bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moral grounds and social norms of safe prosocial behaviour of young people
Authors: Kislyakov P. A. , Shmeleva E. A. , Aleksandrovich M. O. 
Published: December 2020

Introduction. In the current situation of socio-economic development and digitalisation of society, the question of moral standards is becoming particularly relevant. Individualism, values of self-actualisation, enrichment and autonomy are strengthened in the youth environment, and values of civic participation and moral identity are not developed. In this regard, prosocial attitudes aimed at providing selfless assistance to a person or society as a whole are popularised among young people at the state level.The aim of the present research is to identify the dominant moral grounds and norms of safe prosocial behaviour of young people.Methodology and research methods. The current research is based on the theory of moral grounds, the theory of social norms of prosocial behaviour, and the theory of social and psychological security. The following psychodiagnostic methods were applied: “Diagnostics of the Level of Moral and Ethical Responsibility of the Individual” (by I. G. Timoshchuk), “Moral Foundations Questionnaire” (by J. Haidt et al., in the adaptation of O. A. Sychev et al.); “Scale of Altruism” (by F. Rushton, in the adaptation of N. V. Kuhtova), “Social Norms of Prosocial Behaviour” (by I. A. Furmanov, N. V. Kuhtova). The obtained empirical data were processed using percentage analysis, the Kraskel-Wallace criterion, the Pearson correlation analysis, and linear regression analysis (the step method). Calculations were done employing the SPPS 22 statistical program package.Results and scientific novelty. The conducted research has shown that moral and ethical responsibility and prosociality among young people are formed at a sufficient level. The norms of care, justice, and social responsibility are the dominant moral grounds and norms of prosocial safe behaviour of young people. Despite the fact that assistance is mainly dictated by pragmatic motives, safe prosocial behaviour of young people is predicted by compliance with group rules and the absence of selfish expectations of reciprocity.Practical significance. The identified relationships allow for the prediction of the level of readiness of the individual to help and take care of the well-being of another person and society, depending on moral norms and norms of prosocial behaviour. In the process of personal and professional development and spiritual and moral development of young people, it is advisable to use situational modelling aimed at solving moral dilemmas and forming attitudes to prosocial behaviour within the framework of the humanities cycle.
Predicting Noninfectious Pulmonary Complications in HIV Positive Patients based on Persistence of the HIV-Nef Protein
Authors: Arce Guzman Christian , Chelvanambi Sarvesh , Twig III Homer , Clauss Matthias 
Published: December 2020

Background and Hypothesis: According to the Veterans Aging Cohort Study, people living with HIV (PLWH) in the era of antiretroviral therapy (ART) have incidence rates of COPD, pulmonary hypertension and pulmonary fibrosis that are 16, 50 and 50% higher than the general population, respectively. Despite effective treatment, the HIV-Nef protein continues to persist in the blood and bronchoalveolar lavage (BAL) fluid of HIV positive patients. Studies have shown that HIV-Nef promotes inflammation and induces apoptosis within pulmonary immune and endothelial cells, respectively. HIV-Nef transgenic mice display pulmonary disease phenotypes including reduced number of alveoli, increased inspiratory capacity and hypoxemia. Nef persistence in lungs could explain the high rates of pulmonary complications in PLWH. We hypothesize that patients with HIV-Nef are more likely to exhibit pulmonary dysfunction.

Methods: A secondary data analysis was conducted on samples collected from 34 HIV positive patients with variable HIV-Nef levels in plasma and BAL fluids as detected by ELISA. Using GraphPad Prism 8 and p<0.05 for statistical significance, bivariate analyses were performed, including Spearman correlation, simple linear regression and Welch’s t test.

Results: In patients with no detectable HIV-Nef in BAL fluids, pulmonary function test (PFT) parameters, such as FEV1/FVC, FEV1 and FEF 25-75 showed a positive correlation with CD4 counts; however, preservation of CD4 counts did not normalize PFT measures in Nef positive patients. HIV-Nef presence in the lungs resulted in higher levels of chemokines and pro-inflammatory cytokines, which led to increased percentages of infiltrating lymphocytes and neutrophils.

Conclusion and Potential Impact: Our findings suggest that HIV-Nef mediates inflammation in the lungs and disrupts the protective effect of preserving CD4 count on pulmonary function. Screening for HIV-Nef could become a routine test to predict risk of pulmonary complications. Therapies that target Nef induced pulmonary inflammation could reduce the prevalence of pulmonary diseases in PLWH.
The Role of Body Mass Index on Perioperative Medical Complications and Outcomes Following Primary Total Knee Arthroplasty
Authors: Bosler Ashton , Deckard Evan , Ziemba-Davis Mary , Buller Leonard , Meneghini R. Michael 
Published: December 2020

Background and Hypothesis: Obesity is associated with increased medical complications and septic revision following total knee arthroplasty (TKA); however, evidence-based multidisciplinary perioperative care coordination can optimize outcomes. This study examined the relative influence of body mass index (BMI) on outcomes following TKA in an arthroplasty program with specialized perioperative medical care.

Experimental Design or Project Methods: 284 consecutive primary unilateral TKAs performed by one surgeon at a designated hip and knee center between 2019 and 2020 were retrospectively reviewed. Outcomes including (1) inpatient and 90-day medical complications (cardiac, renal, respiratory, venous thromboembolism, cerebrovascular accident, joint infection, sepsis, and death), (2) 90-day emergency department (ED) visits and hospital readmissions, and (3) 90-day reoperations on the index joint were evaluated in relation to BMI.

Results: 59.9% of the sample was non-obese (BMI < 35 kg/m2), 20.1% severely obese (≥ 35 kg/m2), 18.3% morbidly obese (≥ 40 kg/m2), and 1.8% super-obese (≥ 50 kg/m2). There were five inpatient complications (40% non-obese, 60% morbidly obese patients, p=1.000). 64% of 11 90-day ED visits were made by non-obese patients and 36% were made by severely/morbidly obese patients (p=0.395). Nine hospital readmissions within 90-days represented 67% non-obese and 33% severely/morbidly obese patients (p=0.395). All complications were related to renal/respiratory/cardiac issues or joint infection. There were five reoperations of the index joint within 90 days (40% non-obese, 60% severely/morbidly obese, p=1.000), with infection or arthrofibrosis as the underlying cause.

Conclusion and Potential Impact: We observed a similar distribution of perioperative medical complications following primary TKA regardless of BMI. Further evaluation with a larger sample and using machine learning to control for the influence of multiple potential confounders will help determine the relative contribution of various comorbidities associated with obesity on outcomes following TKA. An awareness of the relative contribution of BMI on these outcomes may improve preoperative counseling, management, and treatment of obese patients who undergo TKA.
The effect of pathophysiologic protein accumulation in preclinical Alzheimer’s disease on white matter integrity
Authors: Chien Billy , Shahid Salman , Thukral Rhea , Wu Yu-Chien 
Published: December 2020

Background:
Traditionally, the accumulation of amyloid beta peptides (Aβ) and tau proteins are considered the main pathological hallmarks of AD due to their impact on cortical microstructural organization, which leads to dendritic deficit and neuronal loss. Additionally, it is hypothesized that these pathophysiological processes may induce axonal and oligodendrocyte dysfunction exacerbating myelin impairment. The objective of this cross-sectional study is to estimate the degree of alterations in white matter (WM) microstructural organization associated with pathological proteins at the pre-clinical stage of AD.

Methods:
To achieve this, diffusion magnetic resonance imaging (dMRI) data and cerebrospinal fluid (CSF) samples were obtained from 84 patients determined to be cognitively normal using neurophysiological tests. CSF samples were analyzed for levels of CSF total tau (T-tau), phosphorylated tau (p-tau181), and Aβ42. The participants were then divided into two groups based on their biomarker (BM) levels (BM+: T-tau/Aβ42 ³ 0.18, and BM-: T-tau/Aβ42 < 0.18). The level of WM integrity was determined through Free Water Eliminating Diffusion Tensor Imaging (FWEDTI) and Neurite Orientation Dispersion and Density Imaging (NODDI) analysis of the dMRI data.

Results:
Comparisons of WM integrity between the two groups showed a significant reduction in diffusivity in BM+ participants, relative to the BM- group. Additionally, region of interest (ROI)/cluster-based analysis displayed significant associations between levels of CSF biomarkers (T-tau, T-tau/Aβ42, and p-tau/Aβ42) with sophisticated diffusion metrices in multiple regions. CSF Aβ42 alone lacked significant association with white matter alterations.

Conclusion:
These results suggest that the processes behind pathological protein accumulation influence WM integrity in pre-symptomatic AD, and are primarily driven by tau proteins. Therefore, CSF models which include both measures of tau and Aβ42 are better indicators of AD in its non-dormant stages.
Predicting Fracture Healing with Biomarkers: The Potential for Precision Medicine to Assess Patient Risk of Fracture Nonunion
Authors: Chitwood Joseph , Adam Gremah , Kacena Melissa , Natoli Roman 
Published: December 2020

Objective:
To provide a comprehensive survey of the literature related to the current efficacy of biomarkers for predicting fracture healing.
Methods:
EMBASE and PubMed, were searched using the following terms: fractures, biomarkers, ununited, and nonunion with the assistance of a medical librarian. The initial search yielded 199 records. Additional search of Google Scholar and review of the references yielded zero additional records. The 165 unique records were screened, of which 105 were excluded due to experimental treatments, non-fracture related bone healing, animal studies, and study group design failure to compare union versus nonunion fracture outcomes. This left 21 articles for full review.
Results:
19 serum biomarkers were reviewed for nonunion predicative capability. From this cohort 9 biomarkers had promising results including; bone formation markers OC and PINP, bone resorption markers TRAP and OPN, growth factors VEGF and PGF-1, TEMRA and TReg cells, and miR-193a-3p. 15 SNPs on 11 genes were examined. The polymorphisms with the greatest potential for increased risk of nonunion based on odds ratio include; SMAD6 rs2053423 T/T genotype OR = 10.27. IL-1b rs2853550 T allele OR = 5.9. NOG rs1372857 G/G genotype OR = 4.56. NOS rs2297514 OR = 3.98. and PDGF CCG haplotype OR = 3.57
Conclusion:
There remains an unmet clinical need to develop predictive parameter(s) for bone healing that are objective, reproducible, preferably continuous, unique to the individual, and optimally based on a readily accessible biologic measurement. Ultimately yielding a biomarker predictive of future nonunion that is additive, or superior, to that of known clinical risk factors for nonunion.
Clinical Implications:
Accurate biomarkers could identify patients at early times post-injury who may benefit from intervention to promote healing, thus circumventing unnecessary delays in nonunion intervention. Additionally, biomarkers could eliminate preemptive surgery in patients with early slow progression who are otherwise on a healing trajectory.
Assessment of Cachexia Markers in the TCGA-LIHC Cohort of Patients with Hepatocellular Carcinoma
Authors: Duncheon Ethan , Young Andrew , Zimmers Teresa 
Published: December 2020

Abstract:
Background: Cachexia, unintentional loss of muscle and fat, is frequent in patients with cancer. Cachexia, frequent with hepatocellular carcinoma, associates with decreased quality of life and survival. We sought to measure body composition changes in patients in the liver hepatocellular carcinoma (LIHC) cohort of The Cancer Genome Atlas (TCGA) preparatory to identifying tumor genomic characteristics associated with cachexia.

Methods: Using CT scans from The Cancer Imaging Archive (TCIA), we measured changes in muscle area (SKMA) and height normalized skeletal muscle index (SKMI) between scans. Serum biomarkers, obtained from TCGA, and extracted data were assessed versus progression free survival (PFS) and overall survival (OS) using Spearman nonparametric correlation and log rank tests.

Results: 43 patients of the LIHC cohort had two usable CT scans. 16 were female, mean age 63.4 ± 9.10 years (mean ± SD) and 27 were male, mean age 61.0 ± 15.5 years. SKMA, SKMI, and body weight were strongly correlated to male sex; conversely, platelet count was strongly correlated with female sex (r=0.400, p=0.01). We observed no correlations between change in SMA or SMKI and PFS or OS. However, variables of baseline SKMA (r=0.312, p=0.07), SKMI (r=0.312, p=0.07), patient weight (r=0.367, p=0.03), and body mass index (BMI) (r=.0404, p=0.02) correlated strongly with PFS. Serum platelet count was strongly negatively correlated with PFS (r=-0.401, p=0.02). Mutation count was strongly negatively correlated with OS (r=-0.311, p=0.04).

Conclusion: This cohort is too small to draw general conclusions about body composition, muscle size, and survival. However, observing greater survival in patients with more muscle mass is consistent with studies of patients with advanced cancer showing increased risk of mortality with low muscle mass. Observing longer survival among patients with high starting BMI is consistent with prior studies in lung cancer. These results highlight the importance of body phenotype in prognosis of patients with hepatocellular carcinoma.
Exploring Racial and Age Disproportionalities in COVID-19 Positive Pediatric Cohort
Authors: Freeman Emily , Song Yiqiang , Allen Katie , Hui Siu , Mendonca Eneida 
Published: December 2020

Background: Social and health inequities place marginalized populations at increased risk of contracting the novel coronavirus 2019 (COVID-19). While COVID-19 literature continues to accumulate, there remains a lack of comprehensive epidemiological data on COVID-19 in children. The study aims to identify demographic trends in disease severity amongst COVID-19 positive pediatric patients.

Methods: We analyzed the medical records of 2217 laboratory-confirmed COVID-19 pediatric patients, ages 0-18, across Indiana. Working with Regenstrief Institute Center of Biomedical Informatics, data was extracted from the databases of Indiana Network for Patient Care, Indiana University Health, and Eskenazi Health from February 28th, 2020 to July 13th, 2020. Factors of interest were age, race, and ethnicity. The study assessed the clinical outcome of disease severity which was defined by one of the following clinical designations: outpatient management exclusively, emergency care without hospital admission, non-pediatric intensive care unit (PICU) hospitalization, PICU hospitalization, and death.

Results: The laboratory confirmed COVID-19 pediatric cohort was composed of 12.2% (N= 270) Black or African American, 49.3% (N=1094) white, and 3.2% (N= 71) American Indian/Alaska Native, Asian/Pacific Islander, and Multiracial combined group. 34.4% of Black or African American patients required emergency (12.2%) or inpatient care (22.2%) while 24.4% white patients required emergency (7.0%) or inpatient care (17.3%). 17.6% of the cohort was 0-5 years old, 24.8% was 6-12 years old, and 57.6% was 13-18 years old. 30.9% of the 0-5 age group required emergency or inpatient care while the percentages of the 6-12 age group and 13-18 age group requiring emergency or inpatient care were 20.6% and 18.9%, respectively.

Conclusion:
While our data is preliminary and requires additional validation, our exploration of racial and age disproportionalities in pediatric coronavirus severity serves to expand on the current COVID-19 literature and understanding of this virus.
Stress, Self-Efficacy, Worries, and Challenges for Caregivers of Children with Type 1 Diabetes During the COVID-19 Pandemic
Authors: Hand Breanne , Soni Priya , Oyetoro Rebecca , Albanese-O’Neill Anastasia , Ismail Heba , DiMeglio Linda 
Published: December 2020

Background:
Approximately 200,000 American youth live with Type 1 Diabetes (T1D). Intensive daily management is critical to optimize disease outcomes. Little is known about COVID-19 pandemic effects on persons with T1D and their caregivers. We hypothesized caregivers would report increased stress, lower self-efficacy (SE), and more difficult diabetes management associated with the pandemic.

Methods: A 49-item survey using Likert scales and open-ended response questions was distributed via email and T1D-related social media platforms from May 4-June 2,2020 to caregivers of children with T1D <18 years of age. The Patient-Reported Outcomes Measurement Information System (PROMIS) SE short form was used to measure general SE.

Results:
260 caregivers completed surveys: 94.2% female, mean age 42.4±7.7 years, 80.3% college degree or higher, 53.8% annual income >$99,000, 77.3% privately insured. Mean child age 11.0±4.1 years, mean T1D duration 4.2±3.4 years. 24.2% reported having COVID-19 or knowing someone diagnosed with COVID-19. 71.9% reported greater stress than before the pandemic. 9.6% reported job loss, 25.8% financial difficulty related to COVID-19. General SE levels were high, significantly correlated with overall COVID-19-related SE (r=0.394, p<0.001), and T1D care-SE during COVID-19 (r=0.421, p<0.001). 210 respondents provided open-ended response qualitative information on worries: 87.6% reported a worry, remainder not worried. Common worries were COVID-19-related diabetes complications including uncontrolled blood sugars, diabetic ketoacidosis, and worry about child’s increased risk for severe disease, including death. 209 reported about challenges; 90.9% stated they had at least one challenge. Family isolation and mental health were the most-stated challenges.

Conclusion:
Despite reporting high overall SE, caregivers of T1D children during the pandemic reported greater overall stress, worries, and challenges. Given that data do not suggest that children with T1D are at increased risk of COVID-19 complications, healthcare providers should work to address this knowledge gap while providing families with social and mental health supports.
Heavy Metals and Neurodevelopment of Children in Low and Middle-Income Countries: A Systematic Review
Authors: Heng Yi Yan , Asad Iqra , Coleman Bailey , McHenry Megan 
Published: December 2020

Background: The presence of harmful environmental exposures contributes to >25% of deaths and diseases worldwide. Child neurodevelopment is negatively impacted by environmental exposures, such as certain heavy metals. In low and middle-income countries, where numerous risk factors for poor neurodevelopment exist, it is unclear if this negative impact persists. Our objective with this systematic review is to evaluate the association between heavy metals and the neurodevelopment of children in low-and-middle income countries.

Methods: We conducted a search on PubMed MEDLINE, Embase, Cochrane Library, CINAHL, PsychInfo, Scopus, and Web of Science for articles that included individuals below the age of 18, quantitively measured exposure to a heavy metal and used a standardized measurement of neurodevelopment.

Results: Of the 15,250 screened articles, 292 full-text articles were reviewed, and 96 articles met inclusion criteria. These studies were conducted in 18 countries and included 46,080 participants ranging from birth – 18 years old. At least one domain of neurodevelopment was inversely correlated with 8/11 of arsenic studies, 3/3 of cadmium studies, 29/32 of lead studies, 11/11 of manganese studies, 9/18 of mercury studies, and 21/21 studies with multiple metals. There was no consistent evidence of arsenic affecting behavior; mercury negatively affected neurodevelopment in only half the studies, indicating that the benefits of consuming mercury-containing fish might outweigh the negative impact of mercury exposure; ethylmercury did not affect neurodevelopment; hair manganese was a much more consistent biomarker of manganese exposure than blood; and the neurotoxicity of lead was amplified in the presence of manganese.

Conclusions and potential impact: In low and middle-income countries, heavy metals have a significantly detrimental effect on the neurodevelopment of children, highlighting the need for more regulation.
Family Planning Priorities for Women Living with HIV and Attitudes Towards Mandatory Family Planning Use While Taking Dolutegravir
Authors: Komanapalli Sarah , Thorne Julie , Bernard Caitlin , Humphrey John , Maina Mercy , Jakait Beatrice , Patel Rena 
Published: December 2020

Dolutegravir (DTG) is currently the first and second line antiretroviral therapy (ART) for women living with HIV (WLHIV). However, in 2018 Botswana Harvard AIDS Institute Partnership found that DTG exposure at conception corresponded with an increase in neural tube defects. Therefore, it is important that providers work with WLHIV to ensure they are aware of how to avoid unplanned pregnancies while on DTG. Telephone interviews were conducted with women living with HIV ages 21-59. The interviews were conducted in western Kenya, at clinical sites of the Academic Model Providing Access to Healthcare (AMPATH) program. Nineteen interview transcripts were coded using NVIVO 12. Domains included family planning use and shared decision making (SDM). Within these domains, three themes were used for this analysis: 1) tensions in ARV SDM and pregnancy, 2) decision making in family planning, and 3) decision making in family planning with DTG. The following three themes were discussed frequently: 1) When making decisions surrounding family planning, women preferred in person counseling and prioritized knowing the side effects of contraceptive methods; 2) WLHIV were often aware of the risk of HIV vertical transmission and valued preventing birth defects if told a medication may cause them; 3) When asked about using family planning while on DTG, WLHIV saw the benefit of preventing pregnancies. However, they did not believe family planning should be mandatory and preferred having a wide variety of contraceptive options. Understanding what factors influence women’s family planning choices may improve SDM between patients and providers. This is especially important when it comes to preventing pregnancies in women taking DTG. WLHIV often understood the importance of effective ARTs and wanted to prevent birth defects. Therefore, it is important to navigate SDM conversations such that WLHIV are given control of their own health decisions.