bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of and Factors Associated with Disordered Gambling Disorder, and Use of DSM-5 Based Sports Betting Questionnaire, in a Southwest Nigerian Community
Authors: Afe Taiwo , Ogunsemi Olawale , Daniel Olusoji , Ale Ayotunde , Adeleye Olufunke 
Published: August 2021

Background: Gambling disorder is rarely diagnosed in Nigeria. The prevalence and factors associated with gambling disorder in many parts of Nigeria are not known. Our study aimed to evaluate psychometric properties of the Diagnostic and Statistical Manual (DSM)-5 for use as a self-report screening instrument for large-scale studies in Nigeria. Methods: Cross-sectional surveys were done involving two independent sampled populations from a hospital setting and the surrounding community. Instruments administered included a semistructured sociodemographic questionnaire, South Oaks Gambling Screen (SOGS), International Classification of Diseases (ICD) 11 criteria, and a screening questionnaire based on Diagnostic Statistical Manual (DSM-5), which was designed as a self-report measure (Sports betting). Results: The prevalence rate for gambling disorder was 30.5%. The diagnostic accuracy of DSM-5 and ICD-11, and SOGS were comparably similar. Factors associated with gambling disorder (sports betting) were low educational level and poor employment status. Conclusion: The DSM-5-based screening questionnaire showed good psychometric properties, with sensitivity and specificity comparable to that of ICD-11 criteria and SOGS. The study also found a high prevalence of gambling disorder. There is a need to address educational and employment opportunities.
Surviving COVID-19 is Half the Battle; Living Life with Perceived Stigma is Other Half: A Cross-Sectional Study
Authors: Bhatnagar Sushma , Kumar Sanjeev , Rathore Puneet , Sarma Riniki , Malhotra Rajeev Kumar , Choudhary Nandan , Thankachan Alice , Haokip Nengneivah , Singh Shalini , Pandit Anuja , Vig Saurabh , Ratre Brajesh Kumar , Mohan Anant , Lorenz Karl , Guleria Randeep 
Published: August 2021

Background: Year 2020 started with global health crisis known as COVID-19. In lack of established tools and management protocols, COVID-19 had become breeding ground for fear and confusion, leading to stigma toward affected individuals. Method: A cross-sectional study was conducted to estimate prevalence of stigma in discharged COVID-19 patients from a COVID hospital in India. Participants were approached telephonically using a semistructured questionnaire to record their experiences. Questions were asked regarding stigma at six major domains of daily life. Among total 1,673 discharged participants, 600 were conveniently selected and out of them 311 responded on telephonic interviews. Result: We found that 182 (58.52%) participants (95% CI: 53.04–64.00) have self-perceived stigma, 163 (52.41%) participants (95% CI: 46.86–57.96) experienced quarantine-related stigma, 222 (71.38%) participants (95% CI: 66.36–76.40) experienced neighborhood stigma, 214 (68.81%) participants (95% CI: 63.66–73.95) experienced stigma while going out in marketplaces, 180 (57.88%) participants (95% CI: 52.39–63.37) experienced stigma at their work place, and 207 (66.56%) participants (95% CI: 61.31–71.80) reported stigma experienced by their family members. With a total of 84.5% (95% CI: 80.06–88.39) participants experiencing stigma at some domain and about 42.8% of participants facing stigma at all six domains. The commonest noted cause of stigma was fear of getting infected, reported by 184 (59.2%) participants. Conclusion: This study shows high prevalence of stigma in COVID-19 patients suffering in their common domains of daily lives.
Circulating Tumor Cells Expressing Krüppel-Like Factor 8 and Vimentin as Predictors of Poor Prognosis in Pancreatic Cancer Patients
Authors: Zhu Peng , Liu Hui-Ying , Liu Fu-Chen , Gu Fang-Ming , Yuan Sheng-Xian , Huang Jian , Pan Ze-Ya , Wang Wei-Jun 
Published: August 2021

Background: Circulating tumor cells (CTCs) with an epithelial-mesenchymal transition phenotype in peripheral blood may be a useful marker of carcinomas with poor prognosis. The aim of this study was to determine the prognostic significance of CTCs expressing Krüppel-like factor 8 (KLF8) and vimentin in pancreatic cancer (PC). Methods: CTCs were isolated by immunomagnetic separation from the peripheral blood of 40 PC patients before undergoing surgical resection. Immunocytochemistry was performed to identify KLF8+ and vimentin+ CTCs. The associations between CTCs and time to recurrence (TTR), clinicopathologic factors, and survival were assessed. Univariate and multivariate analyzes were performed to identify risk factors. Results: Patients with CTCs ( n = 30) had a higher relapse rate compared to those without ( n = 10) (70.0% vs 20.0%; P < 0.01). The proportion of KLF8+/vimentin+ CTCs to total CTCs was inversely related to TTR ( r = −0.646; P < 0.01); TTR was reduced in patients with > 50% of CTCs identified as KLF8+/vimentin+ ( P < 0.01). Independent risk factors for recurrence were perineural invasion and > 50% KLF8+/vimentin+ CTCs (both P < 0.05). Conclusion: Poor prognosis can be predicted in PC patients when > 50% of CTCs are positive for KLF8 and vimentin.
Sustained reduction of serum neurofilament light chain over 7 years by alemtuzumab in early relapsing–remitting MS
Authors: Kuhle Jens , Daizadeh Nadia , Benkert Pascal , Maceski Aleksandra , Barro Christian , Michalak Zuzanna , Sormani Maria Pia , Godin Jean , Shankara Srinivas , Samad Tarek A , Jacobs Alan , Chung Luke , Rӧsch Nora , Kaiser Carina , Mitchell Colin P , Leppert David , Havari Evis , Kappos Ludwig 
Published: August 2021

Background: Alemtuzumab efficacy and safety was demonstrated in CARE-MS I and extension studies (CAMMS03409; TOPAZ). Objective: Evaluate serum neurofilament light chain (sNfL) in CARE-MS I patients and highly active disease (HAD) subgroup, over 7 and 2 years for alemtuzumab and subcutaneous interferon beta-1a (SC IFNB-1a), respectively. Methods: Patients received SC IFNB-1a 44 µg 3×/week or alemtuzumab 12 mg/day at baseline and month 12, with further as-needed 3-day courses. sNfL was measured using single-molecule array (Simoa™). HAD definition was ⩾2 relapses in year before randomization and ⩾1 baseline gadolinium-enhancing lesion. Results: Baseline median sNfL levels were similar in alemtuzumab ( n = 354) and SC IFNB-1a–treated ( n = 159) patients (31.7 vs 31.4 pg/mL), but decreased with alemtuzumab versus SC IFNB-1a until year 2 (Y2; 13.2 vs 18.7 pg/mL; p < 0.0001); 12.7 pg/mL for alemtuzumab at Y7. Alemtuzumab-treated patients had sNfL at/below healthy control median at Y2 (72% vs 47%; p < 0.0001); 73% for alemtuzumab at Y7. HAD patients ( n = 102) had higher baseline sNfL (49.4 pg/mL) versus overall population; alemtuzumab HAD patients attained similar levels (Y2, 12.8 pg/mL; Y7, 12.7 pg/mL; 75% were at/below control median at Y7). Conclusion: Alemtuzumab was superior to SC IFNB-1a in reducing sNfL, with levels in alemtuzumab patients remaining stable through Y7. ClinicalTrials.gov identifier: NCT00530348, NCT00930553, NCT02255656
Longitudinal psychometric evaluation of the developmental disorder parenting stressor index with Japanese parents of children with autism
Authors: Yamane Takahiro 
Published: August 2021

Assessing parenting stress in parents of children with autism has crucial clinical implications because increased parental stress is associated with psychological disorders and personal distress, which can result in worse child–parent relationships. We examined the psychometric properties of a new index for assessing parenting stressors—the Developmental Disorder Parenting Stressor Index and the temporal variability of parenting stressors using longitudinal data of 212 Japanese parents of children with autism aged 2–18 years. The findings indicated that the Developmental Disorder Parenting Stressor Index has appropriate cross-validity, structural validity, construct validity, and reliability. Moreover, the psychometric properties and the brevity of the Developmental Disorder Parenting Stressor Index increase the clinical utility of the scale. The implications of the findings of this study are discussed. Lay abstract Parents of children with autism experience high rates of parenting stress. Assessing parenting stress in them has crucial clinical implications because increased parental stress is associated with psychological disorders and personal distress, which can result in worse child–parent relationships. Theorists have proposed that a person’s cognitive appraisal determines whether or not a situation or an encounter is personally stressful. However, prior scales merely measure the outcomes of parental stress as a stress response: little the scales were designed to assess events and cognitive appraisal-related parenting stressors of parents of children with autism. We investigated whether a new index for assessing parenting stressors—the Developmental Disorder Parenting Stressor Index is a valid measure to assess parenting stressors of parents of children with autism using longitudinal online surveys at three times. Participants were 212 Japanese parents of children with autism aged 2–18 years who completed the Developmental Disorder Parenting Stressor Index and measures of autism symptoms and stress response . Overall, the findings indicated that the Developmental Disorder Parenting Stressor Index can be reliably used to measure both experiences and cognitive appraisal of parenting stressors among parents of children with autism. Moreover, the Developmental Disorder Parenting Stressor Index has several advantages and is a valuable measurement tool to be able to evaluate parenting stressors in clinical settings; Developmental Disorder Parenting Stressor Index is shorter, easier to complete, and can evaluate both viewpoints of parenting stressors.
Selection and reporting of outcome measures used in long-term follow-up studies of children and adolescents with chronic pain: A scoping review
Authors: Schults Jessica A , Paterson Rebecca S , Cooke Marie , Richards Julianne , Charles Karina , Raithatha Bhavesh , Theodoros Joanne , Alcock Mark 
Published: August 2021

The aim of this review was to determine the range of outcomes reported in long-term follow-up studies of children and adolescents with chronic pain. Using a scoping review methodology, a systematic search for studies reporting outcomes in children and adolescents with chronic pain over a ≥12 month period was undertaken. Studies were eligible for inclusion if they included children and adolescents (≤18 years old on study enrolment) with chronic pain, and outcomes were followed up for ≥12 months. Overall, 42 studies investigating more than 24,132 children were included in the review. Studies assessed a total of 187 unique outcome measures within the broader measures of pain (38 studies; 90%), function (33 studies; 79%) and other (21 studies; 50%). Unidimensional assessments of the severity or presence of pain and global assessments of function were the most commonly reported outcome measures. The number of study follow-up points ranged from 1 to 5, with mode duration of follow-up 12 months post intervention (25 studies; 60%; range 1–13 years). Overall, we identified a wide range of reported outcome measures in studies of children with chronic pain. Beyond assessments of pain intensity and global function, there is little consistency, and reporting of developmental outcome measures is poor. Further long-term outcome research in this population is needed.
Argumentation in anonymous online discussions about decriminalising cannabis use
Authors: Hämäläinen Lasse , Lahti Emmi 
Published: August 2021

Aims: In October 2019, a citizens’ initiative to decriminalise cannabis use started a large debate about drug policy in Finland. This study examines online discussions about the initiative to supplement the current knowledge about citizens’ drug opinions. The focus is especially on argumentation techniques that are used to support or object to the decriminalisation. Design: Methodologically, the study is based on discourse studies, new rhetoric, and argumentation analysis. The data of 1,092 messages were collected from a popular Finnish anonymous discussion forum Ylilauta. Results: Online discussions about the legal status of cannabis are highly polarised. Decriminalisation is often both supported and resisted in a strong and affective manner, and even hate speech is not rare in the data. Statements made by both discussion parties often lack any argumentation or are based on fallacies, especially ad hominem arguments. Some discussants refer to scientific studies and expert statements, even though such references are usually inaccurate. Cannabis is compared to alcohol more often than to other illegal drugs. Conclusions: The emotional responses and inadequate argumentation might be partially explained by the general nature of online discussions and the culture of the investigated website, but also by the powerful stigma related to illegal drugs and insufficient knowledge on the subject. A future objective is to create a societal atmosphere where the complex question of the legal status of cannabis could be discussed more neutrally and rationally.
Gut bacterial microbiota in patients with myasthenia gravis: results from the MYBIOM study
Authors: Totzeck Andreas , Ramakrishnan Elakiya , Schlag Melina , Stolte Benjamin , Kizina Kathrin , Bolz Saskia , Thimm Andreas , Stettner Mark , Marchesi Julian R. , Buer Jan , Kleinschnitz Christoph , Verhasselt Hedda Luise , Hagenacker Tim 
Published: August 2021

Background: Myasthenia gravis (MG) is an autoimmune neuromuscular disease, with gut microbiota considered to be a pathogenetic factor. Previous pilot studies have found differences in the gut microbiota of patients with MG and healthy individuals. To determine whether gut microbiota has a pathogenetic role in MG, we compared the gut microbiota of patients with MG with that of patients with non-inflammatory and inflammatory neurological disorders of the peripheral nervous system (primary endpoint) and healthy volunteers (secondary endpoint). Methods: Faecal samples were collected from patients with MG ( n = 41), non-inflammatory neurological disorder (NIND, n = 18), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP, n = 6) and healthy volunteers ( n = 12). DNA was isolated from these samples, and the variable regions of the 16S rRNA gene were sequenced and statistically analysed. Results: No differences were found in alpha- and beta-diversity indices computed between the MG, NIND and CIDP groups, indicating an unaltered bacterial diversity and structure of the microbial community. However, the alpha-diversity indices, namely Shannon, Chao 1 and abundance-based coverage estimators, were significantly reduced between the MG group and healthy volunteers. Deltaproteobacteria and Faecalibacterium were abundant within the faecal microbiota of patients with MG compared with controls with non-inflammatory diseases. Conclusion: Although the overall diversity and structure of the gut microbiota did not differ between the MG, NIND and CIDP groups, the significant difference in the abundance of Deltaproteobacteria and Faecalibacterium supports the possible role of gut microbiota as a contributor to pathogenesis of MG. Further studies are needed to confirm these findings and to develop possible treatment strategies.
Identifying genetic variants for age of migraine onset in a Han Chinese population in Taiwan
Authors: Tsai Chia-Kuang , Liang Chih-Sung , Lin Guan-Yu , Tsai Chia-Lin , Lee Jiunn-Tay , Sung Yueh-Feng , Lin Yu-Kai , Hung Kuo-Sheng , Chen Wei-Liang , Yang Fu-Chi 
Published: August 2021

Abstract
Background
Considering the involvement of genetics in migraine pathogenesis in diverse ethnic populations, genome-wide association studies (GWAS) are being conducted to identify migraine-susceptibility genes. However, limited surveys have focused on the onset age of migraine (AoM) in Asians. Therefore, in this study, we aimed to identify the susceptibility loci of migraine considering the AoM in an Asian population.

Methods
We conducted a GWAS in 715 patients with migraine of Han Chinese ethnicity, residing in Taiwan, to identify the susceptibility genes associated with AoM. Based on our standard demographic questionnaire, the population was grouped into different subsets. Single-nucleotide polymorphism (SNP) associations were examined using PLINK in different AoM onset groups.

Results
We discovered eight novel susceptibility loci correlated with AoM that reached the GWAS significance level in the Han Chinese population. First, rs146094041 in ESRRG was associated with AoM $$\le$$
≤
12 years. The other SNPs including rs77630941 in CUX1, rs146778855 in CDH18, rs117608715 in NOL3, rs150592309 in PRAP1, and rs181024055 in NRAP were associated with the later AoM.

Conclusions
To our knowledge, this is the first GWAS to investigate the AoM in an Asian Han Chinese population. Our newly discovered susceptibility genes may have prospective associations with migraine pathogenesis.
Structured headache services as the solution to the ill-health burden of headache. 3. Modelling effectiveness and cost-effectiveness of implementation in Europe: findings and conclusions
Authors: Tinelli Michela , Leonardi Matilde , Paemeleire Koen , Raggi Alberto , Mitsikostas Dimos , de la Torre Elena Ruiz , Steiner Timothy J. ,   on behalf of the European Brain Council Value of Treatment Headache Working Group, the European Headache Federation, the European Migraine and Headache Alliance and Lifting The Burden: the Global Campaign against Headache
Published: August 2021

AbstractBackgroundThere have been several calls for estimations of costs and consequences of headache interventions to inform European public-health policies. In a previous paper, in the absence of universally accepted methodology, we developed headache-type-specific analytical models to be applied to implementation of structured headache services in Europe as the health-care solution to headache. Here we apply this methodology and present the findings.MethodsData sources were published evidence and expert opinions, including those from an earlier economic evaluation framework using the WHO-CHOICE model. We used three headache-type-specific analytical models, for migraine, tension-type-headache (TTH) and medication-overuse-headache (MOH). We considered three European Region case studies, from Luxembourg, Russia and Spain to include a range of health-care systems, comparing current (suboptimal) care versus target care (structured services implemented, with provider-training and consumer-education). We made annual and 5-year cost estimates from health-care provider and societal perspectives (2020 figures, euros). We expressed effectiveness as healthy life years (HLYs) gained, and cost-effectiveness as incremental cost-effectiveness-ratios (ICERs; cost to be invested/HLY gained). We applied WHO thresholds for cost-effectiveness.ResultsThe models demonstrated increased effectiveness, and cost-effectiveness (migraine) or cost saving (TTH, MOH) from the provider perspective over one and 5 years and consistently across the health-care systems and settings. From the societal perspective, we found structured headache services would be economically successful, not only delivering increased effectiveness but also cost saving across headache types and over time. The predicted magnitude of cost saving correlated positively with country wage levels. Lost productivity had a major impact on these estimates, but sensitivity analyses showed the intervention remained cost-effective across all models when we assumed that remedying disability would recover only 20% of lost productivity.ConclusionsThis is the first study to propose a health-care solution for headache, in the form of structured headache services, and evaluate it economically in multiple settings. Despite numerous challenges, we demonstrated that economic evaluation of headache services, in terms of outcomes and costs, is feasible as well as necessary. Furthermore, it is strongly supportive of the proposed intervention, while its framework is general enough to be easily adapted and implemented across Europe.
Emodin-loaded polymer-lipid hybrid nanoparticles enhance the sensitivity of breast cancer to doxorubicin by inhibiting epithelial–mesenchymal transition
Authors: Zou Tengteng , Lan Meng , Liu Fengjie , Li Lihong , Cai Tiange , Tian Huaqin , Cai Yu 
Published: August 2021

Abstract
Background
The role of epithelial–mesenchymal transition (EMT) involved in breast cancer metastasis and chemoresistance has been increasingly recognized. However, it is necessary to search for more effective strategies to inhibit EMT thereby increase the sensitivity of breast cancer cells to chemotherapy drugs. Emodin has a potential in overcoming tumor drug resistance and restraining the development of EMT, but the poor internalization into breast cancer cells limited the application.

Results
MCF-7/ADR cells have more EMT characteristics than MCF-7 cell. EMT in MCF-7/ADR cells promotes the development of drug resistance via apoptosis resistance and facilitating the expression of P-gp. The anti-cancer effect of DOX enhanced by the decreasing of drug resistance protein P-gp and apoptosis-related proteins after EMT inhibited in MCF-7/ADR cells. E-PLNs increase the cellular uptake of EMO and restore DOX sensitivity in MCF-7/ADR cells by inhibiting EMT.

Conclusion
E-PLNs inhibit EMT to enhance the sensitivity of breast cancer to DOX. The combination of E-PLNs and DOX can improve the efficacy of DOX in the treatment of breast cancer, which provides a new method to prevent or delay clinical drug resistance.