bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complicated grief and its relationship with anxiety, depression, and risk suicide in older adults in the context of the COVID-19 pandemic in Peru: a cross-sectional analysis
Authors: Escobar-Agreda Stefan , Albino Zoila Romero , Contreras Pavel J. , Fuentes María Sofía Cuba 
Published: May 2023

Abstract
Background
Complicated grief (CG) resulting from poor adaptation to the death of a close person may have predisposed the presence of other mental health problems in older adults in Peru during the COVID-19 pandemic. The aim of our study was to assess the association between CG and the presence of anxiety, depression, and suicidal risk in older adults in Peru in the context of COVID-19 pandemic.
Methods
We conducted a cross-sectional analysis using data from the "Socioemotional evaluation form" applied in 2020 to assess the presence of mental health problems in older adults being attended in the Peruvian Social Security (EsSalud). For our study we included older adults who reported the death of a close person during the last 6 months when this assessment was performed. CG, depression, anxiety, and risk of suicide was originally evaluated using validated questionnaires. The association between CG and the presence of mental health problems was calculated through multivariate analysis where prevalence ratios (PR) were estimated with 95% confidence intervals (CI).
Results
Of the 249 older adults included, 175 (70.3%) were female with a median age of 71 years (interquartile range: 9) and 35 (14.1%) reported the presence of CG. It was found that CG in this population was associated with the presence of anxiety (PR: 1.35, 95% CI: 0.98 to 1.85), depression (PR: 1.44, 95% CI: 1.06 to 1.95), and suicidal risk (PR: 2.84, 95% CI: 1.06 to 7.59).
Conclusions
CG predisposes the presence of mental health problems in older adults in Peru. It is important to implement measures that facilitate its prevention and proper management of this condition in this population, especially in context of high population mortality such as the COVID-19 pandemic.
Predictive potential of preoperative Naples prognostic score-based nomogram model for the prognosis in surgical resected thoracic esophageal squamous cell carcinoma patients
Authors: Guo Xin-wei , Ji Lei , Xi Xiao-xiang , Zhao Wei-wei , Liu Yang-chen , Zhou Shao-bing , Ji Sheng-Jun 
Published: May 2023

Abstract
The present study aimed to establish an effective prognostic nomogram model based on the Naples prognostic score (NPS) for resectable thoracic esophageal squamous cell carcinoma (ESCC). A total of 277 patients with ESCC, who underwent standard curative esophagectomy and designated as study cohort, were retrospectively analyzed. The patients were divided into different groups, including NPS 0, NPS 1, NPS 2, and NPS 3 or 4 groups, for further analysis, and the results were validated in an external cohort of 122 ESCC patients, who underwent surgery at another cancer center. In our multivariate analysis of the study cohort showed that the TNM stage, SIS, and NPS were the independent prognostic factors for the OS and PFS durations. In addition, the differential grade was also an independent prognostic factor for the OS in the patients with ESCC after surgery (all P < 0.05). The area under curve (AUC) of ROC for the PFS and OS prediction with SIS and NPS were 0.735(95%CI0.676-0.795, P < 0.001) and 0.835(95%CI0.786-0.884, P < 0.001), 0.734(95%CI 0.675–0.793, P < 0.001) and 0.851 (95%CI 0.805–0.896, P < 0.001) respectively. The above independent predictors for OS or PFS were all selected in the nomogram model. The C-indices of the nomogram model for predicting the OS and PFS were 0.718 [95% confidence interval (CI) 0.681–0.755] and 0.669 (95%CI 0.633–0.705), respectively, which were higher than that of the7th edition of AJCC TNM staging system[C-index 0.598 (95%CI 0.558–0.638) for OS and 0.586 (95%CI 0.546–0.626) for PFS]. The calibration curves for predicting the 5-year OS or PFS showed a good agreement between the prediction by nomogram and actual observation. In the external validation cohort, the nomogram discrimination for OS was better than that of the 7th edition of TNM staging systems [C-index: 0.697 (95% CI 0.639–0.755) vs 0.644 (95% CI 0.589–0.699)]. The calibration curves showed good consistency in predicting the 5-year survival between the actual observation and nomogram predictions. The decision curve also showed a higher potential of the clinical application of predicting the 5-years OS of the proposed nomogram model as compared to that of the 7th edition of TNM staging systems. In conclusion, the preoperative NPS-based nomogram model had a certain potential role for predicting the prognosis of ESCC patients.
Effects of physical activity and screen-based sedentary behavior on children's mental health and academic performance
Authors: Su Xuyang , Yan Qiuping , Kovess-Masfety Viviane , Li Peiyao , Li Minghui , Yan Guoli , Yin Huifang , Xu Guangming 
Published: May 2023

Abstract
Background: The present study examined the current status of physical activity and screen-based sedentary behavior among Chinese children aged 6-12 and explored the relationship between physical activity and screen-based sedentary behavior with children's mental health and academic performance.
Methods: Data were drawn from 2012 children aged 6-12 in three primary schools in China in 2020. Children's mental health was assessed by parents and teachers using the Strengths and Difficulties Questionnaire. Parents reported Children’s physical activity and screen-based sedentary behavior. Children's academic performance assessed by teachers. Binary logistic regressions were used to explore the effects of physical activity and screen-based sedentary behavior on children.
Results: Children aged 6-12 had an average of 2.9 hours of physical activity and 3.7 hours of screen-based sedentary behavior per week. Physical activity (>2h per week) was a protective factor for peer relationship problems (OR=0.62,95%CI:0.49-0.78) and internalizing problems (OR=0.65,95%CI:0.52-0.82) reported by parents. It was also associated with better reading skills (OR=1.33, 95%CI: 1.07-1.65). Screen-based sedentary behavior (>2 hours per week) was a risk factor for ADHD (OR=1.40, 95%CI:1.07-1.83) and externalizing problems (OR=1.28, 95%CI:1.01-1.61) reported by parents. And it was a protective factor for conduct problems (OR=0.65, 95%CI:0.44-0.97), peer relationship problems (OR=0.69, 95%CI:0.51-0.94) and internalizing problems (OR=0.69, 95%CI:0.52-0.93) reported by teachers.
Conclusions: Sufficient physical activity had benefits for children's mental health and academic performance. Screen-based sedentary behaviors longer than 2 hours per week had both beneficial and detrimental effects on different mental health problems, and we recommend that children avoid excessive screen time.
Evaluation of different methods in diagnosis of spinal tuberculosis infection
Authors: Li Zhaoxin , Wang Jin , Xiu Xin , Shi Zhenpeng , Zhang Qiang , Chen Deqiang 
Published: May 2023

Abstract
Background and purposes:Tuberculosis (TB) is the most lethal infectious disease worldwide. About 24.6% of tuberculosis cases are extrapulmonary TB which commonly affects spine. Spinal tuberculosis (STB) is difficult to diagnose. This study aims to evaluate the diagnostic performance of MGIT-960 culture, T-SPOT.TB, Xpert MTB/RIF, and Metagenomic Next-Generation Sequencing (mNGS) in detecting STB.
Methods:
126 patients presumed to have STB were tested by 4 methods. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated considering the clinical diagnosis as the reference.
Results:
126 patients were enrolled in this study, 41 with STB and 85 with non-STB infection. In the STB group, the sensitivity, specificity, PPV and NPV of MGIT-960 culture were 29.3% (12/41), 100% (85/85), 100% (12/12), and 74.6% (85/114).The sensitivity of T-SPOT.TB was 92.7% (38/41), and the specificity, PPV and NPV were 82.4% (70/85), 58.5% (31/53) and 95.9% (70/73). The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF were 53.7% (22/41), 100% (85/85), 100% (22/22) and 81.7% (85/104). The sensitivity, specificity, PPV and NPV of mNGS were 39.0% (16/41), 98.8% (84/85), 94.1% (16/17) and 77.1% (84/109).The sensitivity, specificity, PPV and NPV of the mNGS+Xpert MTB/RIF group were 73.2% (30/41), 100% (85/85), 96.8% (30/31) and 72.0% (85/118). The sensitivity, specificity, PPV and NPV of the mNGS+T-spot group were 97.6% (40/41), 100% (85/85), 67.9% (38/56) and 75.9% (85/113).The sensitivity, specificity, PPV and NPV of the T-spot+Xpert MTB/RIF group were 95.1% (39/41), 100% (85/85), 72.2% (39/54) and 81.0% (85/105).
Conclusions:
Among the 4 detection methods, T-SPOT.TB is the most effective technique for diagnosing STB, but Xpert MTB/RIF is more reliable and can detect RIF resistance. mNGS can be used to identify pathogens in patients with spinal infections, and pathogens identified by mNGS appear to be more meaningful in guiding clinical management in patients in the non-STB group. The combination of Xpert MTB/RIF and mNGS can improve the early diagnosis rate and detection of drug resistance of STB, reduce the diagnosis cycle, and provide early targeted anti-tuberculosis treatment.
Ecological Niche Modelling and Density of Sings as Conservation Tools of Taxidea Taxus Berlandieri in Central – Northern Mexico
Authors: Palacio-Núñez Jorge , Martínez-Calderas Jesús Manuel , Rössel-Ramírez David Walter , Martínez-Montoya Juan Felipe , Clemente-Sánchez Fernando , Olmos-Oropeza Genaro 
Published: May 2023

Abstract
The American badger o tlalcoyote (Taxidea taxus berlandieri) is a subspecies that inhabits north-central Mexico; its population and conservation status are unknown, and there is no precise information about its habitat. The objectives of our study were to model the ecological niche suitability for T. t. berlandieri, to estimate the population density by signs km-2 and to identify the habitat variables that contribute to their occurrence in north-central Mexico. We modeled ecological niche using MaxEnt and KUENM, with 13 predictor variables and 43 occurrence records obtained from 177 sites sampled between the total or partial extension of nine physiographic subprovinces in 5 states in the north-central region of Mexico. Our model showed a high suitability probability (P > 0.75) in Llanuras y Sierras Postosino - Zacatecanas, Sierras Transversales and Sierras y Lomeríos de Aldama y Río Grande in parts of the states of Durango, San Luis Potosí, and Zacatecas. The variables with the highest contribution to occurrence probability were slope (plains and plateaus), topography (from flat to undulating), and types of vegetation (dominated by scrub). With the records, we estimated an average density of 0.019 signs km-2 for tlalcoyote in the total extension of the study area. According to our findings, it is possible that the population status of T. t. berlandieri, as a subspecies, is below desirable density levels, and its suitable ecological niche is limited. Therefore, we argued to focus more studies on conservation for this subspecies, using these results as the basis for delimiting its distribution area.
Clinical and Outcome Comparison of Genetically Positive Vs. Negative Patients in a Large Cohort of Suspected Familial Hypocalciuric Hypercalcemia
Authors: Roca Queralt Asla , Simó Helena Sardà , Cerarols Núria Seguí , de Pinillos Guillermo Martínez , Altisent Isabel Mazarico , Flores Ismael Capel , Jiménez José Rives , Balaguer Javier Suárez , Rubio Verónica Ávila , Torres Manuel Muñoz , Ullastre Ignasi Saigí , García Nuria Palacios , Rull Eulàlia Urgell , Webb Susan M , Miró Mercè Fernández , Ambrós Josep Oriola , Porta Mireia Mora , Colomer Mireia Tondo , Aulinas Anna 
Published: May 2023

Abstract
Objective
Biochemical suspicion of familial hypocalciuric hypercalcemia (FHH) might provide with a negative (FHH-negative) or positive (FHH-positive) genetic result. Understanding the differences between both groups may refine the identification of those who need genetic evaluation, aid management decisions and prospective surveillance. We aimed to compare FHH-positive and FHH-negative patients, and to identify predictive variables for FHH-positive cases.
Design
Retrospective, national multi-centre study of patients with suspected FHH and genetic testing of the CASR, AP2S1 and/or GNA11 genes.
Methods
Clinical, biochemical, radiological and treatment data were collected. We established a prediction model for the identification of FHH-positive cases by logistic regression analysis and area under the ROC curve (AUROC) was estimated.
Results
We included 73 index cases, of which 37 (50.7%) had a pathogenic variant. FHH-positive cases were younger (p = 0.023), reported more frequently a positive family history (p < 0.001), presented higher magnesium (p < 0.001) and lower parathormone levels (p < 0.001) and were less often treated for hypercalcemia (p = 0.017) in comparison to FHH-negative cases. Magnesium levels showed the highest AUROC (0.788, 95%CI: 0.659–0.892). The multivariate analysis revealed that family history, parathormone and magnesium levels, were independent predictors of a positive genetic result. The predictive model showed an AUROC of 0.881 (95%CI: 0.770–0.957).
Conclusions
The combination of magnesium, parathormone levels and a positive family history offered a good diagnostic accuracy to predict a positive genetic result. The inclusion of magnesium measurement in the routine evaluation of patients with suspected FHH might provide a more personalized approach in the decision-making process for ordering a genetic examination.
First Molecular Anaplasma capra Detection in Turkish Goats
Authors: Oguz Bekir , Deger M Serdar , Al-Olayan Ebtsam , El-Ashram Saeed 
Published: May 2023

Abstract
Anaplasma capra infection is usually asymptomatic, but it is known to cause zoonotic tick-borne diseases. A. capra's morphological characteristics and the types of cells infected (such as erythrocytes, monocytes, and neutrophil granulocytes) are unknown. Infection with A. capra was mostly found in ixodid ticks. There have been no studies on A. capra infection in goats, one of Turkey's most common farm animals. Infection with A. capra was mostly found in ixodid ticks. There have been no studies on A. capra infection in goats, one of Turkey's most common farm animals. They are required to determine their distribution, genetic diversity, vector species, and host specificity. This study aimed to investigate the A. capra pathogen in goats in Turkey's Van province. A total of 200 goat blood samples were examined. Goat samples were subjected to partial amplification of the gltA gene fragment using a nested polymerase chain reaction. A. capra DNA was detected in 0.5% of goat blood samples. Phylogenetic analysis of a partial gltA gene fragment showed that the eastern Turkey isolate, closely grouped with A. capra isolates reported from wild and domestic ruminants in France, Turkey, and Kyrgyzstan, formed a distinct clade. This is the first report of A. capra in goats in Turkey.
Single-cell transcriptome analysis identifies novel biomarkers involved in major liver cancer subtypes
Authors: Swain Asish Kumar , Pandey Prashant , Sera Riddhi , Yadav Pankaj 
Published: May 2023

Abstract
Background
Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the two aggressive subtypes of liver cancer (LC). Immense cellular heterogeneity and crosstalk between cancer and healthy cells make it challenging to treat these cancer subtypes. To address these challenges, the study aims to systematically characterize the tumour heterogeneity of LC subtypes using single-cell RNA sequencing (scRNA-seq) datasets.
Method
The study combined 51927 single cells from HCC, ICC, and healthy scRNA-seq datasets. After integrating the datasets, cell groups with similar gene expression patterns are clustered and cluster annotation has been performed based on gene markers. Cell-cell communication analysis (CCA) was implemented to understand the crosstalk between various cell types. Further, differential gene expression analysis and enrichment analysis were carried out to identify unique molecular drivers associated with HCC and ICC.
Results
Our analysis identified T-cells, hepatocytes, epithelial cells, and monocyte are the major cell types present in the tumour microenvironment. Among them, abundance of natural killer (NK) cells in HCC, epithelial cells and hepatocytes in ICC were detected. CCA revealed key interaction between T-cells to NK cells in HCC and smooth muscle cells to epithelial cells in the ICC. Additionally, SOX4 and DTHD1 are the top differentially expressed genes (DEGs) in HCC, while keratin and CCL4 are in ICC. Enrichment analysis of DEGs reveals major up-regulated genes in HCC affect protein folding mechanism and in ICC alter pathways involved in cell adhesion.
Conclusion
The findings suggest potential targets for the development of novel therapeutic strategies for the treatment of these two aggressive subtypes of LC.
Lower Serum Cholesterol Levels as a Risk Factor for Critical Illness Polyneuropathy: A matched Case-Control Study
Authors: Zulehner Gudrun , Seidel Stefan , Polanz Alexander , Schörgenhofer Christian , Rommer Paulus , Merrelaar Marieke , Roth Dominik , Herkner Harald , Behrens Sybille , Kienbacher Calvin Lukas 
Published: May 2023

Abstract
Background: Critical illness polyneuropathy (CIP) is a frequent and underdiagnosed phenomenon among intensive care unit patients. The lipophilic nature of neuronal synapses may result in the association of low serum cholesterol levels with a higher rate of CIP development. We aimed to investigate this issue in critically ill patients.
Methods: All cases diagnosed with CIP in our tertiary care hospital between 2013 and 2017 were 1:1 matched with controls without the condition by age, sex, and ICD diagnoses. The main risk factor examined was the difference between initial and minimum serum cholesterol levels. Other predictors were serum markers of acute inflammation.
Results: We included 67 cases and 67 controls (134 critically ill patients, 49% female, 46% medical). Minimum serum cholesterol levels were lower in the cases (median difference: -24, 95% CI [-39, -9], mg/dl). A conditional logistic regression model controlling for the patients’ length of CCU stay showed a 2.2% increase in odds (odds ratio 1.022, 95% CI [1.006, 1.037], p=0.007) for the development of CIP for every 1 mg/dl decrease in serum cholesterol levels between the initial and lowest serum concentrations. Cholesterol levels decreased more profoundly in cases than controls (median: -74 (IQR -115 to -24) vs. ‑22 (IQR -53 to 0), median difference:
-36, 95% CI [-59, -13]), mg/dl). We found significant median differences across matched pairs in maximum serum C-reactive protein (8.9, 95% CI [4.56, 13.24], mg/dl), minimum albumin
(-4.2, 95% CI [-6.7, -1.7], g/l) and lowest cholinesterase levels (-0.72, 95% CI [-1.05, -0.39], U/l).
Conclusion: Lower minimum cholesterol levels and more pronounced decreases in cholesterol levels during critical care unit hospitalizations may be a risk factor for CIP.
Poor attendance by students of medical schools, and application of a novel method to improve the attendance
Authors: Panigrahi Debadatta , Mohamed Yehia S. 
Published: May 2023

Abstract
Background Recently, physical class-attendance of students has drastically reduced in medical schools. Many reasons have been postulated and several remedial measures advocated.Methods In order to improve the students’ attendance in classes, we used a novel method by including a real patient-scenario relating to the day’s topic. We removed the case scenario from the posting of lecture note on Learning Management System (LMS) the previous evening. We also involved the students in the case discussion during the lecture which makes the lecture interactive. Student attendance was reported for three lectures before and after application of the new strategy.Results The student average attendance for both year 3 and year 4 was reported before and after applying the intervention. By statistical analysis of the attendance percentage, there was an increase in the average of attendance and this increase was found highly significant, which indicates an improvement in the student class-attendance after applying the proposed modification in lecture delivery and hand out posting on LMS.Discussion Starting the class with a patient-scenario based on the topic, and motivating the students to participate in the open Q and A discussion makes the lecture more interesting for the students. Since they will face the patients with common problems during their clerkship training, starting in next few months to a year, which makes it more meaningful. By analyzing the class attendance average for a minimum of three classes before and after implementing this intervention, we noticed a significance improvement in the overall attendance for both year 3 and year 4.
Sevoflurane exposure induces neuronal cell ferroptosis initiated by increase of intracellular hydrogen peroxide in the developing brain via ER stress ATF3 activation
Authors: Kang Liheng , Piao Meihua , Liu Nan , Gu Wanping , Feng Chunsheng 
Published: May 2023

Abstract
Neuronal cell death has been well acknowledged as the primary pathological basis underlying developmental neurotoxicity following sevoflurane exposure, whereas the exact mechanism remains elusive. Ferroptosis is a programmed cell death featured by iron-dependent lipid peroxidation that is driven by hydrogen peroxide (H2O2) and ferrous iron through Fenton reaction, and participates in the pathogenesis of multiple neurological diseases. As stress response factor, activating transcription factor 3 (ATF3) can be activated by PERK/ATF4-mediated pathway during endoplasmic reticulum (ER) stress and followed by increased intracellular H2O2, which is involved in regulation of apoptosis, autophagy and ferroptosis. Here, we investigated whether ferroptosis and ATF3 activation are implicated in sevoflurane-triggered neuronal cell death in the developing brain. Results showed that sevoflurane exposure induced neuronal death as a result of iron-dependent lipid peroxidation damage secondary to H2O2 accumulation and ferrous iron increase, which was consistent with the criteria for ferroptosis. Furthermore, we observed that increases of iron and H2O2 induced by sevoflurane exposure were associated with the upregulation and nuclear translocation of ATF3 in response to ER stress. Knockdown of ATF3 expression alleviated iron-dependent lipid peroxidation, which prevented sevoflurane-triggered neuronal ferroptosis. Mechanistically, ATF3 promoted sevoflurane-induced H2O2 accumulation through activating NOX4 and suppressing catalase, GPX4 and SLC7A11. Additionally, we detected that increase of H2O2 was accompanied with upregulation of TFR and TF and downregulation of FPN which linked the iron overload to ferroptosis triggered by sevoflurane. Taken together, our results demonstrated ER stress-mediated ATF3 activation contributes to sevoflurane-induced neuronal ferroptosis via H2O2 accumulation and resultant iron overload.