bluuebunny/crossref_metadata_2025_split huggingface dataset:
High concentrations of illicit stimulants and cutting agents cause false positives on fentanyl test strips
Authors: Lockwood Tracy-Lynn E. , Vervoordt Alexandra , Lieberman Marya 
Published: March 2021

Abstract
Background
The opioid epidemic has caused an increase in overdose deaths which can be attributed to fentanyl combined with various illicit substances. Drug checking programs have been started by many harm reduction groups to provide tools for users to determine the composition of their street drugs. Immunoassay fentanyl test strips (FTS) allow users to test drugs for fentanyl by either filling a baggie or cooker with water to dissolve the sample and test. The antibody used in FTS is very selective for fentanyl at high dilutions, a characteristic of the traditional use of urine testing. These street sample preparation methods can lead to mg/mL concentrations of several potential interferents. We tested whether these concentrated samples could cause false positive results on a FTS.

Methods
20 ng/mL Rapid Response FTS were obtained from BTNX Inc. and tested against 4 different pharmaceuticals (diphenhydramine, alprazolam, gabapentin, and naloxone buprenorphine) and 3 illicit stimulants [cocaine HCl, methamphetamine, and 3,4-methylenedioxymethamphetamine (MDMA)] in concentrations from 20 to 0.2 mg/mL. The FTS testing pad is divided into 2 sections: the control area and the test area. Control and test area signal intensities were quantified by ImageJ from photographs of the test strips and compared to a threshold set by fentanyl at the FTS limit of detection.

Results
False positive results indicating the presence of fentanyl were obtained from samples of methamphetamine, MDMA, and diphenhydramine at concentrations at or above 1 mg/mL. Diphenhydramine is a common cutting agent in heroin. The street sample preparation protocols for FTS use suggested by many online resources would produce such concentrations of these materials. Street samples need to be diluted more significantly to avoid interference from potential cutting agents and stimulants.

Conclusions
Fentanyl test strips are commercially available, successful at detecting fentanyl to the specified limit of detection and can be a valuable tool for harm reduction efforts. Users should be aware that when drugs and adulterants are in high concentrations, FTS can give a false positive result.
Determination of wheat spike and spikelet architecture and grain traits using X-ray Computed Tomography imaging
Authors: Zhou Hu , Riche Andrew B. , Hawkesford Malcolm J. , Whalley William R. , Atkinson Brian S. , Sturrock Craig J. , Mooney Sacha J. 
Published: March 2021

Abstract
Background
Wheat spike architecture is a key determinant of multiple grain yield components and detailed examination of spike morphometric traits is beneficial to explain wheat grain yield and the effects of differing agronomy and genetics. However, quantification of spike morphometric traits has been very limited because it relies on time-consuming manual measurements.

Results
In this study, using X-ray Computed Tomography imaging, we proposed a method to efficiently detect the 3D architecture of wheat spikes and component spikelets by clustering grains based on their Euclidean distance and relative positions. Morphometric characteristics of wheat spikelets and grains, e.g., number, size and spatial distribution along the spike can be determined. Two commercial wheat cultivars, one old, Maris Widgeon, and one modern, Siskin, were studied as examples. The average grain volume of Maris Widgeon and Siskin did not differ, but Siskin had more grains per spike and therefore greater total grain volume per spike. The spike length and spikelet number were not statistically different between the two cultivars. However, Siskin had a higher spikelet density (number of spikelets per unit spike length), with more grains and greater grain volume per spikelet than Maris Widgeon. Spatial distribution analysis revealed the number of grains, the average grain volume and the total grain volume of individual spikelets varied along the spike. Siskin had more grains and greater grain volumes per spikelet from spikelet 6, but not spikelet 1–5, compared with Maris Widgeon. The distribution of average grain volume along the spike was similar for the two wheat cultivars.

Conclusion
The proposed method can efficiently extract spike, spikelet and grain morphometric traits of different wheat cultivars, which can contribute to a more detailed understanding of the sink of wheat grain yield.
The most appropriate titanium mesh cage size for anterior spinal reconstruction after single-level lumbar total en bloc spondylectomy: a finite element analysis and cadaveric validation study
Authors: Paholpak Permsak , Sirichativapee Winai , Wisanuyotin Taweechok , Kosuwon Weerachai , Kasai Yuichi , Murakami Hideki 
Published: March 2021

AbstractPurposeThere is little information available regarding the cage diameter that can provide the most rigid construct reconstruction after total en bloc spondylectomy (TES). The aim of this study was thus to determine the most appropriate titanium mesh cage diameter for reconstruction after spondylectomy.MethodsA finite element model of the single level lumbar TES was created. Six models of titanium mesh cage with diameters of 1/3, 1/2, 2/3, 3/4, 4/5 of the caudad adjacent vertebra, and 1/1 of the cephalad vertebra were tested for construct stiffness. The peak von Mises stress (MPa) at the failure point and the site of failure were measured as outcomes. A cadaveric validation study also conducted to validate the finite element model.ResultsFor axial loading, the maximum stress points were at the titanium mesh cage, with maximum stress of 44,598 MPa, 23,505 MPa, 23,778 MPa, and 16,598 MPa, 10,172 MPa, 10,805 MPa in the 1/3, 1/2, 2/3, 3/4, 4/5, and 1/1 diameter model, respectively. For torsional load, the maximum stress point in each of the cages was identified at the rod area of the spondylectomy site, with maximum stress of 390.9 MPa (failed at 4459 cycles), 141.35 MPa, 70.098 MPa, and 88.972 MPa, 42.249 MPa, 15.827 MPa, respectively. A cadaveric validation study results were coincided with the finite element model results.ConclusionThe most appropriate mesh cage diameter for reconstruction is 1/1 the diameter of the lower endplate of the adjacent cephalad vertebra, due to its ability to withstand both axial and torsional stress. According to the difficulty of large size cage insertion, a cage diameter of more than half of the upper endplate of the caudad vertebrae is acceptable in term of withstand stress. A cage diameter of 1/3 is unacceptable for reconstruction after total en bloc spondylectomy.
The interoperability between the Spanish version of the International Classification of Diseases and ORPHAcodes: towards better identification of rare diseases
Authors: Rico Juan , Echevarría-González de Garibay Luis Javier , García-López María , Guardiola-Vilarroig Sandra , Maceda-Roldán Luis Alberto , Zurriaga Óscar , Cavero-Carbonell Clara 
Published: March 2021

Abstract
Background
Rare diseases present a wide spectrum of clinical manifestations and severity levels and are often poorly known and underrepresented, making them difficult to classify. Diagnoses are usually coded using the International Classification of Diseases (ICD), with its different versions. In Spain, the ICD-10-ES (stem from the ICD-10-CM–Clinical Modification) is used throughout the National Healthcare System since 2016, indistinctively including rare diseases that often lack a specific code. Orphanet aims to provide high-quality resources on rare diseases. The goal was to interrelate the Orphanet classification with the ICD-10-ES in order to engage a tool to track rare diseases diagnosis and characterize the improvement space for the identification of rare diseases patients in the Spanish Healthcare System.

Methods
5775 disorder level ORPHAcodes were mapped to ICD-10-ES codes by comparing the descriptors associated in both classifications. ORPHAcodes were then clustered based on their assigned ICD-10-ES chapter and the redundancy of each individual ICD-10-ES code was calculated by counting the ORPHAcodes they mapped to. Three groups were established: Group 1 (1 ORPHAcode per ICD-10-ES), Group 2 (between 2–49 ORPHAcodes per ICD-10-ES) and Group 3 (≥ 50 ORPHAcodes per ICD-10-ES).

Results
Equivalences to 1700 ICD-10-ES codes were established for 5664 ORPHAcodes. The ORPHAcodes distribution within the ICD-10-ES showed an aggregation in the “Q” (> 40%), “G” (> 14%), and “E” (12%) chapters. The availability of ICD-10-ES codes to map ORPHAcodes reached its lowest at the “G” and “Q” chapters with less than 0.2 ICD-10-ES codes available per ORPHAcode. Global ICD-10-ES codes redundancy analysis revealed that only 1055 of the equivalences pertain to group 1. Group 2 contained 3358 equivalences with 634 ICD-10-ES codes while 1322 equivalences were group 3 (11 ICD-10-ES). Within ICD-10-ES chapters, “G” and “Q” contained over 30% and 45% of their own equivalences in the highest redundancy level (group 3) respectively, but under 10% one to one equivalences each (group 1).

Conclusions
ICD-10-ES codes have not enough specificity to identify rare diseases. Direct mapping between ICD and ORPHAcodes or the integration of ORPHAcodes at the healthcare system for diagnoses codification would enable better detection and epidemiological analysis of rare diseases.
Genetic risk score for ovarian cancer based on chromosomal-scale length variation
Authors: Toh Christopher , Brody James P. 
Published: March 2021

Abstract
Introduction
Twin studies indicate that a substantial fraction of ovarian cancers should be predictable from genetic testing. Genetic risk scores can stratify women into different classes of risk. Higher risk women can be treated or screened for ovarian cancer, which should reduce ovarian cancer death rates. However, current ovarian cancer genetic risk scores do not work that well. We developed a genetic risk score based on variations in the length of chromosomes.

Methods
We evaluated this genetic risk score using data collected by The Cancer Genome Atlas. We synthesized a dataset of 414 women who had ovarian serous carcinoma and 4225 women who had no form of ovarian cancer. We characterized each woman by 22 numbers, representing the length of each chromosome in their germ line DNA. We used a gradient boosting machine to build a classifier that can predict whether a woman had been diagnosed with ovarian cancer.

Results
The genetic risk score based on chromosomal-scale length variation could stratify women such that the highest 20% had a 160x risk (95% confidence interval 50x-450x) compared to the lowest 20%. The genetic risk score we developed had an area under the curve of the receiver operating characteristic curve of 0.88 (95% confidence interval 0.86–0.91).

Conclusion
A genetic risk score based on chromosomal-scale length variation of germ line DNA provides an effective means of predicting whether or not a woman will develop ovarian cancer.
A study protocol for a randomized controlled trial of an anti-inflammatory nutritional intervention in patients with fibromyalgia
Authors: Silva Ana Rita , Bernardo Alexandra , de Mesquita Maria Fernanda , Vaz Patto José , Moreira Pedro , Silva Maria Leonor , Padrão Patrícia 
Published: March 2021

Abstract
Background
This study aims to analyze the effects of a potentially anti-inflammatory nutritional intervention in disease assessment parameters, inflammatory markers, and quality of life of fibromyalgia (FM) patients.

Methods
A sample of 100 female patients diagnosed with FM, followed up at Portuguese Institute of Rheumatology (IPR) in Lisbon, is being randomly allocated in two groups. Patients in the intervention group are adopting an anti-inflammatory diet, characterized by the exemption of the intake of foods containing gluten, dairy, sugar, and ultra-processed foods, during 3 months. During the first month, a low fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) diet is implemented, along with the anti-inflammatory diet, followed by the reintroduction of all fruits and vegetables over a consecutive period of 2 months. Patients in the control group are adopting a diet based on general recommendations for healthy eating. The outcomes are pain, fatigue, quality of sleep, quality of life, gastrointestinal symptoms, and inflammation. Before and after the 3 months intervention, and also 1 month after beginning the intervention, the following questionnaires are applied: Revised Fibromyalgia Impact Questionnaire, visual analog pain scale, Brief Pain Inventory,visual analog scale from a list of common gastrointestinal and extraintestinal symptoms in FM, Short Form 36, Fatigue Severity Survey, and Pittsburg Sleep Quality Index. Ultra-sensitive serum C-reactive protein, eritrocyte sedimentation rate, and interleukin-8 are determined. Age, physical activity, anthropometric parameters, and body composition are being collected. Student’s t test will assess the association between the disease evaluation parameters, the inflammatory markers, and the dietary interventions.

Discussion
The results of this study are expected to determine whether a change in patient nutrition helps to alleviate symptoms, which would optimize medical intervention.

Trial registration
www.ClinicalTrials.gov NCT04007705. Registered on July 5, 2019.
Evaluation of microscopy, serology, circulating anodic antigen (CAA), and eosinophil counts for the follow-up of migrants with chronic schistosomiasis: a prospective cohort study
Authors: Tamarozzi Francesca , Ursini Tamara , Hoekstra Pytsje T. , Silva Ronaldo , Costa Cecilia , Gobbi Federico , Monteiro Gerardo B. , Motta Leonardo , van Dam Govert J. , Corstjens Paul L. , van Lieshout Lisette , Buonfrate Dora 
Published: March 2021

Abstract
Background
An accurate test for the diagnosis and post-treatment follow-up of patients with schistosomiasis is needed. We assessed the performance of different laboratory parameters, including the up-converting reporter particle technology lateral flow assay to detect circulating anodic antigen (UCP-LF CAA), for the post-treatment follow-up of schistosomiasis in migrants attending a dedicated outpatient clinic in a non-endemic country.

Methods
Routine anti-Schistosoma serology results and eosinophil counts were obtained of patients with positive urine/stool microscopy and/or PCR (confirmed cases) or only positive serology (possible cases), and at least one follow-up visit at 6 (T6) or 12 (T12) months after praziquantel treatment. All sera samples were tested with the UCP-LF CAA assay.

Results
Forty-eight patients were included, 23 confirmed and 25 possible cases. The percentage seropositivity and median antibody titers did not change significantly during follow-up. UCP-LF CAA was positive in 86.9% of confirmed and 20% of possible cases. The percentage positivity and median CAA levels decreased significantly post-treatment, with only two patients having positive CAA levels at T12.

Conclusions
The UCP-LF CAA assay proved useful for the diagnosis of active infection with Schistosoma spp. and highly valuable for post-treatment monitoring in migrants, encouraging the development of a commercial test.

Graphical Abstract
Direct detection of Helicobacter pylori from biopsies of patients in Lagos, Nigeria using real-time PCR—a pilot study
Authors: Ajayi A. , Jolaiya T. , Smith S. I. 
Published: March 2021

AbstractObjectivePrompt diagnosis ofHelicobacter pyloriinfection is essential for proper treatment and eradication of the pathogen because prolonged infection could lead to gastric cancer. Sensitive and cost effective diagnostic methods are key to guiding treatment options that will reduce mortality. This study was aimed at detectingH. pylorifrom biopsies of peptic ulcer patients. Real-time PCR using TaqMan and EvaGreen assays targeting 16S rRNA andureAgenes were used to detectH. pyloriDNA extracted from 40 biopsy samples comprising 20 biopsies obtained from the antrum and 20 from the corpus of 20 patients undergoing endoscopy for duodenal ulcer investigation in Lagos, Nigeria.ResultsH. pyloriwas detected in 80% of the biopsy samples by combined cycle threshold (Ct) and melting temperature (Tm) values. MeanCtvalue forureAgene ranged from 21.40 to 37.53 and 22.71 to 35.44 for16SrRNAgene. Average melting temperatures (Tm) of 81.57 and 82.90 °C among amplicons ofureAand 16S rRNA were observed respectively.H. pyloriDNA was generally detected in biopsies collected from antrum and corpus. Real-time PCR in the diagnosis ofH. pylorican be considered a simple, low cost and efficient alternative or addition to the gold standard.
Prevalence of adult eczema, hay fever, and asthma, and associated risk factors: a population-based study in the northern Grassland of China
Authors: Wang Xiaoyan , Zhuang Yan , Chen Yanlei , Wang Hongtian , Wang Xueyan 
Published: March 2021

Abstract
Background
There has been research about the prevalence and risk factors of eczema, hay fever, and asthma in children, but little is known about these conditions in adults in China.

Objectives
To explore the prevalence of adult eczema/atopic dermatitis (AD) and its risk factors in northern China.

Methods
A cluster sampling randomized population-based survey was conducted using a face-to-face questionnaire combined with skin prick tests of ten common aeroallergens including nine pollen allergens and Dermatophagoides pteronyssinu (Dp) allergen. The questionnaire was designed by specialists and included questions on the prevalence of eczema, hay fever, and asthma, socioeconomic risk factors, family history of atopy and environmental exposures. The prevalence of eczema with asthma and/or hay fever (EAH) was applied as a proxy of AD in this study.

Results
Overall, 2096 subjects were enrolled and completed the study. The prevalence of eczema was 15.7% (95% CI 14.3–17.4), while the prevalence of hay fever and asthma were 20.6% (95% CI 18.9–22.4) and 6.5% (95% CI 5.5–7.6), respectively. In particular, the prevalence of EAH was 5.1% (95% CI 4.4–7.0). The prevalence of eczema and EAH was significantly associated with younger age, atopy family history, high education level, urbanization, and antibiotic overuse (P < 0.05, logistic regression). The sensitization rate was higher in EAH compared with eczema (48.2% vs 41.0%, P = 0.018), with weed pollen sensitization being the most common. Subjects with two or more concomitant allergic diseases had increased risk of eczema and EAH (P < 0.001). Allergen sensitization increased the risk of eczema and EAH (P < 0.001, both).

Conclusions
Adult eczema and EAH are prevalent in northern China under high pollen exposure. Socioeconomic and environmental factors affected the prevalence of adult AD in China. Dp had a particular impact on the prevalence of eczema/AD in the grassland region.
Emergent stenting after intravenous thrombolysis for isolated basilar artery dissection in a patient with acute ischemic stroke: a case report
Authors: Goda Toshiaki , Oyama Naoki , Iwamoto Takanori , Takai Hiroki , Matsubara Shunji , Uno Masaaki , Yagita Yoshiki 
Published: March 2021

Abstract
Background
Isolated basilar artery dissection (IBAD) is a rare but important cause of ischemic stroke. Anti-thrombotic therapy is often used to treat IBAD-related ischemic stroke, but selected cases might need more aggressive treatment. There is no previous report of emergent stenting for IBAD-related ischemic stroke after intravenous thrombolysis.

Case presentation
A 53-year-old Japanese woman was admitted to our hospital with disturbance of consciousness, right hemiplegia, severe dysarthria, and total gaze paralysis. Brain magnetic resonance imaging revealed no ischemic lesion, but magnetic resonance angiography showed stenosis in the basilar artery. After initiation of intravenous thrombolysis, her neurological symptoms dramatically improved. Five hours later, however, her symptoms deteriorated again. Cerebral angiography showed IBAD. Emergent stenting was successfully performed. At 90 days after stroke onset, she had no significant disability, with a modified Rankin scale score of 1.

Conclusions
Emergent stenting can be an effective treatment for patients with IBAD-related ischemic stroke who are resistant to IV-rtPA.
Do we cause false positives? An experimental series on droplet or airborne SARS-CoV-2 contamination of sampling tubes during swab collection in a test center
Authors: Scheier Thomas , Shah Cyril , Huber Michael , Sax Hugo , Hasse Barbara , Günthard Huldrych F. , Trkola Alexandra , Schreiber Peter W. 
Published: March 2021

AbstractThe rapid spread of the coronavirus disease 2019 pandemic urged immense testing capacities as one cornerstone of infection control. Many institutions opened outpatient SARS-CoV-2 test centers to allow large number of tests in comparatively short time frames. With increasing positive test rates, concerns for a possible airborne or droplet contamination of specimens leading to false-positive results were raised. In our experimental series performed in a dedicated SARS-CoV-2 test center, 40 open collection tubes placed for defined time periods in proximity to individuals were found to be SARS-CoV-2 negative. These findings argue against false-positive SARS-CoV-2 results due to droplet or airborne contamination.
The impact of climate smart agriculture on household welfare in smallholder integrated crop–livestock farming systems: evidence from Zimbabwe
Authors: Mujeyi Angeline , Mudhara Maxwell , Mutenje Munyaradzi 
Published: March 2021

Abstract
Background
Agriculture contributes significantly to the welfare of smallholder farmers, but it has become highly susceptible to climate change, due to its reliance on the increasingly erratic rainfall patterns. Climate Smart Agriculture (CSA) offers important opportunities for enhancing food security and incomes through increased agriculture productivity. Technology evaluation through impact studies provides information on the effect of CSA on farmer welfare, thereby highlighting its potential in optimizing agriculture productivity. This paper analyses the impact of CSA adoption on food security and income of households, using cross-sectional survey data collected from 386 households across four districts in Zimbabwe. The analysis was done using the endogenous switching regression model which controls for selection bias and unobserved heterogeneity, a commonly used method in adoption impact analysis.

Results
The study found several agricultural and socio-economic factors which affect adoption and food security. The econometric results show that the status of soil fertility in fields, distance to input and output markets, ownership of communication assets, and Total Livestock Units (TLU) have a significant impact on the decision of farmers to adopt CSA. The Average Treatment Effects on the Treated (ATT) and Average Treatment Effects on the Untreated (ATU) were found to be positive and significant for adopters and non-adopters, indicating that CSA adoption has had a significantly positive impact on the welfare of the farmers. An analysis of the outcomes revealed that the characteristics of farmers and farms, as well as market factors, significantly affect the welfare of households. The household income, with reference to the adoption of CSA, was significantly affected by factors such as the education of household head, labour size, TLU, and asset index. Food security was influenced by factors such as the education of household head, TLU, access to sanitation, and arable land size.

Conclusions
The study concludes by giving policy recommendations centred on the access to inputs, sanitation, and encouraging investing in assets and TLU. The findings indicate that the adoption of CSA has a positive impact on the welfare of farmers. To exploit the full potential of these technologies, the study suggests that access to timely weather forecasts must be ensured, that sanitation must be promoted, and that incentives must be provided for agricultural input agro-dealers to decentralize to rural areas.