bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association of FKBP5 gene methylation, adolescents’ sex, and depressive symptoms among Chinese adolescents: a nested case-control study
Authors: Li Wenyan , Wang Wanxin , Lai Wenjian , Li Xiuwen , Zhu Liwan , Shi Jingman , Teopiz Kayla M. , McIntyre Roger S. , Guo Lan , Lu Ciyong 
Published: November 2022

Abstract
Background
Depressive symptoms among adolescents are a serious health concern around the world. Altered DNA methylation in the FK506 binding protein 5 (FKBP5) gene has been reported to regulate stress response, which has been reported to be closely associated with depressive symptoms. However, most of the contributing studies have been conducted among adults and relatively few studies have considered the effect of disparate social influences and sex differences on the DNA methylation of FKBP5 in persons with depressive symptoms. The present study aimed to test the associations of FKBP5 DNA methylation and depressive symptoms among adolescents and explore possible sex differences in the foregoing associations.

Methods
This study was conducted using a nested case-control design within a longitudinal cohort study from January 2019 to December 2019. Adolescents aged 12 to 17 years from 69 classes in 10 public high schools located in Guangdong province of China participated in this research. Students with persistent depressive symptoms that reported having depressive symptoms at both baseline and follow-up were treated as the case group, and those without depressive symptoms were randomly selected as the control group. Our study finally included 87 cases and 151 controls. Quantitative methylation analyses of the selected gene were carried out by MassARRAY platform System.

Results
The overall DNA methylation trend of FKBP5 CpG sites in the case group was lower in comparison to the control group. Compared to healthy controls, lower methylation percentage of FKBP5-12 CpG 1 was observed in adolescents with persistent depressive symptoms after adjusting for covariates (case: 0.94 ± 2.00, control: 0.47 ± 0.92; F = 5.41, P = 0.021), although the statistical significance of the difference was lost after false discovery rate correction (q > 0.05). In addition, the hypomethylation of FKBP5-12 CpG 1 was approaching significance after adjustment for social-environmental factors (aOR = 0.77; P = 0.055), which indicated that no independent association was detected between hypomethylation of FKBP5 CpG sites and persistent depressive symptoms. Furthermore, in the present study, we were unable to identify sex differences in the association of FKBP5 gene methylation with depressive symptoms.

Conclusion
The decreased methylation level of FKBP5 was observed in adolescents with persistent depressive symptoms, albeit non-significant after correction for multiple testing. Our results presented here are preliminary and underscore the complex gene-environment interactions relevant to the risk for depressive symptoms.
Distinct patterns of problematic smartphone use and related factors in Chinese college students
Authors: Hong Lan , Lai Xinyi , Xu Dongwu , Zhang Wei , Wu Bichang , Yu Xin , Zhao Ke , Zhang Guohua 
Published: November 2022

Abstract
Background
This study aimed to categorize different subgroups of problematic smartphone use in Chinese college students. Differences in gender and psychosocial characteristics of the categorized groups were also examined.

Methods
A total of 1123 participants completed the Mobile Phone Addiction Index Scale, the Center for Epidemiologic Studies Depression Scale, the Perceived Social Support Scale, and the Perceived Stress Scale. Using latent profile analysis, we identified different subgroups of problematic smartphone use in college students. Multivariate logistic regression analysis was implemented to examine the relationship between latent classes and demographic and psychosocial covariates.

Results
The four following latent classes were identified: a low-risk group, a moderate-risk with no evasiveness group, a moderate-risk with evasiveness group, and high-risk group that accounted for 11%, 24.1%, 35.5%, and 29.4% of the total sample, respectively. Further analysis revealed that female participants were more likely to be in the moderate-risk with evasiveness and high-risk groups, and individuals with depressed mood were more likely to be in the moderate-risk and high-risk groups.

Conclusions
Classifying college students according to the features of problematic smartphone use is potentially useful for understanding risk factors and developing targeted prevention and intervention programs.
Work after mental-health-related absence: a qualitative study of perceived change after a combination of metacognitive therapy and work-focused interventions
Authors: Bjørndal Marianne Tranberg , Giæver Fay , Aschim Bente Marianne , Gjengedal Ragne Gunnarsdatter Hole , Lending Hilde Dallavara , Bull-Hansen Bente , Hannisdal Marit , Hjemdal Odin 
Published: November 2022

Abstract
Background
Sick leave caused by common mental health disorders (CMD) is becoming more prevalent. For most people, work is essential for good mental and physical health. It is necessary to provide treatments that facilitate return to work (RTW) and a reduction of symptoms. A qualitative study can contribute to an understanding of what makes an intervention successful. The aim of this study was to investigate how individuals who are on sick leave because of CMD perceive and handle their symptoms and their work, after completing metacognitive therapy and work-focused interventions.

Methods
Semi-structured interviews were conducted with 23 participants after they had completed therapy. Thematic analysis was used to analyse the data.

Results
Through both therapy and the process of RTW, the participants had gained increased awareness and understanding of their mental health problems and the relationship between those problems and work. Together with the sense that they were in charge of their own process of RTW, this helped to improve their self-confidence. An important part of the process was the change to new strategies and the rejection of older maladaptive ones, in relation to both mental health and work. Being open about their mental illness in the workplace could lead to support but also to the opposite, and therefore not an option for everyone. After treatment, most had returned to work and gained a more positive outlook on the future, but some had less confidence in their ability to deal with future symptoms and workplace issues.

Conclusions
Achieving improved self-confidence and adopting new strategies, which enabled them to change how they related to their mental problems and how they addressed their problems at work, seemed to have increased their self-efficacy. Active involvement in therapy and at work was also important, both for the process and as a way of increasing self-efficacy. This gave them renewed belief in themselves and in their ability to handle their work at present and in the future. Despite this being a manualized treatment, the participants’ experience was that it was adapted to each individual, something they regarded as important.
The relationship between HIV pre-exposure prophylaxis, sexually transmitted infections, and antimicrobial resistance: a qualitative interview study of men who have sex with men
Authors: Williams Adam Dale Newman , Wood Fiona , Gillespie David , Couzens Zoë , Hughes Kathryn , Hood Kerenza 
Published: November 2022

Abstract
Background
HIV pre-exposure prophylaxis (PrEP) is a medication that prevents the acquisition of HIV. It has been targeted towards men who have sex with men (MSM). Since its introduction there have been concerns raised around changes in sexual behaviour such as increased condomless anal intercourse (CAI), leading to an elevation in sexually transmitted infections (STIs). With antimicrobial resistant strains of STIs rising, there are concerns that PrEP may be contributing to this growth. This study aims to understand how MSM conceptualise the relationship between PrEP, STIs and antimicrobial resistance (AMR).

Methods
Twenty semi-structured interviews were conducted online using Zoom. Participants include a mix of PrEP related experiences (never used, currently use, previously used). Reflexive thematic analysis was undertaken by the lead author with 10% of transcripts double coded.

Results
MSM in Wales have positive views and a good knowledge of PrEP and awareness of bacterial STIs. PrEP is perceived by many to lead to a reduction in condom use and increase in STIs but reported condom use behaviours presented to be stable in terms of PrEP initiation. PrEP use is influenced by increased concern for HIV and minimal concern for bacterial STIs. Awareness of AMR STIs was lacking.

Conclusions
There is a belief that PrEP use will lead to an increase in STI rates through reduced condom use, despite reported behaviours often being stable in relation to PrEP initiation, PrEP stigma may be influencing this dichotomy. Concern and awareness for resistant STIs is low, with little association to PrEP.
The impact of changing nonimmigrant visa policies on international students’ psychological adjustment and well-being in the United States during the COVID-19 pandemic: a qualitative study
Authors: Park Chulwoo , Shimada Shannon 
Published: November 2022

Abstract
Background
Since the Immigration and Nationality Act of 1952, the number of international students in the United States had been gradually increasing. However, the total numbers have begun to decrease since 2019–2020 school year due to the Trump administration's policy and COVID-19. Still, little is known about how international students’ psychological adjustment and well-being have been affected by changing nonimmigrant visa policy and the COVID-19 pandemic.

Methods
We conducted a total of 34 online semi-structured in-depth interviews with international students from 18 countries of origin studying in the San Francisco Bay Area, California. More than 60% of the participants (21 out of 34) were aged 21 to 25. Among our 34 participants, gender and 18 were male and 16 were female, and 19 were undergraduate students and 15 were master’s students. The majority of the participants were first-generation college students (22/34, 64.71%). Verbatim transcription was done for all interviews. NVivo was used for both deductive and inductive approaches to the qualitative analysis.

Results
Overall, the recent political climate negatively impacted participants’ psychology of adjustment and well-being. July 6, 2020 Policy Directive for international students caused severe uncertainty about whether they can continue studying in the United States. There were many resources or services needed to overcome this period, such as extended mental and emotional support from the counseling services as well as financial and informational support from the international student office and university. Although international students had the benefit of the university's food assistance program, they were not eligible to receive any external support outside of the university and financial aid at the local and federal levels. Whether maintaining F-1 visa status was one of their major concerns. Due to COVID-19, job opportunities were limited, which made international students difficult to obtain Curricular Practical Training (CPT) and secure a job in the United States within the 90-day unemployment limit of Optical Practical Training (OPT). H-1B visa and permanent residency were other challenges to go through, but participants saw positive perspectives from the Biden administration.

Conclusions
Uncertain policy changes due to COVID-19 and presidential transitions impacted international students’ psychological well-being and adjustment. International students are important populations in the United States who have supported jobs that are high in demand and economically contributed to the United States. It is expected that future policies at various levels support international students’ life and improve their health equity and mental health.
A rare compound heterozygous EIF2AK4 mutation in pulmonary veno-occlusive disease
Authors: Zhang Chun , Du Qiang , Wang Sha , Zhang Ruifeng 
Published: November 2022

Abstract
Background
Pulmonary veno-occlusive disease (PVOD) is a rare, progressive, and oft-fatal condition of pulmonary arterial hypertension that is typically difficult to diagnose and treat. However, with the development of next-generation sequencing technology, an increasing number of patients with PVOD are being diagnosed.

Methods
Initially, we used whole exome sequencing (WES) to identify the proband as a rare compound heterozygous mutation of EIF2AK4 in PVOD. Subsequently, the parents of patient underwent EIF2AK4 screening by Sanger sequencing.

Results
In this study, we describe the family tree of a patient with PVOD with a rare compound heterozygous EIF2AK4 mutation. Moreover, we identified a new EIF2AK4 mutation, c.2236_2237insAAGTCCTTCT, in exon 12 of the proband and his mother. This frameshift mutation led to premature termination of the coding protein sequence and widespread loss of protein function, which promoted the development of PVOD.

Conclusions
Our results expand our understanding of the EIF2AK4 mutation spectrum in patients with PVOD, as well as highlight the clinical applicability of WES.
Transcorporeal decompression using a fully-endoscopic anterior cervical approach to treat cervical spondylotic myelopathy: surgical design and clinical application
Authors: Ma Yanyan , Xin Zhijun , Kong Weijun , Zhang Longsheng , Du Qian , Liao Wenbo 
Published: November 2022

Abstract
Background
Anterior cervical discectomy and fusion (ACDF) is a common procedure for treating cervical spondylotic myelopathy (CSM), however, ACDF may cause pseudoarthrosis, accelerated degeneration of adjacent segments, loss of activity of fused segments and other complications. The full-endoscopic technique can treat CSM, without the aforementioned complications above. Therefore, it is of great clinical value to investigate the surgical scheme of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC).

Methods
A total of 28 cases with single-segment Cervical spondylotic myelopathy (CSM) from April 2017 to July 2019 were involved in this study. The size of the disc-osteophyte complex was measured using imaging data prior to the operation. The diameter and direction of the bony passage was determined according to the size and central position of the complex, respectively. Twenty-eight patients underwent the above scheme for CSM. The clinical outcome evaluations included Visual Analog Scale (VAS) scores, Japanese Orthopedic Association (JOA) scores. The imaging assessment included MRI, CT and X-rays.

Results
The diameter of the designed bony passage was about 6.9 mm, and directed toward the lower edge of the diseased lower vertebral body oblique to the center of the disc-osteophyte complex. All patients successfully completed the operation. The postoperative neck pain VAS and JOA were significantly improved compared to preoperative values (p < 0.01). Postoperative MRI indicated complete decompression of the spinal cord. CT scanning 1 year after the operation revealed an almost healed bony passage and X-ray imaging showed satisfactory physiological curvature of the cervical spine, without cervical instability.

Conclusion
Based on the diameter and direction of the bony passage, as determined by the size and position of the disc-osteophyte complex, indicated by MRI and CT scanning, anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord offers good decompression of the spinal cord and ensures excellent therapeutic outcome.
Exploring facilitators and barriers to self-management engagement of Chinese people with type 2 diabetes mellitus and poor blood glucose control: a descriptive qualitative study
Authors: Liu Yuan , Jiang Jiajia , You Wenjun , Gong Dandan , Ma Xiaoqing , Wu Min , Li Feng 
Published: November 2022

Abstract
Aims
To explore facilitators and barriers to self-management engagement of Chinese people with poorly controlled type 2 diabetes.

Methods
Purposive sampling method was used for recruitment. Semi-structured interview and thematic analysis was used for data collection and analysis.

Results
Twenty-six semi-structured interviews were conducted. Poor blood glucose control introduced awareness of susceptibility to complications, while mental disorders could be concomitant. General knowledge about healthy lifestyle and unhealthy habits impeded lifestyle management. Temporary remission of hyperglycemia and no perceived symptoms interfered engagement of medication therapy and regular blood glucose monitoring. Family and work environments could impact self-management engagement. Accessibility to reliable diabetes-related information influenced self-management engagement.

Conclusions
Awareness of susceptibility to complications motivated self-management engagement, while the awareness could cause mental disorders that need to be addressed.
Customized lifestyle plans and behavior change technologies were crucial for lifestyle management. The progression of diabetes, importance of continuity of medication therapy, and the value of blood glucose monitoring should be clarified in diabetes education.
Building diabetes-friendly social environments and providing reliable diabetes-related information were essential.
Changes in launch delay and availability of pharmaceuticals in 30 European markets over the past two decades
Authors: Büssgen Melanie , Stargardt Tom 
Published: November 2022

Abstract
Background
The timing of the launch of a new drug is an important factor that determines access for patients. We evaluated patient access to pharmaceuticals in 30 European markets over the past two decades.

Methods
Launch dates were extracted from the IQVIA (formerly IMS) database for 30 European countries for all pharmaceuticals launched internationally between 2000 and 2017. We defined launch delay as the difference between the first international launch date and the corresponding national launch date, and calculated these for each country in our sample over time. Additionally, we ranked countries according to their launch delays and looked at changes in the ranking order over time. Lastly, we determined the availability of new pharmaceuticals in each country, calculating this as the percentage of these pharmaceuticals that were available in each country during a pre-specified interval.

Results
There was a clear trend towards a decrease in launch delays across all countries from 2000 (37.2 months) to 2017 (11.8 months). Over the entire observation period, the three fastest launching countries were the Netherlands, Sweden, and Germany, whereas the three slowest were Bosnia-Herzegovina, Serbia, and Turkey. Germany had the highest availability of new pharmaceuticals with 85.7%, followed by the United Kingdom (83.1%) and Norway (82.9%). Countries with the lowest availability of pharmaceuticals were Bosnia-Herzegovina, Serbia, and Latvia. Gross domestic product per capita was negatively correlated with launch delay (-0.67, p < 0.000) and positively correlated with the availability of pharmaceuticals (+ 0.19, p < 0.000).

Conclusion
Launch delay and the availability of pharmaceuticals varied substantially across all 30 European countries. Using countries with above-average availability and below-average launch delays as a benchmark, stakeholders may discuss or modify current pharmaceutical policy, if needed, to improve access to pharmaceutical care.
Retinal age gap as a predictive biomarker of stroke risk
Authors: Zhu Zhuoting , Hu Wenyi , Chen Ruiye , Xiong Ruilin , Wang Wei , Shang Xianwen , Chen Yifan , Kiburg Katerina , Shi Danli , He Shuang , Huang Yu , Zhang Xueli , Tang Shulin , Zeng Jieshan , Yu Honghua , Yang Xiaohong , He Mingguang 
Published: November 2022

Abstract
Background
The aim of this study is to investigate the association of retinal age gap with the risk of incident stroke and its predictive value for incident stroke.

Methods
A total of 80,169 fundus images from 46,969 participants in the UK Biobank cohort met the image quality standard. A deep learning model was constructed based on 19,200 fundus images of 11,052 disease-free participants at baseline for age prediction. Retinal age gap (retinal age predicted based on the fundus image minus chronological age) was generated for the remaining 35,917 participants. Stroke events were determined by data linkage to hospital records on admissions and diagnoses, and national death registers, whichever occurred earliest. Cox proportional hazards regression models were used to estimate the effect of retinal age gap on risk of stroke. Logistic regression models were used to estimate the predictive value of retinal age and well-established risk factors in 10-year stroke risk.

Results
A total of 35,304 participants without history of stroke at baseline were included. During a median follow-up of 5.83 years, 282 (0.80%) participants had stroke events. In the fully adjusted model, each one-year increase in the retinal age gap was associated with a 4% increase in the risk of stroke (hazard ratio [HR] = 1.04, 95% confidence interval [CI]: 1.00–1.08, P = 0.029). Compared to participants with retinal age gap in the first quintile, participants with retinal age gap in the fifth quintile had significantly higher risks of stroke events (HR = 2.37, 95% CI: 1.37–4.10, P = 0.002). The predictive capability of retinal age alone was comparable to the well-established risk factor-based model (AUC=0.676 vs AUC=0.661, p=0.511).

Conclusions
We found that retinal age gap was significantly associated with incident stroke, implying the potential of retinal age gap as a predictive biomarker of stroke risk.