bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological aspects of individuals with mental disorders in the referral system: the experience of a Community Mental Health Center in the northeast of Iran
Authors: Talebi Mahdi , Nemati Ahmad , Gholami Mobin , Niroumand Shabnam 
Published: August 2023

Abstract
Background
Community Mental Health Centers (CMHCs) provide mental health services to patients at low cost, with less stigma, in a domiciliary setting. This study aimed to assess the epidemiological and variety of mental disorders and treatment dropout among patients attending the only CMHC of Mashhad, northeastern Iran. Furthermore, the association of demographic variables with referral from primary health care centers was investigated.
Methods
This cross-sectional study enrolled 662 patients who contacted this center between January 2014 and December 2021. We completed a checklist that included information on demographics, diagnosed mental disorders, referral status, and the number of psychiatric visits, all of which psychiatrists fully completed clinical records. The frequency distributions of all variables were conducted with SPSS11.5. In addition, the association between epidemiological findings and patient referral (referral system or self-referral) and the association between epidemiological findings and the number of psychiatric revisits were examined by the Chi-square test.
Results
Of 662 patients, 472 (71%) women and 190 (29%) men were enrolled, and the mean age of all patients was 29 years. Among the 475 adult patients, 367 (77.3%) patients were married and had primary or secondary education (40.4%), and the majority of them were housewives (56.4%). Major Depression Disorder (32%), Generalized Anxiety Disorder (18.3%) were the two most common mental illnesses in patients. Most patients (70.7%) were referred to this center via the referral system. Moreover, non-working patients (housewives and unemployed patients) and the female gender were associated with more referrals to this center through the referral system. 431 patients (65.1%) did not return for a second visit, and the higher number of psychiatric visits was associated with a lower level of education.
Conclusions
It is recommended that primary health care centers (PHCs) undergo certain modifications to enhance the screening process for psychiatric patients, focusing on common mental disorders. Referral of mental illnesses to CMHCs should be taken more seriously, especially in women with low socioeconomic status. Better health services in CMHCs can encourage patients to continue treatment in CMHCs.
Joint clustering and missing value imputation for incomplete data via fuzzy modeling and alternate optimization
Authors: Wang Yitang , Pang Yong , Zhang Liyong , Song Xueguan 
Published: August 2023

Abstract
Since missing information is an ordinary phenomenon in actual scenarios that increases the difficulty of data analysis, missing value imputation has attracted ever-growing attention in recent years, by exploiting data modeling. Particularly, missing information in engineering design and optimization is a challenging topic. In this work, an exquisite missing value imputation method based on Takagi-Sugeno (TS) fuzzy modeling is proposed, which first divides incomplete dataset by clustering into several fuzzy subsets and finally establishes global model with different regression models on each subset. Specifically, to improve the clustering performance of practical incomplete issues, we incorporate the measurement of common and uncommon observed feature subspace information of data instances into the fuzzy c-means (FCM) framework. Moreover, to better improve the model accuracy, feature selection is introduced to each fuzzy rule and update model parameters and imputations by co-training. The experiments reported both on UCI and tunnel boring machine (TBM) operation datasets demonstrate the proposed method can accurately accomplish missing value imputation of incomplete data.
Flexural performance of reinforced concrete beams subjected to accelerated non-uniform corrosion
Authors: Huang Jin , Yu Dezhong , Cao Yunzhong , Fu Chuanqing 
Published: August 2023

Abstract
In this study, a modified accelerated corrosion method based on the traditional galvanic method was adopted to generate non-uniform corrosion of reinforcement. The flexural performance of corroded RC beams was experimentally investigated, aiming to study the influence of longitudinal reinforcements corrosion induced by two different accelerated corrosion methods on the degradation of flexural capacity of RC beams. The corrosion-induced and load-induced cracking behaviors, as well as the degradation of flexural performance of beam specimens corroded by these two different methods were studied. The test results showed that the longitudinal reinforcements subjected to the modified accelerated corrosion method demonstrates a considerably higher circumferential and longitudinal non-uniformity, while the traditional accelerated corrosion method induces a rather uniform corrosion. For the corrosion-induced crack, the non-uniform reinforcement corrosion induced by the modified accelerated corrosion method was closer to the one after exposure to the natural environment. The non-uniformity of corrosion aggravates the propagation of both corrosion-induced and load-induced cracks, leading to the change of flexural failure mode. And the uniform corrosion induced by the traditional accelerated corrosion method underestimates the degradation of shear capacity of RC beam, especially in the cases of corrosion degree no less than 15%.
Synchronous Multiple Pulmonary Ground-Glass Nodules That Arose from Different Lesions Rather than from Multiple Metastases of a Single Lesion
Authors: HAN Ya-Qing , HAN Wen-Yu , XIE Shao-Nan , LIU Qing-Yi 
Published: August 2023

Abstract

Purpose
This study aimed to investigate the expression of lung cancer driver genes in patients with synchronous multiple ground-glass nodules (SMGGNs), to calculate the relationships of these genes with clinical features, and to probe into the origin of multiple primary pulmonary ground-glass nodules (GGNs) from the perspective of molecular biology.
Methods
The clinicopathological data of 50 patients with SMGGNs who were admitted to the Department of Thoracic Surgery of the Fourth Hospital of Hebei Medical University from January 2018 to January 2021 were collected for retrospective analysis. All the samples resected were genotyped at 16 lung cancer driver gene loci by next-generation sequencing technology. The relationships between gene mutations and clinical features were analysed, and suspected pulmonary nodules of the same origin were analysed by the whole-exome sequencing.
Results
Fifty patients were included in the study, 86.0% (43/50) of whom had gene mutations. Some 133 pulmonary nodules were resected, which were pathologically classified into the following types: atypical adenomatous hyperplasia (21 nodules), adenocarcinoma in situ (32), micro-invasive adenocarcinoma (30), and invasive adenocarcinoma (50). Lung cancer driver gene mutations were identified in 73 (54.9%) nodules, 63.0% (46/73) of which were in the epidermal growth factor receptor gene (EGFR). Significant differences were observed in the gene mutation status between nodule types, particularly EGFR mutation, which differed between histological and imaging subtypes. Multiple gene mutations were not discovered in the same tissue. A low-probability mutation (RET fusion) was detected in three nodules of one patient, and further whole-exome sequencing showed that the three nodules had different gene mutations and were not metastatic.
Conclusions
The driver gene mutations in patients with SMGGNs are quite different and mutually exclusive, and nodules can arise from multiple primary lesions. Surgical resection is considered a superior approach to treating SMGGNs.
Do environmental subsidies from the government result in better environmental performance by firms?
Authors: Xu Xueguo , Lei Xue 
Published: August 2023

Abstract
Given the prevailing global environmental crisis, this inquiry pertains to the strategies employed by governments to motivate firms towards enhancing their environmental performance via the utilization of environmental subsidies. This study examines the impact of government environmental subsidies on the environmental performance of firms, utilizing data from Chinese A-share listed companies. Additionally, it investigates the moderating effect of executive short-sightedness on this relationship. This study demonstrates that there exists a noteworthy positive correlation between government environmental subsidies and corporate environmental performance. Additionally, it highlights the significance of green innovation as a mediating mechanism through which government environmental subsidies can effectively enhance corporate environmental performance. Executive myopia has a negative moderating effect on the relationship between government environmental subsidies and both green innovation and corporate environmental performance. Hence, it is recommended that the government should formulate a more scientifically grounded and rational environmental subsidy policy in order to incentivize enterprises to actively participate in green innovation and enhance their environmental efficacy. Simultaneously, it is desirable that corporate executives relinquish myopic perspectives and prioritize long-term corporate interests in order to attain sustainable corporate growth.
Short animated video increases knowledge and comfort in clinical counseling on inequitable health impacts of air pollution among interprofessional health learners and clinicians
Authors: Doheny Brenna M. , Inglis Jack J. , Boll Karly A. , Lunos Scott , Surapaneni Vishnu Laalitha 
Published: August 2023

Abstract
Background Air pollution is a major health risk contributing to global morbidity and mortality, yet clinicians do not routinely engage in counseling patients on this topic. Clinicians cite their lack of education as a common barrier. We developed a two-minute animated video on mitigating air pollution health risks and evaluated the efficacy of this video as an educational tool.Methods In March-June 2021, a convenience sample of Minnesota interprofessional health learners and clinicians viewed the video and completed an electronic survey that assessed pre-/post-video intervention changes in a) didactic and clinically applied knowledge on health impacts of air pollution, b) perceived comfort in identifying at-risk patients and counseling them on relevant preventive health behaviors, c) intentions/barriers to counseling patients, d) beliefs and attitudes related to the health harms of air pollution, and e) perceptions of the overall acceptability of the intervention.Results The 218 participants included learners and clinicians in medicine, nursing, and advanced practice provision. Respondents’ knowledge scores and self-reported level of comfort in identifying high-risk patients and counseling them on preventative health behaviors increased significantly pre-/post-intervention. The video also effectively altered participants’ misperceptions about the health impacts of air pollution. While less than half of participants (43.6%) reported they intended to engage in counseling patients as a result of watching the video, 52.3% indicated they might do so. Lack of time during clinical encounters and lack of training were reported as persistent barriers to engaging in this counseling. Overall, participants found the video to be an effective educational tool, indicating that they wanted their colleagues and patients to watch the video and would like to see further short animated videos on other environmental health topics.Conclusions A two-minute animated educational video significantly improved knowledge of inequitable health impacts of air pollution and improved perceived comfort in identifying and counseling at-risk patients among health professional learners and clinicians regardless of profession, level of training, or pre-intervention knowledge level. Academic health professional training programs and health systems should consider adopting this modality as a tool for educating learners, clinicians, and patients on environmental health risks.
Outcome of Early Reversal of Intestinal Stoma: A Cross- Sectional Study
Authors: Talukdar Md. Monoarul Islam , Islam Nazia , Jalal Mohammed Tanvir , Ovi Mir Rasekh Alam , Nasrin Shamima , Sheikh Md. Shahadot Hossain 
Published: August 2023

Abstract
Background
Early reversal of temporary intestinal stoma might bring good clinical outcome as like as late reversal in the context of anastomotic leakage, postoperative ileus, sepsis, intraoperative bleeding etc. This may avoid stoma related morbidity & complications. This study was designed to find out the short-term outcomes of early reversal of intestinal stoma within 14 days of index surgery.
Methods
This cross-sectional observational study was conducted at the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The study duration was 16 months, from March 2021 to June 2022. During this period, a total of 15 patients of either sex who underwent colorectal surgery with employment of intestinal stoma during the study period were included in the study following the inclusion and exclusion criteria. Preoperative checking of anastomotic leakage of index surgery was performed by water soluble rectal contrast imaging prior to selection of cases.
Result
The study included 15 participants with relatively even age and gender distributions. The majority of participants experienced favorable postoperative outcomes, with minimal complications. The anastomotic leak rate was 6.7%, with only one patient experiencing it out of a total of 15. However, a relatively high rate of wound infection (40%) was observed among the participants.
Conclusion
The study demonstrates that early reversal of intestinal stoma in Bangladesh may result in predominantly favorable outcomes in selected patients. However, the high rate of wound infection necessitates further investigation into the causes and implementation of effective preventive measures. Future research with larger and more diverse patient populations is needed to validate and expand upon these findings, contributing to improved surgical care and patient outcomes in Bangladesh and beyond.
Evaluation of the effectiveness of using flipped classroom in puncture skills teaching
Authors: Zhang Weihao , Jiang Miao , Zhao Wei , Li Shuai , Li Fan , Feng Feifei , Wang Yongjing , Li Yan , Liu Lan 
Published: August 2023

Abstract
Background
The effectiveness of flipped classroom (FC) on puncture skills in medical education is still uncertain. The purpose of this study was to assess the role of the FC model in puncture skills and investigate the acceptance and approval of FC among medical students and instructors.
Methods
A mixed quasi-experimental with randomization was conducted in September 2022 for one month, using an FC teaching method that combined instructional videos and group learning. The study participants were 71 fifth-year medical students from two classes at a Chinese medical school and four instructors. The medical students were randomly divided into two groups: the traditional classroom (TC) group (Group A) and the FC group (Group B). Group B used FC for teaching and Group A used PowerPoint-based TC for teaching. The effectiveness of the two teaching models was assessed with Objective Structured Clinical Examination (OSCE), and questionnaires were distributed to the medical students and instructors after the assessment. Two independent sample t-tests were used to analyse the differences in demographic data and OSCE scores of the two groups of medical students.
Results
Group B scored higher in puncture skills than Group A, especially regarding abdominal puncture (p = 0.03), thoracentesis (p < 0.001), bone marrow puncture (p < 0.001), and average performance of puncture skills (p < 0.001). For lumbar puncture, there was no difference in skill scores between Groups A and B (P > 0.409). The medical students thought that the FC improved their self-learning ability and helped them to acquire knowledge. Regarding the OSCE of their skills, most medical students thought that it was more innovative and objective than traditional examinations, and was better for assessing their overall abilities. Both the FC and the OSCE were supported by the medical students. The instructors were also satisfied with the students' performance in the FC and supported the teaching model, agreeing to continue using it.
Conclusions
This study shows that FC teaching that combines instructional videos and group learning is a reliable and well received teaching method for puncture skills, which supplements and expands existing teaching methods in the medical field.
Diagnosis and treatment of syphilitic choroidal retinitis
Authors: Liu Pengfei , Hu Yuzhang 
Published: August 2023

Abstract
Purpose To evaluate the diagnosis and treatment experience of a group of patients with syphilitic choroidal retinitis.
Method Selected 3 patients with syphilitic choroidal retinitis and 2 patients with choroidal retinopathy with similar fundus changes, carefully asking the history, general and specialized examination, such as the best corrected visual acuity (BCVA), slit lamp, binocular indirect ophthalmoscope, fundus photography, autofluorescence (AF), FFA, macular OCT and other auxiliary examinations, and blood routine examiniation, ESR, hypersensitive c-reactive protein, laboratory test of blood transfusion were completed.
Results Correct diagnosis was made and good therapeutic effect was obtained in all the 5 patients ConclusionsThe manifestation of syphilitic choroidal retinitis is complicated. Only by asking the medical history carefully, perfecting the whole body and various specialized examinations and auxiliary examinations, can we make the correct diagnosis and treatment.
FOMO: A Fragment-based Objective Molecule Optimization
Framework
Authors: Ma Cong , Zhang Zeqi , Xu Min , Zhang Haimin 
Published: August 2023

Abstract
Drug discovery greatly relies on optimizing drug-like molecules to improve their properties. In this paper, we propose FOMO, a Fragment-based Objective Molecule Optimization Framework that addresses the challenge of structure collision in molecule optimization. Traditional graph-based methods only considered the types of atoms, bonds, and their connectivity, but they barely account for the varying importance of varying neighboring moieties. FOMO utilizes a multi-head Attention-based Graph model to incorporate the significance of distinct neighboring atoms and bonds during the process of feature aggregation. FOMO is used to modify moieties, by adding new fragments or removing moieties, aiming to improve specific drug-like properties of a given molecule. Our experiments demonstrate that FOMO, trained on a single dataset, generates molecules with superior properties while maintaining similarity to the original molecule. This is important to avoid immediate loss of pharmacological activity of lead compounds. In comparison to the previous state-of-the-art approaches, FOMO achieves the highest success rates in optimizing QED, DRD, PLogP, and multi-objective optimization tasks.
Myeloid dickkopf-1 fuels neurovascular and neuroimmune alterations in ischemic stroke
Authors: ElAli Ayman , Menet Romain , Bernard Maxime , Lecordier Sarah , Trudel Esther , Distéfano-Gagné Félix , Seigneur Josée , Allain Anne-Sophie , Manrique-Castano Daniel , Aldib Natija , Haili Yacine , Bretzner Frederic , Gosselin David 
Published: August 2023

Abstract

Neurovascular impairments and neuroimmune deregulation contribute to injury progression after ischemic stroke. Dickkopf-1 (DKK1) elevated levels correlates with poor stroke outcomes. DKK1 antagonizes the canonical Wnt pathway that plays a critical role in regulating neurovascular and neuroimmune functions. Herein, we report that DKK1 expression in the normal adult brain is absent, but is de novo expressed at the lesion site after experimental ischemic stroke. Using genetic tools to conditionally induce DKK1 expression in a tissue-specific manner, we reveal that its early induction aggravates neurological deficits and injury severity after stroke, associated with altered neuronal and vascular functions. DKK1 post-stroke induction hinders lesion containment by disorganizing the astroglial scar, leading to a chronic neuroinflammation and increased anxiety-like behaviors. Using chimeric mice, we unravel thatDKK1 is released by bone marrow-derived cells (BMDCs) expressing myeloid markers that infiltrate the lesion site. DKK1 restricted induction in BMDCs is sufficient to mediate astroglial scar disorganization. Notably, neutralization of DKK1 limits injury progression and improves neurological recovery after stroke. Our findings indicate that BMDCs-derived DKK1 promotes injury progression after stroke and suggest that neutralizing its biological activity represent a promising therapeutic avenue for ischemic stroke.
Homocysteine Metabolites Inhibit Autophagy by Upregulating the Expression of miR-21-5p (LC3, p62, BECN1), miR-155-5p (ATG5, LC3), miR-216-5p (BECN1, ATG5, LC3) and miR-320c-3p (ATG7) in Human Vascular Endothelial Cells
Authors: Witucki Łukasz , Jakubowski Hieronim 
Published: August 2023

Abstract
Nutritional and genetic deficiencies in homocysteine (Hcy) metabolism lead to hyperhomocysteinemia (HHcy) and cause endothelial dysfunction, a hallmark of atherosclerosis, which is a major cause of cardiovascular disease (CVD). Impaired autophagy causes the accumulation of damaged proteins and organelles and is associated with CVD. Biochemically, HHcy is characterized by elevated levels of Hcy and its metabolites, Hcy-thiolactone and N-Hcy-protein. However, whether these metabolites can dysregulate mTOR signaling and autophagy in endothelial cells is not known. Here, we examined the influence of Hcy-thiolactone, N-Hcy-protein, and Hcy on autophagy human umbilical vein endothelial cells. We found that treatments with Hcy-thiolactone, N-Hcy-protein, or Hcy significantly downregulated BECN1, ATG5, ATG7, and LC3 mRNA and protein levels. We also found that these changes were mediated by upregulation by Hcy-thiolactone, N-Hcy-protein, and Hcy of autophagy-targeting microRNA (miR): miR-21, miR-155, miR-216, and miR-320c. The effects of these metabolites on levels of miR targeting autophagy as well as on the levels of BECN1, ATG5, ATG7, and LC3 mRNA and protein were abrogated by treatments with inhibitors of miR-21, miR-155, miR-216, and mir320c. Taken together, our findings show that Hcy metabolites can upregulate miR-21, miR-155, miR-216, and mir320c, which then downregulate autophagy in human endothelial cells, important for vascular homeostasis.