bluuebunny/crossref_metadata_2025_split huggingface dataset:
An investigation and validation of CT scan in detection of spinal epidural adipose tissue
Authors: Chen Yilei , Hu Ziang , Li Zhaozhi , Fan Shunwu , Zhao Xing , Song Lijiang , Wang Lili 
Published: March 2020

Abstract
To investigate the accuracy of computed tomography (CT) in evaluating spinal epidural adipose tissue compared to magnetic resonance imaging (MRI).
CT scan images and matched magnetic resonance images of total 368 patients between July 2014 and July 2016 were evaluated. Hounsfield units (HU) of epidural fat (EF), dural sac (DuS), ligamentum flavum, bone of facet joints, and paraspinal muscles were measured for comparison. Anteroposterior diameter of the EF, anteroposterior diameter of the DuS, transverse diameter of the DuS, cross-sectional area of the EF, and cross-sectional area of the DuS were measured at each disc level from L1–2 to L5–S1.
Fat tissue showed exclusive negative HU significantly different from all other periphery tissues. Pearson correlation coefficient analyses showed significant positive correlations between CT and MRI measurements; Bland–Altman plots also depicted satisfied agreement. Overgrowth of spinal EF was more commonly found at L2–3 and L3–4 levels in present study, and body weight, age, and gender were significantly associated with amounts of EF both on CT and MRI.
The CT scan is a satisfied alternative of MRI for the evaluation of spinal epidural adipose tissue.
No Pathogen-Specific Sign or Symptom Predicts the Etiology of Monomicrobial Nongonococcal Urethritis in Men
Authors: Jordan Stephen J. , Toh Evelyn , Williams James A. , Fortenberry Lora J. , LaPradd Michelle , Ryan John D. , Nelson David E. , Batteiger Teresa A. 
Published: March 2020

Abstract
Identifying pathogen-specific signs or symptoms of nongonococcal urethritis could improve syndromic management accuracy. We evaluated nongonococcal urethritis signs and symptoms in 220 men with single-pathogen infections (Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis, or Ureaplasma urealyticum) or idiopathic urethritis. No individual sign or symptom accurately predicted the infectious etiology.
Prediction of the Development of Severe Sepsis Among Children With Intestinal Failure and Fever Presenting to the Emergency Department
Authors: Eisenberg Matthew , Puder Mark , Hudgins Joel 
Published: March 2020

Objectives
Children with intestinal failure (IF) and fever are frequently bacteremic, but risk factors for development of sepsis in this population are not well delineated. Our objective was to determine what clinical factors available on arrival to the emergency department (ED), including commonly used vital sign thresholds, predicted the subsequent development of severe sepsis in children with IF and fever.

Study Design
This was a retrospective cohort study of children younger than 21 years with IF presenting to a tertiary care ED between 2010 and 2016 with fever who did not have hypotensive septic shock on arrival. The primary outcome was development of severe sepsis within 24 hours of ED arrival, as defined by consensus criteria. We identified predictors of severe sepsis using both univariate and multivariate models and calculated the test characteristics of 3 different sets of vital sign criteria in determining risk of severe sepsis.

Results
In 26 (9.4%) of 278 encounters, the patient developed severe sepsis within 24 hours of arrival to the ED; 3 were excluded due to hypotensive shock on arrival. Predictors of severe sepsis included history of intestinal pseudo-obstruction (odds ratio, 8.2; 95% confidence interval, 2.3–30.2) and higher initial temperature (odds ratio, 1.7; 95% confidence interval, 1.2–2.3). The 3 sets of vital sign criteria had widely varying sensitivity and specificity in identifying development of severe sepsis.

Conclusions
History of intestinal pseudo-obstruction and higher fever predicted increased risk of severe sepsis among children with IF and fever presenting to an ED. No single set of vital sign criteria had both high sensitivity and specificity for this diagnosis.
Brief Report: Sexual Debut Among 14- to 17-year-old Sexual Minority Males: A Preliminary Investigation of Early HIV Risk and Sexual Health Needs
Authors: Nelson Kimberly M. , Perry Nicholas S. , Stout Claire D. , Carey Michael P. 
Published: March 2020

Background:
Adolescent sexual minority males (ASMM) are disproportionately at risk of HIV.

Purpose:
This study documents the sexual debut behaviors of ASMM, tests whether sexual debut and sexual behavior differed by race/ethnicity, and explores the association between early anal sex debut and engaging in condomless anal sex.

Methods:
Sexually active ASMM (N = 118; ages 14–17) in the United States completed an online sexual health survey. We used Fisher exact tests to explore differences by race/ethnicity in sexual debut characteristics and hypothesized relationships between sexual debut and risk behavior.

Results:
The average age of sexual debut with a male partner was 14 years (SD = 2.4). Approximately one-third (31%) reported anal sex at their sexual debut, with non-Latino black/African American ASMM more likely to report anal sex at debut (63%) compared with non-Latino white (28%), Latino (21%), or mixed race/other identified youth (19%; χ2 = 12.1, P = 0.01). All participants (100%) who reported an anal sex debut before the age of 14 years reported engaging in condomless anal sex in their lifetime, compared to 60% of those who reported an anal sex debut when they were 14 years old or older (χ2 = 5.6, P = 0.03). Participants wanted information about how to safely and comfortably have anal sex (59%) and skills around partner communication (>50%) before debut.

Conclusion:
Sexually active ASMM begin engaging in sexual behavior with other males early and with incomplete knowledge and skills regarding sexual health and safety.
Public Perception of a Normal Head Shape in Children With Sagittal Craniosynostosis
Authors: Al-Shaqsi Sultan Z. , Rai Ahsan , Forrest Christopher , Phillips John 
Published: March 2020

A question that remains unanswered is at what level of surgical correction does the public perceive a head shape to be “normal” or “acceptable?” For most cases of non-syndromic asymptomatic craniosynostosis, the parents desire for surgical correction is to improve the cosmetic appearance of head shape. At the time of this writing, the intraoperative surgeons’ perspective of what constitutes an acceptable head shape is the target for surgical correction. In introducing an improved objectively cosmetic goal, an appropriate outcome measure would be to assess what the general public considers a normal or acceptable head shape in children with craniosynostosis.

Method:
Twenty-two unique images were presented via an online crowdsourcing survey of a severe case of non-syndromic sagittal craniosynosis gradually corrected to an age and gender matched normalized head shape. Participants were recruited via the Sick Kids Twitter account. Participants were invited to rate the head shapes as “normal” or “abnormal.”

Results:
The 538 participants completed the online survey. Participants were able to reliably and consistently identify normal and abnormal head shapes with a Kappa Score >0.775. Furthermore, participants indicated that a correction of 70% is required in order for the cranial deformity to be regarded as “normal.” This threshold closely reflects a normal Cranial Index, which is a widely used morphometric outcome in craniosynostosis.

Conclusion:
Crowdsourcing provides an ideal method for capturing the general population's perspective on what constitutes a normal and acceptable head shape in children with sagittal craniosynostosis. Laypersons are able to reliably and consistently distinguish cranial deformities from a “normal” head shape. The public indicates a threshold correction of 70% in sagittal craniosynosis to regard it as a “normal” head shape.
Aging of the Adult Bony Orbit
Authors: Ching Jessica A. , Ford Jonathan M. , Decker Summer J. 
Published: March 2020

Background:
Accurate quantitative data of the adult bony orbital volume and dimension are needed for treatment optimization. In the present study, the authors aim to evaluate adult orbital volume and corresponding linear dimensions according to age, volume, and individual symmetry.

Methods:
Seventy computerized tomography facial scans of adults were randomly chosen from an institutional database and 3-dimensionally reconstructed. Studies were excluded for orbital pathology or incomplete radiographic data. Anatomic landmarks were marked. Interval linear distances and orbital volumes were calculated. Data were analyzed using paired T-tests, independent T-tests, linear regression analysis, and 1-way analysis of variance.

Results:
A total of 140 orbits from 70 patients were analyzed (female = 35, male = 35), ranging from 20 to 88 years of age. Orbital volume was similar between an individual's left and right side; however, a difference was observed in vertical orbital height, orbital width, inferior orbital rim position, orbital roof length, orbital width, and medial orbital wall length (0.45, 0.64, 0.4, 0.77, 0.97, and 5.1 mm, respectively; P < 0.05). In comparison to females, males averaged larger orbital volume by 3.07 cm3 (29.58 cm3 versus 26.51 cm3, P = 0.0002), medial wall length by 2.66 mm (P < 0.05), and orbital width by 2.66 mm (P < 0.05). Orbital volume did not correlate with patient age, while lateral wall length was correlative.

Conclusion:
This accurate normative data of the adult bony orbit impacts key aspects of patient diagnosis and treatment and also suggest clinical signs of periorbital aging are not due to bony orbital changes.
A Case-matched Comparative Study of Laparoscopic Versus Open Pancreaticoduodenectomy
Authors: Ammori Basil J. , Omari Balqees , Al Najjar Hani , Abdullah Niveen , Dabous Ali , Daoud Faiez , Almasri Mahmoud 
Published: March 2020

Background:
The laparoscopic approach to pancreaticoduodenectomy (LPD) is technically demanding, but may offer benefits over open surgery [open pancreaticoduodenectomy (OPD)]. The aim of this study was to compare the outcomes of these 2 approaches at a tertiary cancer center from the Middle East.

Materials and Methods:
Fifty consecutive patients who underwent LPD (n=12) and OPD (n=38) between 2015 and 2018 were considered. One surgeon performed LPD for “all comers,” while 3 other surgeons performed open surgery. Patients were randomly matched on a 1:2 basis for pathology (benign vs. malignant), malignancy size (±1 cm), and whether the pancreatic duct was dilated (>3 mm).

Results:
Six patients were excluded, leaving 44 patients, of whom 33 were matched (LPD n=11, OPD n=22). The groups were comparable for age (57 vs. 63 y, P=0.123) and sex distribution (female; 55% vs. 45%, P=0.721), tumor size (3 cm in each group), frequency of pancreatic duct dilatation (45% in each group), and malignant pathology (82% in each group). There were no conversions to open surgery. Although the operating time for LPD was significantly longer (680 vs. 313 min, P<0.0001), LPD was associated with significantly shorter primary (4.7 vs. 7.8 d, P<0.0001) and total hospital stay that included readmissions (4.7 vs. 8.9 d, P<0.0001). There were no significant differences in blood loss (200 vs. 325 mL, P=0.082), overall complication rate (36.4% vs. 59.1%, P=0.282), or clinically significant complications (9.1% vs. 22.2%, P=0.643) and readmissions (0 vs. 4 patients). In patients with malignant disease, there were no differences with regard to the number of lymph nodes retrieved (18 vs. 12, P=0.095) and frequency of R0 resections (77.8% in each group).

Conclusion:
In experienced hands, the laparoscopic approach to pancreaticoduodenectomy seems to offer advantages over open surgery in terms of reduction in hospital stay while maintaining an equivalent oncologic resection.
Universal rules for the interaction of selection and transmission in evolution
Authors: Rice Sean H. 
Published: March 2020

The Price equation shows that evolutionary change can be written in terms of two fundamental variables: the fitness of parents (or ancestors) and the phenotypes of their offspring (descendants). Its power lies in the fact that it requires no simplifying assumptions other than a closed population, but realizing the full potential of Price’s result requires that we flesh out the mathematical representation of both fitness and offspring phenotype. Specifically, both need to be treated as stochastic variables that are themselves functions of parental phenotype. Here, I show how new mathematical tools allow us to do this without introducing any simplifying assumptions. Combining this representation of fitness and phenotype with the stochastic Price equation reveals fundamental rules underlying multivariate evolution and the evolution of inheritance. Finally, I show how the change in the entire phenotype distribution of a population, not simply the mean phenotype, can be written as a single compact equation from which the Price equation and related results can be derived as special cases.This article is part of the theme issue ‘Fifty years of the Price equation’.
Selection, adaptation, inheritance and design in human culture: the view from the Price equation
Authors: Nettle Daniel 
Published: March 2020

For decades, parts of the literature on human culture have been gripped by an analogy: culture changes in a way that is substantially isomorphic to genetic evolution. This leads to a number of sub-claims: that design-like properties in cultural traditions should be explained in a parallel way to the design-like features of organisms, namely with reference to selection; that culture is a system of inheritance; and that cultural evolutionary processes can produce adaptation in the genetic sense. The Price equation provides a minimal description of any evolutionary system, and a method for identifying the action of selection. As such, it helps clarify some of these claims about culture conceptually. Looking closely through the lens of the Price equation, the differences between genes and culture come into sharp relief. Culture is only a system of inheritance metaphorically, or as an idealization, and the idealization may lead us to overlook causally important features of how cultural influence works. Design-like properties in cultural systems may owe more to transmission biases than to cultural selection. Where culture enhances genetic fitness, it is ambiguous whether what is doing the work is cultural transmission, or just the genetically evolved properties of the mind. I conclude that there are costs to trying to press culture into a template based on Darwinian evolution, even if one broadens the definition of ‘Darwinian’.
This article is part of the theme issue ‘Fifty years of the Price equation’.
Exploring diseases/traits and blood proteins causally related to expression of ACE2, the putative receptor of SARS-CoV-2: A Mendelian Randomization analysis highlights tentative relevance of diabetes-related traits
Authors: Rao Shitao , Lau Alexandria , So Hon-Cheong 
Published: March 2020

AbstractObjectivesCOVID-19 has become a major public health problem. There is good evidence that ACE2 is a receptor for SARS-CoV-2, and high expression ofACE2may increase susceptibility to infection. We aimed to explore risk factors affecting susceptibility to infection and prioritize drug repositioning candidates, based on Mendelian randomization (MR) studies onACE2lung expression.MethodsWe conducted a phenome-wide MR study to prioritize diseases/traits and blood proteins causally linked toACE2lung expression in GTEx. We also explored drug candidates whose targets overlapped with the top-ranked proteins in MR, as these drugs may alterACE2expression and may be clinically relevant.ResultsThe most consistent finding was tentative evidence of an association between diabetes-related traits and increasedACE2expression. Based on one of the largest GWAS on type 2 diabetes (T2DM) to date (N=898,130), T2DM was causally linked to raisedACE2expression(p=2.91E-03;MR-IVW). Significant associations(at nominal level;p<0.05) withACE2expression was observed across multiple DM datasets and analytic methods, for type 1 and 2 diabetes and related traits including early start of insulin. Other diseases/traits having nominal significant associations with increased expression included inflammatory bowel disease, (ER+)breast and lung cancers, asthma, smoking and elevated ALT. We also identified drugs that may target the top-ranked proteins in MR, such as fostamatinib and zinc.ConclusionsOur analysis suggested that diabetes and related traits may increaseACE2expression, which may influence susceptibility to infection (or more severe infection). However, none of these findings withstood rigorous multiple testing corrections (at FDR<0.05). Proteome-wide MR analyses might help uncover mechanisms underlyingACE2expression and guide drug repositioning. Further studies are required to verify our findings.
Comparative Impact of Individual Quarantine vs. Active Monitoring of Contacts for the Mitigation of COVID-19: a modelling study
Authors: Peak Corey M. , Kahn Rebecca , Grad Yonatan H. , Childs Lauren M. , Li Ruoran , Lipsitch Marc , Buckee Caroline O. 
Published: March 2020

SummaryBackgroundVoluntary individual quarantine and voluntary active monitoring of contacts are core disease control strategies for emerging infectious diseases, such as COVID-19. Given the impact of quarantine on resources and individual liberty, it is vital to assess under what conditions individual quarantine can more effectively control COVID-19 than active monitoring. As an epidemic grows, it is also important to consider when these interventions are no longer feasible, and broader mitigation measures must be implemented.MethodsTo estimate the comparative efficacy of these case-based interventions to control COVID-19, we fit a stochastic branching model to reported parameters for the dynamics of the disease. Specifically, we fit to the incubation period distribution and each of two sets of the serial interval distribution: a shorter one with a mean serial interval of 4.8 days and a longer one with a mean of 7.5 days. To assess variable resource settings, we consider two feasibility settings: a high feasibility setting with 90% of contacts traced, a half-day average delay in tracing and symptom recognition, and 90% effective isolation; and low feasibility setting with 50% of contacts traced, a two-day average delay, and 50% effective isolation.FindingsOur results suggest that individual quarantine in high feasibility settings where at least three-quarters of infected contacts are individually quarantined contains an outbreak of COVID-19 with a short serial interval (4.8 days) 84% of the time. However, in settings where this performance is unrealistically high and the outbreak continues to grow, so too will the burden of the number of contacts traced for active monitoring or quarantine. When resources are prioritized for scalable interventions such as social distancing, we show active monitoring or individual quarantine of high-risk contacts can contribute synergistically to mitigation efforts.InterpretationOur model highlights the urgent need for more data on the serial interval and the extent of presymptomatic transmission in order to make data-driven policy decisions regarding the cost-benefit comparisons of individual quarantine vs. active monitoring of contacts. To the extent these interventions can be implemented they can help mitigate the spread of COVID-19.FundingThis work was supported in part by Award Number U54GM088558 from the US National Institute Of General Medical Sciences.
The Impact of Host-Based Early Warning on Disease Outbreaks
Authors: Hernandez Mark A. , Milechin Lauren E. , Davis Shakti K. , DeLaura Richard A. , Claypool Kajal T. , Swiston Albert J. 
Published: March 2020

AbstractObjectiveThe detection of communicable pathogens responsible for major outbreaks relies on health care professionals’ recognition of symptoms manifesting in infectious individuals. Early warning of such communicable diseases before the onset of symptoms could improve both patient care and public health responses. However, the potential impact of such a host-based early warning system on containing the spread of an outbreak and in steering public health response is unknown.MethodsWe extend the deterministic SEIR (Susceptible, Exposed, Infectious, Recovered) model to simulate disease outbreak scenarios and to quantify the potential impact of a host-based early warning capability to mitigate pathogen transmission during an outbreak. In particular, we compare and contrast the performance of five different policies: Self-monitoring and reporting (baseline SEIR model), Quarantining the entire population, Quarantine-on-alert (with high sensitivity early warning), Quarantine-on-alert (with high specificity early warning), and Quarantine-on-alert (ideal early warning). We further evaluate these five policy options against four different outbreak scenarios with high or low disease transmission and high or low initial population exposures.ResultsFor all scenarios, a quarantine-on-alert policy coupled with the near-ideal early warning capability reduces quarantine needs with only a small increase in the number of additional infections. The cost of a highly specific early detection system (i.e., a reduction in false alarms and thus quarantine costs) is an increase in additional infections relative to the near-ideal system. Conversely, a highly sensitive early detection system increases the percentage of the population in quarantine compared to both the ideal and high-specificity early detection system while also reducing the number of additional infections to nearly the numbers seen by quarantining the entire population a priori.ConclusionsOur simulations demonstrate the utility of host-based early warning systems in controlling an outbreak under various outbreak conditions. Our tools also provide a simulation capability for evaluating public health policies enabling quantitative evaluation of their impacts prior to implementation.