bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resource utilization and outcomes among children risk stratified by pediatric appendicitis risk calculator at a tertiary pediatric center
Authors: Becker Callie R. , Bergmann Kelly R. , Vazquez‐Benitez Gabriela , Bretscher Brianna M. , Kharbanda Anupam B. 
Published: December 2021

AbstractObjectivesAppendicitis is a common pediatric condition requiring surgery. The pediatric appendicitis risk calculator (pARC) was recently developed to guide clinical care. The objective of this study is to describe resource utilization and clinical outcomes among children with appendix ultrasound (US) scans risk stratified by pARC score.MethodsProspective enrolled observational cohort single‐center study of children aged 5–18, who had an US for suspected appendicitis. We estimated the rate of appendicitis, rate of equivocal US scans, and resource utilization by pARC score strata. Total adjusted charges were determined for low‐risk pARC patients compared to discharged emergency department (ED) patients with abdominal pain and complete blood count (CBC) obtained without advanced abdominal imaging.ResultsOver the 13‐month study period, 407 children were enrolled. The overall rate of appendicitis was 33.4%, and 199 (49%) were male. The observed rate of appendicitis was 3.3% in those with a pARC score of <15% and 96.8% in those with a pARC score of ≥85%. Of enrolled patients, 152 (37.3%) had a pARC score <15%. Of those with a pARC score of <15%, the negative appendectomy rate was 28.6%, and the rate of equivocal US was 49.3%. The rate of CT scans and hospitalizations was 19% and 23%, respectively. Median total charges for patients with pARC <15% with usual care were $3756. Median total charges for patients presenting to the ED with abdominal pain who had a CBC but no advanced abdominal imaging performed was $2484, indicating a potential savings of $1272 per patient.ConclusionsThere is a high rate of resource utilization among patients who are low appendicitis risk by pARC score. Outcome variation by pARC scores presents future opportunity to selectively reduce resource utilization in pediatric patients.
Quantitation of phosphatidylethanols in dried blood spots to determine rates of prenatal alcohol exposure in Ontario
Authors: DiBattista Alicia , Ogrel Svetlana , MacKenzie Alex E. , Chakraborty Pranesh 
Published: December 2021

AbstractBackgroundEstimating rates of prenatal alcohol exposure (PAE) in a population is necessary to ensure that proper medical and social supports and interventions are in place. This study sought to estimate PAE in Ontario, Canada by quantifying phosphatidylethanol (PEth) homologues in over 2000 residual neonatal dried blood spots (DBS).MethodsA random selection of 2011 residual DBS collected over a 1‐week time period were anonymized and extracted. A targeted liquid chromatography–mass spectrometry method was used to quantify 1‐palmitoyl‐2‐oleoyl‐sn‐glycero‐3‐phosphoethanol (PEth (16:0/18:1) or POPEth), the clinically accepted biomarker, and six additional PEth homologues. A POPEth level above the United States Drug Testing Laboratories (USDTL) cutoff up to 4 weeks predelivery was indicative of PAE. All PEth homologues were correlated to one another and logistic regression was used to determine the association between PAE status and infant characteristics.ResultsThe estimated rate of PAE in Ontario, up to the last 4 weeks of gestation, was 15.5% (POPEth >28.5 nM). Most PEth homologues were moderately to strongly correlated to one another. A low birth weight and preterm birth were both associated with PAE, while being small for gestational age had lower odds of PAE.ConclusionsThe results of this study suggest that PAE may be more prevalent in Ontario than previous estimates by self‐report or meconium testing. These findings support the need to consider the effectiveness of current interventions and the design of new interventions to address this significant public health issue.
Mild cognitive impairment and fitness to drive: An audit of practice in a driving specialist clinic in Australia
Authors: Spargo Claire , Laver Kate , Adey‐Wakeling Zoe , Berndt Angela , George Stacey 
Published: December 2021

AbstractObjectiveTo describe current practice and outcomes relating to fitness to drive for people with mild cognitive impairment (MCI) attending a specialist driving clinic.MethodsRetrospective medical record audit from a driving fitness assessment clinic at a tertiary medical centre, South Australia, from 2015 to 2019.ResultsOf 100 notes audited, n = 40 had a documented diagnosis of MCI and n = 60 had subjective cognitive concerns characteristic of MCI. Participants mean age was 80.0 years (SD 6.7), and mean Mini‐Mental State Examination score was 26.1 (SD 2.1). Medical practitioners completed a comprehensive initial assessment relating to medical fitness to drive, considering scores from a cognitive assessment battery and non‐cognitive factors (driving history, current driving needs, vision, physical abilities and collateral from family). After the initial assessment, most participants (84%) were referred for a practical on‐road assessment, before receiving a final driving recommendation. Over half of participants continued driving (51%), most with conditions, while 35% ceased driving. Outcomes for the remaining 14% are unknown as we were unable to determine whether the practical assessment (11%) or lessons (3%) were completed.ConclusionsDriving outcomes for people with MCI with questionable driving capabilities are variable, with both cognitive and non‐cognitive factors important in guiding medical fitness to drive recommendations. There is a need for more driving clinics to provide in‐depth assessment for people with MCI who demonstrate uncertain driving capabilities and improved support for decision‐making in other non‐driving specialist settings.
Situating Eden—Culture change in residential aged care: A scoping review
Authors: Larkey Frances Anne 
Published: December 2021

AbstractObjectiveThis review explored the knowledge of the Eden Alternative [Eden] as a well‐being model for aged care and the current research of relationship‐centred care in a residential setting to identify gaps in the literature.MethodsThe search commenced in July 2017 and was updated in January 2020. Eight electronic databases were systematically searched for peer‐reviewed studies published in English between 2000 and 2020. The search revealed 13 papers for final inclusion.ResultsThe Eden model has the potential to reduce loneliness, helplessness and boredom in older people. Implementation requires committed leadership and the inclusion of residents, families and staff in decision‐making.ConclusionsThere remain gaps in the empirical evidence of the benefit of the Eden model. The challenge is for researchers to provide rigorous study design that can evidence well‐being outcomes for residents with complex needs.
Role of epigenetics in parturition and preterm birth
Authors: Li Chunjin , Cao Maosheng , Zhou Xu 
Published: December 2021

AbstractPreterm birth occurs worldwide and is associated with high morbidity, mortality, and economic cost. Although several risk factors associated with parturition and preterm birth have been identified, mechanisms underlying this syndrome remain unclear, thereby limiting the implementation of interventions for prevention and management. Known triggers of preterm birth include conditions related to inflammatory and immunological pathways, as well as genetics and maternal history. Importantly, epigenetics, which is the study of heritable phenotypic changes that occur without alterations in the DNA sequence, may play a role in linking social and environmental risk factors for preterm birth. Epigenetic approaches to the study of preterm birth, including analyses of the effects of microRNAs, long non‐coding RNAs, DNA methylation, and histone modification, have contributed to an improved understanding of the molecular bases of both term and preterm birth. Additionally, epigenetic modifications have been linked to factors already associated with preterm birth, including obesity and smoking. The prevention and management of preterm birth remains a challenge worldwide. Although epigenetic analysis provides valuable insights into the causes and risk factors associated with this syndrome, further studies are necessary to determine whether epigenetic approaches can be used routinely for the diagnosis, prevention, and management of preterm birth.
Identifying epilepsy based on machine‐learning technique with diffusion kurtosis tensor
Authors: Kang Li , Chen Jin , Huang Jianjun , Zhang Tijiang , Xu Jiahui 
Published: December 2021

AbstractIntroductionEpilepsy is a serious hazard to human health. Minimally invasive surgery is an extremely effective treatment to refractory epilepsy currently if the location of epileptic foci is given. However, it is challenging to locate the epileptic foci since a multitude of patients are MRI‐negative. It is well known that DKI (diffusion kurtosis imaging) can analyze the pathological changes of local tissues and other regions of epileptic foci at the molecular level. In this article, we propose a new localization way for epileptic foci based on machine‐learning method with kurtosis tensor in DKI.MethodsWe recruited 59 children with hippocampus epilepsy and 70 age‐ and sex‐matched normal controls; their T1‐weighted images and DKI were collected simultaneously. Then, the hippocampus in DKI is segmented based on a mask as a local brain region, and DKE is utilized to estimate the kurtosis tensor of each subject's hippocampus. Finally, the kurtosis tensor is fed into SVM (support vector machine) to identify epilepsy.ResultsThe classifier produced 95.24% accuracy for patient versus normal controls, which is higher than that obtained with FA (fractional anisotropy) and MK (mean kurtosis). Experimental results show that the kurtosis tensor is a kind of remarkable feature to identify epilepsy, which indicates that DKI images can act as an important biomarker for epilepsy from the view of clinical diagnosis.ConclusionAlthough the classification task for epileptic patients and normal controls discussed in this article did not directly achieve the location of epileptic foci and only identified epilepsy on certain brain region, the epileptic foci can be located with the results of identifying results on other brain regions.
Increasing environmental outcomes with conservation tenders: The participation challenge
Authors: Rolfe John , Schilizzi Steven , Iftekhar Md Sayed 
Published: December 2021

AbstractIncentive payments to landholders have become increasingly popular as mechanisms to achieve conservation goals. Within these mechanisms economists commonly recommend competitive tenders over fixed rate payment schemes because (a) specialist knowledge of landholders about their own enterprises and costs can be utilized, (b) auction prices are more likely to reflect the marginal value of the resources being used to produce the environmental outcome, and (c) the scope for rent seeking is reduced by competition between landholders. Yet there is very little uptake of conservation tenders as agrienvironmental schemes, potentially because of the difficulties in generating sufficient levels of landholder participation to make tenders effective. In this paper we summarize the efficiency benefits of using competitive tenders, analyze reasons why participation rates may be so low, and suggest potential mechanisms to address this.
Extreme citizen science: Lessons learned from initiatives around the globe
Authors: Chiaravalloti Rafael Morais , Skarlatidou Artemis , Hoyte Simon , Badia Marcos Moreu , Haklay Muki , Lewis Jerome 
Published: December 2021

AbstractThe participation of communities living in high conservation value areas is increasingly valued in conservation science and practice, potentially producing multiple positive impacts on both biodiversity and local people. Here, we discuss important steps for implementing a successful extreme citizen science project, based on four case studies from conservation projects with Pantaneiro fishers living in Brazilian Pantanal wetland, Baka hunter‐gatherers and Fang farmers in lowland wet forest in Cameroon, Maasai pastoralists in Kenya, and Ju|'hoansi rangers living in the semiarid deserts of Namibia. We highlight the need for a high level of trust between the target communities and project developers, communities' right to choose the data they will be collecting, and researchers' openness to include new tools that were not initially planned. By following these steps, conservation scientists can effectively create bottom‐up collaborations with those living on the frontlines of conservation through community‐led extreme citizen science.
Association of symptomatic atherosclerotic carotid arteries with plaque areas showing low densities on computed tomographic angiography
Authors: Trandafir Cassiana , Laurent‐Chabalier Sabine , Cosma Catalin , Frandon Julien , Thouvenot Eric , Renard Dimitri 
Published: December 2021

AbstractBackground and purposeIntraplaque hemorrhage is a key feature of vulnerable carotid atherosclerotic plaque (CAP), associated with low densities (<25 Hounsfield units [HU]) on computed tomographic angiography (CTA). This study aimed to analyze CAP on routine CTA performed in patients with symptomatic and asymptomatic carotid stenosis undergoing carotid endarterectomy (CEA) by assessing HU of the CAP area showing the lowest density (CAPALD) using radiological tools available in daily clinical practice, and to compare CAPALD values between symptomatic and asymptomatic carotids.MethodsWe retrospectively screened preoperative CTA scans of 206 consecutive adult patients undergoing CEA for symptomatic or asymptomatic stenosis. CAPALD values were compared between symptomatic and asymptomatic carotids. Asymptomatic carotids included arteries contralateral to the symptomatic CEA artery, and asymptomatic stenotic arteries undergoing CEA and their contralateral arteries. Carotids were excluded when there was <30% stenosis, or when CAP could not be identified or CAPALD could not be measured.ResultsIn total, 95 symptomatic and 112 asymptomatic carotids (derived from 174 patients) were analyzed. In multivariate analysis, symptomatic arteries showed more severe stenosis (median 70% vs. 67%, p = 0.0228) and lower CAPALD values (median 17 vs. 25 HU, p = 0.049), whereas degree of stenosis and CAPALD values were not correlated (rho = −0.02, p = 0.77). HU values of <25 were more frequent in symptomatic than asymptomatic carotids (68% vs. 47%, p = 0.0022).ConclusionsOn CTA, symptomatic carotids are associated with CAP areas with low densities. CTA analysis of CAP may be interesting to help identify vulnerable plaques at risk for future stroke, especially in patients lacking strict indications for CEA based on the current guidelines.
Stepwise changes in morphology during the settlement process in a merobenthic octopus, Octopus sinensis, raised in the laboratory
Authors: Dan Shigeki , Kamei Yoshinori , Takeshima Satoshi , Yamashita Kazuhiro , Hamasaki Katsuyuki 
Published: December 2021

AbstractCephalopoda have no true larval stage because they lack any abrupt morphological changes during growth. However, in shallow‐water merobenthic octopuses, changes occur in the relative proportions of their body parts during the planktonic paralarval phase and the transitional phase from plankton to benthos. How this lifestyle transition is achieved is unclear because the morphological changes during their early life have yet to be fully elucidated. To address this issue, using laboratory‐raised East Asian common octopus, Octopus sinensis, aged 0–100 days after hatching, measurements were taken of total length (TL), mantle length (ML), arm length (AL), the number of suckers on an arm (ASC), and body dry weight (DW). These values were used to explore break points (BPs) in the log‐transformed allometric growth equation: lny = lna + blnx, where x is TL (a reference body dimension) and y is one of the other measurements. In all measurements, a three‐segmented allometric growth model with two BPs was statistically evident, and each segment had a different relative growth coefficient b along with growth, indicating that there are distinct stages of ontogenetic morphological change. Taking into account the times of behavioral changes reported so far, four stepwise phases were detected in the progress of O. sinensis towards settlement: (1) a true planktonic paralarval phase with rapid increase of ASC; (2) a transitional phase between plankton and benthos, characterized by rapid AL increase; (3) a provisional initial benthic juvenile phase, attaining longer AL than ML and approaching adult‐like proportion; and (4) a true benthic juvenile phase, reaching almost completion of the change in body proportion. The stepwise morphological changes seem to be a compromise measure to achieve changes in functional morphology and behavior necessary to lifestyle transition from plankton to benthos for an organism that goes through morphological change without metamorphosis.
Controlled surface crystallization of lithium‐zinc‐alumosilicate glass‐ceramics using thermal poling
Authors: Sander Malte , Engelmann Pawel , Jacobs Philipp , Roos Christian 
Published: December 2021

AbstractTwo glasses from the lithium‐zinc‐alumosilicate (LZAS) glass–ceramic system were thermally poled at 0.5 and 0.9 Tg and subsequently crystallized in heat‐treatment. Underneath the anode‐faced surface of the as‐poled glasses, a lithium depletion layer was found with layer thicknesses up to 15 μm. Between the depletion layer and the bulk, an accumulation of sodium was measured. Structural alterations underneath the anode‐faced and cathode‐faced surfaces of the crystallized glasses were examined using grazing‐incidence X‐ray diffraction and scanning electron microscopy. A mainly amorphous layer was observed on all anode‐faced surfaces, each containing only small amounts of high‐quartz solid solution (high‐quartz s.s.). The low crystalline content was attributed to a reduced lithium content when compared to the untreated reference. Additionally, in one sample a keatite solid solution (keatite s.s.) formed in the anode‐faced surface with its phase content increasing with the poling temperature. The transformation of high‐quartz s.s. to keatite s.s. is facilitated by a silica‐rich glass composition beneath the anode‐faced surface. Underneath the cathode‐faced surface high crystalline contents were obtained, which even exceed the crystalline phase contents found in the untreated reference samples. In combination with an observable larger lattice parameter of the high‐quartz s.s. phase, it could be assumed that Li+ cations enrich at the cathode‐faced surface. The enrichment of Li+ cations on the cathode‐faced and their depletion on the anode‐faced surface lead to different particle sizes. Small grains were observed underneath the amorphous layer in the anode‐faced surface, while larger grains with an overall broader particle size distribution were found on the cathode‐faced surface.
Inhibition of morphological transition and hyphae extension in Candida spp. by occidiofungin
Authors: Kumpakha Rabina , Gordon Donna M. 
Published: December 2021

Abstract

Aims
To assess the efficacy of the antifungal, occidiofungin, against Candida albicans and Candida tropicalis morphological transformation.

Methods and Results
Susceptibility assays and morphological data were used to demonstrate that occidiofungin effectively targets C. albicans and C. tropicalis undergoing morphological transformation. Susceptibility assays found that cell sensitivity to occidiofungin varied with the media conditions used for morphological switching. Microscopy data showed that occidiofungin inhibited hyphae formation when added at the time of morphological induction and hyphal extension when added within the first hour following hyphae induction. Immunoblot analysis demonstrated that occidiofungin addition prevented activation of Cek1p MAPK signalling.

Conclusions
The data indicated that the antimicrobial compound, occidiofungin, effectively targets hyphae elongation in Candida spp. and suggests the biological target of occidiofungin is necessary for the morphological changes associated with yeast-to-hyphae switching.

Significance and Impact of the Study
Findings from this study demonstrated that occidiofungin effectively targets the invasive growth of dimorphic Candida which suggests this compound may also inhibit the heterogenous population of cells present in a clinical setting. This presents occidiofungin as a promising candidate for the treatment of Candida associated infections.
A homeschool‐based cognitive behavioral program to improve adolescent mental health
Authors: Harper Amanda , Brewer Tracy L. 
Published: December 2021

AbstractProblemAnxiety and depression are prevalent in the adolescent population and can have significant consequences. Treatment recommendations are established but rates of utilization remain low, often due to a lack of access to mental health providers. Availability of mental health services in a school‐based setting may increase access, but homeschooled children do not have access to these services. Additionally, the COVID‐19 pandemic has increased the number of homeschooled children and compounded the problem of adolescent mental health disorders.MethodsThis pilot evidence‐based practice project aimed to increase access to cognitive behavioral therapy (CBT) in adolescents. Eight students from a local homeschool cooperative participated in the Creating Opportunities for Personal Empowerment (COPE) program. A Friedman test was used to evaluate median differences on anxiety and depression screening instruments at baseline, program completion, and 1 month after the program. Students also completed an adapted COPE program evaluation.ResultsMedian scores on screening instruments decreased from pre‐COPE to 1 month after, although results were not statistically significant. Students reported that the COPE program was helpful, and they learned new ways to deal with their thoughts, feelings, and behaviors.ConclusionCOPE is a feasible option to increase access to CBT in a homeschool setting.
Study of natural diversity in response to a key pathogenicity regulator of Ralstonia solanacearum reveals new susceptibility genes in Arabidopsis thaliana
Authors: Demirjian Choghag , Razavi Narjes , Desaint Henri , Lonjon Fabien , Genin Stéphane , Roux Fabrice , Berthomé Richard , Vailleau Fabienne 
Published: December 2021

AbstractRalstonia solanacearum gram‐negative phytopathogenic bacterium exerts its virulence through a type III secretion system (T3SS) that translocates type III effectors (T3Es) directly into the host cells. T3E secretion is finely controlled at the posttranslational level by helper proteins, T3SS control proteins, and type III chaperones. The HpaP protein, one of the type III secretion substrate specificity switch (T3S4) proteins, was previously highlighted as a virulence factor on Arabidopsis thaliana Col‐0 accession. In this study, we set up a genome‐wide association analysis to explore the natural diversity of response to the hpaP mutant of two A. thaliana mapping populations: a worldwide collection and a local population. Quantitative genetic variation revealed different genetic architectures in both mapping populations, with a global delayed response to the hpaP mutant compared to the GMI1000 wild‐type strain. We have identified several quantitative trait loci (QTLs) associated with the hpaP mutant inoculation. The genes underlying these QTLs are involved in different and specific biological processes, some of which were demonstrated important for R. solanacearum virulence. We focused our study on four candidate genes, RKL1, IRE3, RACK1B, and PEX3, identified using the worldwide collection, and validated three of them as susceptibility factors. Our findings demonstrate that the study of the natural diversity of plant response to a R. solanacearum mutant in a key regulator of virulence is an original and powerful strategy to identify genes directly or indirectly targeted by the pathogen.