bluuebunny/crossref_metadata_2025_split huggingface dataset:
Autism diagnosis as a social process
Authors: Hayes Jennie , Ford Tamsin , McCabe Rose , Russell Ginny 
Published: July 2021

The diagnosis of autism can be challenging, particularly if an individual coming for assessment is considered to be near the diagnostic threshold. It is important to understand the experiences and challenges of diagnosis from the perspective of clinicians. In this study, 21 in-depth interviews were conducted with clinicians working in specialist autism assessment teams in adult and children’s services in England. Interviews were recorded and transcripts were analysed thematically. We identified four themes that represented how clinicians were frequently engaged with juggling their own professional understanding of what autism is with other factors such as the results of standardised tests and the views of patients and carers, in the context of limited resources: institutional pressure, making diagnosis make sense, seeing through an autism lens and just tools. The study illuminates the diagnostic process as a socially situated activity. We suggest that an examination of the benefits and drawbacks of assessment services specialising in autism only, the resources they require to operate effectively, and how they operate in the context of wider health services would be appropriate and timely. Lay abstract When a child or adult is referred for an autism diagnosis, clinicians from different backgrounds work together to make a diagnostic decision. A few studies have asked clinicians in interview how they feel about diagnosis and what the challenges are. We interviewed clinicians in child and adult assessment services in England, and from different professional backgrounds, about the challenges of autism diagnosis and the factors that might influence the assessment process. We found that there were a number of challenges in autism diagnosis, especially when someone coming for diagnosis was considered to be near the diagnostic threshold. Clinicians told us that making a diagnosis was like creating a ‘narrative’: looking at many different factors that told a story about a person, rather than just looking at the results of diagnostic tests. Clinicians do not always agree with the results of those tests and have to use their specialist clinical judgement to make decisions. Clinicians were concerned about the amount of time people have to wait for an autism assessment, and the resulting pressure on the assessment process. The findings of this work can help us to understand how diagnosis happens and consider ways in which it can be improved for adults, children and families coming for assessment, as well as clinicians.
Second language experience influences salience of phonological units in spoken word production in the first language
Authors: Wang Jie , Wong Andus Wing-Kuen , Chen Hsuan-Chih 
Published: July 2021

Research question: Previous research suggests that the grain size of primary phonological units (PUs) in spoken word production is language-specific (e.g., phonemic segments in Germanic languages, and atonal syllables in Chinese). When the two languages of bilingual speakers have different primary PUs in their native speakers, will first language (L1) phonological processing be influenced by second language (L2) experience? Methodology: In a picture–word interference task, native Chinese speakers who spoke English as L2 were required to say aloud the predesignated L1 name of a picture while ignoring a written L1 character superimposed on the picture. The picture name shared a certain phonological component (i.e., rhyme or atonal syllable) with the distractor in the related condition but not in the unrelated condition. Data and analysis: Data of 186 participants from eight originally independent experiments were pooled. Multiple regression analyses were conducted on subject means to investigate whether the effects of rhyme relatedness and syllable relatedness on L1 naming latency were influenced by L2 self-rated proficiency, age of acquisition (AoA), and/or years of use. Trial-by-trial data were then analyzed with linear mixed-effects modeling. Findings: Both the rhyme effect and the syllable effect increased with years of L2 use, indicating that the salience of PUs in L1 spoken word production can be influenced by L2 experience. Originality: The current study adopted a chronometric approach to investigate the influence of L2 experience on phonological processing during L1 spoken word production. Importantly, multiple aspects of L2 experience (i.e., self-rated proficiency, AoA, and years of use) were examined at the same time in a relatively large sample. Implications: The current findings provide evidence for backward transfer of primary PUs in spoken word production, which demonstrates the plasticity of the phonological encoding process in bilingual speakers. These findings are discussed and compared with cross-language transfer of phonological awareness in the discussion.
Percutaneous Transgastric Duodenal Stenting and Gastrostomy Repair Using a Vascular Closure Device: Proof of Concept in a Porcine Model
Authors: Shlomovitz Eran , Patel Neeral R. , Diana Michele , Pescarus Radu , Swanström Lee L. 
Published: July 2021

Introduction. Gastroduodenal stenting is efficacious and safe in both benign and malignant foregut diseases. Transgastric duodenal stenting has been described and however requires a gastrostomy tube to remain in situ for 4 to 6 weeks post-procedure which can lead to complications. We present a technique for immediate gastric repair using a suture-mediated vascular closure device, without the need for a gastrostomy tube in porcine models. Methods. Percutaneous access into the stomach was achieved using fluoroscopy. Two or 3 Perclose Proglide devices were pre-deployed. The tract was dilated and a wire advanced into the distal duodenum. A 15.5 cm covered enteric stent was delivered through the gastrostomy, deployed and position confirmed. The gastrostomy was closed using Perclose Proglide sutures. Necropsy leak pressure measurement was performed to assess integrity of gastrostomy closure in the porcine models. Results. Two (n = 8) or 3 (n = 2) Perclose Proglide devices were deployed in ten porcine models, with 1 misfire (4.5%). Percutaneous transgastric access and stent delivery was successful in all porcine models. Mean leak pressure in the animals with adequately deployed devices was 219 mmHg (range 172 mmHg–270 mmHg). Conclusion. This study demonstrates percutaneous transgastric duodenal stenting with immediate gastric repair using suture-mediated vascular closure devices is a feasible procedure.
A Retrospective Analysis of Group-Based Boxing Exercise on Measures of Physical Mobility in Patients With Parkinson Disease
Authors: Sonne James W. H. , Joslyn Kyle , Reus Katherine , Angulo Michelle , Guettler Sarah , Beato Morris C. 
Published: July 2021

Objectives: The purpose of this retrospective study is to further the limited body of evidence regarding the effects of a group-based boxing intervention for those with Parkinson’s disease (PD). Design: A retrospective cohort study was performed analyzing data collected on outcome measures at 6-month intervals up to 2 years. Individuals participated in the standardized “Rock Steady Boxing” (RSB) program for up to 24 months. Every 6 months, measures were taken of balance (Fullerton Advanced Balance [FAB] Scale), functional mobility (Timed-Up and Go [TUG]), lower extremity strength (30-second Chair Stand [30CST]), and gait speed (10 Meter Walk Test [10MWT]). Methods: Statistical significance ( P < .05) was determined by a two-tailed t test. Data were collected from RSB-affiliated programs at 4 locations across the southeastern United States. Current and/or past participants in RSB with baseline and at least one subsequent outcome measure were included, resulting in 68 participants (54 male, 14 female, and mean age of 71.2 years ± 8.56 standard deviation). Results: Statistically significant improvements in FAB scale, TUG, and 30CST over time were found at both 6- and 12-month time points. Significant changes continued through 18 months for FAB and 30CST. No significant changes in 10MWT were observed; however, a moderate effect size was observed at the 1-year point. Conclusions: Participants with PD were able to achieve statistically significant improvements in standard measures of functional mobility, balance, and strength within the timeline of this study. Limitations include the retrospective nature, an inability to monitor adherence, and lack of control over pharmaceutical or other interventions.
Comparison of clinical characteristics and outcomes between alcohol-induced and gallstone-induced acute pancreatitis: An Australian retrospective observational study
Authors: Garcia Santiago Cegarra , Toolis Michael , Ubels Max , Mollah Taha , Paul Eldho , Pandey Ashish , Thia Brandon , Wong Tricia , Tiruvoipati Ravindranath 
Published: July 2021

Objectives: To compare the characteristics and outcomes of patients presenting to hospital with alcohol-induced and gallstone-induced acute pancreatitis. Methods: Retrospective study of all patients with alcohol-induced or gallstone-induced pancreatitis during the period 1 June 2012 to 31 May 2016. The primary outcome measure was hospital mortality. Secondary outcome measures included hospital length of stay, requirements for intensive care unit admission, intensive care unit mortality, mechanical ventilation, renal replacement therapy, requirement of inotropes and total parenteral nutrition. Results: A total of 642 consecutive patients (49% alcohol; 51% gallstone) were included. No statistically significant differences were found between alcohol-induced and gallstone-induced acute pancreatitis with respect to hospital mortality, requirement for intensive care unit admission, intensive care unit mortality and requirement for mechanical ventilation, renal replacement therapy, inotropes or total parenteral nutrition. There was significant difference in hospital length of stay (3.07 versus 4.84; p  < 0.0001). On multivariable regression analysis, Bedside Index of Severity in Acute Pancreatitis score (estimate: 0.393; standard error: 0.058; p < 0.0001) and admission haematocrit (estimate: 0.025; standard error: 0.008; p = 0.002) were found to be independently associated with prolonged hospital length of stay. Conclusion: Hospital mortality did not differ between patients with alcohol-induced and gallstone-induced acute pancreatitis. The duration of hospital stay was longer with gallstone-induced pancreatitis. Bedside Index of Severity in Acute Pancreatitis score and admission haematocrit were independently associated with hospital length of stay.
Toxic Stress in a Mid-Sized Urban Community: An Initial Needs Assessment of Families with Children in Maywood, IL
Authors: McCune Erin , Wojtowicz Jennifer , Adams William , Sigman Garry , Williams Collette , Ahn Pauline , Ciliberti Ashley , Hatchett Lena , O’Keefe Julie 
Published: July 2021

Background Loyola Medical Center is located in Maywood, IL, a community that faces high rates of poverty, violence, and barriers to healthcare. These factors can contribute to toxic stress, which has been shown to negatively impact children’s health. Objectives The goal of this project was to partner with community organizations to obtain a baseline needs assessment from families in Maywood regarding sources of toxic stress and to identify interventions of interest. Methods In total, 75 anonymous surveys were collected from the Loyola Outpatient Center Pediatric Clinic and a Maywood community center. Survey responses were statistically analyzed in order to determine toxic stressors most commonly impacting families in Maywood as well as interventions of most interest to the community. Results There were 78 respondents for a response rate of approximately 71%. The most common stressors were smoking in the home (33.3%), food insecurity (29.5%), and exposure to violence (26.9%). In this sample, Black respondents were 11.5 times more likely than non-Black respondents to report that their child was exposed to violence in the community – even after controlling for concern about their child’s behavior which served as a surrogate measure of the child’s exposure to toxic stress (P = 0.001). Further, those living with food insecurity were 7.40 times more likely to report that access to food and transportation vouchers were important ( P < .001). For every 1-point increase in the total toxic stress score, respondents were 1.35 times more likely to report that increasing access to mental health resources was important to them, though this was not significant ( P = .10). Conclusion The data demonstrate that toxic stressors, health risks and unmet social needs are prevalent in the Maywood community, which puts local children at risk for future adverse health outcomes. With this information, pediatricians at Loyola Medical Center can work with community organizations to allocate resources to address toxic stressors in Maywood.
Final results of the PUPs B-LONG study: evaluating safety and efficacy of rFIXFc in previously untreated patients with hemophilia B
Authors: Nolan Beatrice , Klukowska Anna , Shapiro Amy , Rauch Antoine , Recht Michael , Ragni Margaret , Curtin Julie , Gunawardena Sriya , Mukhopadhyay Sutirtha , Jayawardene Deepthi , Winding Bent , Fischer Kathelijn , Liesner Raina 
Published: July 2021

Abstract
PUPs B-LONG evaluated the safety and efficacy of recombinant factor IX Fc fusion protein (rFIXFc) in previously untreated patients (PUPs) with hemophilia B. In this open-label, phase 3 study, male PUPs (age &lt;18 years) with hemophilia B (≤2 IU/dL of endogenous factor IX [FIX]) were to receive treatment with rFIXFc. Primary end point was occurrence of inhibitor development, with a secondary end point of annualized bleed rate (ABR). Of 33 patients who received ≥1 dose of rFIXFc, 26 (79%) were age &lt;1 year at study entry and 6 (18%) had a family history of inhibitors. Twenty-eight patients (85%) received prophylaxis; median dosing interval was 7 days, with an average weekly dose of 58 IU/kg. Twenty-seven patients (82%) completed the study. Twenty-one (64%), 26 (79%), and 28 patients (85%) had ≥50, ≥20, and ≥10 exposure days (EDs) to rFIXFc, respectively. One patient (3.03%; 95% confidence interval, 0.08% to 15.76%) developed a low-titer inhibitor after 11 EDs; no high-titer inhibitors were detected. Twenty-three patients (70%) had 58 treatment-emergent serious adverse events; 2 were assessed as related (FIX inhibition and hypersensitivity in 1 patient, resulting in withdrawal). Median ABR was 1.24 (interquartile range, 0.00-2.49) for patients receiving prophylaxis. Most (&gt;85%) bleeding episodes required only 1 infusion for bleed resolution. In this first study reporting results with rFIXFc in pediatric PUPs with hemophilia B, rFIXFc was well tolerated, with the adverse event profile as expected in a pediatric hemophilia population. rFIXFc was effective, both as prophylaxis and in the treatment of bleeding episodes. This trial was registered at www.clinicaltrials.gov as #NCT02234310.
Prognostic impact of posttransplant FDG PET/CT scan in multiple myeloma
Authors: Kaddoura Marcella , Dingli David , Buadi Francis K. , Lacy Martha Q. , Gertz Morie A. , Dispenzieri Angela , Kapoor Prashant , Hwa Lisa , Fonder Amie , Hobbs Miriam , Hayman Suzanne , Lust John , Leung Nelson , Go Ronald S. , Lin Yi , Gonsalves Wilson , Kourelis Taxiarchis , Warsame Rahma , Kyle Robert A. , Broski Stephen M. , Rajkumar Vincent , Kumar Shaji 
Published: July 2021

Abstract
Multiple myeloma (MM) is a heterogeneous disease that may be evaluated by a broad array of imaging and laboratory techniques to measure disease activity and predict prognosis. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scanning has been shown to be predictive of patient outcomes throughout the disease course. We sought to corroborate these findings by examining the prognostic impact of PET/CT scanning in the posttransplant setting. We retrospectively analyzed PET/CT scans in 229 MM patients receiving an autologous stem cell transplant (ASCT) near day 100, and correlated these findings with time to progression(TTP) and overall survival (OS) to assess the impact of day 100 PET/CT scan findings as an independent prognostic factor. The median OS for the entire cohort was 61.5 months (95% confidence interval [CI], 49-75) and the median TTP was 18.5 months (95% CI, 15.4-21.8). Among patients with abnormal day 100 PET findings (PET+), median TTP was 12.4 months vs 24 months among those with normal PET findings (PET−) (P &lt; .0001). The median OS in the PET+ group was 46 months compared with 99 months in the PET− group (P &lt; .0001). We conclude that an abnormal PET/CT scan near day 100 post-ASCT is predictive of shorter TTP and OS, with prognostic significance retained after adjusting for disease response and other prognostic variables in MM.
A phase 2 trial of the histone deacetylase inhibitor panobinostat for graft-versus-host disease prevention
Authors: Perez Lia , Fernandez Hugo , Kharfan-Dabaja Mohamed , Khimani Farhad , Betts Brian , Mishra Asmita , Ayala Ernesto , Locke Frederick L. , Ochoa-Bayona Leonel , Nieder Michael , Pidala Joseph , Achille Alex , Powers John , Sahakian Eva , Thapa Ram , Wang Xuefeng , Anasetti Claudio 
Published: July 2021

Abstract
Immunomodulatory properties of histone deacetylase inhibitors represent a reasonable approach for acute graft-versus-host disease (aGVHD) prevention. We report a phase 2 trial evaluating panobinostat (PANO) administered over 26 weeks, starting on day −5 (5 mg orally 3 times a week) with tacrolimus initiated on day −3 plus sirolimus on day −1, with a median patient age of 58 years (range, 19-72 years) (n = 38). Donor source consisted of HLA 8/8–matched donors, related (n = 13) or unrelated (n = 25), using granulocyte colony-stimulating factor–stimulated peripheral blood stem cells. Myeloablative (n = 18) or reduced-intensity (n = 20) conditioning regimens were used for patients with acute myeloid leukemia (n = 17), myelodysplastic syndrome (n = 13), or other malignancies (n = 8). The cumulative incidence of aGVHD II-IV by day 100 was 18.4% (90% confidence interval [CI], 9.4% to 29.9%). Cumulative incidence of chronic GVHD at 1 year was 31.6% (90% CI, 19.5% to 44.3%). Adverse events related to PANO were thrombocytopenia (n = 5), leukopenia (n = 6), gastrointestinal toxicity (n = 3), rash (n = 4), renal failure/peripheral edema (n = 1), and periorbital edema (n = 1). At 1 year, overall survival was 89.5% (90% CI, 81.6% to 98.0%), relapse-free survival was 78.9% (90% CI, 68.8% to 90.6%), nonrelapse mortality was 2.6% (90% CI, 0.3% to 9.9%), and GVHD relapse-free survival was 60.5% (90% CI, 48.8% to 75.1%). PANO hits histone 3 as early as day 15 in CD8, CD4 and T regs. In conclusion, PANO combination met the primary study end point for aGVHD prevention and warrants further testing. This trial was registered at www.clinicaltrials.gov as #NCT02588339.
A thrombin-PAR1/2 feedback loop amplifies thromboinflammatory endothelial responses to the viral RNA analogue poly(I:C)
Authors: Subramaniam Saravanan , Ogoti Yamini , Hernandez Irene , Zogg Mark , Botros Fady , Burns Robert , DeRousse Jacob T. , Dockendorff Chris , Mackman Nigel , Antoniak Silvio , Fletcher Craig , Weiler Hartmut 
Published: July 2021

AbstractActivation of blood coagulation and endothelial inflammation are hallmarks of respiratory infections with RNA viruses that contribute significantly to the morbidity and mortality of patients with severe disease. We investigated how signaling by coagulation proteases affects the quality and extent of the response to the TLR3-ligand poly(I:C) in human endothelial cells. Genome-wide RNA profiling documented additive and synergistic effects of thrombin and poly(I:C) on the expression level of many genes. The most significantly active genes exhibiting synergistic induction by costimulation with thrombin and poly(I:C) included the key mediators of 2 critical biological mechanisms known to promote endothelial thromboinflammatory functions: the initiation of blood coagulation by tissue factor and the control of leukocyte trafficking by the endothelial-leukocyte adhesion receptors E-selectin (gene symbol, SELE) and VCAM1, and the cytokines and chemokines CXCL8, IL-6, CXCL2, and CCL20. Mechanistic studies have indicated that synergistic costimulation with thrombin and poly(I:C) requires proteolytic activation of protease-activated receptor 1 (PAR1) by thrombin and transactivation of PAR2 by the PAR1-tethered ligand. Accordingly, a small-molecule PAR2 inhibitor suppressed poly(I:C)/thrombin–induced leukocyte-endothelial adhesion, cytokine production, and endothelial tissue factor expression. In summary, this study describes a positive feedback mechanism by which thrombin sustains and amplifies the prothrombotic and proinflammatory function of endothelial cells exposed to the viral RNA analogue, poly(I:C) via activation of PAR1/2.
Ultrasound-activated nano-TiO2 loaded with temozolomide paves the way for resection of chemoresistant glioblastoma multiforme
Authors: Rehman Fawad Ur , Rauf Mohd Ahmar , Ullah Sajjad , Shaikh Sana , Qambrani Aqsa , Muhammad Pir , Hanif Sumaira 
Published: July 2021

Abstract
Background
Glioblastoma multiforme (GBM) is one of the most daunting issues to modern therapeutics, with a higher mortality rate post-diagnosis. Temozolomide (TMZ) is the only available treatment; however, the frequent resistance leaves the oncologists at a dead end. Therefore, new approaches to circumvent the GBM are highly desired. We have employed TiO2 nanosticks loaded with TMZ as nanomedicine for TMZ-resistant GBM resection in this contribution.

Results
The ultrasonication triple-action effect could greatly facilitate tumor ablation by enhancing the TiO2 nanosticks traversing across BBB, releasing the TMZ payload from TiO2 nanosticks and reactive oxygen species (ROS) generation from TiO2 nanosticks within the GBM milieu. The tumor ablation was confirmed by MTT and Annexin(v)-PI assays, apoptotic proteins expression via western blot and ROS level detection in vitro, whereas tumor volume, weight, survival rate, and relative photon flux in the xenograft and orthoptic TMZ-resistant GBM murine models as in vivo.

Conclusion
We found this nanomedicine-based ultrasound modality highly efficient in GBM treatment and is of future clinical application value due to the employment of already FDA-approved techniques and nanomedicine.