bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Stimulants in Patients with Comorbid Anorexia Nervosa and Attention-Deficit/Hyperactivity Disorder in a Structured Inpatient Setting
Authors: Shear Matthew , Deliberto Tara , Kerrigan Sean , Belak Lauren , Attia Evelyn 
Published: October 2020

ABSTRACT:

Objective:
Clinicians may be concerned about using psychostimulant medications in patients in whom weight gain is desired because of their potential side effects of appetite suppression and weight loss. This report depicts the successful treatment of 2 adolescent patients with anorexia nervosa (AN) and attention-deficit/hyperactivity disorder (ADHD) in an inpatient eating disorders unit.

Method:
A report of 2 clinical cases (ages 19 and 20 years) was used to describe the management of comorbid AN and ADHD. Tolerance to stimulants, meal completion, and ability to restore weight were assessed over the course of hospitalization.

Results:
Behaviorally focused refeeding combined with psychostimulants notably improved symptoms of AN and comorbid ADHD without adverse effects.

Conclusion:
Psychostimulant medications may be used successfully in patients with AN and ADHD in the context of structured behavioral treatment designed for weight restoration.
Insights from Behavioral Economics: A Case of Delayed Diagnosis of Autism Spectrum Disorder
Authors: Wallis Kate E. , Buttenheim Alison M. , Mandell David S. 
Published: October 2020

ABSTRACT:
We present the case of a child of color diagnosed with autism spectrum disorder (ASD) at 67 months of age. Drawing from behavioral economics, we used this case to explore errors in decision-making by clinicians and family members and structural factors that may have delayed ASD diagnosis well beyond the national average.
Gene expression in urinary incontinence and pelvic organ prolapse: a review of literature
Authors: Isali Ilaha , Abdeldayem Jasmin , El-Nashar Sherif 
Published: October 2020

Purpose of review
To review current evidence on gene expression in women with urinary incontinence and pelvic organ prolapse (POP).

Recent findings
Our literature review revealed numerous genes that are associated with urinary incontinence and POP. For overactive bladder and urge urinary incontinence, four genes were highlighted: adrenergic receptor β3, Rho guanine nucleotide exchange factor 10, Rho-associated coiled-coil containing protein kinase 2, and potassium two pore domain channel subfamily K member-1. For Stress Urinary incontinence (SUI), 13 genes were included: skin-derived antileukoproteinase, collagen type XVII alpha 1 chain, plakophilin 1, keratin 16, decorin, biglycan, protein bicaudal D homolog 2, growth factor receptor-bound protein 2, signal transducer and activator of transcription 3, apolipoprotein E, Golgi SNAP receptor complex member 1, fibromodulin, and glucocerebrosidase. For POP seven genes were identified: homeobox A13, matrix metallopeptidase 9, estrogen receptor 2, collagen type XIV alpha 1 chain, collagen type V alpha 1 chain, collagen type IV alpha 2 chain, and catenin beta 1.

Summary
The current review highlights many genes which are potential biomarkers and targets for drug development.
Diagnosis of Community-acquired Pneumonia in Hospitalized Children: A Multicenter Experience in Bolivia
Authors: Gareca Perales José , Soleto Ortiz Lorena , Loayza Mafayle Roxana , Machuca Soto Blanca , Hidalgo Flores Lucia , López Montaño Javier , Zuna Calle Neida , Jarovsky Daniel , Naaman Berezin Eitan 
Published: October 2020

Background:
Community-acquired pneumonia (CAP) represents a major cause of hospitalization, especially among young children. In the third world countries, information about CAP etiology is scarce. Therefore, rapid and highly sensitive diagnostic methods are crucial to determine etiologic agents.

Methods:
Between March 2016 and March 2017, we have prospectively studied the clinical, radiologic, laboratory, and molecular aspects of patients with CAP at 2 tertiary-level hospitals in Santa Cruz de la Sierra, using a multiplex real-time polymerase chain reaction (RT-PCR).

Results:
A total of 274 children were evaluated, with a median age of 13 months. An etiologic agent was identified in 187 patients (68.2%): 54% (n = 148) were viruses and 14.2% (n = 39) were bacteria. CAP prevalence was highest among children under 2 years (71%; 195/274); respiratory syncytial virus (RSV) was the most frequent cause in 22% (60/274), especially among infants, followed by influenza (14.5%; 40/274). Streptococcus pneumoniae accounted for 7% of the total (19/274), followed by Staphylococcus aureus (3%;8/274) and Haemophilus influenzae (1.4%;4/274). Together, these cases accounted for 79.5% (31/39) of all bacterial CAP. Pleural effusion (PE) complicated CAP in 13.8% (38/274), of which 29 were of bacterial etiology. RT-PCR increased the detection rate of pneumococcus by 47%. Coinfection occurred in 28 patients (10%); 26 (9.5%) required intensive care and 9 patients (3%) died.

Conclusions:
RT-PCR provided additional diagnostic value to conventional, clinical, and laboratory methods. The higher prevalence of RSV, influenza, and Streptococcus pneumoniae reveals the need for preventive measures with better vaccine uptake and future research for RSV vaccines.
Self-Report Measures of Presenteeism Are Not Strongly Correlated With Health Workers’ Logged Activity
Authors: Thompson Angus H. , Waye Arianna , Jacobs Philip , Dewa Carolyn S. 
Published: October 2020

Objective:
Low productivity while at work (presenteeism) has been reported to produce significant cost excesses for organizations and economies. However, many of these reports have been based on estimates drawn from self-report instruments that are not supported by evidence showing their efficacy. Thus, the aim of this study was to assess associations between responses to leading self-report tests of presenteeism and self-recorded on-the-job productivity.

Methods:
Health care worker self-ratings of productivity were taken from a questionnaire that contained the key item from each presenteeism instrument. Productivity levels were drawn from employee reported daily work activity logs.

Results:
Test-based productivity estimates did not show strong associations with daily recordings of work activity.

Conclusions:
Associations were too low to recommend any test as a proxy measure for reported productivity. It is suggested that objective measures of work output be explored.
Proton‐pump Inhibitor Response Prediction Using Esophageal microRNAs in Children With Eosinophilic Esophagitis
Authors: Cañas José Antonio , Tabares Ana , Barbero Claudia , García‐Sánchez Daniel , Sastre Beatriz , Rodrigo‐Muñoz José Manuel , Mahíllo‐Fernández Ignacio , Rayo Ana , Borrell Belén , Cilleruelo Mª Luz , Román Enriqueta , Fernandez‐Fernandez Sonia , Gutiérrez‐Junquera Carolina , del Pozo Victoria 
Published: October 2020

ABSTRACTObjectives:Eosinophilic esophagitis (EoE) is a chronic esophageal disease characterized by eosinophilic inflammation. Proton‐pump inhibitors (PPI) induce disease remission but no predictive factors of PPI‐responsiveness have been identified yet. So, a biomarker must be found to differentiate between responders (PPI‐R) and nonresponder patients (PPI‐NR) to PPI. Aims were to identify any molecular biomarker that could predict PPI responsiveness and to study molecular remission after PPI therapy.Methods:This prospective study enrolled 39 controls and 43 pediatric children with EoE from 2 hospitals, and they were treated with esomeprazole for 8 to 12 weeks. After therapy, patients were classified as either PPI‐R or PPI‐NR. Biopsies were collected and RNA, microRNAs, and proteins were isolated from them, measuring levels by qPCR and Western blot (WB). Also, miRNAs were evaluated in serum.Results:We found several esophageal miRNAs with different expression values between PPI‐R and PPI‐NR children, which can be used to discriminate them (area under curve = 0.90). No useful serum miRNAs were, however, identified. Also, these miRNAs were dysregulated in responder patients before and after PPI therapy. Moreover, we corroborated in this child population, that PPI‐R displayed a significant decrease in eotaxin‐3, IL‐5, IL‐13, periostin, and major basic protein (P < 0.05) and a significant increase in filaggrin levels after PPI treatment (P < 0.01).Conclusions:Esophageal miRNA levels found are able to discriminate between both PPI‐R and PPI‐NR at baseline, and before and after treatment in PPI‐R, so they could be used as biomarkers. Furthermore, we observed clinical and esophageal molecular restoration in PPI‐R patients after PPI therapy.
Establishing a National Rate of Rectal Biopsy Positivity in the Diagnosis of Hirschsprung Disease
Authors: Maassel Nathan L. , Ozgediz Doruk E. , Solomon Daniel G. 
Published: October 2020

ABSTRACTObjectives:Although rectal biopsy has long been established as the criterion standard for the diagnosis of Hirschsprung disease, little to no information exists regarding nationwide rates of rectal biopsy positivity or interinstitutional variability. We sought to determine the national rate of rectal biopsy positivity and factors contributing to institutional variability.Methods:A retrospective review of the Children's Hospital Association's (CHA) Pediatric Health Information System from 2009 to 2018 identified infants <100 days old with ICD‐9/ICD‐10 procedural codes for rectal biopsy in addition to codes for pull‐through procedures within 500 days of life as a proxy for positive biopsy. A subgroup analysis of only patients biopsied at institutions with positive biopsy rates 1 standard deviation above or below the mean positive biopsy rate (deemed high and low outliers) was performed to better delineate these populations.Results:A total of 7225 children underwent rectal biopsies between 2009 and 2018 at 52 Children's Hospital Association Hospitals. Mean positive biopsy rate for individual institutions was 21.5% (standard deviation ± 6.4%). Linear regression to predict the effect of hospital surgical volume on positive biopsy rate demonstrated no volume outcome relationship (R2 = 0.049). Patients at high outlier hospitals for biopsy positivity were found to travel significantly further to the hospital (232.5 vs 123.1 miles, P < 0.0001) when compared to patients presenting at low outlier hospitals.Conclusions:There appears to be little interinstitutional variability in the rate of surgery following rectal biopsy for presumed Hirschsprung and no significant relationship to surgical volume. About 1 in every 4 infants undergoing biopsy proceeds to surgery.
Mean arterial pressure maintenance following spinal cord injury: Does meeting the target matter?
Authors: Weinberg Jordan A. , Farber S. Harrison , Kalamchi Louay D. , Brigeman Scott T. , Bohl Michael A. , Varda Bianca M. , Sioda Natasha A. , Radosevich John J. , Chapple Kristina M. , Snyder Laura A. 
Published: October 2020

INTRODUCTION
Neurosurgical guidelines recommend maintaining mean arterial pressure (MAP) between 85 and 90 mm Hg following acute spinal cord injury (SCI). In our hospital, SCI patients receive orders for MAP targeting for 72 hours following admission, but it is unclear how often the patient’s MAP meets the target and whether or not this affects outcome. We hypothesized that the proportion of MAP measurements ≥85 mm Hg would be associated with neurologic recovery.

METHODS
Spinal cord injury patients with blunt mechanism of injury admitted between 2014 and 2019 were identified from the registry of a level 1 trauma center. Proportion of MAP values ≥85 mm Hg was calculated for each patient. Neurologic improvement, as measured by positive change in American Spinal Injury Association (ASIA) impairment scale by ≥1 level from admission to discharge was evaluated with respect to proportion of elevated MAP values.

RESULTS
A total of 136 SCI patients were evaluated. Average proportion of elevated MAP values was 75%. Admission ASIA grades were as follows: A, 30 (22.1%); B, 20 (14.7%); C, 28 (20.6%); and D, 58 (42.6%). One hundred six patients (77.9%) required vasopressors to elevate MAP (ASIA A, 86.7%; B, 95.0%; C, 92.9%; D, 60.3%). Forty patients (29.4%) were observed to have improvement in ASIA grade by discharge (admission ASIA A, 15%; B, 33%; C, 40%; D, 13%). The proportion of elevated MAP values was higher for patients with neurologic improvement (0.81 ± 0.15 vs. 0.72 ± 0.25, p = 0.014). Multivariate modeling demonstrated a significant association between proportion of elevated MAP values and neurologic improvement (p = 0.028). An interaction revealed this association to be moderated by vasopressor dose (p = 0.032).

CONCLUSION
The proportion of MAP measurements ≥85 mm Hg was determined to be an independent predictor of neurologic improvement. Increased vigilance regarding MAP maintenance above 85 mm Hg is warranted to optimize neurologic recovery following SCI.

LEVEL OF EVIDENCE
Therapeutic/care management, level IV.
Examining Australian public perceptions and behaviors towards a future COVID-19 vaccine
Authors: Seale Holly , Heywood Anita E , Leask Julie , Sheel Meru , Durrheim David N , Bolsewicz Katarzyna , Kaur Rajneesh 
Published: October 2020

ABSTRACTBackgroundThere is an indication that vaccine(s) for COVID-19 could be available by early 2021. As immunisation program launches have previously demonstrated, it is essential that careful planning occurs now to ensure the readiness of the public for a COVID-19 vaccine. As part of that process, this study aimed to understand the public perceptions regarding a future COVID-19 vaccine in Australia.MethodsA national cross-sectional online survey of 1420 Australian adults (18 years and older) was undertaken between 18 and 24 March 2020. The statistical analysis of the data included univariate and multivariate logistic regression analysis.ResultsParticipants generally held positive views towards vaccination. Eighty percent (n=1143) agreed with the statement that getting myself vaccinated for COVID-19 would be a good way to protect myself against infection. Females (614, 83%) were more likely to agree with the statement than males (529, 78%) (aOR=1.4 (95% CI: 1.1-1.8); P=0.029), while 90.9% aged 70 and above agreed compared to 76.6% aged 18-29 year old (aOR=2.3 (95% CI:1.2-4.1); 0.008). Agreement was also higher for those with a self-reported chronic disease (aOR=1.4 (95% CI: 1.1-2.0); P=0.043) and among those who held private health insurance (aOR=1.7 (95% CI: 1.3-2.3); P<0.001). Beyond individual perceptions, 78% stated that their decision to vaccinate would be supported by family and friendsConclusionThis study presents an early indication of public perceptions towards a future COVID-19 vaccine and represents a starting point for mapping vaccine perceptions. To support an effective launch of these new vaccines, governments need to use this time to understand the communities concerns and to identify the strategies that will support engagement.
On Mendelian Randomisation Mixed-Scale Treatment Effect Robust Identification (MR MiSTERI) and Estimation for Causal Inference
Authors: Liu Zhonghua , Ye Ting , Sun Baoluo , Schooling Mary , Tchetgen Eric Tchetgen 
Published: October 2020

AbstractStandard Mendelian randomization analysis can produce biased results if the genetic variant defining instrumental variable (IV) is confounded and/or has a horizontal pleiotropic effect on the outcome of interest not mediated by the treatment. We provide novel identification conditions for the causal effect of a treatment in the presence of unmeasured confounding by leveraging an invalid IV for which both the IV independence and exclusion restriction assumptions may be violated. The proposed Mendelian Randomization Mixed-Scale Treatment Effect Robust Identification (MR MiSTERI) approach relies on (i) an assumption that the treatment effect does not vary with the invalid IV on the additive scale; and (ii) that the selection bias due to confounding does not vary with the invalid IV on the odds ratio scale; and (iii) that the residual variance for the outcome is heteroscedastic and thus varies with the invalid IV. Although assumptions (i) and (ii) have, respectively appeared in the IV literature, assumption (iii) has not; we formally establish that their conjunction can identify a causal effect even with an invalid IV subject to pleiotropy. MR MiSTERI is shown to be particularly advantageous in the presence of pervasive heterogeneity of pleiotropic effects on the additive scale. For estimation, we propose a simple and consistent three-stage estimator that can be used as preliminary estimator to a carefully constructed one-step-update estimator, which is guaranteed to be more efficient under the assumed model. In order to incorporate multiple, possibly correlated and weak IVs, a common challenge in MR studies, we develop a MAny Weak Invalid Instruments (MR MaWII MiSTERI) approach for strengthened identification and improved estimation accuracy. Both simulation studies and UK Biobank data analysis results demonstrate the robustness of the proposed MR MiSTERI method.
Conservative Management of Acute Appendicitis In The Era Of COVID 19: A Multicenter prospective observational study at The United Arab Emirates
Authors: Hashmi Fatima Y. AL , Zuabi Abeer Al , Hachim Ibrahim Yaseen , Mannaerts Guido H.H. , Bekdache Omar 
Published: October 2020

AbstractBackgroundSince its emergence in December 2019, the Novel Coronavirus (COVID-19) pandemic resulted in a profound impact on the health care system worldwide. We propose herein to evaluate the impact of implementing conservative management as an alternative approach to surgical appendectomy in the treatment of proven acute appendicitis during COVID19 pandemic.MethodsOur study is a prospective multicenter study that includes a cohort of 160 patients admitted to the surgical departments in both Tawam Hospital and Sheikh Shakhbout Medical City, Abu Dhabi, UAE, for the period from February 2020 till July 2020.ResultsOur results showed that 56 of our patients (35%) were treated conservatively, while the other 104 (65%) underwent operative management. There was a significant decrease in length of hospital stay (LOS) (2.32± 0.83 days) among the first group compared to the second (2.8± 1.47 days). Also, short term follow-up showed that 90% of those patients did not require further operative intervention or developed any serious complications. Out of the 110 patients that were swapped for COVID19, nine (8.18%) were confirmed to be positive. Our protocol was to avoid surgical management for COVID19 positive patients unless indicated. This resulted in (8/9) of COVID19 positive patients to be treated conservatively. Follow up was achieved by using telemedicine-based follow-up with the aim of empowering social distancing and reducing risk of viral exposure to patients as well as the health care providers. In conclusion, our results showed that the implementation of conservative management in treating patients with acute appendicitis who were COVID19 positive is a safe and feasible approach that maybe essential in reducing viral transmission risks as well as avoiding operative risks on COVID19 positive patients.
A small interfering RNA (siRNA) database for SARS-CoV-2
Authors: Medeiros Inácio Gomes , Khayat André Salim , Stransky Beatriz , dos Santos Sidney Emanuel Batista , de Assumpção Paulo Pimentel , de Souza Jorge Estefano Santana 
Published: October 2020

ABSTRACTCoronavirus disease 2019 (COVID-19) rapidly transformed into a global pandemic, for which a demand for developing antivirals capable of targeting the SARS-CoV-2 RNA genome and blocking the activity of its genes has emerged. In this work, we propose a database of SARS-CoV-2 targets for siRNA approaches, aiming to speed the design process by providing a broad set of possible targets and siRNA sequences. Beyond target sequences, it also displays more than 170 features, including thermodynamic information, base context, target genes and alignment information of sequences against the human genome, and diverse SARS-CoV-2 strains, to assess whether siRNAs targets bind or not off-target sequences. This dataset is available as a set of four tables in a single spreadsheet file, each table corresponding to sequences of 18, 19, 20, and 21 nucleotides length, respectively, aiming to meet the diversity of technology and expertise among labs around the world concerning siRNAs design of varied sizes, more specifically between 18 and 21nt length. We hope that this database helps to speed the development of new target antivirals for SARS-CoV-2, contributing to more rapid and effective responses to the COVID-19 pandemic.
The DNA methylation landscape of multiple myeloma shows extensive inter- and intrapatient heterogeneity that fuels transcriptomic variability
Authors: Derrien Jennifer , Guérin-Charbonnel Catherine , Gaborit Victor , Campion Loïc , Devic Magali , Douillard Elise , Roi Nathalie , Avet-Loiseau Hervé , Decaux Olivier , Facon Thierry , Mallm Jan-Philipp , Eils Roland , Munshi Nikhil C. , Moreau Philippe , Herrmann Carl , Magrangeas Florence , Minvielle Stéphane 
Published: October 2020

AbstractBackgroundCancer evolution depends on epigenetic and genetic diversity. Historically, in multiple myeloma (MM), subclonal diversity and tumor evolution have been investigated mostly from a genetic perspective.ResultsHere, we combined the notions of epipolymorphism and epiallele switching to analyze DNA methylation heterogeneity in MM patients. We show that MM is characterized by the continuous accumulation of stochastic methylation at the promoters of development-related genes. High entropy change is associated with poor outcomes and depends predominantly on partially methylated domains (PMDs). These PMDs, which represent the major source of inter- and intrapatient DNA methylation heterogeneity in MM, are linked to other key epigenetic aberrations, such as CpG island (CGI)/transcription start site (TSS) hypermethylation and H3K27me3 redistribution as well as 3D organization alterations. In addition, transcriptome analysis revealed that intratumor methylation heterogeneity was associated with low-level expression and high variability.ConclusionWe propose that disordered methylation in MM is responsible for high epigenetic and transcriptomic instability allowing tumor cells to adapt to environmental changes by tapping into a pool of evolutionary trajectories.
Trade and jobs in South Africa: a case of skilled vs unskilled workers
Authors: Mazorodze Brian Tavonga 
Published: October 2020

PurposeThe purpose is to establish the impact of trade on manufacturing employment in South Africa.Design/methodology/approachTwo techniques, the Pooled Mean Group (PMG) and the Dynamic Common Correlated Effects (DCCE), are applied on a panel dataset comprising 26 three-digit manufacturing industries with data observed between 1970 and 2016.FindingsThe impact of trade on employment is miniscule at best and insignificant at worst once the study controls for cross-sectional dependency. This is true for both skilled and unskilled workers. Employment of skilled workers is explained by remuneration while employment of unskilled workers is explained by output dynamics.Practical implicationsTrade is widely attacked for causing labour market disruption through job losses. This hypothesis is not supported by data for South Africa as no link is confirmed between trade and employment of skilled and unskilled workers.Originality/valueEstimating the trade and employment link for skilled and unskilled workers while controlling for both endogeneity and cross-sectional dependency.