bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mental health of children with and without special healthcare needs and of their caregivers during COVID-19: a cross-sectional study
Authors: Geweniger Anne , Haddad Anneke , Barth Michael , Högl Henriette , Mund Annette , Insan Shrabon , Langer Thorsten 
Published: June 2022

ObjectiveTo describe mental health outcomes and measures of pandemic burden of children with and without special healthcare needs, and their caregivers following the second wave of the COVID-19 pandemic in Germany.DesignThis is the second of a sequential series of cross-sectional online surveys conducted among caregivers of children ≤18 years since the onset of the COVID-19 pandemic, administrated between 2 April 2021 and 31 July 2021.Main outcome measuresChild and parental mental health were assessed using the Strengths and Difficulties Questionnaire and WHO-5 Well-being index. Children with Special Healthcare Needs (CSHCN) were identified using the CSHCN-Screener. Descriptive statistics, linear and hierarchical logistic regression modelling assessed associations between parent-reported child mental health problems and measures of pandemic burden, disease complexity, caregiver mental well-being and socioeconomic status.Results521 participants were included in the final sample. There was a high prevalence of parent-reported mental health problems in n=302 (66.7%) children, particularly in CSHCN. Among caregivers, n=372 (72.5%) screened positive for depression. Logistic regression modelling showed a strong association of child mental health problems and disease complexity, parental mental well-being, increase in family conflict and inadequate social support.ConclusionsOur study identifies CSHCN as a particularly vulnerable group in terms of mental health outcomes. Psychosocial factors were important predictors of parent-reported child mental health problems. Policy measures should consider the importance of social support systems for vulnerable children and their families, and aim to provide accessible mental health support for caregivers.
Cancer cell-autonomous overactivation of PARP1 compromises immunosurveillance in non-small cell lung cancer
Authors: Juncheng Pan , Joseph Adrien , Lafarge Antoine , Martins Isabelle , Obrist Florine , Pol Jonathan , Saavedra Ester , Li Sijing , Sauvat Allan , Cerrato Giulia , Lévesque Sarah , Leduc Marion , Kepp Oliver , Durand Sylvère , Aprahamian Fanny , Nirmalathansan Nitharsshini , Michels Judith , Kroemer Guido , Castedo Maria 
Published: June 2022

BackgroundHigh activity of poly(ADP-ribose) polymerase-1 (PARP1) in non-small cell lung cancer (NSCLC) cells leads to an increase in immunohistochemically detectable PAR, correlating with poor prognosis in patients with NSCLC, as well as reduced tumor infiltration by cytotoxic T lymphocytes (CTLs). Intrigued by this observation, we decided to determine whether PARP1 activity in NSCLC cells may cause an alteration of anticancer immunosurveillance.MethodsContinuous culture of mouse NSCLC cells in the presence of cisplatin led to the generation of cisplatin-resistant PARhighclones. As compared with their parental controls, such PARhighcells formed tumors that were less infiltrated by CTLs when they were injected into immunocompetent mice, suggesting a causative link between high PARP1 activity and compromised immunosurveillance. To confirm this cause-and-effect relationship, we used CRISPR/Cas9 technology to knock out PARP1 in two PARhighNSCLC mouse cell lines (Lewis lung cancer [LLC] and tissue culture number one [TC1]), showing that the removal of PARP1 indeed restored cisplatin-induced cell death responses.ResultsPARP1 knockout (PARP1KO) cells became largely resistant to the PARP inhibitor niraparib, meaning that they exhibited less cell death induction, reduced DNA damage response, attenuated metabolic shifts and no induction of PD-L1 and MHC class-I molecules that may affect their immunogenicity. PARhightumors implanted in mice responded to niraparib irrespective of the presence or absence of T lymphocytes, suggesting that cancer cell-autonomous effects of niraparib dominate over its possible immunomodulatory action. While PARhighNSCLC mouse cell lines proliferated similarly in immunocompetent and T cell-deficient mice, PARP1KOcells were strongly affected by the presence of T cells. PARP1KOLLC tumors grew more quickly in immunodeficient than in immunocompetent mice, and PARP1KOTC1 cells could only form tumors in T cell-deficient mice, not in immunocompetent controls. Importantly, as compared with PARhighcontrols, the PARP1KOLLC tumors exhibited signs of T cell activation in the immune infiltrate such as higher inducible costimulator (ICOS) expression and lower PD-1 expression on CTLs.ConclusionsThese results prove at the genetic level that PARP1 activity within malignant cells modulates the tumor microenvironment.
LDL cholesterol is associated with higher AD neuropathology burden independent of APOE
Authors: Wingo Aliza P , Vattathil Selina M , Liu Jiaqi , Fan Wen , Cutler David J , Levey Allan I , Schneider Julie A , Bennett David A , Wingo Thomas S 
Published: June 2022

ObjectiveAPOEis a strong risk factor for Alzheimer’s disease (AD) and associated with higher low-density lipoprotein cholesterol (LDL-C) levels. Moreover, LDL-C is associated with the development of clinically ascertained AD; however, whether this association is present with the underlying neuropathological manifestations of AD or whether it is independent of the effect ofAPOEis unknown and is the focus of this paper.MethodsIndividuals in the Religious Orders Study/Memory and Ageing Project cohorts with longitudinal measures of blood lipids and detailed autopsies were studied. We modelled the relationship between blood lipids and 12 age-related brain pathologies using a linear mixed model adjusted for potential confounding factors and stratified byAPOEgenotype with overall significance determined by meta-analysis. Blood lipids considered were LDL-C, high-density lipoprotein cholesterol and triglycerides. Brain pathologies included AD pathology measured by silver staining (Braak stage, a modified Consortium to Establish a Registry for Alzheimer’s Disease [CERAD] score and global AD pathology) and immunohistochemistry (beta-amyloid and neurofibrillary tangles) as well as cerebral microinfarct, cerebral macroinfarct, cerebral amyloid angiopathy, cerebral atherosclerosis, hippocampal sclerosis, TDP-43 cytoplasmic inclusions and Lewy bodies.Results559 participants (69.1% female) had complete data for analysis. They were followed for a median of 7 years and a median of 3 years prior to dementia onset. LDL-C was associated with all measures of AD neuropathology (neurofibrillary tangles, beta-amyloid, Braak stage, modified CERAD score and global AD pathology) and cerebral amyloid angiopathy independent ofAPOEafter adjusting for age, sex, cholesterol-lowering medication use, body mass index, smoking and education at false discovery rate (FDR) p-value <0.05.ConclusionsThese findings implicate LDL-C in the pathophysiology of AD independent ofAPOEand suggest LDL-C is a modifiable risk factor for AD.
The Leaves of Cyclocarya paliurus: A Functional Tea with Preventive and Therapeutic Potential of Type 2 Diabetes
Authors: Qiu Miao , Peng Jiao , Deng Huan , Chang Yaoyao , Hu Die , Pan Weidong , Wu Haiqiang , Xiao Haitao 
Published: June 2022

Type 2 diabetes mellitus (T2DM) has become a universal and chronic global public health concern and causes multiple complex complications. In order to meet the rapidly growing demand for T2DM treatment, increased research has been focused on hypoglycemic drugs. Cyclocarya paliurus (Batal.) Iljinsk is the only living species of the genus Cyclocarya Iljinskaja, whose leaves have been extensively used as a functional tea to treat obesity and diabetes in China. An enormous amount of very recent pharmacological research on the leaves of C. paliurus has demonstrated that they carry out numerous biological activities, such as hypoglycemic, anti-inflammatory, and intestinal microbiota regulation. Multiple in vitro and in vivo studies have also shown that the extracts of C. paliurus leaves are innocuous and safe. This study aims to provide an up-to-date review of the botany, traditional uses, phytochemistry, pharmacological effects against diabetes, toxicology, and clinical studies of C. paliurus leaves, in hopes of promoting a better understanding of their role in the prevention and treatment of T2DM.
Pump Up Password Security! Evaluating and Enhancing Risk-Based Authentication on a Real-World Large-Scale Online Service
Authors: Wiefling Stephan , Jørgensen Paul René , Thunem Sigurd , Iacono Luigi Lo 
Published: June 2022

Risk-based authentication (RBA) aims to protect users against attacks involving stolen passwords. RBA monitors features during login, and requests re-authentication when feature values widely differ from those previously observed. It is recommended by various national security organizations, and users perceive it more usable than and equally secure to equivalent two-factor authentication. Despite that, RBA is still used by very few online services. Reasons for this include a lack of validated open resources on RBA properties, implementation, and configuration. This effectively hinders the RBA research, development, and adoption progress.
To close this gap, we provide the first long-term RBA analysis on a real-world large-scale online service. We collected feature data of 3.3 million users and 31.3 million login attempts over more than 1 year. Based on the data, we provide (i) studies on RBA’s real-world characteristics plus its configurations and enhancements to balance usability, security, and privacy; (ii) a machine learning–based RBA parameter optimization method to support administrators finding an optimal configuration for their own use case scenario; (iii) an evaluation of the round-trip time feature’s potential to replace the IP address for enhanced user privacy; and (iv) a synthesized RBA dataset to reproduce this research and to foster future RBA research. Our results provide insights on selecting an optimized RBA configuration so that users profit from RBA after just a few logins. The open dataset enables researchers to study, test, and improve RBA for widespread deployment in the wild.
Application Effect of Dexmedetomidine and Dezocine in Patients Undergoing Lung Cancer Surgery under General Anesthesia and Analysis of Their Roles in Recovery Time and Cognitive Function
Authors: Ding Jie , Zhu Mengqi , Lv Hu , Zhang Jun , Chen Wei 
Published: June 2022

Objective. To explore the application influence of dexmedetomidine (DEX) and dezocine in patients undergoing lung cancer surgery under general anesthesia and analysis of their roles in recovery time and cognitive function. Methods. A total of 120 patients who accepted thoracoscopic pulmonary wedge resection in our hospital from November 2021 to April 2022 were selected and randomly divided into group A (

n

=60) and group B (

n

=60). DEX combined with dezocine-assisted anesthesia was performed to group A, and the equal dose of normal saline was administered to group B, so as to compare their inflammatory influence level, brain function, arterial blood gas index, and cognitive function. Results. Compared with group B, group A obtained significantly lower intraoperative and postoperative inflammatory factor levels (

P
<
0.001

), better postoperative brain function and arterial blood gas index (

P
<
0.001

), and lower Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) scores after surgery (

P
<
0.001

). Combining DEX with dezocine-assisted general anesthesia can improve the inflammatory factors level of patients undergoing lung cancer surgery and maintain their brain function and oxygen saturation, so that they have better postoperative cognitive function. Therefore, such anesthesia modality should be promoted in practice.
Cost-Effectiveness of Waiving Coinsurance for Follow-Up Colonoscopy after a Positive Stool-Based Colorectal Screening Test in a Medicare Population
Authors: Fendrick A. Mark , Lieberman David , Vahdat Vahab , Chen Jing Voon , Ozbay A. Burak , Limburg Paul J. 
Published: June 2022

AbstractCommercial insurance covers a follow-up colonoscopy after a positive colorectal cancer–screening test with no patient cost-sharing. Instituting a similar policy for Medicare beneficiaries may increase screening adherence and improve outcomes. The cost-effectiveness of stool-based colorectal cancer screening was compared across adherence scenarios that assumed Medicare coinsurance status quo (20% for follow-up colonoscopy) or waived coinsurance. The CRC-AIM model simulated previously unscreened eligible Medicare beneficiaries undergoing stool-based colorectal cancer screening at age 65 for 10 years. Medicare costs, colorectal cancer cases, colorectal cancer–related deaths, life-years gained (LYG), and quality-adjusted life-years (QALY) were estimated versus no screening. Scenario 1 (S1) assumed 20% coinsurance for follow-up colonoscopy. Scenario 2 (S2) assumed waived coinsurance without adherence changes. Scenarios 3–7 (S3–S7) assumed that waiving coinsurance increased real-world stool-based screening and/or follow-up colonoscopy adherence by 5% or 10%. Sensitivity analyses assumed 1%–4% increased adherence. Cost-effectiveness threshold was ≤$100,000/QALY. Waiving coinsurance without adherence changes (S2) did not affect outcomes versus S1. S3–S7 versus S1 over 10 years estimated up to 3.6 fewer colorectal cancer cases/1,000 individuals, up to 2.1 fewer colorectal cancer deaths, up to 20.7 more LYG, and had comparable total costs per-patient (≤$6,478 vs. $6,449, respectively) as reduced colorectal cancer medical costs offset increased screening and colonoscopy costs. In sensitivity analyses, any increase in adherence after waiving coinsurance was cost-effective and increased LYG. In simulated Medicare beneficiaries, waiving coinsurance for follow-up colonoscopy after a positive stool-based test improved outcomes and was cost-effective when assumed to modestly increase colorectal cancer screening and/or follow-up colonoscopy adherence.Prevention Relevance:Follow-up colonoscopy after a positive stool-based test is necessary to complete the colorectal cancer-screening process. This analysis demonstrated that in a simulated Medicare population, waiving coinsurance for a follow-up colonoscopy improved estimated outcomes and was cost-effective when it was assumed that waiving the coinsurance modestly increased screening adherence.See related Spotlight, p. 641
Reduced Opioid Use and Prescribing in a Same Day Discharge Pilot Enhanced Recovery Program for Elective Minimally Invasive Colorectal Surgical Procedures During the COVID-19 Pandemic
Authors: Tran-McCaslin Marie , Basam Motahar , Rudikoff Andrew , Thuraisingham Dhilan , McLemore Elisabeth C. 
Published: June 2022

Purpose Enhanced recovery pathways (ERPs) are associated with reduced complications and length of stay. The validation of the I-FEED scoring system, advances in perioperative anesthesia, multimodal analgesia, and telehealth remote monitoring have resulted in further evolution of ERPs setting the stage for same day discharge (SDD). Pioneers and early adopters have demonstrated the safety and feasibility of SDD programs. The aim of this study is to evaluate the impact of a pilot SDD ERP on patient self-reported pain scoring and narcotic usage. Methods A quality improvement pilot program was conducted to assess the impact of a SDD ERP on post-operative pain score reporting and opioid use in healthy patients undergoing elective colorectal surgery as an alternative to post-operative hospitalization during the COVID-19 pandemic (May 2020-December 2021). Patients were monitored remotely with daily telephone visits on POD 1-7 assessing the following variables: I-FEED score, pain score, pain management, bowel function, dietary advancement, any complications, and/or re-admissions. Results Thirty-seven patients met the highly selective eligibility criteria for “healthy patient, healthy anastomosis.” SDD occurred in 70%. The remaining 30% were discharged on POD 1. Mean total narcotic usage was 5.2 tablets of 5 mg oxycodone despite relatively high reported pain scores. Conclusions In our initial experience, SDD is associated with significantly lower patient narcotic utilization for postoperative pain management than hypothesized. This pilot SDD program resulted in a change in clinical practice with reduction of prescribed discharge oxycodone 5 mg quantity from #40 to #10 tablets.
Understanding the Impact of Time Pressure and Automation Support in a Visual Search Task
Authors: Rieger Tobias , Manzey Dietrich 
Published: June 2022

Objective To understand the impact of time pressure and automated decision support systems (DSS) in a simulated medical visual search task. Background Time pressure usually impairs manual performance in visual search tasks, but DSS support might neutralize this negative effect. Moreover, understanding the impact of time pressure and DSS support seems relevant for many real-world applications of visual search. Method We used a visual search paradigm where participants had to search for target letters in a simulated medical image. Participants performed the task either manually or with support of a highly reliable DSS. Time pressure was varied within-subjects by either a trialwise time–pressure manipulation (Experiment 1) or a blockwise manipulation (Experiment 2). Performance was assessed based on signal detection measures. To further analyze visual search behavior, a mouse-over approach was used. Results In both experiments, results showed impaired sensitivity under high compared to low time pressure in the manual condition, but no negative effect of time pressure when working with a highly reliable DSS. Moreover, participants searched less under time pressure and when receiving DSS support, indicating participants followed the automation without thoroughly checking recommendations. However, the human-DSS team’s sensitivity was always worse than that of the DSS alone, independent of the strength of time pressure. Conclusion Negative effects of time pressure can be ameliorated when receiving support by a DSS, but joint overall performance remains below DSS-alone performance. Application Highly reliable DSS seem capable of ameliorating the negative impact of time pressure in complex detection tasks.
The Struggles of the Indian Constitution in the Face of Autocratic Legalism: Constitutionalism at Crossroads?
Authors: Sen Shameek , Guha Shouvik K 
Published: June 2022

AbstractIn this article, we seek to delineate the nature of India’s ongoing constitutional struggles against a grave crisis, considering the threat that such crisis poses to the functioning of the country’s constitutional democracy. Using the acceptable definitive models of such a crisis, we then try to examine the extent to which India’s constitutional struggle might have been necessary in order to confront such a crisis. The role played by the deliberate usage of the legal and prima facie constitutional routes to render the very spirit and safeguards of the constitutional system redundant, or the concept of autocratic legalism, as a singular symptom displayed by such a crisis, is focused upon in this context. We draw analogies from multiple jurisdictions with myriad political legacies, including the USA, Poland, Hungary, Turkey, Russia and the Latin American nations. Increasing the judicial burden to cripple the adjudicating machinery; appointment of judges exhibiting specific political inclination; emergence of a charismatic political leader commanding mass support — the potential impact of these factors on liberal constitutionalism is examined. The article delves into the Indian narrative, citing instances from the past such as the Nehruvian legacy of superseding the judiciary as watchdogs of constitutional values, emergency and relevant constitutional amendments, as well as from the present, such as abrogation of special status of Indian states like Jammu and Kashmir, introduction of national population register and modification of citizenship norms, passing contentious legislation via the Money Bill route to avoid close scrutiny and constitutional debates, reservation on economic grounds and introducing new tax structures impinging on the federal relationship. We assess the role played by the Indian judiciary in each of these instances, along with instances of judicial (pro)activism, and their impact on the overall stability of the judicial institution.
Effects of hearing aids in patients with unilateral tinnitus with acquired ipsilateral sensorineural hearing loss
Authors: Ueno Masafumi , Shinden Seiichi , Oishi Naoki , Suzuki Noriomi , Suzuki Daisuke , Ogawa Kaoru , Ozawa Hiroyuki 
Published: June 2022

Objectives To evaluate the effectiveness of sound therapy using hearing aids in patients experiencing tinnitus with acquired unilateral sensorineural hearing loss. Methods A total of 97 patients with unilateral tinnitus with acquired ipsilateral sensorineural hearing loss were included. Evaluation involved self-report questionnaires administered at entry, 3 months after treatment, and 1 year after treatment. Results The mean Tinnitus Handicap Inventory score before treatment decreased significantly ( p < 0.01) at 3 months (50.0 ± 24.5-12.7 ± 16.2), and 1 year (53.3 ± 25.5-8.79 ± 13.9), after treatment. Moreover, the visual analog scale score decreased significantly at 3 months (loudness, 69.6 ± 21.9-29.1 ± 27.2; annoyance, 71.1 ± 24.7-22.7 ± 25.5) and 1 year (loudness, 69.8 ± 22.0-21.1 ± 26.1; annoyance, 72.7 ± 25.6-19.4 ± 27.6). Approximately 80-90% of patients noticed improvements in tinnitus annoyance and loudness, as determined by their responses to the questionnaires of subjective symptom improvement. Conclusions Hearing aids are remarkably effective for patients with unilateral tinnitus with acquired ipsilateral sensorineural hearing loss.