bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Stratification Using Metabolomics to Address the Heterogeneity of Psychosis
Authors: MacDonald Kellie , Jiang Yuting , Krishnan Ankur , Sardaar Sameer , Qi Bill , Eleftheriadis Aristotelis , Glatt Stephen J , Joober Ridha , Mitchell John , Tabbane Karim , Trakadis Yannis 
Published: June 2020

AbstractPsychosis is a symptomatic endpoint with many causes, complicating its pathophysiological characterization and treatment. Our study applies unsupervised clustering techniques to analyze metabolomic data, acquired using 2 different tandem mass spectrometry (MS-MS) methods, from an unselected group of 120 patients with psychosis. We performed an independent analysis of each of the 2 datasets generated, by both hierarchical clustering and k-means. This led to the identification of biochemically distinct groups of patients while reducing the potential biases from any single clustering method or datatype. Using our newly developed robust clustering method, which is based on patients consistently grouped together through different methods and datasets, a total of 20 clusters were ascertained and 78 patients (or 65% of the original cohort) were placed into these robust clusters. Medication exposure was not associated with cluster formation in our study. We highlighted metabolites that constitute nodes (cluster-specific metabolites) vs hubs (metabolites in a central, shared, pathway) for psychosis. For example, 4 recurring metabolites (spermine, C0, C2, and PC.aa.C38.6) were discovered to be significant in at least 8 clusters, which were identified by at least 3 different clustering approaches. Given these metabolites were affected across multiple biochemically different patient subgroups, they are expected to be important in the overall pathophysiology of psychosis. We demonstrate how knowledge about such hubs can lead to novel antipsychotic medications. Such pathways, and thus drug targets, would not have been possible to identify without patient stratification, as they are not shared by all patients, due to the heterogeneity of psychosis.
Coexpression analysis of a large-scale transcriptome identified a calmodulin-like protein regulating the development of adventitious roots in poplar
Authors: Xiao Zheng’ang , Zhang Yan , Liu Meifeng , Zhan Chang , Yang Xiaoqing , Nvsvrot Tashbek , Yan Zhaogui , Wang Nian 
Published: June 2020

Abstract
Poplars are important woody plants, and the ability to form adventitious roots (ARs) is the key factor for their cultivation because most poplars are propagated by cloning. In previous studies, Ca2+ was confirmed to regulate AR formation in poplar. In this study, wild-type poplar cuttings grown in 1.0 mM Ca2+ solution showed the best visible performance of AR development. Coexpression analysis of a large-scale RNA-Seq transcriptome was conducted to identify Ca2+-related genes that regulate AR development in poplar. A total of 15 coexpression modules (CMs) were identified, and two CMs showed high association with AR development. Functional analysis identified a number of biological pathways, including ‘oxidation-reduction process’, ‘response to biotic stimulus’ and ‘metabolic process’, in tissues of AR development. The Ca2+-related pathway was specifically selected, and its regulation in poplar AR development was predicted. A Ca2+ sensor, PdeCML23-1, which is a member of the calmodulin-like protein (CML) family, was found to promote AR development by phenotypic assay of overexpressed PdeCML23-1 transgenic lines at various growing conditions. By measuring cytosolic Ca2+ in AR tips, PdeCML23-1 seemed to play a role in decreasing cytosolic Ca2+ concentration. Additionally, the expression profiles of some genes and phytohormone indole acetic acid (IAA) were also changed in the overexpressed PdeCML23-1 transgenic lines. According to this study, we were able to provide a global view of gene regulation for poplar AR development. Moreover, we also observed the regulation of cytosolic Ca2+ concentration by PdeCML23-1, and this regulation was involved in AR development in poplar. We also predicted that PdeCML23-1 possibly regulates AR development by modulating IAA content in poplar.
Even Experts Can Be Fooled: Reliability of Clinical Examination for Diagnosing Hip Dislocations in Newborns
Authors: Harper Philip , Joseph Brijil M. , Clarke Nicholas M.P. , Herrera-Soto Jose , Sankar Wudbhav N. , Schaeffer Emily K. , Mulpuri Kishore , Aarvold Alexander 
Published: June 2020

Background:
The aim of this study was to assess the accuracy of clinical screening examination in newborns with dislocated hips compared with ultrasound scan (USS).

Methods:
Newborns, up to 3 months of age, with confirmed hip dislocations on USS were prospectively enrolled in a multinational observational study. Data from 2010 to 2016 were reviewed to determine pretreatment clinical examination findings of the treating orthopaedic surgeon as well as baseline ultrasound indices of developmental dysplasia of the hip (DDH). All infants had been referred to specialist centres with expertise in DDH, due to abnormal birth examination or risk factor.

Results:
The median age of the study population was 2.3 weeks and 84% of patients were female. Of the total 515 USS-confirmed dislocated hips included in the study, 71 (13.8%) were incorrectly felt to be reduced on clinical examination by the treating orthopaedist (P<0.001). Full hip abduction was documented in 106 hips. Of the hips correctly identified as dislocated, 322 hips were further analyzed based on clinical reducibility. Thirty-three of 322 (10.2%) were incorrectly thought to be reducible when in fact they were irreducible or vice versa.

Conclusions:
Expert examiners missed a significant number of frankly dislocated hips on clinical examination and their ability to classify hips based on clinical reducibility was only moderately accurate. This study provides evidence that, even in experienced hands, physical examination findings in DDH are often too subtle to elicit clinically in the first few months of life. This may explain the persistent and measurable rate of late presenting dislocations in countries with screening programmes reliant on clinical examination.

Level of Evidence:
Level 1—testing of previously developed diagnostic criteria in series of consecutive patients (with universally applied reference “gold” standard).
Correction of Recurrent Equinus Deformity in Surgically Treated Clubfeet by Anterior Distal Tibial Hemiepiphysiodesis
Authors: Ebert Nicola , Ballhause Tobias M. , Babin Kornelia , Schelling Katrin , Stiel Norbert , Stuecker Ralf , Spiro Alexander S. 
Published: June 2020

Background:
Residual or recurrent equinus deformity is a common problem in surgically treated clubfeet. This deformity may occur due to soft tissue–related reasons or due to bony deformity. An increased anterior distal tibial angle (ADTA) was previously found in 48% of the operated clubfeet. This study aimed to determine the efficacy and safety of anterior distal tibial hemiepiphysiodesis (ADTE) in the treatment of recurrent equinus deformity in patients with an increased ADTA.

Methods:
Eighteen children (23 feet) treated by ADTE to correct recurrent equinus deformity in surgically treated clubfeet were included in this retrospective, single-center study. ADTE using 8 plates was performed in children with an increased ADTA (>82 degrees) and inability to dorsiflex the ankle (≤0 degree of dorsiflexion). The mean patient age was 11.3 years (range: 10.2 to 12.9 y). All patients had completed treatment with implant removal after an average of 20.3 months (range: 9 to 37 mo).

Results:
The mean preoperative ankle dorsiflexion significantly improved from −3.3 degrees (range: −20 to –0 degrees) to 6.1 degrees (range: −15 to 10 degrees) at the time of 8-plate removal (correction rate: 9.4 degrees; P<0.0001). The ADTA was a mean of 87.5 degrees (range: 83 to 110 degrees) before surgery and significantly improved to 75.8 degrees (range: 63 to 106 degrees) at the time of implant removal (correction rate: 11.7 degrees; P<0.0001). Average follow-up was 43.9 months (range: 10 to 76 mo). Follow-up examinations were continued in 11 patients (13 feet) after implant removal. Changes of ankle dorsiflexion (mean: −2.5 degrees) and ADTA (mean: 3.6 degrees) occurred in this group.

Conclusions:
ADTE was safe and effective in the treatment of recurrent equinus deformity in surgically treated clubfeet with increased ADTA. Deterioration of ankle dorsiflexion and ADTA occurred after implant removal in some cases. The results of this study have to be analyzed with caution due to the limited number of included patients and its retrospective nature.

Level of Evidence:
Level IV—retrospective case series.
Four-in-one Extensor Realignment for the Treatment of Obligatory or Fixed, Lateral Patellar Instability in Skeletally Immature Knee
Authors: Danino Baruch , Deliberato David , Abousamra Oussama , Singh Satbir , Klingele Kevin 
Published: June 2020

Background:
Congenital (fixed) and obligatory (habitual) patellar dislocations in children are a complex clinical and surgical challenge. Numerous individual surgical techniques have been described. This study aims to assess results, patient satisfaction, and complications after a combined Roux-Goldthwait procedure, vastus medialis obliquus advancement, Galeazzi procedure, and extensive, lateral release (4-in-1 extensor realignment) in the skeletally immature knee with obligatory, or fixed lateral patellar instability.

Methods:
Records of children with congenital fixed or obligatory patellar instability, who underwent the 4-in-1 procedure at a single institution, were reviewed. Clinical results included ability and time for the return to activities of daily living (ADL) and sport, recurrent instability and/or dislocation, and necessity of long-term bracing. Continued pain was assessed by the Kujala Score. Complications including infection, recurrent instability, and the necessity for secondary procedures were recorded.

Results:
A total of 34 patients (46 knees) mean age 10.3±2.4 years, underwent the 4-in-1 procedure with a mean postoperative follow-up of 51.6±31.5 (range, 12 to 146) months. Sixteen patients (22 knees) responded to a phone interview and questionnaire. All 16 patients returned to ADL in a mean time of 10.3±2.4 weeks. Ninety-one percent returned to sport in a mean time of 23.1±15.5 weeks. Long-term bracing was required for 6 knees after the surgery. The mean Kujala Score was 93.0±5.2 (range, 83 to 100). Complications included 6 of 34 patients (18%) with recurrent instability at the latest follow-up and 2 with superficial wound infection.

Conclusions:
Patients with obligatory or fixed lateral, patellar instability who undergo the 4-in-1 procedure have good short-term results with low complication rates. Return to ADL and sporting activity with minimal pain can be expected, usually without the need for long-term bracing. The 4-in-1 procedure is a viable option for skeletally immature patients with obligatory or fixed, lateral patellar instability.

Level of Evidence:
Level IV—Therapeutic study.
Review of Viral Testing (Polymerase Chain Reaction) and Antibody/Serology Testing for Severe Acute Respiratory Syndrome-Coronavirus-2 for the Intensivist
Authors: Motley Michael P. , Bennett-Guerrero Elliott , Fries Bettina C. , Spitzer Eric D. 
Published: June 2020

Objective:
As the severe acute respiratory syndrome-coronavirus-2 pandemic develops, assays to detect the virus and infection caused by it are needed for diagnosis and management. To describe to clinicians how each assay is performed, what each assay detects, and the benefits and limitations of each assay.

Data Sources:
Published literature and internet.

Study Selection:
As well done, relevant and recent as possible.

Data Extraction:
Sources were read to extract data from them.

Data Synthesis:
Was synthesized by all coauthors.

Conclusions:
Available assays test for current or previous severe acute respiratory syndrome-coronavirus-2 infection. Nucleic acid assays such as quantitative, or real-time, polymerase chain reaction and loop-mediated isothermal amplification are ideal for acute diagnosis with polymerase chain reaction testing remaining the “gold standard” to diagnose acute infection by severe acute respiratory syndrome-coronavirus-2, specifically the presence of viral RNA. Assays that detect serum antibodies can theoretically diagnose both acute and remote infection but require time for the patient to develop immunity and may detect nonspecific antibodies. Antibody assays that quantitatively measure neutralizing antibodies are needed to test efficacy of convalescent plasma therapy but are more specialized.
Effectiveness and Safety of Reirradiation With Stereotactic Ablative Radiotherapy of Lung Cancer After a First Course of Thoracic Radiation
Authors: Viani Gustavo A. , Arruda Caio V. , De Fendi Ligia I. 
Published: June 2020

Objective:
The effectiveness and safety of reirradiation with stereotactic ablative radiotherapy (re-SABR) in patients with recurrence after a previous course of radiation are limited to small series. We carried out a meta-analysis to summarize existing data and identify trends in overall survival (OS), local control (LC), and toxicity after re-SABR in patients with recurrence of lung cancer.

Materials and Methods:
Eligible studies were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through June 2019. We followed the PRISMA and MOOSE guidelines. A meta-regression analysis was carried out to assess whether there is a relationship between moderator variables and outcomes. A P-value<0.05 was considered significant.

Results:
Twenty observational studies with a total of 595 patients treated were included. The 2-year OS and LC were 0.54 (95% confidence interval [CI]: 0.48-0.61) and 0.73 (95% CI: 0.66-0.80), respectively. The rate of any toxicity grade ≥3 was 0.098 (95% CI: 0.06-13.6), with 9 grade 5 toxicity (1.5%). In the meta-regression, the re-SABR dose (P=0.028), tumor size (P=0.031), and time to recurrence (P=0.018) showed an association with survival. For LC, the re-SABR dose (P=0.034) and tumor size (P=0.040) were statistically significant. Any toxicity grade ≥3 showed a relationship with the cumulative dose (P=0.024). Cumulative dose ≤145 versus >145 Gy2 had 3% versus 15% (P=0.013) of any grade ≥3 toxicity.

Conclusions:
Re-SABR produces satisfactory LC and OS rates with an acceptable rate of toxicity. The balancing between the re-SABR dose and the tumor location has the potential to reduce severe and fatal toxicity.
Short-term reproducibility of ambulatory blood pressure measurements: a systematic review and meta-analysis of 35 observational studies
Authors: Bo Yacong , Kwok Kin-On , Chung Vincent Chi-Ho , Yu Chun-Pong , Tsoi Kelvin Kam-Fai , Wong Samuel Yeung-Shan , Lee Eric Kam-Pui 
Published: June 2020

Objective:
A systematic review on the reproducibility of ambulatory blood pressure measurements (ABPM) has not yet been conducted. This meta-analysis compared 24-h/daytime/night-time SBP and DBP mean values and SBP/DBP nocturnal dipping status from ABPMs in participants with or without hypertension.

Methods:
Ovid MEDLINE, EMBASE, and CINAHL Complete databases were searched for articles published before 3 May 2019. Eligible studies reporting a 24-h ABPM repeated at least once within 1 month were included. The mean daytime/night-time/24-h BP values, percentage of nocturnal dipping, and proportion of nondippers were compared between the first and second day of measurements, and the proportion of participants with inconsistent dipping status were estimated using a random effect model.

Results:
Population-based analysis found a 0–1.1 mmHg difference between the first and second ABPM for 24-h/daytime/night-time SBP and DBP and 0–0.5% for percentage of SBP/DBP nocturnal dipping. The proportion of non-dippers was not different between the first and second ABPM. Intra-individual analysis found that the 95% limit of agreements (LOA) for SBP/DBP were wide and the 95% LOA for daytime SBP, common reference to diagnose hypertension, ranged −16.7 to 18.4 mmHg. Similarly, 32% of participants had inconsistent nocturnal dipping status.

Conclusion:
ABPM had excellent reproducibility at the population level, favouring its application for research purposes; but reproducibility of intra-individual BP values and dipping status from a 24-h ABPM was limited. The available evidence was limited by the lack of high-quality studies and lack of studies in non-Western populations.
The Influence of Ultrasound Ciliary Plasty on Corneal Parameters
Authors: Bolek Bartłomiej , Wylęgała Adam , Wylęgała Edward 
Published: June 2020

Précis:
The ultrasound ciliary plasty (UCP) procedure affects corneal parameters, although the effect is transient. Ultrasound energy affects the sclera, leading to induced astigmatism. The area of energy application correlates with the astigmatism axis.

Purpose:
To assess the postoperative corneal topography for 1 year after UCP.

Materials and Methods:
In total, 78 patients with primary and secondary refractory glaucoma were enrolled in the study. The primary outcome measures were the corneal parameters obtained with anterior segment swept-source optical coherence tomography. Intraocular pressure, number of antiglaucoma medications, and best-corrected logMAR visual acuities were analyzed as secondary outcome measures. Measurements were performed preoperatively and at 1 week, and 1, 3, 6, and 12 months postoperatively. A total of 39 patients (39 eyes) completed the follow-up period of 12 months.

Results:
There was a significant difference in the anterior/posterior steep/flat keratometry and anterior/posterior astigmatism values immediately after UCP. However, 3 months postoperatively these parameters returned to their initial values and there were no significant differences noted. The mean±SD values of anterior astigmatism preoperatively and at 1 week, and 1, 3, 6, and 12 months postoperatively were 1.12±0.66 D, 2.17±0.91 D (P<0.001), 2.05±0.93 D (P<0.001), 1.55±0.75 D (P=0.004), 1.31±0.70 D (P=0.024), and 1.20±0.73 D (P=0.406), respectively. The astigmatism axis tended to approach 90 degrees meridian with a significant difference 1 week postoperatively. Central and minimal corneal thickness remained unchanged, whereas the intraocular pressure and the number of antiglaucoma medications decreased significantly.

Conclusions:
UCP influenced the corneal topography parameters in the immediate postoperative period; however, with time, all parameters returned to their initial values.
Facilitators of Self-Initiated HIV Testing Among Youths: A Qualitative Study
Authors: ADEBAYO Oluwamuyiwa Winifred , DE SANTIS Joseph P. , GATTAMORTA Karina A. , VILLEGAS Natalia Andrea 
Published: June 2020

ABSTRACT

Background
Youth experience disparities in HIV infection but have significantly low rates of HIV testing that lead to late diagnoses, increased transmission rates, and adverse health outcomes. There is limited knowledge regarding self-initiated HIV testing, which is a promising strategy for improving testing rates among youth.

Purpose
This study aimed to identify the facilitators of self-initiated HIV testing among youth.

Method
Thirty youths aged 18–24 years were recruited to participate in a qualitative descriptive study. Potential participants were recruited from a combination of HIV testing sites, including community testing events, a community-based organization, an adolescent health clinic, and a college campus. A demographic and sexual history questionnaire and audio-recorded interviews were used to collect data. Transcribed interviews were analyzed using qualitative content analysis.

Results
Salient themes and subthemes that explain the study findings are as follows: testing within the context of a sexual relationship (e.g., infidelity), support and influence from social relationships (e.g., family support), taking the initiative for health (e.g., signs and symptoms of infection), HIV testing preferences (e.g., free testing), and HIV testing experiences (e.g., provision of other health services).

Conclusions
The findings of this study advance scholarly understanding regarding the predictors of self-initiated testing and provide critical information necessary to further improve evidence-based nursing clinical practice and develop public health nursing interventions that target self-initiated HIV testing. Encouraging self-initiated HIV testing is an effective approach to increasing testing rates and, consequently, preventing new HIV transmissions in this vulnerable population.
An Integrative Review of Brain-Derived Neurotrophic Factor and Serious Cardiovascular Conditions
Authors: Halloway Shannon , Jung Miyeon , Yeh An-Yun , Liu Jia , McAdams Ellen , Barley Maddison , Dorsey Susan G. , Pressler Susan J. 
Published: June 2020

BackgroundThere is emerging evidence that supports a role for brain-derived neurotrophic factor (BDNF) in the risk and presence of serious cardiovascular conditions. However, few existing literature reviews methodically describe empirical findings regarding this relationship.ObjectivesThe purpose of this integrative review was to (a) evaluate BDNF (serum/plasma BDNF levels,BDNFVal66Met genotype) among humans at risk for or with serious cardiovascular conditions and (b) investigate the relationship between BDNF and risk/presence of serious cardiovascular conditions in humans.MethodsAn integrative review was conducted. Articles in English included human subjects, a measure of BDNF levels orBDNFgene, serious cardiovascular conditions, and quantitative data analyses. The search resulted in 475 unique titles, with the final sample including 35 articles representing 30 studies. Articles that received “good” or “fair” ratings (n= 31) using the National Heart, Lung, and Blood Institute Study Quality Assessment Tools were included for synthesis.ResultsThe retrieved articles were largely nonexperimental, with sample sizes ranging from 20 to 5,510 participants. Overall, BDNF levels were lower in patients with chronic heart failure and stroke, but higher in patients with unstable angina and recent myocardial infarction. Lower BDNF levels were associated with higher incidence of cardiovascular events in patients with a prior history of serious cardiovascular conditions and decreased cardiovascular risk in healthy samples. ForBDNFgenotype, on average, 36.3% of participants had Met alleles. The frequency of theBDNFMet allele varied across race/ethnicity and cardiovascular conditions and in terms of association with serious cardiovascular condition incidence/risk.DiscussionThese findings indicate an emerging area of science. Future investigation is needed on serious cardiovascular condition phenotypes in relationship to BDNF in the same study conditions. Results also suggest for use of standardized BDNF measurement across studies and additional investigation in cardiovascular inflammatory processes that affect BDNF. Moreover, within specific populations, the frequency of Met alleles may be too low to be detected in sample sizes normally found in these types of studies.