bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel uniquely ovary-expressed insulin-like receptor in the female prawn, Macrobrachium rosenbergii (Decapoda, Palaemonidae)
Authors: Xu Hai-Jing , Li Jian-Wen , Chen Yi-Lai , Yang Jin-Shu , Ma Wen-Ming , Qian Guo-Ying 
Published: March 2021

Abstract
The insulin signalling pathway is one of the most studied pathways, including ovary maturation and female reproduction. However, downstream elements involved in this cascade remain unknown. Here, we identified and characterized an insulin-like receptor (IR) in female Macrobrachium rosenbergii, and named as Mro-IR. The deduced Mro-IR contained conserved domains of IR proteins, including two ligand-binding domains, a furin-like domain, two fibronectin-3 domains, a transmembrane domain and an intracellular tyrosine kinase domain in order. Multiple sequence alignment of the first ligand-binding domain and the tyrosine kinase domain in Mro-IR revealed a high degree of similarity to other representative IRs. Mro-IR was clustered into a separate branch with IRs from decapods by phylogenetic analysis. Additionally, tissue distribution analysis showed that Mro-IR was uniquely expressed in the ovary of M. rosenbergii. This study would possibly provide a new highlight to the molecular mechanism of insulin-like signalling cascade, regulating female sexual differentiation in crustaceans.
The Case for Mom and Dad
Authors: Sullins D. Paul 
Published: March 2021

Is the system of norms comprising traditional, natural marriage—featuring formally enacted, irrevocable, exclusive man/woman sexual union preceded by chastity—essential for children’s development and well-being, as Catholic teaching asserts? Review of an extensive body of diverse research finds that, compared to children continuously living with two parents, married parents, or their own biological parents, children in other family arrangements consistently experience lower emotional well-being, physical health, and academic achievement. Competing research has variously attributed this difference to a lack of married parents, two parents, complementary man/woman parents, or family stability, but these possibilities have not previously been studied in combination. To address this question, family structure differences and determinants of child well-being (reverse coded to show child distress) were examined using the 2008–2018 National Health Interview Surveys ( n = 82,635). Adjusted odds ratios (AOR) for child emotional problems were higher with less than two parents (AOR = 1.42, 95% CI 1.27–1.56), unmarried parents (1.46, 95% CI 1.31–1.61), unstable parents (1.55, 95% CI 1.27–1.76), or less than two biological parents (AOR = 1.70, 95% CI 1.55–2.87 for one biological parent; 4.77, 95% CI 3.95–5.77 for no biological parents). When combined in the same model, only the lack of joint biological parentage accounted for higher distress, with outcomes significantly worse without the biological father than without the biological mother (interaction AOR = 1.33, 95% CI 1.04–1.71). This evidence strongly supports the claim that maximum child development occurs only in the persistent care of both of the child’s own biological parents. Marriage benefits children primarily by ensuring such care. Implications are discussed. Summary: Children raised apart from the care of both natural parents consistently experience lower developmental outcomes. Traditional, religious marriage norms—a lifelong, exclusive sexual union between man and woman—benefit children by establishing strong conditions that promote such care. More than any other family arrangement, marriage assures to children the care of their own mom and dad.
Community Versus Hospital Opioid-Related Overdose Deaths in Illinois
Authors: Feinglass Joe , Walker Garth , Khazanchi Rushmin , Rydland Kelsey , Tessier Robert Andrew , Mason Maryann 
Published: March 2021

Objective To better understand approaches to reducing mortality from the opioid epidemic, we analyzed in-hospital versus community opioid-related overdose deaths in Illinois. Methods We used data from the Statewide Unintentional Drug Overdose Reporting System (July 2017 through December 2018) to identify deaths that occurred in hospitals and communities (ie, homes or public spaces). We used census tract–level data for 34 Illinois counties to create bivariate mapping by overdose death rates. We used logistic regression to analyze the association of demographic and overdose characteristics with the likelihood of death in a hospital versus a community. Results During the study period, 2833 opioid-related overdose deaths occurred in 24 Illinois counties, 655 (23.1%) of which occurred in the hospital; of 2178 community deaths, 1888 (86.7%) occurred in the same census tract as the decedent’s recorded residence and 1285 (59.0%) occurred in the decedent’s home. Non-Hispanic Black people were 1.63 (95% CI, 1.27-2.10) times more likely than non-Hispanic White people to die in a hospital. Decedents from suburban Cook County and other Chicago suburban counties were significantly more likely to die in the hospital than decedents from Chicago or other Illinois counties. Documentation of a previous overdose, history of opioid use, and having bystanders present were significantly associated with hospital deaths. Evidence of a rapid overdose, fentanyl present, or prescription opioids were significantly associated with deaths in a community. Conclusions The high number of opioid-related overdose deaths in the community illustrates the need to decriminalize illicit drug use and facilitate treatment seeking. Establishing supervised safe consumption sites may have the biggest effect in reducing the number of opioid-related overdose deaths.
Very rare case of Graves’ disease with resistance to methimazole: a case report and literature review
Authors: Mori Yusaku , Hiromura Munenori , Terasaki Michishige , Kushima Hideki , Ohara Makoto , Fukui Tomoyasu , Takahashi Yasuyoshi , Yamagishi Sho-ichi 
Published: March 2021

Background Methimazole (MMI) is used to treat hyperthyroidism in Graves’ disease. It is rare to encounter patients in whom hyperthyroidism cannot be controlled using high doses of MMI. Case presentation: A 21-year-old woman was referred to our hospital because of MMI-resistant Graves’ disease. Although her MMI dose had been increased to 120 mg/day, her serum thyroid hormone concentration was too high to be measured. Additional therapy with lithium carbonate, and then with dexamethasone and inorganic iodine, was initiated. After 14 days, the patient’s serum thyroid hormone concentration normalized, while she was taking 150 mg/day MMI, 800 mg/day lithium carbonate, 6 mg/day dexamethasone and 306 mg/day inorganic iodine, and total thyroidectomy was then performed. The patient was discharged 8 days after the thyroidectomy and experienced no major complications. Conclusions We have presented a rare case of Graves’ disease that was resistant to high-dose MMI. Combination therapy of MMI with lithium carbonate, dexamethasone and inorganic iodine may represent a therapeutic option for the preoperative preparation of patients with MMI-resistant Graves’ disease.
Differences between diabetic and non-diabetic nephropathy patients in cardiac structure and function at the beginning of hemodialysis and their impact on the prediction of mortality
Authors: Tang Chao , Ouyang Han , Huang Jian , Zhu Jing , Gu Xiaosong 
Published: March 2021

Objectives To characterize differences in cardiac structure and function in hemodialysis (HD) patients with diabetic nephropathy (DN) and in those without using echocardiography and to determine their impact on the prediction of mortality using echocardiographic parameters. Methods Clinical, laboratory, and echocardiographic data were collected from patients commencing HD. Results Compared with those without DN, patients with DN had lower peak velocity of the early diastolic wave (e′), larger left atria, and higher peak early diastolic velocity (E)/e′ and peak velocity of tricuspid regurgitation (TR). In addition, a larger proportion of DN patients had a combination of left ventricular (LV) diastolic dysfunction, cardiac valve calcification, moderate-to-severe cardiac valve regurgitation (CVR), and at least moderate pericardial effusion (PE). After accounting for age, sex, smoking, hypertension, hemoglobin, and albumin, DN was responsible for e′  < 10 cm/s, E/e′ >13 m/s, TR >2.8 m/s, LV diastolic dysfunction, CVR, and PE. LV diastolic dysfunction and E/e′ >13 were the most useful predictors of mortality in patients with DN. Conclusions Patients with DN who undergo HD tend to have worse LV diastolic function and are more likely to have heart valve problems. LV diastolic dysfunction and E/e′ are predictors of death in DN patients.
Family Matters in Ontario: Understanding and Addressing Homelessness Among Newcomer Families in Canada
Authors: Forchuk Cheryl , Russell Gordon , Richardson Jan , Perreault Chantele , Hassan Heba , Lucyk Bryanna , Gyamfi Sebastian 
Published: March 2021

Background Canada, a key player in global humanitarian affairs is faced with enormous challenges in relation to housing and homelessness. As international migration continues to occur, homelessness among immigrant families is increasing worldwide; a situation that needs urgent attention and action. Purpose We designed this study to explore the needs of homeless families, identify risk factors associated with family homelessness, and to find strategies that could assist in mitigating and preventing homelessness among families in Canada. Methods This paper reports qualitative findings from a focused ethnographic study embedded in participatory action research that explored the experiences of 11 immigrant families with housing challenges in Ontario Canada. Results Thematic analysis yielded five (5) major themes: life challenges; lack of understanding of the system; difficulty with conflict resolution; escaping as a solution for hardship; and reducing immigrant family homelessness. Conclusion Findings from the study highlight the urgent need for advocacy and a well-tailored supportive housing policy to address family homelessness in Ontario.
Head circumference trajectory in children with perinatal stroke
Authors: Leong Amanda , Floer Amalia , Kirton Adam , Mineyko Aleksandra 
Published: March 2021

Background: Perinatal stroke is a leading cause of hemiparetic cerebral palsy and lifelong disability. Neurodevelopmental outcomes are difficult to predict and markers of long-term poor outcome continue to be investigated. Deceleration in growth of head circumference has been associated with worse developmental outcomes in neonatal brain injury. We hypothesized that perinatal stroke would result in decreased rates of head growth during childhood that would be associated with worse developmental outcomes. Methods: Patients with magnetic resonance imaging (MRI)–confirmed neonatal arterial ischemic stroke and arterial presumed perinatal ischemic stroke were identified from a population-based research cohort (Alberta Perinatal Stroke Project). Demographics and occipital-frontal circumference data were collected from medical records. Head growth was compared to typically developing control charts using a 2-tailed t test. The Fisher exact test was used to examine associations between Pediatric Stroke Outcome Measures (PSOM) scores and occipital-frontal head circumference. Results: Three hundred fifteen occipital-frontal head circumference measurements were collected from 102 patients (48 female, 54 male), over a median of 3.2 years (standard deviation = 5.18, range = 0-18.3). After 3 months for female patients and 1 year for male patients, occipital-frontal head circumference deviated and remained below normal growth trajectories ( P < .05) with a large effect size (Cohen d >0.8). Poor outcome (PSOM ≥ 1) was associated with smaller occipital-frontal head circumference ( P < .05). Conclusion: Head growth deceleration is observed in children with perinatal arterial ischemic stroke and is associated with poor outcome. Head circumference may be a tool to alert clinicians to the potential of abnormal neurologic outcome.
Selection of patients for large mailed fecal immunochemical test colorectal cancer screening outreach programs: A systematic review
Authors: Wang Andrew , Lee Briton , Patel Shreya , Whitaker Evans , Issaka Rachel B , Somsouk Ma 
Published: March 2021

Objective Digital health care offers an opportunity to scale and personalize cancer screening programs, such as mailed outreach for colorectal cancer (CRC) screening. However, studies that describe the patient selection strategy and process for CRC screening are limited. Our objective was to evaluate implementation strategies for selecting patients for CRC screening programs in large health care systems. Methods We conducted a systematic review of 30 studies along with key informant surveys and interviews to describe programmatic implementation strategies for selecting patients for CRC screening. PubMed and Embase were searched since inception through December 2018, and hand searches were performed of the retrieved reference lists but none were incorporated ( n = 0). No language exclusions were applied. Results Common criteria for outreach exclusion included: being up-to-date with routine CRC screening ( n = 22), comorbidities ( n = 20), and personal history ( n = 22) or family history of cancer ( n = 9). Key informant surveys and interviews were performed ( n = 28) to understand data sources and practices for patient outreach selection, and found that 13 studies leveraged electronic medical care records, 10 studies leveraged a population registry (national, municipal, community, health), 4 studies required patient opt-in, and 1 study required primary care provider referral. Broad ranges in fecal immunochemical test completion were observed in community clinic ( n = 8, 31.0–59.6%), integrated health system ( n = 5, 21.2–82.7%), and national regional CRC screening programs ( n = 17, 23.0–64.7%). Six studies used technical codes, and four studies required patient self-reporting from a questionnaire to participate. Conclusion This systematic review provides health systems with the diverse outreach practices and technical tools to support efforts to automate patient selection for CRC screening outreach.
Systematic Review of the Long-Term Effects of Presurgical Orthopedic Devices on Patient Outcomes
Authors: Garland Katie , McNeely Brendan , Dubois Luc , Matic Damir 
Published: March 2021

Objective: To perform a systematic review of the literature to identify the long-term effects of presurgical orthopedic (PSO) device use on patient outcomes. Design: A comprehensive literature review of Embase and Ovid databases was performed to identify all English-language publications related to unilateral cleft lip and palate, presurgical devices, and patient outcomes. Studies were excluded if they did not report patient outcomes beyond 2 years of age, did not describe the use of a PSO device, were case reports (n < 10), or were purely descriptive studies. Main Outcome Measures: Reported patient outcomes following the use of PSO devices. Results: Following a review of all articles by 2 independent reviews, 30 articles were selected for inclusion. Overall, there was no reported consensus as to the long-term effects of PSO devices. Furthermore, this study identified that only 10% of published research controlled for confounding factors that could influence the reported results. Confounding factors that were identified included different operating surgeon, different surgical protocols, and different rates of revision surgeries. Conclusions: Overall, this systematic review identified 2 important conclusions. Firstly, there is no consensus in the literature about the long-term effects of PSO devices on long-term patient outcomes. Secondly, research in this domain is limited by confounding factors that influence the applicability of the reported results.
Prediction of Drug-Induced Long QT Syndrome Using Machine Learning Applied to Harmonized Electronic Health Record Data
Authors: Simon Steven T. , Mandair Divneet , Tiwari Premanand , Rosenberg Michael A. 
Published: March 2021

Background: Drug-induced QT prolongation is a potentially preventable cause of morbidity and mortality, however there are no widespread clinical tools utilized to predict which individuals are at greatest risk. Machine learning (ML) algorithms may provide a method for identifying these individuals, and could be automated to directly alert providers in real time. Objective: This study applies ML techniques to electronic health record (EHR) data to identify an integrated risk-prediction model that can be deployed to predict risk of drug-induced QT prolongation. Methods: We examined harmonized data from the UCHealth EHR and identified inpatients who had received a medication known to prolong the QT interval. Using a binary outcome of the development of a QTc interval >500 ms within 24 hours of medication initiation or no ECG with a QTc interval >500 ms, we compared multiple machine learning methods by classification accuracy and performed calibration and rescaling of the final model. Results: We identified 35,639 inpatients who received a known QT-prolonging medication and an ECG performed within 24 hours of administration. Of those, 4,558 patients developed a QTc > 500 ms and 31,081 patients did not. A deep neural network with random oversampling of controls was found to provide superior classification accuracy (F1 score 0.404; AUC 0.71) for the development of a long QT interval compared with other methods. The optimal cutpoint for prediction was determined and was reasonably accurate (sensitivity 71%; specificity 73%). Conclusions: We found that deep neural networks applied to EHR data provide reasonable prediction of which individuals are most susceptible to drug-induced QT prolongation. Future studies are needed to validate this model in novel EHRs and within the physician order entry system to assess the ability to improve patient safety.
Low concentration atropine combined with orthokeratology in the treatment of axial elongation in children with myopia: A meta-analysis
Authors: Yang Ning , Bai Junxing , Liu Li 
Published: March 2021

Objective: To evaluate the effect of low concentration atropine combined with Orthokeratology (OK) lens compared with the OK lens on the changes of axial length in children with moderate and low myopia by meta-analysis. Methods: Databases such as PubMed, Web of Science, Embase, and Cochrane Library were comprehensively searched to collect related studies on atropine combined with the OK lens in the treatment of children with moderate and low myopia. The retrieval time was from the establishment of the database to December 2020. The standardized mean difference (SMD) and its 95% confidence interval (CI) were selected as the effect to analyze the changes of the axial length of the eye axis in children with low and moderate myopia treated with low concentration atropine combined with OK lens. Results: A total of eight articles were included in this study. Compared with OK lens treatment, low concentration atropine combined with the OK lens significantly slowed down the axial elongation of low and moderate myopia, SMD = −0.68(95% CI: −0.86–−0.50, p < 0.05). According to the subgroup analysis of treatment time, when the treatment time was less than or equal to 6 months, SMD = −0.63(95% CI: −0.88–−0.37, p < 0.05), when the treatment time was 1 year, SMD = −0.76(95% CI: −1.08–−0.43, p < 0.05), and when the treatment time was 2 years, SMD = −0.69(95% CI: −1.07–−0.31, p < 0.05). Conclusion: Low concentration atropine combined with the OK lens is more effective than the OK lens in the treatment of children with low to moderate myopia in reducing axial elongation.
The cerebellum and its network: Disrupted static and dynamic functional connectivity patterns and cognitive impairment in multiple sclerosis
Authors: Schoonheim Menno M , Douw Linda , Broeders Tommy AA , Eijlers Anand JC , Meijer Kim A , Geurts Jeroen JG 
Published: March 2021

Background: The impact of cerebellar damage and (dys)function on cognition remains understudied in multiple sclerosis. Objective: To assess the cognitive relevance of cerebellar structural damage and functional connectivity (FC) in relapsing-remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS). Methods: This study included 149 patients with early RRMS, 81 late RRMS, 48 SPMS and 82 controls. Cerebellar cortical imaging included fractional anisotropy, grey matter volume and resting-state functional magnetic resonance imaging (MRI). Cerebellar FC was assessed with literature-based resting-state networks, using static connectivity (that is, conventional correlations), and dynamic connectivity (that is, fluctuations in FC strength). Measures were compared between groups and related to disability and cognition. Results: Cognitive impairment (CI) and cerebellar damage were worst in SPMS. Only SPMS showed cerebellar connectivity changes, compared to early RRMS and controls. Lower static FC was seen in fronto-parietal and default-mode networks. Higher dynamic FC was seen in dorsal and ventral attention, default-mode and deep grey matter networks. Cerebellar atrophy and higher dynamic FC together explained 32% of disability and 24% of cognitive variance. Higher dynamic FC was related to working and verbal memory and to information processing speed. Conclusion: Cerebellar damage and cerebellar connectivity changes were most prominent in SPMS and related to worse CI.
Sex, Race, Insurance, and Pain: Do Patient Sociodemographics Influence Postoperative Opioid Prescriptions Among Hand Surgeons?
Authors: Peck Connor J. , Carney Martin , Chiu Alexander , Park Kitae E. , Prassinos Alexandre , Allam Omar , Thomson J. Grant , Prsic Adnan 
Published: March 2021

Background: Social and demographic factors may influence patient treatment by physicians. This study analyzes the influence of patient sociodemographics on prescription practices among hand surgeons. Methods: We performed a retrospective analysis of all hand surgeries (N = 5278) at a single academic medical center from January 2016 to September 2018. The average morphine milligram equivalent (MME) prescribed following each surgery was calculated and then classified by age, race, sex, type of insurance, and history of substance use or chronic pain. Multivariate linear regression was used to compare MME among groups. Results: Overall, patients with a history of substance abuse were prescribed 31.2 MME more than those without ( P < .0001), and patients with a history of chronic pain were prescribed 36.7 MME more than those without ( P < .0001). After adjusting for these variables and the type of procedure performed, women were prescribed 11.2 MME less than men ( P = .0048), and Hispanics were prescribed 16.6 MME more than whites ( P = .0091) overall. Both Hispanic and black patients were also prescribed more than whites following carpal tunnel release (+19.0 and + 20.0 MME, respectively; P < .001). Patients with private insurance were prescribed 24.5 MME more than those with Medicare ( P < .0001), but 25.0 MME less than those with Medicaid ( P < .0001). There were no differences across age groups. Conclusions: Numerous sociodemographic factors influenced postoperative opioid prescription among hand surgeons at our institution. These findings highlight the importance of establishing more uniform, evidence-based guidelines for postoperative pain management, which may help minimize subjectivity and prevent the overtreatment or undertreatment of pain in certain patient populations.