bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing anxiety among adolescents in Hong Kong: psychometric properties and validity of the Generalised Anxiety Disorder-7 (GAD-7) in an epidemiological community sample
Authors: Ip Hang , Suen Yi Nam , Hui Christy Lai Ming , Wong Stephanie Ming Yin , Chan Sherry Kit Wa , Lee Edwin Ho Ming , Wong Michael Tak Hing , Chen Eric Yu Hai 
Published: November 2022

AbstractBackgroundThe development of a valid and simple-to-use self-administered tool in Asian adolescents for clinical screening and intervention remains limited. The present study assessed the psychometric characteristics and validity of the Generalised Anxiety Disorder Scale-7 (GAD-7) among adolescents in Hong Kong.MethodsEpidemiological data from 3,261 Hong Kong adolescents aged 15 - 24 years were analysed for the construct validity, criterion validity, concurrent validity, and Rasch Model. All analyses were age- and gender-weighted according to the distributions of Hong Kong’s general population.ResultsThe GAD-7 showed high internal consistency and strong fit to the one-factor structure. The best cut-off value was set at 7 or more. Regression models found that the total scores of the scale were positively associated with symptoms of depression and hypomania, schizotypal personality and alcohol dependence. Rasch model analysis found that the separation index was 2.18 and 16.51 for the respondents and items, respectively and all residual pairs had small correlation coefficients (i.e., < 0.3).ConclusionsAll psychometric findings presented in this study support the use of the GAD-7 as a legitimate measure of anxiety severity. A cut-off score of 7 should indicate a potential diagnosable condition in Asian adolescents, which requires our attention but should not be used as a formal diagnostic screening tool. The findings revealed the local dependence of the items of the GAD-7 and that the scale can separate respondents into at least two groups and items into numerous groups according to the separation index.
Relevant vs non-relevant subspecialist for patients hospitalised in internal medicine at a local hospital: which is better? A retrospective cohort study
Authors: Berg Øyvind , Hurtig Ulf , Steinsbekk Aslak 
Published: November 2022

Abstract
Background
Studies of the treatment of patients in-hospital with a specific diagnosis show that physicians with a subspecialisation relevant to this diagnosis can provide a better quality of care. However, studies including patients with a range of diagnoses show a more negligible effect of being attended by a relevant subspecialist. This project aimed to study a more extensive set of patients and diagnoses in an environment where the subspecialist present could be controlled. Thus, this study investigated whether being attended by a physician with a subspeciality relevant to the patient’s primary diagnosis was prospectively associated with readmission, in-hospital mortality, or length of stay compared to a physician with a subspeciality not relevant to the patient’s primary diagnosis.

Methods
We have conducted a retrospective register-based study of 11,059 hospital admissions across 9 years at a local hospital in south-eastern Norway, where it was possible to identify the physician attending the patients at the beginning of the stay. The outcomes studied were emergency readmissions to the same ward within 30 days, any in-hospital mortality and the total length of stay. The patients admitted were matched with the consultant(s) responsible for their treatment. Then, the admissions were divided into two groups according to their primary diagnosis. Was their diagnosis within the subspeciality of the attending consultant (relevant subspecialist) or not (non-relevant subspecialist). The two groups were then compared using bivariable and multivariable models adjusted for patient characteristics, comorbidities, diagnostic group and physician sex.

Results
A relevant subspecialist was present during the first 3 days in 8058 (73%) of the 11,059 patient cases. Patients attended to by a relevant subspecialist had an odds ratio (OR) of 0.91 (95% confidence interval 0.76 to 1.09) for being readmitted and 0.71 (0.48 to 1.04) for dying in the hospital and had a length of stay that was 0.18 (− 0.07 to 0.42) days longer than for those attended to by a non-relevant subspecialist.

Conclusions
This study found that patients attended by a relevant subspecialist did not have a significantly different outcome to those attended by a non-relevant subspecialist.
Difficulties and countermeasures in implementing age-friendly policies in primary health centers in Taiwan
Authors: Shih Chen-I , Hung Tuey-Wen , Chen Wei , Yang Hui-Fei , Chia Shu-Li , Chang Yung-Hung , Fan Sheng-Yu 
Published: November 2022

Abstract
Background
Taiwan is predicted to become a super-aged society by 2025, and primary health centers (PHCs) are set to play a crucial role in the care of older adults. The Taiwanese government has developed an age-friendly verification framework for PHC. The aims of this study were to explore the difficulties faced by PHC staff in the implementation of age-friendly policies and their solution strategies.

Methods
This study adopted a qualitative research method. The first stage involved conducting five focus groups with the responsible staff of PHCs (n = 41) that have been certified “age-friendly.” The focus groups covered the effectiveness, difficulties, and resources of PHCs in regards to the introduction of age-friendly policies. In the second stage, in-depth interviews were conducted with executives of PHCs (n = 5), both certified and not certified as age-friendly, to further compare the difficulties faced by these two types of PHCs, thereby gaining perspectives for solution strategies. The principles of grounded theory were used for data analysis.

Results
Four major PHC strategies are employed in the promotion of age-friendliness. First, organizational management, through which managers apply management methods and analyze the present PHC-related health concerns; second, resource utilization, which refers to the tallying, linking, and integrating of resources; third, business operation process, in which work efficiency is improved through the combination of business operations and staff training; finally, hardware improvement, which is achieved through comprehensive cataloging of facility environments.

Conclusion
The implementation of age-friendliness in PHCs requires the efforts of both the service units and government. With resources provided by the government, PHCs can integrate management methods, businesses operations, and essential resources. Moreover, PHC executives can lead their teams in promoting age-friendly policies, and closely monitor their effectiveness.
Spatial multi-omics analyses of the tumor immune microenvironment
Authors: Hsieh Wan-Chen , Budiarto Bugi Ratno , Wang Yi-Fu , Lin Chih-Yu , Gwo Mao-Chun , So Dorothy Kazuno , Tzeng Yi-Shiuan , Chen Shih-Yu 
Published: November 2022

AbstractIn the past decade, single-cell technologies have revealed the heterogeneity of the tumor-immune microenvironment at the genomic, transcriptomic, and proteomic levels and have furthered our understanding of the mechanisms of tumor development. Single-cell technologies have also been used to identify potential biomarkers. However, spatial information about the tumor-immune microenvironment such as cell locations and cell–cell interactomes is lost in these approaches. Recently, spatial multi-omics technologies have been used to study transcriptomes, proteomes, and metabolomes of tumor-immune microenvironments in several types of cancer, and the data obtained from these methods has been combined with immunohistochemistry and multiparameter analysis to yield markers of cancer progression. Here, we review numerous cutting-edge spatial ‘omics techniques, their application to study of the tumor-immune microenvironment, and remaining technical challenges.
Black carbon content in airway macrophages is associated with increased severe exacerbations and worse COPD morbidity in SPIROMICS
Authors: Tejwani Vickram , Woo Han , Liu Chen , Tillery Anna K. , Gassett Amanda J. , Kanner Richard E. , Hoffman Eric A. , Martinez Fernando J. , Woodruff Prescott G. , Barr R. Graham , Fawzy Ashraf , Koehler Kirsten , Curtis Jeffrey L. , Freeman Christine M. , Cooper Christopher B. , Comellas Alejandro P. , Pirozzi Cheryl , Paine Robert , Tashkin Donald , Krishnan Jerry A. , Sack Coralynn , Putcha Nirupama , Paulin Laura M. , Zusman Marina , Kaufman Joel D. , Alexis Neil E. , Hansel Nadia N. 
Published: November 2022

Abstract
Background
Airway macrophages (AM), crucial for the immune response in chronic obstructive pulmonary disease (COPD), are exposed to environmental particulate matter (PM), which they retain in their cytoplasm as black carbon (BC). However, whether AM BC accurately reflects environmental PM2.5 exposure, and can serve as a biomarker of COPD outcomes, is unknown.

Methods
We analyzed induced sputum from participants at 7 of 12 sites SPIROMICS sites for AM BC content, which we related to exposures and to lung function and respiratory outcomes. Models were adjusted for batch (first vs. second), age, race (white vs. non-white), income (<$35,000, $35,000~$74,999, ≥$75,000, decline to answer), BMI, and use of long-acting beta-agonist/long-acting muscarinic antagonists, with sensitivity analysis performed with inclusion of urinary cotinine and lung function as covariates.

Results
Of 324 participants, 143 were current smokers and 201 had spirometric-confirmed COPD. Modeled indoor fine (< 2.5 μm in aerodynamic diameter) particulate matter (PM2.5) and urinary cotinine were associated with higher AM BC. Other assessed indoor and ambient pollutant exposures were not associated with higher AM BC. Higher AM BC was associated with worse lung function and odds of severe exacerbation, as well as worse functional status, respiratory symptoms and quality of life.

Conclusion
Indoor PM2.5 and cigarette smoke exposure may lead to increased AM BC deposition. Black carbon content in AMs is associated with worse COPD morbidity in current and former smokers, which remained after sensitivity analysis adjusting for cigarette smoke burden. Airway macrophage BC, which may alter macrophage function, could serve as a predictor of experiencing worse respiratory symptoms and impaired lung function.
Long noncoding RNA DLGAP1-AS2 promotes tumorigenesis and metastasis by regulating the Trim21/ELOA/LHPP axis in colorectal cancer
Authors: Wang Xue , Cheng Han , Zhao Jing , Li Jiuming , Chen Ying , Cui Kaisa , Tian Lu , Zhang Jia , Li Chaoqun , Sun Shengbai , Feng Yuyang , Yao Surui , Bian Zehua , Huang Shenglin , Fei Bojian , Huang Zhaohui 
Published: November 2022

Abstract
Background
Long noncoding RNAs (lncRNAs) have driven research focused on their effects as oncogenes or tumor suppressors involved in carcinogenesis. However, the functions and mechanisms of most lncRNAs in colorectal cancer (CRC) remain unclear.

Methods
The expression of DLGAP1-AS2 was assessed by quantitative RT-PCR in multiple CRC cohorts. The impacts of DLGAP1-AS2 on CRC growth and metastasis were evaluated by a series of in vitro and in vivo assays. Furthermore, the underlying mechanism of DLGAP1-AS2 in CRC was revealed by RNA pull down, RNA immunoprecipitation, RNA sequencing, luciferase assays, chromatin immunoprecipitation, and rescue experiments.

Results
We discovered that DLGAP1-AS2 promoted CRC tumorigenesis and metastasis by physically interacting with Elongin A (ELOA) and inhibiting its protein stability by promoting tripartite motif containing 21 (Trim21)-mediated ubiquitination modification and degradation of ELOA. In particular, we revealed that DLGAP1-AS2 decreases phospholysine phosphohistidine inorganic pyrophosphate phosphatase (LHPP) expression by inhibiting ELOA-mediated transcriptional activating of LHPP and thus blocking LHPP-dependent suppression of the AKT signaling pathway. In addition, we also demonstrated that DLGAP1-AS2 was bound and stabilized by cleavage and polyadenylation specificity factor (CPSF2) and cleavage stimulation factor (CSTF3).

Conclusions
The discovery of DLGAP1-AS2, a promising prognostic biomarker, reveals a new dimension into the molecular pathogenesis of CRC and provides a prospective treatment target for this disease.
Association between remnant cholesterol and verbal learning and memory function in the elderly in the US
Authors: Xie Ying-Yi , Zhao Liang , Gao Li-Jian , Xu Rui-Xia , Gao Ying , Dou Ke-Fei , Guo Yuan-Lin , He Yong-Ming 
Published: November 2022

Abstract
Background
The relationship between remnant cholesterol (RC) and atherosclerotic cardiovascular risk has been given increasing attention in recent years. However, its association with verbal learning and memory performance has not been reported.

Methods
Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 database. Participants aged ≥60 years with available fasting lipid data were included. Verbal learning and memory performance were evaluated using the Consortium to Establish a Registry for Alzheimer’s Disease Word List Memory Task (CERAD-WL) subtest. The CERAD total score was calculated as the mean of three immediate recalls and a delayed recall. RC was calculated as total cholesterol (TC) minus the sum of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Multivariate ordinal logistic regression was performed to evaluate the association between RC, as well as its derived marker, the TC/RC ratio, and age-stratified quartiles of the CERAD total score.

Results
A total of 1377 participants were analysed. On a continuous scale, per 1 mmol/L increase in RC and per 1 unit increase in the TC/RC ratio were associated with multivariable adjusted odds ratios (95% CI) of 0.74 (0.58–0.94) and 1.45 (1.13–1.87), respectively, for having a CERAD total score in a higher quartile. On a categorical scale, higher RC quartiles were associated with a CERAD total score in a lower quartile; in contrast, the higher TC/RC quartile was associated with a CERAD total score in a higher quartile (all P for trend < 0.05).

Conclusions
The current study suggests that lower RC levels and a higher TC/RC ratio are associated with better verbal learning and memory function, which indicates that lowering RC levels could be beneficial for preventing cognitive impairment in elderly individuals. Further research is needed to validate the causal roles of RC and the TC/RC ratio in cognition.
Under contract and in good health: a multigroup cross-lagged panel model of time use and health-related quality of life in working-age men and women
Authors: Altweck Laura , Tomczyk Samuel , Schmidt Silke 
Published: November 2022

Abstract
Background
Self-reported time-use in relation to health-related quality of life (HRQoL) has been widely studied, yet less is known about the directionality of the association and how it compares across genders when controlling for sociodemographic confounders.

Methods
This study focused on the working population of the most recent waves (2013–2018) of the Core-Study of the German Socio-Economic Panel (N = 30,518, 46.70% female, M = 39.24 years). It examined the relationship between three time-use categories (contracted, committed, & leisure time) and HRQoL (self-rated health & life satisfaction) in men and women via multigroup fixed effects cross-lagged panel models. The models controlled for sociodemographic background (age, household income, number of children living in household, employment status, education, & marital status), which was associated with time-use and psychosocial health in previous research.

Results
Contracted time showed consistent positive relationships with HRQoL across genders while associations with the other types of time use differed significantly between men and women and across indicators of HRQoL.

Conclusions
The way we spend our time directly predicts our health perceptions, but in the same vein our health also predicts how we can spend our time. Contracted time in particular was associated with positive HRQoL, across genders, and beyond sociodemographic predictors, highlighting the important role of employment in health, for men and women alike. The impact of commitments beyond contracted time-use—like household chores and childcare—however, continues to affect mainly women, which ultimately reflects in poorer health outcomes.
Degree of protection provided by poverty alleviation policies for the middle-aged and older in China: evaluation of effectiveness of medical insurance system tools and vulnerable target recognition
Authors: Tian Wanxin , Wu Bing , Yang Yahong , Lai Yongqiang , Miao Wenqing , Zhang Xiyu , Zhang Chenxi , Xia Qi , Shan Linghan , Yang Huiying , Yang Huiqi , Huang Zhipeng , Li Yuze , Zhang Yiyun , Ding Fan , Tian Yulu , Li Hongyu , Liu Xinwei , Li Ye , Wu Qunhong 
Published: November 2022

Abstract
Background
China’s medical insurance schemes and poverty alleviation policy at this stage have achieved population-wide coverage and the system's universal function. At the late stage of the elimination of absolute poverty task, how to further exert the poverty alleviation function of the medical insurance schemes has become an important agenda for targeted poverty alleviation. To analyse the risk of catastrophic health expenditure (CHE) occurrence in middle-aged and older adults with vulnerability characteristics from the perspectives of social, regional, disease, health service utilization and medical insurance schemes.

Methods
We used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database and came up with 9190 samples. The method for calculating the CHE was adopted from WHO. Logistic regression was used to determine the different characteristics of middle-aged and older adults with a high probability of incurring CHE.

Results
The overall regional poverty rate and incidence of CHE were similar in the east, central and west, but with significant differences among provinces. The population insured by the urban and rural integrated medical insurance (URRMI) had the highest incidence of CHE (21.17%) and health expenditure burden (22.77%) among the insured population. Integration of Medicare as a medical insurance scheme with broader benefit coverage did not have a significant effect on the incidence of CHE in middle-aged and older people with vulnerability characteristics.

Conclusions
Based on the perspective of Medicare improvement, we conducted an in-depth exploration of the synergistic effect of medical insurance and the poverty alleviation system in reducing poverty, and we hope that through comprehensive strategic adjustments and multidimensional system cooperation, we can lift the vulnerable middle-aged and older adults out of poverty.
Association of body mass index and inflammatory dietary pattern with breast cancer pathologic and genomic immunophenotype in the nurses’ health study
Authors: Asad Sarah , Damicis Adrienne , Heng Yujing J. , Kananen Kathryn , Collier Katharine A. , Adams Elizabeth J. , Kensler Kevin H. , Baker Gabrielle M. , Wesolowski Robert , Sardesai Sagar , Gatti-Mays Margaret , Ramaswamy Bhuvaneswari , Eliassen A. Heather , Hankinson Susan E. , Tabung Fred K. , Tamimi Rulla M. , Stover Daniel G. 
Published: November 2022

Abstract
Background
Breast tumor immune infiltration is clearly associated with improved treatment response and outcomes in breast cancer. However, modifiable patient factors associated with breast cancer immune infiltrates are poorly understood. The Nurses’ Health Study (NHS) offers a unique cohort to study immune gene expression in tumor and adjacent normal breast tissue, immune cell-specific immunohistochemistry (IHC), and patient exposures. We evaluated the association of body mass index (BMI) change since age 18, physical activity, and the empirical dietary inflammatory pattern (EDIP) score, all implicated in systemic inflammation, with immune cell-specific expression scores.

Methods
This population-based, prospective observational study evaluated 882 NHS and NHSII participants diagnosed with invasive breast cancer with detailed exposure and gene expression data. Of these, 262 women (training cohort) had breast tumor IHC for four classic immune cell markers (CD8, CD4, CD20, and CD163). Four immune cell-specific scores were derived via lasso regression using 105 published immune expression signatures’ association with IHC. In the remaining 620 patient evaluation cohort, we evaluated association of each immune cell-specific score as outcomes, with BMI change since age 18, physical activity, and EDIP score as predictors, using multivariable-adjusted linear regression.

Results
Among women with paired expression/IHC data from breast tumor tissue, we identified robust correlation between novel immune cell-specific expression scores and IHC. BMI change since age 18 was positively associated with CD4+ (β = 0.16; p = 0.009), and CD163 novel immune scores (β = 0.14; p = 0.04) in multivariable analyses. In other words, for each 10 unit (kg/m2) increase in BMI, the percentage of cells positive for CD4 and CD163 increased 1.6% and 1.4%, respectively. Neither physical activity nor EDIP was significantly associated with any immune cell-specific expression score in multivariable analyses.

Conclusions
BMI change since age 18 was positively associated with novel CD4+ and CD163+ cell scores in breast cancer, supporting further study of the effect of modifiable factors like weight gain on the immune microenvironment.
A new continuous hybrid block method with one optimal intrastep point through interpolation and collocation
Authors: Tassaddiq Asifa , Qureshi Sania , Soomro Amanullah , Hincal Evren , Shaikh Asif Ali 
Published: November 2022

AbstractImplicit block approaches are used by a number of numerical analyzers to model mild, medium, and hard differential systems. Their excellent stability characteristics, self-starting nature, quick convergence, and large decrease in computing cost all contribute to their widespread application. With these numerical benefits in mind, a new one-step implicit block method with three intrastep grid points has been created. The major term of the local truncation error is minimized to determine which of these points is optimal. The reformulation of the suggested technique leads to a significant decrease in computing cost while maintaining the same consistency, zero-stability, $\mathcal{A}$
A
-stability, and convergence. Several sorts of error are calculated, together with CPU time and efficiency plot, to determine which is superior. Differential models from the fields of heat transfer, population dynamics, and chemical engineering show that the suggested method does a better job than some of the current hybrid block and implicit Radau methods with similar properties.