bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Shrinkage of Lake Lop Nur in the Twentieth Century: A Comprehensive Ecohydrological Analysis
Authors: Cai Danlu , Yu Lijun , Zhu Jianfeng , Fraedrich Klaus , Guan Yanning , Sielmann Frank , Zhang Chunyan , Yu Min 
Published: August 2022

Abstract
A comprehensive ecohydrological analysis is designed to understand the formation and evolution of lake Lop Nur and the environmental change over the Tarim River basin. Three temporal scales from century-based climatological mean to decade-based quasi-steady state change and to annual-scale-based abrupt change test are included. Combining the Budyko and Tomer–Schilling framework, this research first analyzes hydroclimatic and ecohydrological resistance/resilience conditions, then attributes observed changes to external/climate impact or to internal/anthropogenic activities, and finally diagnoses the possible tipping point on ecohydrological dynamics. (i) The arid regions reveal less sensitivity in terms of low variabilities of excess water W and energy U and show high resilience, which will more likely stay the same pattern in the future. (ii) Present towns situated in the semiarid regions with a natural hydraulic linkage with the mainstream of the Tarim River show a higher sensitivity and likelihood to be affected if drier scenarios occurred in the future. (iii) The attribution from two subsequent quasi-steady states indicates increasing effects of the anthropogenic activities increase (1961–80 versus 1981–2000) and provides climatical evidence that the central Tarim River basin was getting wetter before 1960 and then kept drying afterward. (iv) In the Kongqi subcatchment, the excess water reveals a significant decrease-then-increase evolution, from which the years with abrupt changes are observed in the 1960s. Generally, both points iii and iv are in agreement with that the closed-basin lake Lop Nur desiccation until the 1970s and its connection with the eastern part of the Taklamakan Sand Sea.
Predictive value of hemoglobin-to-red blood cell distribution width ratio for contrast-induced nephropathy after emergency percutaneous coronary intervention
Authors: Sun Xipeng , Zhang Ruixue , Fan Zhenxing , Liu Zhi , Hua Qi 
Published: August 2022

Background Although the relationship of either hemoglobin or red blood cell distribution width (RDW) with contrast-induced nephropathy (CIN) has been reported individually. To date, no studies have evaluated the predictive value of hemoglobin-to-red blood cell distribution width ratio (HRR) for CIN. Methods A total of 1658 elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) were retrospectively screened. Preoperative complete blood count was collected and the HRR was calculated as the ratio of hemoglobin to RDW. CIN was defined as an absolute ≥0.5 mg/dL (44.2 μmol/L) or a relative ≥25% increase in creatinine level at 72 h after contrast administration. Univariate and multivariate regression analysis were conducted to determine the effective predictors for CIN. The ROC curve analysis was plotted to determine the optimal cutoff value for HRR in predicting CIN. Results The overall incidence of CIN was 8.38%. The HRR was significantly lower in the CIN group compared with the non-CIN group (0.87 ± 0.15 vs 1.24 ± 0.23, p < 0.001). After multivariate regression analysis was performed, HRR was noted to be an effective predictor for the development of CIN (OR 1.617, 95% CI 1.439–2.706, p = 0.014), along with age, creatinine, eGFR, hs-CRP and contrast volume. An optimal cutoff value of 0.94 or lower for HRR was identified with 82.4% sensitivity and 63.5% specificity to predict CIN. Conclusion Lower HRR on admission was an effective predictor for CIN in elderly patients with STEMI undergoing emergency PCI. HRR may be a convenient, economical and reliable biomarker for risk stratification.
Outcomes of distal radial endoprostheses for tumour reconstruction: a single centre experience over 15 years
Authors: Mahoney Rachel , Khan Zeeshan , Abudu Adesegun , Kurisunkal Vineet , Evans Scott , Jeys Lee M. 
Published: August 2022

We report a retrospective study over a 15-year period, between 2005 and 2020, evaluating clinical and functional outcomes in patients who underwent reconstruction of the distal radius with an endoprosthetic replacement following excision of both malignant and aggressive benign bone tumours. Data was collected retrospectively from a prospectively maintained electronic database, and prospectively via telephone patient consultation. Musculoskeletal Tumour Society and patient-rated wrist evaluation scores were assessed at a minimum of 1 year postoperatively. Of nine implants, five were arthrodeses and four were arthroplasties. One patient required amputation within 6 months for proximal metastatic disease. At last follow-up, eight patients subjectively reported good function. Five patients returned to high functionally demanding jobs. Mean Musculoskeletal Tumour Society and patient-rated wrist evaluation scores were 72% and 50/100, respectively. We conclude that distal radius endoprosthetic replacements offer acceptable functional outcomes and remain a viable option when biological reconstruction is not possible. Level of evidence: IV
The Role of Maternal and Environmental Factors During Pregnancy on the Risk of Hypospadias Occurrence
Authors: Siregar Safendra , Sibarani Jupiter , Saputra Daniel 
Published: August 2022

Introduction and Objectives Hypospadias is a congenital disorder in boys in which the urethral meatus is located on the ventral penis. The incidence rate of hypospadias is increasing, however, there is still no literature regarding how significant is the role of maternal and environmental factors to the risk of hypospadias, especially in Indonesia. This study aims to analyze the maternal and environmental factors during pregnancy to the risk of hypospadias. Materials and Methods This study was an analytical observational study with a case control design. The subjects were mothers who gave birth to children with hypospadias, compared to normal, who visited the urology, pediatric-surgery, plastic-surgery, and pediatric clinic at Hasan Sadikin General Hospital. Results A total of 120 samples (60 cases and 60 control) were included in this study. There were 14 maternal factors, which 5 of them found significantly correlated with hypospadias, including maternal occupation as an industrial worker ( P = .003; OR:4.789), pregnancy-enhancing drugs usage ( P = .004; OR: 5.783), smoking consumption ( P = .034; OR: 2.294), mosquito-repellant usage ( P = .0001; OR: 82.600), and preterm birth ( P = .013; OR: 2.895). There were 2 environmental factors, and one of them was significant, which was the distance from home to industrial/rice fields/waste areas, approximately 780 m ( P = .0001; OR: 6.102). Based on multivariate analysis, we found that maternal occupation, mosquito repellent usage, and the distance from home to industrial area had a strong relationship in predicting hypospadias occurrence. Conclusion Several maternal and environmental factors were found significantly correlated to hypospadias occurrence. Among these, mosquito-repellant usage was found to be the most significant factor.
Applying a biopsychosocial model to migraine: rationale and clinical implications
Authors: Rosignoli Chiara , Ornello Raffaele , Onofri Agnese , Caponnetto Valeria , Grazzi Licia , Raggi Alberto , Leonardi Matilde , Sacco Simona 
Published: August 2022

AbstractMigraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.
Diversity and dynamics of the CRISPR-Cas systems associated with Bacteroides fragilis in human population
Authors: Lam Tony J. , Mortensen Kate , Ye Yuzhen 
Published: August 2022

Abstract
Background
CRISPR-Cas (clustered regularly interspaced short palindromic repeats—CRISPR-associated proteins) systems are adaptive immune systems commonly found in prokaryotes that provide sequence-specific defense against invading mobile genetic elements (MGEs). The memory of these immunological encounters are stored in CRISPR arrays, where spacer sequences record the identity and history of past invaders. Analyzing such CRISPR arrays provide insights into the dynamics of CRISPR-Cas systems and the adaptation of their host bacteria to rapidly changing environments such as the human gut.

Results
In this study, we utilized 601 publicly available Bacteroides fragilis genome isolates from 12 healthy individuals, 6 of which include longitudinal observations, and 222 available B. fragilis reference genomes to update the understanding of B. fragilis CRISPR-Cas dynamics and their differential activities. Analysis of longitudinal genomic data showed that some CRISPR array structures remained relatively stable over time whereas others involved radical spacer acquisition during some periods, and diverse CRISPR arrays (associated with multiple isolates) co-existed in the same individuals with some persisted over time. Furthermore, features of CRISPR adaptation, evolution, and microdynamics were highlighted through an analysis of host-MGE network, such as modules of multiple MGEs and hosts, reflecting complex interactions between B. fragilis and its invaders mediated through the CRISPR-Cas systems.

Conclusions
We made available of all annotated CRISPR-Cas systems and their target MGEs, and their interaction network as a web resource at https://omics.informatics.indiana.edu/CRISPRone/Bfragilis. We anticipate it will become an important resource for studying of B. fragilis, its CRISPR-Cas systems, and its interaction with mobile genetic elements providing insights into evolutionary dynamics that may shape the species virulence and lead to its pathogenicity.
Inappropriate and potentially avoidable emergency department visits of Swiss nursing home residents and their resource use: a retrospective chart-review
Authors: Zúñiga Franziska , Gaertner Katharina , Weber-Schuh Sabine K. , Löw Barbara , Simon Michael , Müller Martin 
Published: August 2022

Abstract
Background
Emergency department (ED) visits for nursing home residents lead to higher morbidity and mortality. Therefore, inappropriate visits (for conditions treatable elsewhere) or potentially avoidable visits (those avoidable through adequate chronic care management) must be minimized. This study aimed to investigate factors and resource consumption patterns associated with inappropriate and potentially avoidable visits in a Swiss tertiary hospital.

Methods
This is a single-center retrospective chart review in an urban Swiss university hospital ED. A consecutive sample of 1276 visits by nursing home residents (≥ 65 years old), recorded between January 1, 2015 and December 31, 2017 (three calendar years) were included. Case characteristics were extracted from ED electronic documentation. Appropriateness was assessed via a structured Appropriateness Evaluation Protocol; potentially avoidable visits—measured as ambulatory-care sensitive conditions (ACSCs)—were analyzed separately. Inter-group differences concerning ED resource use were tested respectively with chi-square or Wilcoxon rank sum tests. To identify predictors of inappropriate or potentially-avoidable visits, we used multivariable logistic regression analysis.

Results
Six percent of visits were rated as inappropriate: they had lower triage levels (OR 0.55 [95%-CI 0.33-0.92], p=0.024) and, compared to ambulance calls, they had higher odds of initiation via either patient-initiated walk-in (OR 3.42 [95%-CI 1.79-6.55], p≤0.001) or GP referrals (OR 2.13 [95%-CI 1.16-3.90], p=0.015). For inappropriate visits, overall ED resource use was significantly lower (median 568 vs. 1403 tax points, p≤0.001). Of all visits included, 29% were due to (often potentially-avoidable) ACSCs. In those cases, compared to ambulance initiation, odds of being potentially-avoidable were considerably lower for walk-in patients (OR 0.46 [95%-CI 0.27-0.77], p=0.004) but higher for GP referrals (OR 1.40 [95%-CI 1.00-1.94], p=0.048). Nurse work (93 tax points vs. 64, p≤0.001) and laboratory resource use (334 tax points vs. 214, p≤0.001) were higher for potentially-avoidable ED visits.

Conclusions
We revealed substantial differences between the investigated groups. While nearly one third of ED visits from nursing homes were potentially avoidable, inappropriate visits were lower in numbers and not resource-intensive. Further research is required to differentiate potentially avoidable visits from inappropriate ones and to determine these findings’ public health implications.
Prognostic significance of AKR1C4 and the advantage of combining EBV DNA to stratify patients at high risk of locoregional recurrence of nasopharyngeal carcinoma
Authors: Guo Shan-Shan , Chen Yan-Zhou , Liu Li-Ting , Liu Rong-Ping , Liang Yu-Jing , Wen Dong-Xiang , Jin Jing , Tang Lin-Quan , Mai Hai-Qiang , Chen Qiu-Yan 
Published: August 2022

Abstract
Background
Distinguishing patients at a greater risk of recurrence is essential for treating locoregional advanced nasopharyngeal carcinoma (NPC). This study aimed to explore the potential of aldo–keto reductase 1C4 (AKR1C4) in stratifying patients at high risk of locoregional relapse.

Methods
A total of 179 patients with locoregionally advanced NPC were grouped by different strategies; they were: (a) divided into two groups according to AKR1C4 expression level, and (b) classified into three clusters by integrating AKR1C4 and Epstein-Barr virus (EBV) DNA. The Kaplan–Meier method was used to calculate locoregional relapse-free survival (LRFS), overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). The Cox proportional hazards model was used to determine potential prognostic factors, and a nomogram was generated to predict 3-year and 5-year LRFS.

Results
A significant difference in the 5-year LRFS was observed between the high and low AKR1C4 expression groups (83.3% vs. 92.7%, respectively; p = 0.009). After integrating AKR1C4 expression and EBV DNA, the LRFS (84.7%, 84.5%, 96.9%, p = 0.014) of high-, intermediate-, and low- AKR1C4 and EBV DNA was also significant. Multivariate analysis indicated that AKR1C4 expression (p = 0.006) was an independent prognostic factor for LRFS. The prognostic factors incorporated into the nomogram were AKR1C4 expression, T stage, and EBV DNA, and the concordance index of the nomogram for locoregional relapse was 0.718.

Conclusions
In conclusion, high AKR1C4 expression was associated with a high possibility of relapse in NPC patients, and integrating EBV DNA and AKR1C4 can stratify high-risk patients with locoregional recurrence.
Humanistic and economic burden associated with depression in the United States: a cross-sectional survey analysis
Authors: Jain Saundra , Gupta Shaloo , Li Vicky W. , Suthoff Ellison , Arnaud Alix 
Published: August 2022

Abstract
Background
Depression (major depressive disorder [MDD]) affects the functioning of patients in many facets of life. Very few large-scale studies to date have compared health and economic related outcomes of those with versus without depression, and across various depression severity groups. We aimed to evaluate humanistic and economic burden in respondents with and without depression diagnosis, and across symptom severity groups.

Methods
Data from the 2017 US National Health and Wellness Survey (NHWS) were utilized. Of the adult respondents (N = 75,004), 59,786 were < 65 years old. Respondents not meeting eligibility criteria were excluded (e.g., those self-reporting bipolar disorder or experiencing depression in past 12 months but no depression diagnosis). Overall, data from 39,331 eligible respondents (aged 18–64 years) were analyzed; and comprised respondents ‘with depression diagnosis’ (n = 8853; self-reporting physician diagnosis of depression and experiencing depression in past 12 months) and respondents ‘without depression diagnosis’ (n = 30,478; no self-reported physician diagnosis of depression and not experiencing depression). Respondents with depression were further examined across depression severity based on Patient Health Questionnaire-9 (PHQ-9). Outcome measures included health-related quality-of-life (HRQoL; Medical Outcomes Study 36-item Short Form [SF-36v2]: mental and physical component summary [MCS and PCS]; Short-Form 6 Dimensions [SF-6D]; and EuroQol 5 Dimensions [EQ-5D]), work productivity and activity impairment (WPAI), and health resource utilization (HRU). Multivariate analysis was performed to examine group differences after adjusting covariates.

Results
Respondents with depression diagnosis reported significantly higher rates of diagnosed anxiety and sleep problems versus those without depression (for both; P < 0.001). Adjusted MCS, PCS, SF-6D, and EQ-5D scores were significantly lower in respondents with depression versus those without depression (all P < 0.001). Consistently, respondents with depression reported higher absenteeism, presenteeism, and overall WPAI, as well as greater number of provider visits, emergency room visits, and hospitalizations compared with those without depression (all P < 0.001). Further, burden of each outcome increased with an increase in disease severity.

Conclusions
Diagnosed depression was associated with lower health-related quality-of-life and work productivity, and higher healthcare utilization than those without depression, and burden increased with an increase in symptom severity. The results show the burden of depression remains high even among those experiencing minimal symptoms.
Adverse childhood experiences are associated with a higher risk for increased depressive symptoms during Covid-19 pandemic – a cross-sectional study in Germany
Authors: Clemens Vera , Köhler-Dauner Franziska , Keller Ferdinand , Ziegenhain Ute , Fegert Jörg M. 
Published: August 2022

Abstract
Background
Covid-19 pandemic has been profoundly affecting people around the world. While contact restrictions, school closures and economic shutdown were effective to reduce infection rates, these measures go along with high stress for many individuals. Persons who have experienced adverse childhood experiences (ACEs) have an increased risk for mental health problems already under normal conditions. As ACEs can be associated with a higher vulnerability to stress we aimed to assess the role of ACEs on depressive symptoms during the Covid-19 pandemic.

Methods
In a cross-sectional online survey, 1399 participants above the age of 18 years were included during the first lockdown in Germany. Via two-way repeated measures ANOVA, differences in depressive symptoms before (retrospectively assessed) and during the pandemic were analyzed. Linear regression analyses were performed in order to identify predictors for increase of depressive symptoms.

Results
Compared to prior to the Covid-19 pandemic, depressive symptoms increased among all participants. Participants with ACEs and income loss reported about a stronger increase of depressive symptoms. Other predictors for increased depressive symptoms were young age and a lack of social support.

Conclusions
Based on these results, ACEs are a significant predictor for an increase in depressive symptoms during the pandemic, indicating that personss with ACEs may be a risk group for mental health problems during the current and potential later pandemics. These findings underline the relevance of support for persons who have experienced ACEs and may help to provide more targeted support in possible scenarios due to the current or possible other pandemics. Besides, economic stability seems to be of prior importance for mental health.
Predictors for weight loss after Roux-en-Y gastric bypass: the trend and associated factors for weight loss
Authors: Eghbali Foolad , Bahardoust Mansour , Pazouki Abdolreza , Barahman Gelayol , Tizmaghz Adnan , Hajmohammadi Amir , Karami Reza , Hosseini-Baharanchi Fatemeh Sadat 
Published: August 2022

Abstract
Background
Historically, Roux-en-Y gastric bypass (RYGB) has been considered the gold standard of bariatric surgery (BS). This procedure acts as a mixed restrictive and malabsorptive operation.

Methods
This retrospective cohort study included 410 morbidly obese patients (BMI > 40 kg/m2 or BMI > 35 kg/m2 along with at least one major comorbidity) who underwent primary laparoscopic RYGB surgery from 2009 to 2015 by a single surgery team. The patients were 18 years and older with at least 12 months of follow-up. Total weight loss (%TWL) and comorbidity resolution were compared in short-term (12 months) and mid-term (12–60 months) follow-ups. The primary and secondary outcomes were evaluating the effect of Roux-en-Y on weight loss and control of comorbidities, respectively.

Results
The mean ± SD age, weight, and BMI at surgery were 40.1 ± 10.58 years, 123.32 ± 19.88 kg, and 45.78 ± 5.54 kg/m2, respectively, and 329 (80%) were female, and 62 (15%) had T2DM. %TWL was significantly higher in T2DM patients 9 months postoperatively and after that. Patients with lower BMI (< 50 kg/m2) at surgery and non-diabetic patients had a significantly lower %TWL over a short- and long-term follow-up (P < 0.001).

Conclusions
BS remains the most efficacious and durable weight loss treatment. However, a proportion of patients will experience insufficient weight loss following BS.