

Methods
In total, 105 participants were evaluated using the Autism Spectrum Quotient, the Internalized Stigma of Mental Illness Scale, the Quick Inventory of Depressive Symptomatology, and the Recovery Assessment Scale to investigate autistic symptoms, self-stigma, depressive symptoms, and recovery, respectively. The relationship between self-stigma, autistic symptoms, depressive symptoms, and recovery was assessed using structural equation modeling analysis.

Results
Impaired attention switching, one symptom of autism, was found to positively affect stereotype endorsement, which negatively influenced recovery through depressive symptoms. Moreover, problems with communication skills negatively affected recovery through depressive symptoms. Concerning self-stigma, stereotype endorsement and perceived discrimination had a negative effect on recovery through depressive symptoms, whereas stigma resistance had a direct negative effect on recovery.

Conclusions
This study may provide meaningful insight into the psychological structure of recovery and could inform effective interventions for patients with schizophrenia-spectrum disorders. This was a cross-sectionally designed study; therefore, further longitudinal studies are needed to identify the causal relationships between self-stigma, autistic and depressive symptoms, and recovery.
Frequency and determinants of domestic violence against Iranian women during the COVID-19 pandemic: a national cross-sectional survey
Authors: Yari Arezoo , Zahednezhad Hosein , Gheshlagh Reza Ghanei , Kurdi Amanj 
Published: September 2021

Abstract
Introduction
Domestic violence (social, legal, and health violence) is the most common type of violence against women. Due to factors such as the current quarantine, this type of violence has increased during the COVID-19 pandemic. The present study aimed to assess the frequency of domestic violence against women and identify the risk factor among Iranian women during the COVID-19 pandemic.

Methods
This online cross-sectional study was conducted on 203 Iranian women during May–June 2020. Data were collected using a domestic violence questionnaire, which measured three forms of violence, including physical, emotional, and sexual violence. A link of the questionnaire was distributed among anonymous subjects through social networking apps, such as WhatsApp and Telegram. The subjects were asked to complete the questionnaire based on their experiences during the COVID-19 pandemic. Data analysis was performed using descriptive statistics and a regression model.

Results
The descriptive results showed that the mean domestic violence against women in all the participants was 34.9 (SD: 17.28). In addition, 26.6% (n = 84), 26.1% (n = 53), and 21.2% of the subjects (n = 43) experienced high levels of physical, emotional, and sexual violence during the COVID-19 pandemic, respectively. The regression model also indicated that lower age, illiteracy/primary education, previous marriage(s), and unwanted/unwise marriage were the significant risk factors for domestic violence against women.

Conclusion
According to the results, domestic violence against women is common among Iranian women during the COVID-19 pandemic. Therefore, strategies are urgently needed to prevent and minimize such domestic violence, and such strategies could be adopted through providing educational opportunities, raising awareness, promoting wanted/wise marriage, and providing social support and rehabilitation opportunities to vulnerable social groups, especially vulnerable women.
Application of metagenomic next-generation sequencing in the diagnosis of severe pneumonia caused by Chlamydia psittaci
Authors: Wu Huan-huan , Feng Lan-fang , Fang Shuang-yan 
Published: September 2021

Abstract
Purpose
Psittacosis is a zoonotic infectious disease caused by the transmission of the bacterium Chlamydia psittaci (C. psittaci) from birds to humans. Infections in humans mainly present as community-acquired pneumonia (CAP). However, most cases are treated without diagnostic testing, and the importance of Chlamydia psittaci infection as a cause of CAP is therefore unclear. Diagnostic tools, including culture, serologic test, and PCR-based methods, are available but prone to false negative results. Metagenomic next-generation sequencing (mNGS) has been increasingly used in the diagnosis of infectious diseases, particularly when conventional diagnostic approaches have limitation.
Detection of nucleic acid sequence of C. psittaci in respiratory tract samples by metagenomic next-generation sequencing (mNGS) is effective for early diagnosis of severe C. psittaci pneumonia. Timely treatment based on tetracycline can reduce unnecessary use of antibiotics and improve prognosis of patients with severe C. psittaci pneumonia.

Methods
Clinical data of thirteen patients with severe C. psittaci pneumonia diagnosed by mNGS were collected. Clinical manifestations, treatment and prognosis of patients were summarized.

Results
The typical symptoms of pneumonia caused by C. psittaci include fever, headache, myalgia, cough, and dyspnea. In the current study, all patients met the criteria for severe C. psittaci pneumonia and received mechanical ventilation, including noninvasive mechanical ventilation (five/thirteen) and invasive mechanical ventilation (eight/thirteen). The findings showed that patients with C. psittaci pneumonia presented with normal or slightly increased leucocytes and procalcitonin, and high C-reactive protein levels. Computed tomography manifestations included consolidation of lung parenchyma, with air bronchogram and pleural effusion in some patients. mNGS analysis results were obtained within 48–72 h. Eleven patients fully recovered after targeted treatment, however, two patients died from secondary multidrug-resistant Pseudomonas aeruginosa infection.

Conclusions
The findings of the current study show that mNGS is effective in diagnosis of C. psittaci pneumonia, and has significant diagnosis value in patients with severe infection. Patients responds well to the timely use of appropriate antibiotics.
Health questionnaire on back care knowledge and spine disease prevention for 6–10 years old children: development and psychometric evaluation
Authors: Szilágyi Brigitta , Tardi Péter , Magyar Borbála , Tanács-Gulyás Nóra , Romhányi Fanny , Vida Elizabetta , Makai Alexandra , Járomi Melinda 
Published: September 2021

Abstract
Background
Back school programs, that improve back care and spine disease prevention knowledge are recommended at the age of 4-14 years. There is Health Questionnaire on Back Care Knowledge in the literature for children aged 14-17 years. At other ages, there is no questionnaire examining this knowledge. We aimed to develop a Health Questionnaire on Back Care and Spine Disease Prevention Knowledge for 6-10 years old children and validate its psychometric properties (internal consistency, test-retest reliability, agreement, convergent validity, discriminant validity) in 6-10 years old children, who attended back school program or not.

Methods
463 children took part in the research (6-10 years old). The development was performed according to the Delphi method. The final version contained 7 questions. 463 participants completed the questionnaire twice with an interval of 7 days to evaluate test-retest reliability. The internal consistency was tested by Cronbach’s alpha value, test–retest reliability was calculated by Intraclass Correlation Coefficients (ICC), Standard Error of Measurement (SEM) and 95% of Minimal Detectable Change (MDC95) and Bland–Altman plots. Convergent validity was tested against the age variable and discriminant validity was tested by Kruskal-Wallis tests among the different subgroups.

Results
Cronbach’s alpha of the total score was (α=0.797), showed a strong internal consistency with minimal SEM (0.606) and MDC95 (1.680). The test-retest result for the total score was strong (0.989), for the questions showed moderate to strong results (0.742-0.975), the limits of agreement of the Bland-Altman plot showed a narrow error of measurement range (-3.49-1.29), and the value of mean differences was −1.10 (SD ± 1.22). The convergent validity showed a weak, but significant relationship between total score and age (R=0.171; p < 0.001). The discriminant validity showed significantly different mean scores in non-back school and back school groups.

Conclusion
For the examination of back care and spine disease prevention knowledge of 6-10 years old children, the questionnaire proved to be a valid and reliable tool. The knowledge requested in the questionnaire covers the knowledge material of the theoretical part of the back school for children aged 4-10 years.
Rolipram plays an anti-fibrotic effect in ligamentum flavum fibroblasts by inhibiting the activation of ERK1/2
Authors: Wu Likang , Xu Lei , Chen Yu , Xu Guohua , Guo Qunfeng , Meng Depeng , Fan Jianping , Song Guoqiang , Xu Peng 
Published: September 2021

Abstract
Background
Fibrosis is an important factor and process of ligamentum flavum hypertrophy. The expression of phosphodiesterase family (PDE) is related to inflammation and fibrosis. This article studied the expression of PDE in hypertrophic ligamentum flavum fibroblasts and investigated whether inhibition of PDE4 activity can play an anti-fibrotic effect.

Methods
Samples of clinical hypertrophic ligamentum flavum were collected and patients with lumbar disc herniations as a control group. The collagenase digestion method is used to separate fibroblasts. qPCR is used to detect the expression of PDE subtypes, type I collagen (Col I), type III collagen (Col III), fibronectin (FN1) and transforming growth factor β1 (TGF-β1). Recombinant TGF-β1 was used to stimulate fibroblasts to make a fibrotic cell model and treated with Rolipram. The morphology of the cells treated with drugs was observed by Sirius Red staining. Scratch the cells to observe their migration and proliferation. WB detects the expression of the above-mentioned multiple fibrotic proteins after drug treatment. Finally, combined with a variety of signaling pathway drugs, the signaling mechanism was studied.

Results
Multiple PDE subtypes were expressed in ligamentum flavum fibroblasts. The expression of PDE4A and 4B was significantly up-regulated in the hypertrophic group. Using Rolipram to inhibit PDE4 activity, the expression of Col I and TGF-β1 in the hypertrophic group was inhibited. Col I recovered to the level of the control group. TGF-β1 was significantly inhibited, which was lower than the control group. Recombinant TGF-β1 stimulated fibroblasts to increase the expression of Col I/III, FN1 and TGF-β1, which was blocked by Rolipram. Rolipram restored the increased expression of p-ERK1/2 stimulated by TGF-β1.

Conclusion
The expressions of PDE4A and 4B in the hypertrophic ligamentum flavum are increased, suggesting that it is related to the hypertrophy of the ligamentum flavum. Rolipram has a good anti-fibrosis effect after inhibiting the activity of PDE4. This is related to blocking the function of TGF-β1, specifically by restoring normal ERK1/2 signal.
Inhibitory effects of Lactobacillus casei Shirota against both Candida auris and Candida spp. isolates that cause vulvovaginal candidiasis and are resistant to antifungals
Authors: Paniágua Aline Lorenzoni , Correia Amabel Fernandes , Pereira Lívia Custódio , de Alencar Bruna Maciel , Silva Fabiana Brandão Alves , Almeida Rosane Mansan , de Medeiros Nóbrega Yanna Karla 
Published: September 2021

Abstract
Background
Vulvovaginal candidiasis (VVC), the second leading cause of genital infection in women of reproductive age, is caused by yeasts of the genus Candida. Treatment is usually empirical and performed with azoles, which have shown increasing ineffectiveness due to resistance from these species. This therapeutic challenge has led to the search for new treatment strategies. Lactobacillus spp. produce several components with microbicidal effects, such as lactic acid. These species are the main components of a healthy vaginal microbiota and have been used as probiotics. The aim of this work was to investigate the in vitro inhibitory effects of Lactobacillus casei Shirota on both the Candida spp. that cause VVC and on C. auris.

Methods
The microbicidal effects of L. casei Shirota on the main VVC-causing species, C. albicans, C. tropicalis, C. norvegensis and C. parapsilosis, in addition to C. auris were investigated by counting the Colony-forming Units (CFUs) after cocultivation. The antifungal activity of lactic acid against these Candida strains was assessed using the microtiter broth dilution method to determine the minimum inhibitory concentrations (MICs). The effects of L. casei Shirota on hyphal and early biofilm formation was measured by optical microscopy.

Results
L. casei Shirota showed inhibitory action against all tested Candida spp., ranging from 66.9 to 95.6% inhibition depending on the species. This inhibition is possibly related to the production of lactic acid, since lactic acid has shown microbicidal action against these same Candida spp. at a concentration of 5 mg/mL, which corresponds to half of the normal physiological concentration. In addition, L. casei Shirota was able to reduce the formation of C. albicans hyphae and early biofilms, showing strong anti-Candida effects.

Conclusions
These results suggest that L. casei Shirota has antifungal activity against the Candida species that cause VVC. L. casei also has microbicidal action against C. auris.
Epigenome-wide association study detects a novel loci associated with central obesity in healthy subjects
Authors: Xie Ting , Gorenjak Vesna , Stathopoulou Maria G. , Dadé Sébastien , Marouli Eirini , Masson Christine , Murray Helena , Lamont John , Fitzgerald Peter , Deloukas Panos , Visvikis-Siest Sophie 
Published: September 2021

AbstractBackground and aimsCentral obesity is a condition that poses a significant risk to global health and requires the employment of novel scientific methods for exploration. The objective of this study is to use DNA methylation analysis to detect DNA methylation loci linked to obesity phenotypes,i.e. waist circumference and waist-to-hip ratio adjusted for BMI.Methods and resultsTwo-hundred and ten healthy European participants from the STANISLAS Family Study (SFS), comprising 73 nuclear families, were comprehensively assessed for methylation status using Illumina Infinium HumanMethylation450 BeadChip. An epigenome-wide association study was performed, which identified a CpG site cg16170243 located on chromosome 18q21.2 significantly associated with waist circumference, after adjusting for BMI (β = 2.32, SE = 0.41, Padj = 0.048). Cg16170243 corresponds to a 50 bp-length human methylation oligoprobe located within theAC090241.2gene that overlapsST8SIA5gene. No significant association was observed with waist-to-hip ratio adjusted for BMI (Padj > 0.05).ConclusionsA novel association between DNA methylation and WC was identified, which is demonstrating that epigenetic mechanisms may have a significant impact on waist circumference ratio in healthy individuals. Further studies are warranted to address the causal effects of this association.
A 2D–3D hybrid convolutional neural network for lung lobe auto-segmentation on standard slice thickness computed tomography of patients receiving radiotherapy
Authors: Gu Hengle , Gan Wutian , Zhang Chenchen , Feng Aihui , Wang Hao , Huang Ying , Chen Hua , Shao Yan , Duan Yanhua , Xu Zhiyong 
Published: September 2021

Abstract
Background
Accurate segmentation of lung lobe on routine computed tomography (CT) images of locally advanced stage lung cancer patients undergoing radiotherapy can help radiation oncologists to implement lobar-level treatment planning, dose assessment and efficacy prediction. We aim to establish a novel 2D–3D hybrid convolutional neural network (CNN) to provide reliable lung lobe auto-segmentation results in the clinical setting.

Methods
We retrospectively collected and evaluated thorax CT scans of 105 locally advanced non-small-cell lung cancer (NSCLC) patients treated at our institution from June 2019 to August 2020. The CT images were acquired with 5 mm slice thickness. Two CNNs were used for lung lobe segmentation, a 3D CNN for extracting 3D contextual information and a 2D CNN for extracting texture information. Contouring quality was evaluated using six quantitative metrics and visual evaluation was performed to assess the clinical acceptability.

Results
For the 35 cases in the test group, Dice Similarity Coefficient (DSC) of all lung lobes contours exceeded 0.75, which met the pass criteria of the segmentation result. Our model achieved high performances with DSC as high as 0.9579, 0.9479, 0.9507, 0.9484, and 0.9003 for left upper lobe (LUL), left lower lobe (LLL), right upper lobe (RUL), right lower lobe (RLL), and right middle lobe (RML), respectively. The proposed model resulted in accuracy, sensitivity, and specificity of 99.57, 98.23, 99.65 for LUL; 99.6, 96.14, 99.76 for LLL; 99.67, 96.13, 99.81 for RUL; 99.72, 92.38, 99.83 for RML; 99.58, 96.03, 99.78 for RLL, respectively. Clinician's visual assessment showed that 164/175 lobe contours met the requirements for clinical use, only 11 contours need manual correction.

Conclusions
Our 2D–3D hybrid CNN model achieved accurate automatic segmentation of lung lobes on conventional slice-thickness CT of locally advanced lung cancer patients, and has good clinical practicability.
Serum lncRNA-ANRIL and SOX9 expression levels in glioma patients and their relationship with poor prognosis
Authors: Sun Youlu , Jing Yuesong , Zhang Yuxin 
Published: September 2021

Abstract
Background
lncRNA-CDKN2B antisense RNA 1 (ANRIL) and SRY-box transcription factor 9 (SOX9) has abnormal expression in many tumors including glioma, but the underlying molecular mechanism is unclear. This study set out to investigate the serum lncRNA-ANRIL and SOX9 levels in glioma patients and their effects on prognosis.

Methods
We enrolled 142 glioma patients admitted to our hospital from May 2014 to May 2016 into the research group (RG) and 120 healthy subjects receiving concurrent physical examinations into the control group (CG). Fasting peripheral blood (4 mL each) was sampled from subjects from the two groups. Using the quantitative real-time polymerase chain reaction (qRT-PCR), lncRNA-ANRIL and SOX9 were measured to explore their values in the early diagnosis of glioma. Patients from RG were followed up for 3 years to analyze the influence of lncRNA-ANRIL and SOX9 on patient prognosis. We purchased glioma cell lines U251 and U87 and grouped them according to the transfection of different plasmids. We conducted CCK8 assay to test cell proliferation, Transwell assay to test cell invasion, the flow cytometry to test cell apoptosis, and Western Blot assay to measure bcl-2 and bax protein levels.

Results
ANRIL and SOX9 were evidently higher in RG than in CG (P<0.01). The receiver operating characteristic (ROC) curve revealed that the diagnostic sensitivity of ANRIL combined with SOX9 for glioma was 81.62%, and the specificity was 90.83% (P<0.01). ANRIL and SOX9 were closely related to tumor grade, tumor diameter, distant metastasis, and family history of glioma (P<0.01). In total, 135 patients were successfully followed up (95.07%). Patients with high levels of ANRIL and SOX9 had a markedly poorer prognosis than those with low levels (P<0.05). ANRIL and SOX9 were markedly higher in glioma cell lines (U251 and U87) than in normal brain cells (P<0.01). The proliferation and invasion of U251 cells were notably reduced after the transfection of ANRIL and SOX9 inhibitory sequences (P<0.01), but the apoptosis was notably increased (P<0.01). Bcl-2 expression was markedly increased in lncRNA-ANRIL-inhibitor and SOX9-inhibitor (P<0.01), while bax expression was markedly reduced in lncRNA-ANRIL-inhibitor and SOX9-inhibitor (P<0.01).

Conclusion
lncRNA-ANRIL and SOX9 levels were higher in glioma patients than in healthy people. High-lncRNA-ANRIL and SOX9 levels were strongly associated with unfavorable prognosis of patients. The testing of biological behaviors revealed that lncRNA-ANRIL and SOX9 worked as tumor-promoting genes in glioma.
High-risk human papillomavirus detection in self-collected vaginal samples compared with healthcare worker collected cervical samples among women attending gynecology clinics at a tertiary hospital in Pretoria, South Africa
Authors: Tiiti Teboho Amelia , Mashishi Tebogo Loraine , Nkwinika Varsetile Varster , Benoy Ina , Selabe Selokela Gloria , Bogers Johannes , Lebelo Ramokone Lisbeth 
Published: September 2021

Abstract
Background
In 2017, the South African National Department of Health (NDoH) Cervical Cancer Prevention and Control Policy was revised. Human papillomavirus (HPV) testing on self-collected samples may offer improved screening uptake. The objectives of the study were to compare the positivity of high-risk (hr)-HPV deoxyribonucleic acid (DNA) and hrHPV viral messenger ribonucleic acid (mRNA) between healthcare worker-collected cervical and self-collected vaginal samples and investigate the accuracy of the applicator-tampon-based self-collected samples in detecting hrHPV DNA and hrHPV mRNA.

Methods
A total of 527 women aged 18 years and older and seeking gynecology services at a tertiary hospital in Pretoria, South Africa, were enrolled. Vaginal samples were self-collected using SelfCerv applicator tampon, followed by cervical samples collected by a healthcare worker using a Cervex Brush® Combi. Both samples were tested with the Abbott m2000 analyzer for 14-hrHPV types and 285 paired samples were tested for hrHPV E6/E7 mRNA using the Aptima HR-HPV mRNA assay. The prevalence of hrHPV DNA and hrHPV E6/E7 mRNA was estimated and the positivity between the two collection methods was compared for the total group as well as per age group.

Results
HrHPV prevalence was 48.0% (95% CI 43.7–52.4) among healthcare worker collected samples and 47.6% (95% CI 43.3–52.0) among self-collected samples. There was no difference in positivity between healthcare worker collection (48.0%) and applicator-tampon-based self-collection, 47.6% (p-value = 0.90). The proportions of hrHPV were equal between the age groups as shown by the McNemar test (p = 0.9036) results for correlated proportions. The prevalence of hrHPV mRNA was 78.6% (95% CI 73.4–83.2) and 58.6% (95% CI 52.6–64.4) for healthcare worker- and self-collection, respectively. The McNemar test for correlated proportions was highly significant (p < 0.0001), indicating that the hrHPV mRNA proportions are not comparable, although this differed between age groups.

Conclusions
Applicator-tampon-based self-collection has a comparable hrHPV DNA positivity rate as healthcare worker collection but different positivity rates for hrHPV mRNA. Self-sampling showed high concordance with healthcare worker-collected sampling for hrHPV DNA detection, especially regarding HPV 16/18 detection. HrHPV DNA was equally detected between the total group as well as per age group. Implementation of self-sampling using an applicator tampon as a primary screening tool may be considered.