bluuebunny/crossref_metadata_2025_split huggingface dataset:
Several weeks of low mood, decreased appetite, and poor sleep after changing schools
Authors: Grossman Mila N. 
Published: June 2021

Abstract
Major depressive disorder (MDD) is one of the most common psychiatric disorders affecting children and adolescents. The diagnostic criteria require the history of one or more depressive episodes in the absence of a history of mania. In contrast to adults, youth may experience predominantly irritable rather than sad mood. The assessment of depression should include a psychiatric evaluation, medical history, and focused laboratory studies to rule out medical and/or substance-related causes. The evaluation should also consider potential precipitants such as recent losses, interpersonal problems, or trauma. The patient should be asked directly about suicidal ideation, plans, and past attempts. Psychotherapy alone or in combination with antidepressant therapy is effective for the treatment of pediatric depression. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are the most well-studied psychotherapies. Selective serotonin reuptake inhibitors (SSRIs) are the first-line medication class and should be considered in moderate to severe cases of depression.
A fear of dogs
Authors: Hill Kevin M. 
Published: June 2021

Abstract
Specific phobia is a marked fear or anxiety about a specific object or situation. The fear or anxiety is out of proportion to the actual danger posed by the situation and the symptoms cause clinically significant distress or impairment in functioning. Often patients have more than one specific phobia. Children may be less able to spontaneously articulate their fears and the presenting symptoms may include nonspecific behaviors such as crying, tantrums, freezing, or clinging. A specific phobia can be distinguished from a developmentally appropriate fear by the persistence, severity, and degree of associated functional impairment. The treatment of choice for specific phobia is cognitive behavioral therapy (CBT) including exposure therapy and systematic desensitization.
Decreased food intake after a choking incident
Authors: Czepiel Kathryn S. 
Published: June 2021

Abstract
Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by problematic eating habits that place the patient at risk for nutritional deficiencies, weight loss, dependence on enteral feeding or nutritional supplements, or marked interference with psychosocial functioning. Unlike most other eating disorders, the abnormal eating behaviors seen in ARFID are not motivated by a disturbance in body image or the desire to be thinner. Compared to other eating disorders, ARFID is more likely to present in younger males with a median age of onset of 11 to 12 years. Symptoms of ARFID may develop after a traumatic food event such as choking. The assessment of ARFID should include a history including eating habits and a medical workup that evaluates for coexisting medical conditions. Successful treatment plans employ a multidisciplinary approach that includes weight stabilization and exposure-based cognitive behavioral therapy.
Recurrent episodes of binging and purging
Authors: Macenski Christina L. 
Published: June 2021

Abstract
Bulimia nervosa (BN) is an eating disorder that consists of recurrent binging episodes and inappropriate compensatory behaviors. Binge eating is defined as eating a large amount of food within a discrete time period accompanied by a sense of lack of control over eating during the episode. Examples of inappropriate compensatory behaviors include self-induced vomiting, fasting, excessive exercise, and laxative or diuretic misuse. Additionally, patients with BN experience body image disturbance, where their self-evaluation is unduly affected by weight and body shape concerns. Bulimia nervosa typically begins in late adolescence or young adulthood. Patients either are typically of normal weight or are overweight. Physical examination and laboratory findings are typically normal; however, medical complications can include electrolyte disturbances, cardiac arrhythmia, and dental caries. Fluoxetine and other selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat BN. A nutritional consultation is another important component of care. Finally, cognitive behavioral therapy (CBT) and family therapy are the psychotherapies of choice.
A young boy with stool soiling
Authors: Czepiel Kathryn S. 
Published: June 2021

Abstract
Encopresis is an elimination disorder in which an individual has recurrent passage of feces into inappropriate places such as their clothing or the floor that is not due to the physiological effects of a substance or another medical condition aside from constipation. The child must be at least four years of age or the equivalent developmental level. The most common cause of functional encopresis is constipation with overflow incontinence. It typically occurs in children between the ages of five and 10 years. It often occurs during points of childhood transition, for example, when the child starts school. A medical history and physical examination by a pediatrician or pediatric gastroenterologist are required to rule out gastrointestinal or other causes of encopresis. The primary treatment of encopresis is treatment of constipation through the use of laxatives and dietary modifications. Behavioral therapy may also be necessary to help break the cycle of stool withholding.
An adolescent with new-onset inattention
Authors: Taylor Samantha M. , Beckmann David L. 
Published: June 2021

Abstract
Cannabis use disorder is defined as a pattern of use that includes at least two signs or symptoms of problematic use. Cannabis is the second most commonly used psychoactive substance by adolescents. Cannabis use is associated with significant impairments in multiple cognitive domains, although even one week of abstinence can result in improved cognitive functioning. Cannabis use, particularly of products containing high concentrations of tetrahydrocannabinol (THC), increases the likelihood of developing schizophrenia. N-acetylcysteine (NAC) may be helpful for decreasing cravings and the risk of relapse. The most effective therapy modalities for cannabis use disorder are motivational enhancement therapy, contingency management, cognitive behavioral therapy (CBT), and family-based therapy.
Confusion and mental status changes in a medically ill child
Authors: Thom Robyn P. 
Published: June 2021

Abstract
Delirium is an acute, transient syndrome of global brain dysfunction that is the pathophysiological consequence of an underlying medical condition or toxic exposure. It affects 13% to 44% of hospitalized children. Signs and symptoms of delirium include disturbances in attention, awareness, and cognition that develop over a short period of time and fluctuate in severity. Patients with suspected delirium should undergo a physical examination and laboratory investigation to determine potential underlying medical etiologies. The primary treatment of delirium is identification and management of the underlying medical condition. Antipsychotics may be used to manage symptoms that threaten safety or impede the provision of medical care. Children with delirium may also benefit from supportive psychotherapy, involvement with child-life specialists, and other stress reduction strategies.
Detection of the cyanomidyl radical (HNCN): a new interstellar species with the NCN backbone
Authors: Rivilla V M , Jiménez-Serra I , García de la Concepción J , Martín-Pintado J , Colzi L , Rodríguez-Almeida L F , Tercero B , Rico-Villas F , Zeng S , Martín S , Requena-Torres M A , de Vicente P 
Published: June 2021

ABSTRACT
We report here the first detection in the interstellar medium of the cyanomidyl radical (HNCN). Using the Yebes 40m and the IRAM 30m telescopes, we have targeted the doublets of the N = 2–1, 4–3, 5–4, 6–5, and 7–6 transitions of HNCN towards the molecular cloud G+0.693-0.027. We have detected three unblended lines of HNCN, these are the N = 6–5 doublet and one line of the N = 4–3 transition. Additionally, we present one line of the N = 5–4 transition partially blended with emission from other species. The local thermodynamic equilibrium best fit to the data gives a molecular abundance of (0.91 ± 0.05) × 10−10 with respect to H2. The relatively low abundance of this species in G+0.693-0.027 and its high reactivity suggest that HNCN is possibly produced by gas-phase chemistry. Our work shows that this highly reactive molecule is present in interstellar space, and thus it represents a plausible precursor of larger prebiotic molecules with the nitrogen–carbon–nitrogen backbone such as cyanamide (NH2CN), carbodiimide (HNCNH), and formamidine (NH2CHNH).
Assessing the Performance of Australian Federalism in Responding to the Pandemic
Authors: Murphy Julian R , Arban Erika 
Published: June 2021

AbstractThis article provides a comprehensive evaluation of the federalism-implicated aspects of Australia’s response to the COVID-19 pandemic. The article’s research question is: to what extent was Australia’s federal structure responsible for the relative successes and failures of the national pandemic response? The method chosen to answer this question is largely theoretical, supplemented by aspects of institutional and policy analysis. That is to say, the inquiry identifies what were widely considered to be important policies, and considers the extent to which the formulation and implementation of those policies was furthered or hindered by the institutions and relations forming Australia’s federal structure. Five policy areas are considered, namely: the National Cabinet; social distancing and related policies; international travel and quarantine; interstate travel; and cities and local government. The conclusions reached are that a number of policy responses achieved federalism’s objectives of enhancing local decision-making power, increasing state and federal cooperation, and cabining policy failure. While Australia’s was not an unmitigated success story, on the whole the pandemic galvanized and reinvigorated Australia’s federal structure and institutions.
Orbitofrontal cortex connectivity is associated with food reward and body weight in humans
Authors: Rolls Edmund T , Feng Ruiqing , Cheng Wei , Feng Jianfeng 
Published: June 2021

AbstractThe aim was to investigate with very large-scale analyses whether there are underlying functional connectivity differences between humans that relate to food reward and whether these in turn are associated with being overweight. In 37 286 humans from the UK Biobank, resting-state functional connectivities of the orbitofrontal cortex (OFC), especially with the anterior cingulate cortex, were positively correlated with the liking for sweet foods (False Discovery Rate (FDR) P &lt; 0.05). They were also positively correlated with the body mass index (BMI) (FDR P &lt; 0.05). Moreover, in a sample of 502 492 people, the ‘liking for sweet foods’ was correlated with their BMI (r = 0.06, P &lt; 10−125). In a cross-validation with 545 participants from the Human Connectome Project, a higher functional connectivity involving the OFC relative to other brain areas was associated with a high BMI (≥30) compared to a mid-BMI group (22–25; P = 6 × 10−5), and low OFC functional connectivity was associated with a low BMI (≤20.5; P &lt; 0.024). It is proposed that a high BMI relates to increased efficacy of OFC food reward systems and a low BMI to decreased efficacy. This was found with no stimulation by food, so may be an underlying individual difference in brain connectivity that is related to food reward and BMI.
Metric variation in the postcranial skeleton of ostriches,Struthio(Aves: Palaeognathae), with new data on extinct subspecies
Authors: Elzanowski Andrzej , Louchart Antoine 
Published: June 2021

AbstractAs a result of numerous fossil and subfossil finds of ostriches, there is great demand for a comprehensive osteometric dataset for the living species and subspecies of the genus Struthio. We meet this demand by providing a set of &gt; 100 measurements for a sample of 18 sexed skeletons, including all living and recently extinct species and subspecies of ostriches. We provide the first mensural data for two extinct subspecies, the hitherto questioned Struthio camelus spatzi from north-western Africa and the Arabian ostrich, Struthio camelus syriacus. The unique skeletal proportions of S. c. spatzi, with a relatively short wing, broad pelvis, short tarsometatarsus and big third toe, confirm the validity of this taxon and suggest an increased stability at the expense of cursoriality, which might have contributed to its extermination by humans. Our biometric analysis of the entire sample suggests a subtle sexual dimorphism in the ostrich skeleton, with females having more robust limb bones (especially wider and/or deeper at the ends) despite being on average smaller than males. If confirmed by further research, this size-independent dimorphism might reflect the independent regulation of the longitudinal and transverse dimensions of bones as revealed by several independent studies of morphological integration (covariance among morphological traits) in the avian skeleton.
Evaluation of the Inhibitory Effects of Wuyiencin, a Secondary Metabolite of Streptomyces albulus CK-15, Against Sclerotinia sclerotiorum In Vitro
Authors: Yang Miaoling , Zhang Wei , Lv Zhaoyang , Shi Liming , Zhang Kecheng , Ge Beibei 
Published: June 2021

Sclerotinia sclerotiorum (Lib.) de Bary, a destructive fungal pathogen with an extensive host range, causes various diseases with the potential to cause huge economic losses to crops worldwide. Streptomyces species produce secondary metabolites with variable structures and biological activities that offer possible control methods for crop diseases. Herein, we evaluated the inhibitory effects of wuyiencin, a secondary metabolite of Streptomyces albulus CK-15, against S. sclerotiorum. The results showed that wuyiencin markedly inhibited mycelial growth and germination and the formation of sclerotia. It also increased cell membrane permeability, resulting in leakage of intracellular substances in pathogen mycelia. Wuyiencin markedly decreased oxalic acid content and the activities of polygalacturonase and pectin methyl-galacturonic enzymes. Moreover, it downregulated Nox1, ITL, pph1, Caf1, and sca1, all genes related to growth and infection. Lesions were smaller and less pronounced on soybean (Glycine max [L.] Merr.) leaves pretreated with wuyiencin in vitro, and the inhibition rate reached 78.36%. The results suggest that wuyiencin holds promise for the management of diseases caused by S. sclerotiorum, and the findings provide clues on the mechanism of action.
Does Cervical Alignment Matter? The Effect of 2-level Anterior Cervical Discectomy and Fusion on Sagittal Alignment and Patient-reported Outcomes
Authors: Quek Clara X. , Goh Graham S. , Soh Reuben C.C. 
Published: June 2021

Study Design:
Retrospective review of prospectively collected data.

Objective:
This study aimed to determine the change in cervical sagittal balance following 2-level anterior cervical discectomy and fusion (ACDF) and whether the degree of change was associated with improvement in patient-reported outcomes (PROs).

Summary of Background Data:
Sagittal balance in cervical spine surgery has been recognized as an important surgical goal. However, its influence on clinical outcomes following anterior decompressive procedures remains debatable.

Materials and Methods:
Patients who underwent primary 2-level ACDF for cervical spondylotic radiculopathy and/or myelopathy were identified from an institutional spine registry. Radiographic measurements were done preoperatively, postoperatively, and at minimum 24 months follow-up. Measurements comprised segmental lordosis (SL), C2−C7 cervical lordosis (CL), C2−C7 sagittal vertical axis, C7 slope (C7S), T1 slope (T1S) and C7 slope minus cervical lordosis (C7S−CL). Disk heights were measured preoperatively and postoperatively. PROs including the Neck Disability Index, Short Form-36, and Visual Analog Scale for neck pain and arm pain were collected preoperatively and at 24 months postoperatively.

Results:
In total, 90 patients were included. Mean follow-up was 58.6±22.9 months. Significant improvement in all PROs was achieved at 24 months (P<0.05). SL was −1.2±8.2 degrees preoperatively, increased to 5.2±5.9 degrees postoperatively (P<0.001), and decreased to 1.2±6.2 degrees at follow-up (P=0.005). CL was 8.5±12.5 degrees preoperatively, increased to 10.8±12.4 degrees postoperatively (P=0.018), and maintained at 10.9±11.2 degrees at follow-up (P=0.030). Sagittal vertical axis, C7S, T1S, and C7S−CL did not change significantly. Significant increases in disk heights were achieved postoperatively (P<0.001). Fusion rate was 98.9% at follow-up. PROs were not related to radiologic measurements. Maintaining or increasing CL or SL was not related to a greater degree of improvement in PROs.

Conclusions:
Two-level ACDF restored segmental and global CL, but changes in cervical sagittal alignment did not correlate with the magnitude of improvement in PROs. Adequate decompression with solid fusion remains fundamental to achieving good clinical outcomes in patients with degenerative cervical disease.
Effects of oral versus transdermal estradiol plus micronized progesterone on thyroid hormones, hepatic proteins, lipids, and quality of life in menopausal women with hypothyroidism: a clinical trial
Authors: Kaminski Juliana , Junior Cleo Mesa , Pavesi Helena , Drobrzenski Beatriz , Amaral Gisah M. do 
Published: June 2021

Abstract

Objective:
The aim of the study was to evaluate the effects of usual doses of oral estradiol with transdermal estradiol and the effects of these estrogens plus micronized progesterone (MP) in menopausal women with primary hypothyroidism.

Methods:
Twenty women were randomized to 12 weeks of treatment with estradiol 1 mg tablets or estradiol 1 mg gel. Then, women with a uterus received a 100 mg capsule of oral MP. Thyroid function, thyroxine-binding globulin (TBG), sex hormone-binding globulin (SHBG), insulin-like growth factor 1 (IGF-1), lipid profiles, and quality of life were measured at baseline and after 12 and 24 weeks.

Results:
Oral estradiol led to an increase in total T4 levels (5.84 ± 1.11 vs 8.41 ± 1.61 μg/dL; P < 0.001); changes in thyroid-stimulating hormone (TSH) levels were clinically important in 3 of 10 participants who needed to increase their dose of levothyroxine. Significant changes were detected in hepatic proteins with oral estradiol: TBG and SHBG levels increased (15.29 ± 3.87 vs 20.84 ± 5.49 μg/mL, P < 0.001; 61.85 ± 33.6 vs 121.4 ± 49.36 nmol/L, P < 0.001; respectively), whereas IGF-1 levels decreased (152 ± 38.91 vs 96 ± 17.59 ng/mL; P < 0.001). Transdermal estradiol alone did not significantly affect the thyroid function. Transdermal estradiol plus MP led to a decrease in TSH levels (1.79 ± 1.05 vs 1.09 ± 0.52 mIU/L; P = 0.04), while total T4 levels increased (7.54 ± 1.34 vs 9.95 ± 2.24 μg/dL; P = 0.01). Hormonal therapy had a greater impact on depressed mood and vasomotor symptoms.

Conclusions:
Total T4 and TBG levels increase after oral estradiol in women with hypothyroidism and it may cause clinical changes in TSH levels. Conversely, transdermal estradiol alone or plus MP does not cause major changes in thyroid function in these women.

Video Summary:

http://links.lww.com/MENO/A783.
Trajectories of Function and Symptom Change in Desvenlafaxine Clinical Trials
Authors: Zilcha-Mano Sigal , Wang Xuemei , Wajsbrot Dalia B. , Boucher Matthieu , Fine Stuart A. , Rutherford Bret R. 
Published: June 2021

Abstract

Purpose/Background
Heterogeneity has been documented in trajectories of symptom change during antidepressant treatment for major depressive disorder (MDD). It is unclear whether distinct trajectories of change exist for functioning during antidepressant treatment.

Methods/Procedures
This analysis explored distinct trajectories of functioning in MDD and tested whether they corresponded to trajectories of symptom change. Data were from 4317 patients and were pooled from 9 randomized placebo-controlled trials. Growth mixture modeling was used to identify trajectories of Hamilton Rating Scale for Depression (HRSD) and Sheehan Disability Scale (SDS) for placebo- and desvenlafaxine-treated patients.

Findings/Results
Three trajectories were identified for symptoms (HRSD) in patients receiving placebo (mean reduction baseline to week 8, −18.4 [most favorable] to −2.6 points [least favorable]). Four HRSD trajectories were identified for patients receiving desvenlafaxine (mean reduction from baseline to week 8, −17.2 [most favorable] to −2.6 points [least favorable]). Four trajectories were identified for functioning (SDS) in patients receiving placebo (mean reduction baseline to week 8, −13.6 [most favorable] to −0.8 points [least favorable]), and 3 for desvenlafaxine (−12.8 to −1.4 points, respectively). Percentages of agreement between most favorable HRSD and SDS trajectories were 75% (placebo) and 85% (desvenlafaxine), and for least favorable trajectories were 88% (placebo) and 80% (desvenlafaxine).

Implications/Conclusions
Distinct trajectories of change based on symptoms and functioning were identified among patients with MDD receiving desvenlafaxine and among patients with MDD receiving placebo. Differentiating subpopulations of patients has the potential to provide a more personalized treatment of patients with MDD.

ClinicalTrials.gov
Identifiers: NCT00072774; NCT00277823; NCT00300378; NCT00384033; NCT00798707; NCT00863798; NCT01121484; NCT00824291; NCT01432457.
Predicting Unplanned Health Care Utilization and Cost
Authors: Kinsky Suzanne , Liang Qingfeng , Bellon Johanna , Helwig Amy , McCracken Polly , Minnier Tamra , Thirumala Parthasarathy D. , Hanmer Janel 
Published: June 2021

Objectives:
There is little literature describing if and how payers are utilizing patient-reported outcomes to predict future costs. This study assessed if Patient-reported Outcomes Measurement Information System (PROMIS) domain scores, collected in routine practice at neurology clinics, improved payer predictive models for unplanned care utilization and cost.

Study Design:
Retrospective cohort analysis of private Health Plan-insured patients with visits at 18 Health Plan-affiliated neurology clinics.

Methods:
PROMIS domains (Anxiety v1.0, Cognitive Function Abilities v2.0, Depression v1.0, Fatigue v1.0, Pain Interference v1.0, Physical Function v2.0, Sleep Disturbance v1.0, and Ability to Participate in Social Roles and Activities v2.0) are collected as part of routine care. Data from patients’ first PROMIS measures between June 27, 2018 and April 16, 2019 were extracted and combined with claims data. Using (1) claims data alone and (2) PROMIS and claims data, we examined the association of covariates to utilization (using a logit model) and cost (using a generalized linear model). We evaluated model fit using area under the receiver operating characteristic curve (for unplanned care utilization), akaike information criterion (for unplanned care costs), and sensitivity and specificity in predicting top 15% of unplanned care costs.

Results:
Area under the receiver operating curve values were slightly higher, and akaike information criterion values were similar, for PROMIS plus claims covariates compared with claims alone. The PROMIS plus claims model had slightly higher sensitivity and equivalent specificity compared with claims-only models.

Conclusion:
One-time PROMIS measure data combined with claims data slightly improved predictive model performance compared with claims alone, but likely not to an extent that indicates improved practical utility for payers.