bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subpulse drifting and periodic nulling in single pulse emission of PSR B2000+40
Authors: Basu Rahul , Lewandowski Wojciech , Kijak Jarosław 
Published: August 2020

ABSTRACT
We have carried out a detailed study of single pulse emission from the pulsar B2000+40 (J2002+4050), observed at 1.6-GHz frequencies using the Effelsberg radio telescope. The pulsar has three components, which are not well separated, with the central component resembling core emission. We have investigated modulations in single pulse behaviour using the fluctuation spectral analysis, which showed the presence of two prominent periodicities, around 2.5P and 40P, respectively. The shorter periodicity was associated with the phenomenon of subpulse drifting and was seen to be absent in the central core component. Drifting showed large phase variations in conal components. Additionally, the periodic modulations had significant evolution with time, varying between very sharp and highly diffuse features. In addition to drifting the pulsar also had the presence of nulling in the single pulse sequence. The longer periodic feature in the fluctuation spectra was associated with nulling behaviour. The pulsar joins a select group, which shows the presence of the phase-modulated drifting as well as periodic nulling in the presence of core emission. This provides further evidence for the two phenomena to be distinct from each other with different physical origins.
Atypical structures of GAA/TTC trinucleotide repeats underlying Friedreich’s ataxia: DNA triplexes and RNA/DNA hybrids
Authors: Zhang Jiahui , Fakharzadeh Ashkan , Pan Feng , Roland Christopher , Sagui Celeste 
Published: August 2020

AbstractExpansion of the GAA/TTC repeats in the first intron of the FXN gene causes Friedreich’s ataxia. Non-canonical structures are linked to this expansion. DNA triplexes and R-loops are believed to arrest transcription, which results in frataxin deficiency and eventual neurodegeneration. We present a systematic in silico characterization of the possible DNA triplexes that could be assembled with GAA and TTC strands; the two hybrid duplexes [r(GAA):d(TTC) and d(GAA):r(UUC)] in an R-loop; and three hybrid triplexes that could form during bidirectional transcription when the non-template DNA strand bonds with the hybrid duplex (collapsed R-loops, where the two DNA strands remain antiparallel). For both Y·R:Y and R·R:Y DNA triplexes, the parallel third strand orientation is more stable; both parallel and antiparallel protonated d(GA+A)·d(GAA):d(TTC) triplexes are stable. Apparent contradictions in the literature about the R·R:Y triplex stability is probably due to lack of molecular resolution, since shifting the third strand by a single nucleotide alters the stability ranking. In the collapsed R-loops, antiparallel d(TTC+)·d(GAA):r(UUC) is unstable, while parallel d(GAA)·r(GAA):d(TTC) and d(GA+A)·r(GAA):d(TTC) are stable. In addition to providing new structural perspectives for specific therapeutic aims, our results contribute to a systematic structural basis for the emerging field of quantitative R-loop biology.
Robust partitioning of microRNA targets from downstream regulatory changes
Authors: Patel Ravi K , West Jessica D , Jiang Ya , Fogarty Elizabeth A , Grimson Andrew 
Published: August 2020

Abstract
The biological impact of microRNAs (miRNAs) is determined by their targets, and robustly identifying direct miRNA targets remains challenging. Existing methods suffer from high false-positive rates and are unable to effectively differentiate direct miRNA targets from downstream regulatory changes. Here, we present an experimental and computational framework to deconvolute post-transcriptional and transcriptional changes using a combination of RNA-seq and PRO-seq. This novel approach allows us to systematically profile the regulatory impact of a miRNA. We refer to this approach as CARP: Combined Analysis of RNA-seq and PRO-seq. We apply CARP to multiple miRNAs and show that it robustly distinguishes direct targets from downstream changes, while greatly reducing false positives. We validate our approach using Argonaute eCLIP-seq and ribosome profiling, demonstrating that CARP defines a comprehensive repertoire of targets. Using this approach, we identify miRNA-specific activity of target sites within the open reading frame. Additionally, we show that CARP facilitates the dissection of complex changes in gene regulatory networks triggered by miRNAs and identification of transcription factors that mediate downstream regulatory changes. Given the robustness of the approach, CARP would be particularly suitable for dissecting miRNA regulatory networks in vivo.
Long-term cognitive deficits in pediatric low-grade glioma (LGG) survivors reflect pretreatment conditions—report from the German LGG studies
Authors: Traunwieser Thomas , Kandels Daniela , Pauls Franz , Pietsch Torsten , Warmuth-Metz Monika , Bison Brigitte , Krauss Juergen , Kortmann Rolf-Dieter , Timmermann Beate , Thomale Ulrich-Wilhelm , Luettich Peggy , Neumann-Holbeck Anne , Tischler Tanja , Hernáiz Driever Pablo , Witt Olaf , Gnekow Astrid K 
Published: August 2020

AbstractBackgroundDisease and treatment contribute to cognitive late effects following pediatric low-grade glioma (LGG). We analyzed prospectively collected neuropsychological data of German pediatric LGG survivors and focused on the impact of hydrocephalus at diagnosis, neurofibromatosis type 1 (NF1) status, and extent of surgery.MethodsWe used the Neuropsychological Basic Diagnostic screening tool based on the Cattell–Horn–Carroll model for intelligence and the concept of cross-battery assessment at 2 and 5 years from diagnosis for 316 patients from the German pediatric LGG study and LGG registry (7.1 years median age; 45 NF1; cerebral hemispheres 16%, supratentorial midline 39%, infratentorial 45%). Hydrocephalus was classified radiologically in 137 non-NF1 patients with infratentorial tumors (95/137 complete/subtotal resection).ResultsPatients with NF1 versus non-NF1 exhibited inferior verbal short-term memory and visual processing (P &lt; .001–.021). In non-NF1 patients, infratentorial tumor site and complete/subtotal resection were associated with sequelae in visual processing, psychomotor speed, and processing speed (P &lt; .001–.008). Non-NF1 patients without surgical tumor reduction and/or nonsurgical treatment experienced similar deficits. Degree of hydrocephalus at diagnosis had no further impact. Psychomotor and processing speed were impaired comparably following chemo-/radiotherapy (P &lt; .001–.021). Pretreatment factors such as NF1 or tumor site were relevant at multivariate analysis.ConclusionsAll pediatric LGG survivors are at risk to experience long-term cognitive impairments in various domains. Even surgical only management of cerebellar LGG or no treatment at all, that is, biopsy only/radiological diagnosis did not protect cognitive function. Since pattern and extent of deficits are crucial to tailor rehabilitation, neuropsychological and quality of survival assessments should be mandatory in future LGG trials.
The MEK inhibitor selumetinib reduces spinal neurofibroma burden in patients with NF1 and plexiform neurofibromas
Authors: Jackson Sadhana , Baker Eva H , Gross Andrea M , Whitcomb Patricia , Baldwin Andrea , Derdak Joanne , Tibery Cecilia , Desanto Jennifer , Carbonell Amanda , Yohay Kaleb , O’Sullivan Geraldine , Chen Alice P , Widemann Brigitte C , Dombi Eva 
Published: August 2020

Abstract

Background
Spinal neurofibromas (SNFs) in neurofibromatosis type 1 (NF1) can cause progressive spinal cord compression and neurological dysfunction. The MEK inhibitor selumetinib shrinks the majority of plexiform neurofibromas (PNs) in patients with NF1. We assessed the effect of selumetinib on SNF.

Methods
Pediatric and adult patients with NF1 and inoperable PN participating in phase 2 studies of selumetinib for PN were included in this analysis if they had SNF and serial spine magnetic resonance imaging (MRI). Selumetinib was administered orally at the recommended dose of 25 mg/m2/dose twice daily (max 50 mg b.i.d.; 1 cycle = 28 days). We qualitatively assessed the effect of selumetinib on SNF-related spinal canal distortion, cerebrospinal fluid distribution, and spinal cord deformity on MRI.

Results
Twenty-four patients (18 male), median age 16.9 years (range, 6.2–60.3), had SNF, 22 of which were associated with the same nerves as the target PN assessed on the clinical trial. Twenty patients had spinal cord deformity. Twenty-three patients completed at least 12 treatment cycles to date. Eighteen patients showed subtle to a marked improvement in SNF burden, 5 remained stable, and no worsening was observed during treatment.

Conclusions
This is the first study describing the effect of selumetinib on SNF. Of 24 patients, 18 exhibited some improvement of SNF burden on imaging. These findings suggest that selumetinib may prevent the worsening of cord compression, potentially reducing the need for surgical interventions in select patients or benefitting patients who do not have a surgical option. Prospective evaluation of the clinical benefit of selumetinib for SNF is warranted.
Credit Default Swaps and Bank Regulatory Capital*
Authors: Shan Chenyu , Tang Dragon Yongjun , Yan Hong , Zhou Xing (Alex) 
Published: August 2020

Abstract
While credit default swaps (CDSs) can be used to hedge credit risk exposures or to speculate, we examine another use of them: banks buy CDS referencing their borrowers to obtain regulatory capital relief. Such capital relief activities have unintended consequences, as banks extend riskier loans when they buy CDS to boost capital ratios. While capital-induced CDS-user banks achieve higher profitability during normal times, they perform worse and request more government support in crisis periods than other banks that use CDS for trading or speculation. Our findings suggest that banks’ CDS trading for capital relief purposes may make these banks riskier.
Missed opportunities for tuberculosis investigation in a municipal hospital in Ghana: evidence from patient exit interviews
Authors: Der Joyce B , Grint Daniel J , Narh Clement T , Bonsu Frank , Grant Alison D 
Published: August 2020

Abstract

Background
We assessed coverage of symptom screening and sputum testing for tuberculosis (TB) in hospital outpatient clinics in Ghana.

Methods
In a cross-sectional study, we enrolled adults (≥18 years) exiting the clinics reporting ≥1 TB symptom (cough, fever, night sweats or weight loss). Participants reporting a cough ≥2 weeks or a cough of any duration plus ≥2 other TB symptoms (per national criteria) and those self-reporting HIV-positive status were asked to give sputum for testing with Xpert MTB/RIF.

Results
We enrolled 581 participants (median age 33 years [IQR: 24–48], 510/581 [87.8%] female). The most common symptoms were fever (348, 59.9%), chest pain (282, 48.5%) and cough (270, 46.5%). 386/581 participants (66.4%) reported symptoms to a healthcare worker, of which 157/386 (40.7%) were eligible for a sputum test per national criteria. Only 31/157 (19.7%) had a sputum test requested. Thirty-two additional participants gave sputum among 41 eligible based on positive HIV status. In multivariable analysis, symptom duration ≥2 weeks (adjusted odds ratio [aOR] 6.99, 95% confidence interval [CI] 2.08–23.51) and previous TB treatment (aOR: 6.25, 95% CI: 2.24–17.48) were the strongest predictors of having a sputum test requested. 6/189 (3.2%) sputum samples had a positive Xpert MTB/RIF result.

Conclusion
Opportunities for early identification of people with TB are being missed in health facilities in Ghana.
Are Nursing Students Learning About Social Determinants of Health?
Authors: Lee Susan K. , Willson Pamela 
Published: August 2020

Abstract
Nurses must be knowledgeable about social determinants of health (SDH) to provide holistic care with improved patient outcomes. When evaluating the Baccalaureate of Science in Nursing curriculum, it is unclear if SDH are adequately identified, assessed, and discussed, or if students grasp their importance. To move to a population health approach, faculty need to be more inclusive of community and public health. For purposes of this study, the factors comprising SDH were identified as childhood experiences, housing, education, social support, family income, employment, communities, and access to health services. These eight factors were used to categorize participants’ qualitative responses to baseline and completion surveys.
Innovation in Health Policy Education: Examples From Jonas Policy Scholars
Authors: Hallowell Sunny G. , Oerther Sarah E. , Dowling-Castronovo Annemarie , Rossiter Alicia Gill , Montalvo Wanda 
Published: August 2020

Abstract
In the decade since the Institute of Medicine published the Future of Nursing report, the development of a pipeline of doctorally prepared nursing leaders proficient in research, leadership, teaching, and practice has been one of great successes. The investment of Jonas Philanthropies, in collaboration with donors and foundation partners, has supported scholarships to more than 1,000 scholars nationwide. Scholars are prepared to lead health care reform in education, practice, and leadership. This article shares four examples of creative approaches to teaching health policy with students and professionals who may inspire similarly creative approaches to prepare future health policy leaders.
Design and Implementation of an Innovative Undergraduate Pediatric Clinical Experience With Teenagers of Mexican Heritage
Authors: D'Alonzo Karen T. , Seaman Kimberly , Rawlins Latoya 
Published: August 2020

Abstract
This article describes an innovative community-based pediatric clinical rotation for undergraduate nursing students. Students were charged with conducting interactive educational sessions on health-related topics of interest to participants in a six-week summer day camp for adolescents of Mexican heritage. At the completion of the experience, students identified social determinants of health that impacted the health of the community and the impact of the experience on their nursing practice. Overall, both the adolescents and the nursing students benefited from the experience. Community-academic partnerships can be used to promote student learning while contributing to the overall health of the community.
Interprofessional Education: TeamSTEPPS® and Simulation With Respiratory Therapy and Nursing Students in Their Final Year
Authors: Russell Kendra , Brown Jasmine , Manella Leanne , Colquitt James , Ingram Donna 
Published: August 2020

Abstract
TeamSTEPPS® is a curriculum designed to improve team communication to reduce medical errors and improve patient safety. This exploratory study used a questionnaire to explore differences in attitudes of 130 nursing and respiratory therapy students using a TeamSTEPPS-based interprofessional education seminar and simulation. Results support that students’ attitudes regarding the principles Team Structure, Leadership, Situation Monitoring, Mutual Support, and Communication improved from Time 1 (preseminar) to Time 2 (postseminar; p < .05). This improvement was sustained at Time 3 (postsimulation) in all principles except for Mutual Support. Participation in a TeamSTEPPS seminar and simulation can influence attitudes among health care professional students.
Sex-specific Associations of Alcohol Withdrawal in Patients Admitted for the Treatment of Alcohol Use Disorder
Authors: Sanvisens Arantza , Zuluaga Paola , Short Antoni , Rubio Gabriel , Gual Antoni , Torrens Marta , Fuster Daniel , Bolao Ferran , Rodríguez de Fonseca Fernando , Muga Roberto 
Published: August 2020

Objectives:
There are sex differences in the pattern of alcohol consumption and in the complications of alcohol use disorder (AUD). We aimed to identify sex-specific differences in the factors associated with alcohol withdrawal syndrome (AWS) among patients that requested a first treatment for AUD.

Methods:
We enrolled 313 patients (75% men) with a Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) AUD diagnosis that started treatment between 2014 and 2016. We collected socio-demographics, the type and amount of alcohol and other substances consumed, and clinical and laboratory parameters. According to Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) AUD criteria, AWS occurred when patients experienced 2 or more clinical signs/symptoms and/or consumed alcohol to relieve symptoms. Logistic regression models were used to determine factors associated with AWS according to sex.

Results:
The median age of participants was 50 years (interquartile range [IQR]: 43–54 years). The median age of starting alcohol consumption was 16 years (IQR: 14–18 years). Notably, 69% of participants smoked tobacco, and 61% had a family history of AUD; 18% currently used cannabis, and 7.7% used cocaine. Overall, 73% of patients exhibited AWS criteria, and men (76.5%) were more likely than women (64.6%) to report AWS (P = 0.038). In the adjusted analysis, factors associated with AWS were the age at starting alcohol consumption (odds ratio [OR] for every 5 years = 1.89, 95% confidence interval [CI]: 1.69–2.08), and cannabis use (OR = 2.8, 95% CI: 1.04–7.7) in men, and a family history of AUD in women (OR = 2.85 95% CI: 1.07–7.54).

Conclusions:
factors associated with AWS differ by sex which may have clinical implications for proactive management of AWS during treatment for AUD.
Anxiety, Depression, and Opioid Misuse Among Adults With Chronic Pain
Authors: Rogers Andrew H. , Garey Lorra , Bakhshaie Jafar , Viana Andres G. , Ditre Joseph W. , Zvolensky Michael J. 
Published: August 2020

Objectives:
The opioid epidemic is a significant public health problem largely driven by opioid prescriptions for chronic pain. Among those with chronic pain, anxiety and depressive symptoms have been linked to opioid misuse, and individual differences in anxiety and depressive symptoms among adults with chronic pain may be important for better understanding pain. Yet, little work has examined mechanisms that may link anxiety and depressive symptoms to opioid misuse among adults with chronic pain. Anxiety sensitivity (AS), or the fear of anxiety-related physical sensations, may be one candidate construct that has been linked independently to anxiety and depressive symptoms as well as opioid misuse.

Methods:
The current survey-based study examined the indirect association of AS in the relation between anxiety and depressive symptoms and opioid misuse among 429 adults with chronic pain currently using prescription opioid medication (73.9% female, M
age
=38.32 y, SD=11.07).

Results:
Using structural equation modeling, it appears that AS is a potential construct in the interrelation between anxiety and depressive symptoms and opioid misuse. However, an alternative model found equally strong empirical support, as mental health symptoms may serve as an explanatory factor between AS and opioid misuse.

Discussion:
Bi-directional effects are apt to be involved among the studied variables. Prospective research is needed to replicate the study results and isolate the temporal patterning between the studied constructs. Nonetheless, the data overall highlight the importance of both AS and anxiety and depressive symptoms in terms of understanding opioid misuse among adults with chronic pain.
Child- and Environment-Related Factors Influencing Daily Cochlear Implant Use: A Datalog Study
Authors: de Jong Tjeerd , van der Schroeff Marc , Vroegop Jantien 
Published: August 2020

Objectives:
To understand the varying levels of daily cochlear implant (CI) use in children, previous studies have investigated factors that may be of influence. The objective of this study was to investigate the degree with which new child-related and environment-related characteristics were associated with consistent CI use.

Design:
The design of this study was retrospective. Data were reviewed of 81 children (51% females, mean age 6.4 years with a range of 1.3 to 17.7 years) who received a CI between 2012 and 2019. Developmental status, quantified burden of comorbidity, hearing experience, and hearing environment were investigated for correlation with consistency in daily CI use. The CIs datalog was used to objectively record the wearing times. Associations were examined using univariate correlation analyses and a linear regression analysis.

Results:
On average, the CI was worn 8.6 hr per day and 59% of the children wore it more than 8 hr daily. The latter children’s hearing performance was significantly higher than that of the others. Consistency in CI use correlated significantly with the child-related characteristics chronological age, nonverbal intelligence quotient (IQ), American Society of Anesthesiologists physical status class, pre CI acoustic experience, CI experience, and one of the environment related characteristics “parental communication mode.” In a multivariate linear regression model, consistency in CI use was significantly dependent on nonverbal IQ and parental communication mode. These together accounted for 47% of the variation in daily CI use.

Conclusions:
The findings indicate that children with lower nonverbal IQ scores and low exposure to oral communication by their parents are at risk of inconsistent CI use.
Rhythmic Abilities of Children With Hearing Loss
Authors: Hidalgo Céline , Zécri Annabelle , Pesnot-Lerousseau Jacques , Truy Eric , Roman Stéphane , Falk Simone , Dalla Bella Simone , Schön Daniele 
Published: August 2020

Objectives:
Children with hearing loss (HL), in spite of early cochlear implantation, often struggle considerably with language acquisition. Previous research has shown a benefit of rhythmic training on linguistic skills in children with HL, suggesting that improving rhythmic capacities could help attenuating language difficulties. However, little is known about general rhythmic skills of children with HL and how they relate to speech perception. The aim of this study is twofold: (1) to assess the abilities of children with HL in different rhythmic sensorimotor synchronization tasks compared to a normal-hearing control group and (2) to investigate a possible relation between sensorimotor synchronization abilities and speech perception abilities in children with HL.

Design:
A battery of sensorimotor synchronization tests with stimuli of varying acoustic and temporal complexity was used: a metronome, different musical excerpts, and complex rhythmic patterns. Synchronization abilities were assessed in 32 children (aged from 5 to 10 years) with a severe to profound HL mainly fitted with one or two cochlear implants (n = 28) or with hearing aids (n = 4). Working memory and sentence repetition abilities were also assessed. Performance was compared to an age-matched control group of 24 children with normal hearing. The comparison took into account variability in working memory capacities. For children with HL only, we computed linear regressions on speech, sensorimotor synchronization, and working memory abilities, including device-related variables such as onset of device use, type of device, and duration of use.

Results:
Compared to the normal-hearing group, children with HL performed poorly in all sensorimotor synchronization tasks, but the effect size was greater for complex as compared to simple stimuli. Group differences in working memory did not explain this result. Linear regression analysis revealed that working memory, synchronization to complex rhythms performances, age, and duration of device use predicted the number of correct syllables produced in a sentence repetition task.

Conclusion:
Despite early cochlear implantation or hearing aid use, hearing impairment affects the quality of temporal processing of acoustic stimuli in congenitally deaf children. This deficit seems to be more severe with stimuli of increasing rhythmic complexity highlighting a difficulty in structuring sounds according to a temporal hierarchy.