bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between emotional neglect and non-suicidal self-injury among middle school students in China: the mediating role of social anxiety symptoms and insomnia
Authors: Hou Shiyi , Twayigira Mireille , Luo Xuerong , Song Lintong , Cui Xilong , Xie Qiuxiang , Shen Yanmei , Yang Feilong , Yuan Xiuhong 
Published: April 2023

Abstract
Background
Non-suicidal self-injury (NSSI) is a vital public concern around the world, and it often starts in adolescence. Emotional neglect (EN) has been considered a distal risk factor for NSSI, but the effects of social anxiety symptoms (SA) and insomnia on this relationship have remained unclear. This study aimed to investigate the potential pathways from EN to NSSI, examining the role of SA and insomnia in this association.

Methods
One thousand three hundred thirty seven Chinese middle school students (Mage = 13.040, SD = 0.981, 50.2% males) in China were enrolled in this cross-sectional study. Participants completed the Emotional Neglect sub-scale of Childhood Trauma Questionnaire (CTQ-SF), the Social Anxiety Scale for Adolescent (SAS-A), Athens Insomnia Scale (AIS) and non-suicidal self-injury assessment. Structural equation modelling (SEM) was used to test the possible mediation model among these variables.

Results
231(17.3%) students reported NSSI history during last year and 322 (24.1%) participants reported experiences of EN. Students who experienced EN have higher rates of NSSI compared to students without EN history (29.2% vs 13.5%). EN, SA, insomnia and NSSI were positively related to each other. Furthermore, both SA and insomnia played a mediating role in the relationship between EN and NSSI, the series mediating effect of SA and insomnia on this association was also significant after controlling for demographics. Indirect effects accounted for 58.26% of the total effects (EN → NSSI).

Conclusions
Our study revealed that EN was associated with NSSI, SA and insomnia play indirect roles in the association between EN and NSSI. The findings of our research may have implications for clinicians, families, and schools in their efforts to lower the risk of NSSI in adolescents.
Hybrid pedicle screw and modified cortical bone trajectory technique in transforaminal lumbar interbody fusion at L4-L5 segment: finite element analysis
Authors: Kahaer Alafate , Zhang Rui , Wang Yixi , Luan Haopeng , Maimaiti Abulikemu , Liu Dongshan , Shi Wenjie , Zhang Tao , Guo Hailong , Rexiti Paerhati 
Published: April 2023

Abstract
Background
Investigate the biomechanical properties of the hybrid fixation technique with bilateral pedicle screw (BPS) and bilateral modified cortical bone trajectory screw (BMCS) in L4-L5 transforaminal lumbar interbody fusion (TLIF).

Methods
Three finite element (FE) models of the L1-S1 lumbar spine were established according to the three human cadaveric lumbar specimens. BPS-BMCS (BPS at L4 and BMCS at L5), BMCS-BPS (BMCS at L4 and BPS at L5), BPS-BPS (BPS at L4 and L5), and BMCS-BMCS (BMCS at L4 and L5) were implanted into the L4-L5 segment of each FE model. The range of motion (ROM) of the L4-L5 segment, von Mises stress of the fixation, intervertebral cage, and rod were compared under a 400-N compressive load with 7.5 Nm moments in flexion, extension, bending, and rotation.

Results
BPS-BMCS technique has the lowest ROM in extension and rotation, and BMCS-BMCS technique has the lowest ROM in flexion and lateral bending. The BMCS-BMCS technique showed maximal cage stress in flexion and lateral bending, and the BPS-BPS technique in extension and rotation. Compared to the BPS-BPS and BMCS-BMCS technique, BPS-BMCS technique presented a lower risk of screw breakage and BMCS-BPS technique presented a lower risk of rod breakage.

Conclusion
The results of this study support that the use of the BPS-BMCS and BMCS-BPS techniques in TLIF surgery for offering the superior stability and a lower risk of cage subsidence and instrument-related complication.
Application of transverse acetabular ligament in total hip arthroplasty: a systematic review
Authors: Ning Dongfang , Xu Feng , Zhang Zhongxing , Yang Xiaolong , Wei Jun 
Published: April 2023

Abstract
Introduction
In total hip arthroplasty (THA), the correct position of the acetabular component directly determines the outcome of the surgery, or the success of the surgery. Therefore, how to accurately locate the position of the acetabular component has become a very critical step in THA. As an important anatomical structure of the hip joint, the transverse acetabular ligament (TAL) is helpful for acetabular component orientation in THA. The aim of this systematic review was to investigate application of TAL in THA.

Materials and methods
A systematic literature search of PUBMED, EMBASE, and Cochrane Library was performed (January and February 2023) using keywords “total hip arthroplasty,” “total hip replacement,” “total hip replacements,” “total hip arthroplasties,” “total hip prosthesis,” and “transverse acetabular ligament” in all possible combinations. Reference lists of included articles were reviewed. Study design, surgical approach, patient demographics, TAL identification rate, appearance of the TAL, anteversion and inclination angle and rate of dislocations were recorded.

Results
In total, 19 studies met the screening criteria. Study designs were prospective cohorts (42%), retrospective cohorts (32%), Case series (21%), and randomized controlled trial (5%). Twelve of the 19 (63.2%) studies investigated the application of TAL as an anatomical landmark for locating acetabular component position in THA. Analysis revealed that TAL is a reliable anatomical landmark for acetabular component orientation within the safe zone in THA.

Conclusions
TAL can reliably be used to align the acetabular component in the safe zone for anteversion and inclination in THA. However, TAL has individual variation influenced by some risk factors. More randomized controlled studies with larger numbers of patients are needed to investigate the precision and accuracy of TAL as an intraoperative landmark in THA.

Level of evidence
IV.
The prescription drug monitoring program in a multifactorial approach to the opioid crisis: PDMP data, Pennsylvania, 2016–2020
Authors: Adalbert Jenna R. , Syal Amit , Varshney Karan , George Brandon , Hom Jeffrey , Ilyas Asif M. 
Published: April 2023

Abstract
Background
Prescription opioids remain an important contributor to the United States opioid crisis and to the development of opioid use disorder for opioid-naïve individuals. Recent legislative actions, such as the implementation of state prescription drug monitoring programs (PDMPs), aim to reduce opioid morbidity and mortality through enhanced tracking and reporting of prescription data. The primary objective of our study was to describe the opioid prescribing trends in the state of Pennsylvania (PA) as recorded by the PA PDMP following legislative changes in reporting guidelines, and discuss the PDMP’s role in a multifactorial approach to opioid harm reduction.

Methods
State-level opioid prescription data summaries recorded by the PA PDMP for each calendar quarter from August 2016 through March 2020 were collected from the PA Department of Health. Data for oxycodone, hydrocodone, and morphine were analyzed by quarter for total prescription numbers and refills. Prescription lengths, pill quantities, and average morphine milliequivalents (MMEs) were analyzed by quarter for all 14 opioid prescription variants recorded by the PA PDMP. Linear regression was conducted for each group of variables to identify significant differences in prescribing trends.

Results
For total prescriptions dispensed, the number of oxycodone, hydrocodone, and morphine prescriptions decreased by 34.4, 44.6, and 22.3% respectively (p < 0.0001). Refills fluctuated less consistently with general peaks in Q3 of 2017 and Q3 of 2018 (p = 0.2878). The rate of prescribing for all opioid prescription lengths decreased, ranging in frequency from 22 to 30 days (47.5% of prescriptions) to 31+ days of opioids (0.8% of prescriptions) (p < 0.0001). Similarly, decreased prescribing was observed for all prescription amounts, ranging in frequency from 22 to 60 pills (36.6% of prescriptions) to 60–90 pills (14.2% of prescriptions) (p < 0.0001). Overall, the average MME per opioid prescription decreased by 18.9%.

Conclusions
Per the PA PDMP database, opioid prescribing has decreased significantly in PA from 2016 to 2020. The PDMP database is an important tool for tracking opioid prescribing trends in PA, and PDMPs structured similarly in other states may enhance our ability to understand and influence the trajectory of the U.S. opioid crisis. Further research is needed to determine optimal PDMP policies and practices nationwide.
The effect of the hospital working environment on the work limitation of the employees in Turkey: a multivariable analysis
Authors: Kiliç Mahmut , Uslukiliç Güllü , Yaman Sevda 
Published: April 2023

Abstract
Background
The aim of this study is to examine the effects of working environment and demographic variables on the level of work limitation in a university hospital.

Methods
The study is cross-sectional and was conducted in 2022 among employees of a university hospital. 254 people voluntarily participated in the study. Data were collected by applying the sociodemographic data form, the Work Limitation Questionnaire (WLQ), and the Work Environment Scale (WES). Institutional permission and ethical approval were obtained for the study. In the analysis of the data, t-test, ANOVA, and linear regression (LR) were used.

Results
The WLQ score average of hospital staff was low. According to LR analysis, the factors affecting the level of work limitation of hospital staff; worsening perception of health status, being a doctor, decreased income level, increased working time in the institution, and age reduction. It was determined that 32.8% of the change in the WLQ score was related to these factors. While in the univariate tests, the mean of work limitation was found to be significant by getting occupational health safety training, having health problems due to the work done, and taking leave due to work accidents, in the multivariable LR analysis, these factors were insignificant.

Conclusions
As the working environment gets worse, the level of work limitation increases. It is recommended that hospital managers make the working environment better and safer, and make arrangements and programs to increase personnel satisfaction.
Promoter evolution of mammalian gene duplicates
Authors: Fraimovitch Evgeny , Hagai Tzachi 
Published: April 2023

Abstract
Background
Gene duplication is thought to be a central process in evolution to gain new functions. The factors that dictate gene retention following duplication as well paralog gene divergence in sequence, expression and function have been extensively studied. However, relatively little is known about the evolution of promoter regions of gene duplicates and how they influence gene duplicate divergence. Here, we focus on promoters of paralog genes, comparing their similarity in sequence, in the sets of transcription factors (TFs) that bind them, and in their overall promoter architecture.

Results
We observe that promoters of recent duplications display higher sequence similarity between them and that sequence similarity rapidly declines between promoters of more ancient paralogs. In contrast, similarity in cis-regulation, as measured by the set of TFs that bind promoters of both paralogs, does not simply decrease with time from duplication and is instead related to promoter architecture—paralogs with CpG Islands (CGIs) in their promoters share a greater fraction of TFs, while CGI-less paralogs are more divergent in their TF binding set.
Focusing on recent duplication events and partitioning them by their duplication mechanism enables us to uncover promoter properties associated with gene retention, as well as to characterize the evolution of promoters of newly born genes: In recent retrotransposition-mediated duplications, we observe asymmetry in cis-regulation of paralog pairs: Retrocopy genes are lowly expressed and their promoters are bound by fewer TFs and are depleted of CGIs, in comparison with the original gene copy. Furthermore, looking at recent segmental duplication regions in primates enable us to compare successful retentions versus loss of duplicates, showing that duplicate retention is associated with fewer TFs and with CGI-less promoter architecture.

Conclusions
In this work, we profiled promoters of gene duplicates and their inter-paralog divergence. We also studied how their characteristics are associated with duplication time and duplication mechanism, as well as with the fate of these duplicates. These results underline the importance of cis-regulatory mechanisms in shaping the evolution of new genes and their fate following duplication.
A tumor microenvironment-based prognostic index for osteosarcoma
Authors: Wu Changwu , Gong Siming , Duan Yingjuan , Deng Chao , Kallendrusch Sonja , Berninghausen Laura , Osterhoff Georg , Schopow Nikolas 
Published: April 2023

AbstractBackgroundThe tumor microenvironment (TME) has a central role in the oncogenesis of osteosarcomas. The composition of the TME is essential for the interaction between tumor and immune cells. The aim of this study was to establish a prognostic index (TMEindex) for osteosarcoma based on the TME, from which estimates about patient survival and individual response to immune checkpoint inhibitor (ICI) therapy can be deduced.MethodsBased on osteosarcoma samples from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database, the ESTIMATE algorithm was used to estimate ImmuneScore and StromalScore. Combined differentially expressed gene analysis, weighted gene co-expression network analyses, the Least Absolute Shrinkage and Selection Operator regression and stepwise regression to construct the TMEindex. The prognostic role of TMEindex was validated in three independent datasets. The molecular and immune characteristics of TMEindex and the impact on immunotherapy were then comprehensively investigated. The expression of TMEindex genes in different cell types and its effects on osteosarcoma cells were explored by scRNA-Seq analysis and molecular biology experiments.ResultsFundamental is the expression of MYC, P4HA1, RAMP1 and TAC4. Patients with high TMEindex had worse overall survival, recurrence-free survival, and metastasis-free survival. TMEindex is an independent prognostic factor in osteosarcoma. TMEindex genes were mainly expressed in malignant cells. The knockdown of MYC and P4HA1 significantly inhibited the proliferation, invasion and migration of osteosarcoma cells. A high TME index is related to the MYC, mTOR, and DNA replication-related pathways. In contrast, a low TME index is related to immune-related signaling pathways such as the inflammatory response. The TMEindex was negatively correlated with ImmuneScore, StromalScore, immune cell infiltration, and various immune-related signature scores. Patients with a higher TMEindex had an immune-cold TME and higher invasiveness. Patients with a low TME index were more likely to respond to ICI therapy and achieve clinical benefit. In addition, the TME index correlated with response to 29 oncologic drugs.ConclusionsThe TMEindex is a promising biomarker to predict the prognosis of patients with osteosarcoma and their response to ICI therapy, and to distinguish the molecular and immune characteristics.
The NF-ĸB p50 subunit generated by KPC1-mediated ubiquitination and limited proteasomal processing, suppresses tumor growth
Authors: Kravtsova-Ivantsiv Yelena , Goldhirsh Gilad , Tomuleasa Ciprian , Pikarsky Eli , Ciechanover Aaron 
Published: April 2023

AbstractNuclear factor-ĸB (NF-ĸB) is an important transcriptional regulator of key cellular processes, including cell cycle, immune response, and malignant transformation. We found that the ubiquitin ligase Kip1 ubiquitination-promoting complex subunit 1 (KPC1; also known as Ring finger protein 123 – RNF123) stimulates ubiquitination and limited proteasomal processing of the p105 NF-ĸB precursor to generate p50, the active subunit of the heterodimeric transcription factor. KPC1 binds to the ankyrin repeats’ (AR) domain of NF-ĸB p105 via a short binding site of 7 amino acids—968-WILVRLW-974. Though mature NF-ĸB is overexpressed and constitutively active in different tumors, we found that overexpression of the p50 subunit, exerts a strong tumor suppressive effect. Furthermore, excess of KPC1 that stimulates generation of p50 from the p105 precursor, also results in a similar effect. Analysis of transcripts of glioblastoma and breast tumors revealed that excess of p50 stimulates expression of many NF-ĸB-regulated tumor suppressive genes. Using human xenograft tumor models in different immune compromised mice, we demonstrated that the immune system plays a significant role in the tumor suppressive activity of p50:p50 homodimer stimulating the expression of the pro-inflammatory cytokines CCL3, CCL4, and CCL5 in both cultured cells and in the xenografts. Expression of these cytokines leads to recruitment of macrophages and NK cells, which restrict tumor growth. Finally, p50 inhibits the expression of the programmed cell death-ligand 1 (PDL1), establishing an additional level of a strong tumor suppressive response mediated by the immune system.
Monitoring variability in parameter estimates for lumped parameter models of the systemic circulation using longitudinal hemodynamic measurements
Authors: Bjørdalsbakke Nikolai L. , Sturdy Jacob , Ingeström Emma M. L. , Hellevik Leif R. 
Published: April 2023

Abstract
Background
Physics-based cardiovascular models are only recently being considered for disease diagnosis or prognosis in clinical settings. These models depend on parameters representing the physical and physiological properties of the modeled system. Personalizing these parameters may give insight into the specific state of the individual and etiology of disease. We applied a relatively fast model optimization scheme based on common local optimization methods to two model formulations of the left ventricle and systemic circulation. One closed-loop model and one open-loop model were applied. Intermittently collected hemodynamic data from an exercise motivation study were used to personalize these models for data from 25 participants. The hemodynamic data were collected for each participant at the start, middle and end of the trial. We constructed two data sets for the participants, both consisting of systolic and diastolic brachial pressure, stroke volume, and left-ventricular outflow tract velocity traces paired with either the finger arterial pressure waveform or the carotid pressure waveform.

Results
We examined the feasibility of separating parameter estimates for the individual from population estimates by assessing the variability of estimates using the interquartile range. We found that the estimated parameter values were similar for the two model formulations, but that the systemic arterial compliance was significantly different ($$p < 10^{-6}$$

p
<

10

-
6

) depending on choice of pressure waveform. The estimates of systemic arterial compliance were on average higher when using the finger artery pressure waveform as compared to the carotid waveform.

Conclusions
We found that for the majority of participants, the variability of parameter estimates for a given participant on any measurement day was lower than the variability both across all measurement days combined for one participant, and for the population. This indicates that it is possible to identify individuals from the population, and that we can distinguish different measurement days for the individual participant by parameter values using the presented optimization method.
A study on the current state and equity level of the health promotion service demands among older adults in China
Authors: Ren Weicun , Ma Xiwang , Tarimo Clifford Silver , Xing Yiqing , Lv Xinyuan , Liang Zhang 
Published: April 2023

Abstract
Background
Meeting the demands of older adults for health promotion services (DOAHPS) is essential for maintaining their health and enhancing their quality of life. The purpose of this study was to construct a model for evaluating DOAHPS to quantitatively evaluate the current state and equity level of DOAHPS in China, as well as to explore the main factors affecting DOAHPS’ current state and equity level.

Methods
This study analyzed the DOAHPS data from the "Survey on Chinese Residents' Health Service Demands in the New Era", which included 1542 older adults aged 65 and older. Relationships between evaluation indicators of DOAHPS were explored using Structural Equation Modeling (SEM). The Weighted TOPSIS method and Logistic regression (LR) were used to analyze the current state and factors impacting DOAHPS. The equity level of DOAHPS’ allocation among different older adult groups and its influencing factors were determined using the Rank Sum Ratio (RSR) method and T Theil index.

Results
The evaluation score for DOAHPS was 42.57 ± 1.51. Health status, health literacy and behavior were positively correlated with DOAHPS (r = 0.40, 0.38; P < 0.05). The LR results revealed that the most significant determinants of DOAHPS were sex, residence, education level and pre-retirement occupation (all P < 0.05). The number of older adults with very poor, poor, general, high and very high level health promotion service demands accounted for 2.27%, 28.60%, 53.05%, 15.43% and 0.65%, respectively. The total T Theil index of DOAHPS was 2.7433*10–4, and the intra-group difference contribution rate exceeded 72%.

Conclusions
Compared to the maximum level, the total DOAHPS level was found to be moderate, although the demands of urban seniors with higher levels of education may be substantially greater. The observed inequities in the allocation of DOAHPS were primarily related to differences in education level and pre-retirement occupation within group. To better address health promotion services for older adults, policymakers could target older males with low education who reside in rural regions.