bluuebunny/crossref_metadata_2025_split huggingface dataset:
The validity and reliability of the PHQ-9 on screening of depression in neurology: a cross sectional study
Authors: Sun Yajing , Kong Zhifei , Song Yuqing , Liu Jing , Wang Xilin 
Published: February 2022

Abstract
Background
This study aimed to explore the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) on screening of depression among patients with neurological disorders, and to explore factors influencing such patients.

Methods
In this study, 277 subjects who were admitted to the department of neurology of our hospital due to different neurological disorders completed the PHQ-9 questionnaire. The Mini-International Neuropsychiatric Interview (MINI) and Hamilton Rating Scale for Depression (HAMD) were employed to evaluate the depressive symptoms of patients who completed the PHQ-9 questionnaire. The internal consistency, criterion validity, structural validity, and optimal cut-off values of PHQ-9 were evaluated, and the consistency assessment was conducted between the depression severity as assessed by PHQ-9, HAMD and MINI. Logistic regression analysis was used to calculate the risk factors of depression.

Results
The Cronbach’s α coefficient of the PHQ-9 was 0.839. The Pearson’s correlation coefficient among the 9 items of the PHQ-9 scale was 0.160 ~ 0.578 (P < 0.01), and the Pearson’s correlation coefficient between each item and the total score was at the range of 0.608 ~ 0.773. Taking the results of MINI as the gold standard, the area under the receiver operating characteristic (ROC) curve of the PHQ-9 results for all the subjects (n = 277) was 0.898 (95% confidence interval (CI): 0.859 ~ 0.937, P < 0.01). When the cut-off score was equal to 5, the values of sensitivity, specificity, and the Youden’s index were 91.2, 76.6%, and 0.678, respectively. Multivariate logistic regression analysis showed that the influence of unemployment on the occurrence of depression was statistically significant (P = 0.027, OR = 3.080, 95%CI: 1.133 ~ 8.374).

Conclusions
The application of PHQ-9 for screening of depression among Chinese patients with neurological disorders showed a good reliability and validity.
Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol
Authors: Aguilera-Martín Ángel , Gálvez-Lara Mario , Cuadrado Fátima , Moreno Eliana , García-Torres Francisco , Venceslá José F. , Corpas Jorge , Jurado-González Francisco J. , Muñoz-Navarro Roger , González-Blanch César , Ruiz-Rodríguez Paloma , Barrio-Martínez Sara , Prieto-Vila Maider , Carpallo-González María , Cano-Vindel Antonio , Moriana Juan A. 
Published: February 2022

Abstract
Background
Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU).

Methods
A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios.

Discussion
This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems.

Trial registration
ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021)
A systematic review and meta-analysis of studies on screening for mild cognitive impairment in primary healthcare
Authors: Karimi Leila , Mahboub–Ahari Alireza , Jahangiry Leila , Sadeghi-Bazargani Homayoun , Farahbakhsh Mostafa 
Published: February 2022

Abstract
Background
Cognitive disorders and dementia have an important effect on individual independence and orientation. According to the Alzheimer's Disease International (ADI) 75% of people with dementia are not diagnosed; this may be as high as 90% in some low- and middle-income countries. This systematic review and meta-analysis aimed to identify the test performance of screening tools and compare them pairwise. The findings of our study can support countries in planning to establish and care for mild cognitive impairment in primary health centers.

Methods
Medline (PubMed), Scopus, Cochrane, Dare, All EBM Reviews, CRD (OVID), and Proquest were searched from 2012 to November 2021. The risk of bias was assessed through the QUADAS-2 instrument. Given the high heterogeneity between studies, a random-effects model was used to calculate the pooled effect sizes for diagnostic accuracy measures (sensitivity, specificity, and area under curve indices). I2 test was used for assessing heterogeneity and predefined subgroup analyses were performed using participants’ age, country’s income, and sample size of studies.

Results
A systematic search identified 18,132 records, of which, 20 studies were included in the quality assessment, and six were included in quantitative analysis. None of the studies had examined the feasibility or efficiency of mass screening. According to a pairwise comparison, IQCODE, AD8 and GPCOG showed equal or better diagnostic performance relative to the MMSE in terms of sensitivity and specificity. The random-effect model for the MMSE showed the pooled sensitivity equal to 0.73 (95% CI 0.57–0.90), the pooled specificity equal to 0.83 (95% CI 0.75—0.90), and the pooled AUC equal to 0.88 (95% CI 0.83–0.93).

Conclusion
Several benefits have been attached to short tests making them a suitable choice for use in primary healthcare settings. Considering factors such as accuracy, time of application, ease of scoring, and utilization charges, tests such as IQCODE, AD8, and GPCOG or appropriate combination with counterpart tools seem to be good alternatives to the use of the MMSE in primary care.
Prevalence and determinants of anxiety and depression in long-term breast cancer survivors
Authors: Breidenbach Clara , Heidkamp Paula , Hiltrop Kati , Pfaff Holger , Enders Anna , Ernstmann Nicole , Kowalski Christoph 
Published: February 2022

Abstract
Background
There is a significant number of long-term breast cancer survivors in Germany. However, research on the psychological challenges of cancer survivors is limited. This analysis describes prevalence, development and determinants of depression and anxiety 5 to 6 years after diagnosis and identifies predictors for an increase of anxiety and depression over time.

Methods
Data from 164 women was collected by survey and tumour documentation during post-operative hospital stay, 40 weeks and 5 to 6 years after diagnosis. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Sankey-diagrams were created for visual presentation of prevalence over time. Logistic and linear regression models were calculated to identify determinants of anxiety and depression.

Results
Respondents had higher levels of depression and anxiety 5 to 6 years than 40 weeks after the diagnosis. Lower vocational status and having children were associated with depression, surgery type was correlated with anxiety, and age, as well as comorbidities, were predictors for both anxiety and depression 5 to 6 years after diagnosis. An increase of depression over time was more likely when having children and comorbidities. An increase in anxiety was less likely after cancer recurrence.

Conclusions
Findings highlight that anxiety and depression are relevant burdens for breast cancer survivors in Germany. Several sociodemographic and clinical predictors are identified. There is need for psychosocial support after acute treatment and in the long-term. Research on psychological burdens of long-term breast cancer survivors in the identified vulnerable groups is needed.
Profiling the variability and inequity in the residential environment in Cyprus according to citizens’ ratings: a cross-sectional internet-based “Place Standard” survey
Authors: Kleopa Daphne , Panayiotou Andrie , Kouta Christiana , Kaiafa Chrystalla , Middleton Nicos 
Published: February 2022

Abstract
Background
The “Place Standard Tool” (PST) offers a practical framework for structuring conversations about physical and social dimensions of Place which impact on health and well-being. The aim of this study was to survey citizens’ perceptions of Place across diverse settings in Cyprus. While the PST has been extensively used in the context of community engagement, its properties as a measurement tool haven’t been explored.

Methods
An open call was addressed to citizens to rate their neighbourhood environment across the 14 PST items (1: large to 7: little room for improvement). Exploratory factor, cluster and regression analyses were used to explore the dimensionality of the scale, depict neighbourhood profiles and explore differences in ratings according to socio-demographic characteristics, area-level census indicators and residents’ assessment of neighbourhood social position (10-step ladder).

Results
With the exception of safety (M = 4.4, SD = 1.7), 492 participants (mean age 42, 50% residents for > 10 years) from 254 postcodes (21.7% islandwide) did not rate other features favourably, with lowest scores for “influence and sense of control” and “public transport”. A stepwise pattern of dissatisfaction was observed along the social position continuum both for features rated less as well as more favourably (e.g. social contact). For instance, among participants who placed their neighbourhood at the three top steps of the ladder, 48.8% gave a low rating for “influence and sense of control”, while the equivalent figure was 81.0% at the bottom three steps (OR = 4.5, 95% CI 2.3, 8.6). A clear dimensionality of Built (6 items, Cronbach’s α = 0.798), Physical (3 items, α = 0.765), Social (2 items, α = 0.749) and Service (3 items, α = 0.58) environment was identified. A social gradient was evident according to census measures of socio-economic disadvantage (e.g. pre-1980 housing, single-parent households) with larger differences in terms of the built than the social environment.

Conclusions
The study profiled the variability and documented the inequity in the health-related neighbourhood environment across Cypriot communities. The readily interpretable dimensionality of the scale supports its construct validity, allowing calculation of composite scores. The PST can be used as measurement tool in research as well as public health practice to advocate for neighbourhood initiatives which support and enhance citizens’ participation.
Readiness to enter the workforce: perceptions of health professions students at a regional Australian university
Authors: Malau-Aduli Bunmi S. , Jones Karina , Alele Faith , Adu Mary D. , Drovandi Aaron , Knott Gillian , Young Louise , Jo Clara 
Published: February 2022

AbstractBackgroundPerceived readiness for practice can help mitigate the stress and uncertainty associated with transitioning from university into the workforce. This study aimed to identify factors influencing the readiness for clinical practice among final-year medical, dental, and pharmacy students at an Australian regional university.MethodsThe study utilised a sequential explanatory mixed-methods approach with surveys administered for the quantitative phase and interviews/focus groups for the qualitative phase. Descriptive statistics and inductive thematic analysis were utilised for the quantitative and qualitative data, respectively. Triangulation of findings from both phases facilitated in-depth understanding of the factors that influenced participants’ self-perceived readiness for clinical practice.ResultsFrom the three disciplines, 132 students completed the survey and 14 participated in the focus groups and interviews. Students felt most prepared in their patient-centred capabilities, core skills, and advanced consultation skills, and least prepared in their system-related capabilities and clinical care skills. Themes identified as essential enablers and confidence builders in relation to workforce readiness in all three disciplines were: gained knowledge and skills, value of clinical placement experiences, support from peers, family and staff. However, students felt their work-readiness was impaired by heavy academic workloads and poor knowledge of health care systems, which affected skills development. Participants suggested additional support in health care system and clinical governance, mental healthcare, and induction to placement sites to further improve their work readiness.ConclusionsThe findings of this study suggest that improving work-readiness of healthcare students requires alignment of learning needs to real-world practice opportunities, ensuring support systems are appropriate, and early familiarisation with the healthcare system.
Mutant C. elegans mitofusin leads to selective removal of mtDNA heteroplasmic deletions across generations to maintain fitness
Authors: Meshnik Lana , Bar-Yaacov Dan , Kasztan Dana , Neiger Tali , Cohen Tal , Kishner Mor , Valenci Itay , Dadon Sara , Klein Christopher J. , Vance Jeffery M. , Nevo Yoram , Züchner Stephan , Ovadia Ofer , Mishmar Dan , Ben-Zvi Anat 
Published: February 2022

Abstract
Background
Mitochondrial DNA (mtDNA) is present at high copy numbers in animal cells, and though characterized by a single haplotype in each individual due to maternal germline inheritance, deleterious mutations and intact mtDNA molecules frequently co-exist (heteroplasmy). A number of factors, such as replicative segregation, mitochondrial bottlenecks, and selection, may modulate the exitance of heteroplasmic mutations. Since such mutations may have pathological consequences, they likely survive and are inherited due to functional complementation via the intracellular mitochondrial network. Here, we hypothesized that compromised mitochondrial fusion would hamper such complementation, thereby affecting heteroplasmy inheritance.

Results
We assessed heteroplasmy levels in three Caenorhabditis elegans strains carrying different heteroplasmic mtDNA deletions (ΔmtDNA) in the background of mutant mitofusin (fzo-1). Animals displayed severe embryonic lethality and developmental delay. Strikingly, observed phenotypes were relieved during subsequent generations in association with complete loss of ΔmtDNA molecules. Moreover, deletion loss rates were negatively correlated with the size of mtDNA deletions, suggesting that mitochondrial fusion is essential and sensitive to the nature of the heteroplasmic mtDNA mutations. Introducing the ΔmtDNA into a fzo-1;pdr-1;+/ΔmtDNA (PARKIN ortholog) double mutant resulted in a skewed Mendelian progeny distribution, in contrast to the normal distribution in the fzo-1;+/ΔmtDNA mutant, and severely reduced brood size. Notably, the ΔmtDNA was lost across generations in association with improved phenotypes.

Conclusions
Taken together, our findings show that when mitochondrial fusion is compromised, deleterious heteroplasmic mutations cannot evade natural selection while inherited through generations. Moreover, our findings underline the importance of cross-talk between mitochondrial fusion and mitophagy in modulating the inheritance of mtDNA heteroplasmy.
CPNE1 is a potential prognostic biomarker, associated with immune infiltrates and promotes progression of hepatocellular carcinoma
Authors: Su Jinfang , Huang Yongbiao , Wang Yali , Li Rui , Deng Wanjun , Zhang Hao , Xiong Huihua 
Published: February 2022

Abstract
Background
Copine1 (CPNE1), the first discovered CPNE1 family member, participates in the process of carcinogenesis and development of diverse tumors. Our study aimed to investigate the expression and prognostic value of CPNE1 gene in hepatocellular carcinoma (HCC), to explore its functional network in HCC and its effects on biological behaviors.

Methods
HCCDB, CCLE, HPA and LinkedOmics online databases were used to explore the expression of CPNE1 gene and analyze the co-expression network of CPNE1 in hepatocellular carcinoma. Gene set enrichment analysis (GSEA) was used for GO functional annotation, KEGG pathway enrichment analysis and regulators of CPNE1 networks in LIHC. HepG2 and MHCC-97H cells were selected to construct CPNE1 knockdown cell lines by transfection with siRNA, and Hep3B cell was selected to construct CPNE1 overexpression cell line by transfection with plasmid. The effect of CPNE1 on the proliferation of hepatocellular carcinoma cells was examined by CCK8 assay and clone formation assay; the effect of CPNE1 on the migration ability of hepatocellular carcinoma cells was assessed by cell scratch assay and Transwell cell migration assay; finally, the expression of related signaling pathway proteins was examined by Western Blot. The correlation of CPNE1 expression with immune infiltration and immune checkpoint molecules in HCC tissues was analyzed using TIMER online database and GSEA.

Results
CPNE1 was highly expressed in HCC tissues and significantly correlated with sex, age, cancer stage and tumor grade. Overall survival (OS) was significantly lower in patients with high CPNE1 expression than in patients with low CPNE1 expression, and CPNE1 could be used as an independent prognostic indicator for HCC. Knockdown of CPNE1 gene inhibited the AKT/P53 pathway, resulting in decreased proliferation, migration and invasion of HCC cells. Overexpression of CPNE1 gene showed the opposite results. The level of CPNE1 expression in HCC was significantly and positively correlated with the level of infiltration of B cells, CD8+ T cells, CD4+ T cells, macrophages, neutrophils, and dendritic cells (P < 0.001). GSEA results also showed that CPNE1 of LIHC was involved in some immune response regulating signaling pathways.

Conclusions
Our study firstly found the expression of CPNE1 was significantly higher in LIHC tissues than in normal liver tissues, and high CPNE1 expression was associated with poor prognosis. In addition, we identified the possible mechanism by which CPNE1 functioned in LIHC. CPNE1 influenced AKT/P53 pathway activation and LIHC cell proliferation and migration. There was a significant correlation between CPNE1 expression and tumor immune infiltration in LIHC.
Race and sex differences in HDL peroxide content among American adults with and without type 2 diabetes
Authors: Flaherty Shelby M. , Wood Elizabeth K. , Ryff Carol D. , Love Gayle D. , Kelesidis Theodoros , Berkowitz Loni , Echeverría Guadalupe , Rivera Katherine , Rigotti Attilio , Coe Christopher L. 
Published: February 2022

Abstract
Background
High-density lipoprotein (HDL) plays a critical role in protection against atherosclerosic and cardiovascular disease (ASCVD). In addition to contributing to clearing excess vascular cholesterol, HDL particles exhibit antioxidative functions, helping to attenuate adverse effects of oxidized low-density lipoproteins. However, these beneficial properties can be undermined by oxidative stress, inflammation, and unhealthy lifestyles and diet, as well as influenced by race and sex. Thus, when assessing cardiovascular risk, it is important to consider multifactorial aspects of HDL, including antioxidant activity rather than just total amount and type of HDL-cholesterol (HDL-C) particles. Because prior research showed HDL peroxide content (HDLperox) can be inversely associated with normal anti-oxidant HDL activity, elevated HDLperox may serve as a bioindicator of HDL dysfunction.

Methods
In this study, data from a large national cohort of Americans was utilized to determine the impact of sex, race, and diabetes status on HDLperox in middle-aged and older adults. A previously developed cell-free fluorometric method was utilized to quantify HDLperox in serum depleted of apo-B containing lipoproteins.

Results
In keeping with predictions, white men and diabetics exhibited HDLperox in the atypical upper range, suggestive of less functional HDL. White men had higher HDLperox levels than African American males (13.46 ± 6.10 vs. 10.88 ± 5.81, p < .001). There was also a significant main effect of type 2 diabetes (F(1,1901) = 14.9, p < .0001). Overall, African Americans evinced lower HDLperox levels, despite more obesity (10.3 ± 4.7 vs.11.81 ± 5.66 for Whites) suggesting that other aspects of lipid metabolism and psychosocial factors account for the higher prevalence of ASCVD in African Americans.

Conclusion
This research helps to provide a more comprehensive understanding of HDL function in a racially and metabolically diverse adult population. HDLperox content was significantly different in adults with type 2 diabetes, and distinctive in nondiabetic White males, and suggests other processes account for the higher prevalence of ASCVD among African Americans.
The effects of extracellular vesicles derived from Krüppel-Like Factor 2 overexpressing endothelial cells on the regulation of cardiac inflammation in the dilated cardiomyopathy
Authors: Zhang Wenfeng , Chen Ziwei , Qiao Shuaihua , Chen Siyuan , Zheng Hongyan , Wei Xuan , Li Qiaoling , Xu Biao , Huang Wei 
Published: February 2022

Abstract
Background
Dilated cardiomyopathy (DCM) is one of the common causes of heart failure. Myocardial injury triggers an inflammatory response and recruits immune cells into the heart. High expression of Krüppel-like factor 2 (KLF2) in endothelial cells (ECs) potentially exerts an anti-inflammatory effect. However, the role of extracellular vesicles (EVs) from KLF2-overexpressing ECs (KLF2-EVs) in DCM remains unclear.

Methods and results
EVs were separated from the supernatant of KLF2-overexpressing ECs by gradient centrifugation. Mice were repeatedly administered low-dose doxorubicin (DOX) and then received KLF2-EVs through an intravenous injection. Treatment with KLF2-EVs prevented doxorubicin-induced left ventricular dysfunction and reduced the recruitment of Ly6high Mo/Mø in the myocardium. We used flow cytometry to detect Ly6high monocytes in bone marrow and spleen tissues and to elucidate the mechanisms underlying this beneficial effect. KLF2-EVs increased the retention of Ly6Chigh monocytes in the bone marrow but not in the spleen tissue. KLF2-EVs also significantly downregulated C–C chemokine receptor 2 (CCR2) protein expression in cells from the bone marrow.

Conclusions
EVs derived from KLF2-overexpressing ECs reduced cardiac inflammation and ameliorated left ventricular dysfunction in DCM mice by targeting the CCR2 protein to inhibit Ly6Chigh monocyte mobilization from the bone marrow.

Graphical Abstract