bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Practical Cleft Palate Training Model
Authors: Ozkan Burak , Cologlu Harun , Uysal Cagri A. , Ertas Nilgun M. 
Published: February 2020

Summary:
Educational models are essential for training surgeons and making them familiar with experience- and skill-dependent operations such as cleft palate closure. The development of computer and 3D printer technology has allowed cleft lip and palate models to be produced and used for surgical training. However, these technology-dependent models are not affordable and reproducible for surgeons in developing countries where cleft cases are more commonly seen. Thus, we aimed to create a cleft palate educational model prepared with play-dough and latex. The play-dough is shaped in the form of a palate and the cleft is created by scissors. Then, a latex glove is cut and applied to the dough to mimic the mucosal layer. The combination of the latex glove and play-dough lets the trainee perform surgical markings, incisions, elevation of the flaps, and layer closure. We think this easily producible model might be beneficial for demonstrating cleft types, surgical techniques, and improving surgical skills, especially in developing countries.
Delirium and Developmental Disability: Improving Specificity of a Pediatric Delirium Screen*
Authors: Kaur Savneet , Silver Gabrielle , Samuels Susan , Rosen Anna H. , Weiss Meredith , Mauer Elizabeth A. , Gerber Linda M. , Greenwald Bruce M. , Traube Chani 
Published: February 2020

Objectives:
Children with developmental disabilities are at high risk for developing delirium when critically ill. However, existing pediatric delirium screening tools were designed for children with typical development. The objective of this study was to improve the specificity of the Cornell Assessment for Pediatric Delirium, to allow for accurate detection of delirium in developmentally delayed children admitted to the PICU. We hypothesized that the Cornell Assessment for Pediatric Delirium, when combined with fluctuation in level of awareness as measured by the Richmond Agitation-Sedation Scale, would be valid and reliable for the diagnosis of delirium in developmentally delayed children.

Design:
Prospective observational double-blind cohort study.

Setting:
Tertiary care academic PICU.

Patients:
Children with moderate to severe developmental delay.

Interventions:
Each child was evaluated by the bedside nurse with the Cornell Assessment for Pediatric Delirium once every 12 hours and the Richmond Agitation-Sedation Scale every 4 hours. Cornell Assessment for Pediatric Delirium (score ≥ 9) + Richmond Agitation-Sedation Scale fluctuation (change in Richmond Agitation-Sedation Scale score of at least 2 points during a 24-hr period) was compared with the criterion standard psychiatric evaluation for diagnosis of delirium.

Measurements and Main Results:
Forty children participated; 94 independent paired assessments were completed. The psychiatrists’ diagnostic evaluations were compared with the detection of delirium by the Cornell Assessment for Pediatric Delirium and Richmond Agitation-Sedation Scale. Specificity of the Cornell Assessment for Pediatric Delirium + Richmond Agitation-Sedation Scale fluctuation was 97% (CI, 90–100%), positive predictive value of Cornell Assessment for Pediatric Delirium + Richmond Agitation-Sedation Scale fluctuation was 89% (CI, 65–99%); and negative predictive value remained acceptable at 87% (95% CI, 77–94%). In addition, to confirm interrater reliability of the criterion standard, 11 assessments were performed by two or more psychiatrists in a blinded fashion. There was perfect agreement (κ = 1), indicating reliability in psychiatric diagnosis of delirium in developmentally delayed children.

Conclusion:
When used in conjunction with Richmond Agitation-Sedation Scale score fluctuation, the Cornell Assessment for Pediatric Delirium is a sensitive and specific tool for the detection of delirium in children with developmental delay. This allows for reliable delirium screening in this hard-to-assess population.
Variation in Practice Related to the Use of High Flow Nasal Cannula in Critically Ill Children
Authors: Kawaguchi Atsushi , Garros Daniel , Joffe Ari , DeCaen Allan , Thomas Neal J. , Schibler Andreas , Pons-Odena Marti , Udani Soonu , Takeuchi Muneyuki , Junior José Colleti , Ramnarayan Padmanabhan 
Published: February 2020

Objectives:
To determine current management of critically ill children and gather views regarding high flow nasal cannula therapy and to evaluate research priorities for a large prospective randomized controlled trial of noninvasive respiratory support in children.

Design:
Multinational cross-sectional questionnaire survey conducted in 2018.

Setting:
The sample included pediatric intensive care physicians in North and South America, Asia, Europe, and Australia/New Zealand.

Measurement:
Questions consisted of: 1) characteristics of intensivists and hospital, 2) practice of high flow nasal cannula, 3) supportive treatment, and 4) research of high flow nasal cannula.

Interventions:
None.

Main Results:
We collected data from 1,031 respondents; 919 (North America, 215; Australia/New Zealand, 34; Asia, 203; South America, 186; Europe, 281) were analyzed. Sixty-nine percent of the respondents used high flow nasal cannula in non-PICU settings in their institutions. For a case of bronchiolitis/pneumonia infant, 2 L/kg/min of initial flow rate was the most commonly used. For a scenario of pneumonia with 30 kg weight, more than 60% of the respondents initiated flow based on patient body weight; while, 18% applied a fixed flow rate. Noninvasive ventilation was considered as a next step in more than 85% of respondents when the patient is failing with high flow nasal cannula. Significant practice variations were observed in clinical practice markers used, flow weaning strategy, and supportive practices. Views comparing high flow nasal cannula to continuous positive airway pressure also noticeably varied across the respondents.

Conclusions:
Significant practice variations including views of high flow nasal cannula compared to continuous positive airway pressure was found among pediatric intensive care physicians. To expedite establishment and standardization of high flow nasal cannula practice, research aimed at understanding the heterogeneity found in this study should be undertaken.
Peripheral inflammatory response in human tuberculosis treatment is predicted by a combination of pathogen sterilization and microbiome dysbiosis
Authors: Wipperman Matthew F. , Bhattarai Shakti K. , Vorkas Charles Kyriakos , Taur Ying , Mathurin Laurent , McAulay Katherine , Vilbrun Stalz Charles , Francois Daphie Jean , Bean James , Walsh Kathleen F. , Nathan Carl , Fitzgerald Daniel W. , Glickman Michael S. , Bucci Vanni 
Published: February 2020

AbstractAntibiotic therapy cures infection predominantly by killing the infecting pathogen, but for infections such as tuberculosis (TB), which are accompanied by chronic inflammation, the salutary effects of antibiotic therapy may reflect a combination of pathogen killing and microbiome alteration. This question has not been examined in humans due to the difficulty in dissociating the immunologic effects of antibiotic induced pathogen clearance and microbiome alteration. We analyzed sputum TB bacterial load, microbiome composition, and peripheral blood transcriptomics from a clinical trial (NCT02684240) comparing two antimicrobial therapies for tuberculosis, only one of which was clinically effective. We confirm that standard TB therapy (HRZE) rapidly depletes Clostridia from the intestinal microbiota. The antiparasitic drug nitazoxanide (NTZ), although ineffective in reducing Mycobacterium tuberculosis (Mtb) bacterial load in the sputum, caused profound alterations to host microbiome composition overlapping with alterations generated by HRZE. We then evaluated the effect of these two treatments on the TB driven inflammatory state and found that whereas HRZE normalized proinflammatory TB-associated gene sets, NTZ exacerbated these pathways. Using Random Forest Regression, we identify both pathogen sterilization and microbiome disruption as the top predictors of changes in TB-associated inflammatory transcriptomic markers. We then validate the observed microbiome-peripheral gene expression associations in an independent human cohort of healthy subjects in which the abundance of Clostridia was positively associated with homeostatic, and negatively associated with pro-inflammatory pathways, while the abundance of Bacilli and Proteobacteria species displayed the opposite trend. Our findings indicate that antibiotic-induced reduction in pathogen burden and changes in the microbiome are independently associated with treatment-induced changes of the inflammatory response of active TB, and more broadly indicate that response to antibiotic therapy may be a combined effect of pathogen killing and microbiome driven immunomodulation. Additionally, to our knowledge, this is the first analysis to directly test the hypothesis that the microbiome composition is associated with peripheral gene expression inflammatory profile in humans.
Clinical Data on Hospital Environmental Hygiene Monitoring and Medical Staff Protection during the Coronavirus Disease 2019 Outbreak
Authors: Jiang Yanfang , Wang Haifeng , Chen Yukun , He Jiaxue , Chen Liguo , Liu Yong , Hu Xinyuan , Li Ang , Liu Siwen , Zhang Peng , Zou Hongyan , Hua Shucheng 
Published: February 2020

AbstractBackgroundThe outbreak of coronavirus disease 2019 (COVID-19) has placed unprecedented challenges on hospital environmental hygiene and medical staff protection. It is crucial to assess hospital environmental hygiene to understand the most important environmental issues for controlling the spread of COVID-19 in hospitals.ObjectiveTo detect the presence of COVID-19 in the samples from the area at risk of contamination in the First Hospital of Jilin University.MethodsViruses in the air were collected by natural sedimentation and air particle sampler methods. Predetermined environmental surfaces were sampled using swabs at seven o’clock in the morning before disinfection. The real-time reverse-transcription PCR method was used to detect the existence of COVID-19 pathogens.ResultsViruses could be detected on the surfaces of the nurse station in the isolation area with suspected patients and in the air of the isolation ward with an intensive care patient.ConclusionComprehensive monitoring of hospital environmental hygiene during pandemic outbreaks is conducive to the refinement of hospital infection control. It is of great significance to ensure the safety of medical treatment and the quality of hospital infection control through the monitoring of environmental hygiene.
Repeated colonization of caves leads to phenotypic convergence in catfishes (Siluriformes:Trichomycterus) at a small geographical scale
Authors: Flórez Juan Sebastián , Cadena Carlos Daniel , DoNascimiento Carlos , Torres Mauricio 
Published: February 2020

ABSTRACTAcross various animal groups, adaptation to the extreme conditions of cave environments has resulted in convergent evolution of morphological, physiological, and behavioral traits. We document a Neotropical cave fish system with ample potential to study questions related to convergent adaptation to cave environments at the population level. In the karstic region of the Andes of Santander, Colombia, cave-dwelling catfishes in the genusTrichomycterusexhibit variable levels of reduction of eyes and body pigmentation relative to surface congeners. We tested whether cave-dwelling, eye reduced, depigmentedTrichomycterusfrom separate caves in Santander were the result of a single event of cave colonization and subsequent dispersal, or of multiple colonizations to caves by surface ancestors followed by phenotypic convergence. Using mitochondrial DNA sequences to reconstruct phylogenetic relationships ofTrichomycterusfrom Santander, we found that caves in this region have been colonized independently by two separate clades. Additional events of cave colonization -and possibly recolonization of surface streams- may have occurred in one of the clades, where surface and cave-dwelling populations exhibit shallow mtDNA differentiation, suggesting recent divergence or divergence in the face of gene flow. We also identified various taxonomic challenges including both a considerable number of potentially undescribed species and likely problems with the circumscription of named taxa. The system appears especially promising for studies on a wide range of ecological and evolutionary questions.
Bottom-up control of leakage in spectral electrophysiological source imaging via structured sparse bayesian learning
Authors: Gonzalez-Moreira Eduardo , Paz-Linares Deirel , Areces-Gonzalez Ariosky , Wang Ying , Li Min , Harmony Thalia , Valdes-Sosa Pedro A. 
Published: February 2020

AbstractBrain electrical activity in different spectral bands has been associated with diverse mechanisms underlying Brain function. Deeper reconnoitering of these mechanisms entails mapping in grayordinates (Gray Matter coordinates), the spectral features of electrophysiological Brain signals. Such mapping is possible through MEG/EEG signals, due to their wide Brain coverage and excellent temporal resolution in reflecting neural-electrical-activity. This process-coined Electrophysiological Source Imaging (ESI)-can only produce approximated images of Brain activity, which are severely distorted by leakage: a pervasive effect in almost any imaging technique. It has been proposed that leakage control to tolerable levels can be achived through using priors or regularization within ESI, but their implementation commonly yields meager statistical guaranties. We introduce bottom-up control of leakage: defined as maximum Bayesian evidence search braced with priors precisely on the spectral responses. This is feasible due to an instance of Bayesian learning of complex valued data: spectral Structured Sparse Bayesian Learning (sSSBL). “Spectral” refers to specific spatial topologies that are reflected by the MEG/EEG spectra. We also present a new validation benchmark based on the concurrency between high density MEG and its associated pseudo-EEG of lower density. This reveals that prevealing methods like eLORETA and LCMV can fall short of expectations whereas sSSBL exibits an exellent performance. A final qualitative assesment reveals that sSSBL can outline brain lessions using just low density EEG, according to the T2 MRI shine through of the affected areas.
Recombinant production of active microbial transglutaminase inE. coliby using self-cleavable zymogen with mutated propeptide
Authors: Sato Ryo , Minamihata Kosuke , Ariyoshi Ryutaro , Taniguchi Hiromasa , Kamiya Noriho 
Published: February 2020

AbstractMicrobial transglutaminase fromStreptomyces mobaraensis(MTG) has been widely used in food industry and also in research and medical applications, since it can site-specifically modify proteins by the cross-linking reaction of glutamine residue and the primary amino group. The recombinant expression system of MTG inE. coliprovides better accessibility for the researchers and thus can promote further utilization of MTG. Herein, we report production of active and soluble MTG inE. coliby using a chimeric protein of tobacco etch virus (TEV) protease and MTG zymogen. A chimera of TEV protease and MTG zymogen with native propeptide resulted in active MTG contaminated with cleaved propeptide due to the strong interaction between the propeptide and catalytic domain of MTG. Introduction of mutations of K9R and Y11A to the propeptide facilitated dissociation of the cleaved propeptide from the catalytic domain of MTG and active MTG without any contamination of the propeptide was obtained. The specific activity of the active MTG was 22.7±2.6 U/mg. The successful expression and purification of active MTG by using the chimera protein of TEV protease and MTG zymogen with mutations in the propeptide can advance the use of MTG and the researches using MTG mediated cross-linking reactions.
Changing hand appearance using visual illusions modulates body perception disturbance and pain in longstanding Complex Regional Pain Syndrome: A randomised trial
Authors: Lewis Jennifer S , Newport Roger , Taylor Gordon , Smith Mike , McCabe Candida S 
Published: February 2020

ABSTRACTEffective treatment of longstanding Complex Regional Pain Syndrome (CRPS) is a challenge, as causal mechanisms remain elusive. People with CRPS frequently report distorted subjective perceptions of their affected limb. Evidence of pain reduction when the affected limb is visually altered in size, suggests that visual illusions used to target central processing could restore coherence of this disrupted limb representation. We hypothesised that using virtual reality that alters hand image to match the patient’s desired hand appearance, would improve body perception disturbance and pain. Also, repeated exposure would maintain any therapeutic effect.A blinded randomised controlled trial of 45 participants with refractory upper-limb CRPS and body perception disturbance (BPD) viewed a digital image of their affected hand for one minute. The image was digitally altered according to the patient’s description of how they desired their hand to look in the experimental group and unaltered in the control group. BPD and pain were measured pre and post-intervention. A subgroup was followed up two weeks after a course of repeated interventions.BPD (p=0.036, effect size (ES)=0.6) and pain intensity (p = 0.047, ES=0.5) reduced in 23 participants after single exposure compared to controls (n=22). At follow-up the subgroup (experimental n= 21; control n=18) showed sustained pain reduction only (p=0.037 ES=0.7), with an overall 1.2 decrease on an 11-point scale.Visually changing the CRPS hand to a desired appearance modulates BPD and pain suggesting therapeutic potential for those with refractory CRPS. Future detailed studies to optimise this therapeutic effect are required.
Genetic correlates of socio-economic status influence the pattern of shared heritability across mental health traits
Authors: Marees Andries T. , Smit Dirk J.A. , Abdellaoui Abdel , Nivard Michel G. , van den Brink Wim , Denys Damiaan , Galama Titus , Verweij Karin J.H. , Derks Eske M. 
Published: February 2020

AbstractEpidemiological studies show high comorbidity between different mental health problems, indicating that individuals with a diagnosis of one disorder are more likely to develop other mental health problems. Genetic studies reveal substantial sharing of genetic risk factors across mental health traits. However, mental health is genetically correlated with socio-economic status (SES) and it is therefore important to investigate and disentangle the genetic relationship between mental health and SES. We used summary statistics from large genome-wide association studies (average N∼160,000) to estimate the genetic overlap across nine psychiatric disorders and seven substance use traits and explored the genetic influence of three different indicators of SES. Using Genomic SEM, we show significant changes in patterns of genetic correlations after partialling out SES-associated genetic variation. Our approach allows the separation of disease-specific genetic variation and genetic variation shared with SES, thereby improving our understanding of the genetic architecture of mental health.
ADHD is more closely linked to neurodevelopmental than externalizing and internalizing disorders: A genetically informed multivariate Swedish population study
Authors: Rietz Ebba Du , Pettersson Erik , Brikell Isabell , Ghirardi Laura , Chen Qi , Hartman Catharina , Lichtenstein Paul , Larsson Henrik , Kuja-Halkola Ralf 
Published: February 2020

AbstractBackgroundWhile ADHD is currently classified as a neurodevelopmental disorder in the latest diagnostic manuals, the disorder shows phenotypic and genetic associations of similar magnitudes across neurodevelopmental, externalizing and internalizing disorders. This study aimed to investigate if ADHD is etiologically more closely related to neurodevelopmental than externalizing or internalizing disorder clusters after accounting for a general psychopathology factor.MethodsFull- and maternal half-sibling pairs (N=774,416), born between 1980 and 1995, were identified from the Swedish Medical Birth and Multi-Generation Registers, and ICD-diagnoses were obtained using the Swedish National Patient Register. A higher-order confirmatory factor analytic model was performed to examine associations between ADHD and a general psychopathology factor as well as a neurodevelopmental, externalizing, and internalizing subfactor. Quantitative genetic modelling was performed to estimate the extent to which genetic, shared and non-shared environmental effects influenced the associations with ADHD.ResultsADHD was significantly and strongly associated with all three neurodevelopmental, externalizing and internalizing factors (r=0.67-0.75). However, after controlling for a general psychopathology factor, only the association between ADHD and the neurodevelopmental-specific factor remained moderately strong (r=0.43, 95%Confidence Interval [CI]=0.42-0.45) and was almost entirely influenced by genetic effects. In contrast, the association between ADHD and the externalizing-specific factor was smaller (r=0.25, 95%CI=0.24-0.27), and largely influenced by non-shared environmental effects. There remained no internalizing-specific factor after accounting for a general factor.ConclusionsADHD comorbidity is largely explained by genetically influenced general psychopathology, but the strong link between ADHD and other neurodevelopmental disorders is also substantially driven by unique genetic influences.
Perceptions of the Adult US Population regarding the Novel Coronavirus Outbreak
Authors: McFadden SarahAnn M. , Malik Amyn A. , Aguolu Obianuju G. , Willebrand Kathryn S. , Omer Saad B. 
Published: February 2020

AbstractBackgroundCOVID-19 outbreak is spreading globally. Although the risk of infection in the US is currently low, it is important to understand the public perception of risk and trust in sources of information to better inform public health messaging. In this study, we surveyed the adult US population to understand their risk perceptions about the COVID-19 outbreak.Methods and FindingsWe used an online platform to survey 718 adults in the US in early February 2020 using a questionnaire that we developed. Our sample was fairly similar to the general adult US population in terms of age, gender, race, ethnicity and education. We found that 69% of the respondents wanted the scientific/public health leadership (either the CDC Director or NIH Director) to lead the US response to COVID-19 outbreak as compared to 14% who wanted the political leadership (either the president or the Congress) to lead the response. Risk perception was low (median score of 5 out of 10) with the respondents trusting health professionals and health officials for information on COVID-19. Majority of the respondents were in favor of strict infection prevention policies to control the outbreak.ConclusionGiven our results, the public health/scientific leadership should be at the forefront of the COVID-19 response to promote trust.