bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
Authors: Di Renzo Magda , di Castelbianco Federico Bianchi , Alberto Villani , Antonio Del Vecchio , Giovanni Corsello , Vanadia Elena , Petrillo Massimiliano , Davide Trapolino , Racinaro Lidia , Rea Monica 
Published: March 2021

AbstractBackgroundAutism spectrum disorder is a complex condition with wide variation in type and severity that involves persistent challenges in social interaction, speech and nonverbal communication, restricted/repetitive behaviours and adaptive behaviours. In recent years, research has deepened the study of the predictive factors of optimal outcome, intended as indicators of positive trajectory in children with a previous diagnosis of autism who, after a therapeutic path, show a significant reduction in the “core” symptoms of autism and a positive evolution in social, adaptive, affective, and relational skills.MethodsThe study included 40 children aged 21 to 66 months, enrolled between 2015 and 2016 for an autism spectrum disorder clinical suspicious. Children were re-evaluated after at least 2 years of therapy and they were divided into two groups: the ASD-ASD group included children with a confirmed diagnosis of ASD, and the ASD-OO comparison group included children who no longer met the criteria for an autism classification. The aim of this retrospective study was to investigate the presence of cognitive, emotional and relational predictors capable of predicting the presence of optimal outcome in with a diagnosis of autism; the predictors taken into consideration were the intelligence quotient, the play, the emotional contagion and the understanding of other’s intentions. In this way, it is possible to support clinicians in defining a more complete diagnostic framework of autism, using assessment tools that can be administered quickly and therefore suitable for short observation sessions in paediatric patients.ResultsThe findings showed that 15 out of 40 children, after at least for 2 years, no longer fell into the diagnostic ASD category based on the ADOS-2, DSM-5 and clinical criteria. The children in the ASD-OO group initially had a higher IQ than those in the ASD-ASD group, lower severity of autistic symptoms, greater understanding of intentions, more emotional contagion, and better quality of play. The results suggest that the initial coexistence of skills in these areas at the time of the first diagnostic assessment may allow us to predict the possibility of achieving optimal outcome after 2 years of therapy.ConclusionsThe data of this study highlight the importance of considering, during assessment, intelligence quotient, play, emotional contagion, and understanding of the intentions of others as potential prognostic predictors that can become useful tools for clinicians and paediatricians. This allows us to focus attention, in both the diagnostic and prognostic phases, on emotional-relational variables that can support the clinician in defining a more complete diagnostic framework and in planning a more personalized therapeutic path.
Eribulin, Child-Pugh score, and liver-function tests: lessons from pivotal breast cancer studies 301 and 305
Authors: Macpherson Iain R. , He Yaohua , Palmieri Carlo 
Published: March 2021

Abstract
Background
The recommended starting dose of eribulin in patients with hepatic impairment is based on the Child-Pugh score, largely informed by a pharmacokinetic study of 18 patients. In the pivotal studies of eribulin in metastatic breast cancer (Study 301 and Study 305 [EMBRACE]), entry criteria and dose modifications were based on liver-function test (LFT) results rather than Child-Pugh score. In populations such as patients with metastatic breast cancer, in which metastatic infiltration is the predominant cause of hepatic impairment, using Child-Pugh score may be problematic; in clinical practice, it has been more common for oncologists to make dosing decisions based on LFTs. To address this, the effects of abnormal baseline LFT results on eribulin efficacy and safety were investigated.

Methods
In this pooled post hoc analysis, 1062 patients who were randomized to receive eribulin in Studies 301 and 305 were divided into 4 groups: (A) no elevated LFT results (no liver impairment); (B) increased levels of aspartate aminotransferase and/or alanine aminotransferase; (C) decreased albumin and/or increased levels of aspartate aminotransferase and/or alanine aminotransferase but not increased bilirubin; and (D) increased bilirubin. Patients were subcategorized by presence of liver metastasis. Drug exposure, dose intensity, and treatment-emergent adverse events (TEAEs) were analyzed.

Results
Eribulin mesylate mean dosage was 0.82 (group A)–0.65 mg/m2/week (group D). Group D had shorter treatment, more dose reductions/delays, more TEAEs leading to dose modifications, and numerically lower objective response rates and clinical benefit rates versus groups A–C. TEAE rates leading to dose modification were similar between group D (45.5%) and groups A–C (range, 43.5–54.9%) in the absence of liver metastases, but higher in group D (91.3%) compared with groups A–C (range, 41.7–54.3%) if liver metastases were present.

Conclusions
Mild elevations in bilirubin levels were associated with increased toxicity and a greater requirement for dose modifications. Based both on these study data and existing recommendations, we propose a novel scheme to guide initial dose selection in patients with metastatic breast cancer and hepatic impairment that is based on LFTs rather than Child-Pugh score.
Description of a new species of Aplectana (Nematoda: Ascaridomorpha: Cosmocercidae) using an integrative approach and preliminary phylogenetic study of Cosmocercidae and related taxa
Authors: Chen Hui-Xia , Gu Xiao-Hong , Ni Xue-Feng , Li Liang 
Published: March 2021

Abstract
Background
Nematodes of the family Cosmocercidae (Ascaridomorpha: Cosmocercoidea) are mainly parasitic in the digestive tract of various amphibians and reptiles worldwide. However, our knowledge of the molecular phylogeny of the Cosmocercidae is still far from comprehensive. The phylogenetic relationships between Cosmocercidae and the other two families, Atractidae and Kathlaniidae, in the superfamily Cosmocercoidea are still under debate. Moreover, the systematic position of some genera within Cosmocercidae remains unclear.

Methods
Nematodes collected from Polypedates megacephalus (Hallowell) (Anura: Rhacophoridae) were identified using morphological (light and scanning electron microscopy) and molecular methods [sequencing the small ribosomal DNA (18S), internal transcribed spacer 1 (ITS-1), large ribosomal DNA (28S) and mitochondrial cytochrome c oxidase subunit 1 (cox1) target regions]. Phylogenetic analyses of cosmocercoid nematodes using 18S + 28S sequence data were performed to clarify the phylogenetic relationships of the Cosmocercidae, Atractidae and Kathlaniidae in the Cosmocercoidea and the systematic position of the genus Aplectana in Cosmocercidae.

Results
Morphological and genetic evidence supported the hypothesis that the nematode specimens collected from P. megacephalus represent a new species of Aplectana (Cosmocercoidea: Cosmocercidae). Our phylogenetic results revealed that the Cosmocercidae is a monophyletic group, but not the basal group in Cosmocercoidea as in the traditional classification. The Kathlaniidae is a paraphyletic group because the subfamily Cruziinae within Kathlaniidae (including only the genus Cruzia) formed a seperate lineage. Phylogenetic analyses also showed that the genus Aplectana has a closer relationship to the genus Cosmocerca in Cosmocercidae.

Conclusions
Our phylogenetic results suggested that the subfamily Cruziinae should be moved from the hitherto-defined family Kathlaniidae and elevated as a separate family, and the genus Cosmocerca is closely related to the genus Aplectana in the family Cosmocercidae. The present study provided a basic molecular phylogenetic framework for the superfamily Cosmocercoidea based on 18S + 28S sequence data for the first time to our knowledge. Moreover, a new species, A. xishuangbannaensis n. sp., was described using integrative approach.

Graphical abstract
Towards achieving efficient MAC protocols for WBAN-enabled IoT technology: a review
Authors: Olatinwo Damilola D. , Abu-Mahfouz Adnan M. , Hancke Gerhard P. 
Published: March 2021

AbstractInternet of things (IoT) is a concept that is currently gaining a lot of popularity as a result of its potential to be incorporated into many heterogeneous systems. Because of its diversity, integrating IoT is conceivable in almost all fields, including the healthcare sector. For instance, a promising technology in the healthcare sector known as wireless body area network (WBAN) could be integrated with the IoT to enhance its productivity. However, in order to guarantee the optimization of the operation of the healthcare applications facilitated by the WBAN-enabled IoT technology, there must be enough support from all the different protocol stack layers so as to satisfy the critical quality-of-service (QoS) requirements of the WBAN systems. Consequently, the medium access control (MAC) protocol has recently been gaining lots of attention in the area of WBANs due to its ability to manage and coordinate when a shared communication channel can be accessed. For the purpose of achieving efficient MAC protocols for WBAN-enabled IoT technology, this paper investigates some key MAC protocols that could be exploited in WBANs based on their characteristics, service specifications, technical issues such as energy wastage issues, and possible technical solutions were provided to enhance energy efficiency, channel utilization, data transmission rate, and dealy rate. Also, these MAC protocols were grouped and compared based on short- and long-range communication standards. Following this, future directions and open research issues are pointed out.
An Updated Reference for Calculating Bone Mineral Density T-Scores
Authors: Xue Shanshan , Zhang Yuzheng , Qiao Wenjing , Zhao Qianqian , Guo Dingjie , Li Binbin , Shen Xue , Feng Lijie , Huang Fengyi , Wang Na , Oumer Kemal Sherefa , Getachew Charkos Tesfaye , Yang Shuman 
Published: March 2021

Abstract

Context
Bone mineral density (BMD) T-score references may be updated when the peak BMD of the population is unclear and warrants reevaluation.

Objective
To update BMD T-score references using the peak BMD from the most recent National Health and Nutrition Examination Survey (NHANES) data.

Methods
This cross-sectional study used NHANES data from 2005 to 2014. Non-Hispanic White females between the ages of 10 and 40 years (N = 1549) were our target population to estimate peak BMD (SD). Individuals aged ≥ 50 years (N = 5523) were used to compare the percentages of osteoporosis and low bone mass based on existing and updated BMD T-score references. BMD data within the age at attainment of peak BMD ± 5 years were used to calculate updated BMD T-score references.

Results
The updated average of BMD (SD) for diagnosing osteoporosis at the femoral neck and lumbar spine were 0.888 g/cm2 (0.121 g/cm2) and 1.065 g/cm2 (0.122 g/cm2), respectively. The percentages of individuals with osteoporosis at the femoral neck and low bone mass at the femoral neck and lumbar spine based on the updated BMD T-score references were higher than the percentages of people designated with these outcomes under the existing guidelines (P &lt; 0.001). However, we observed the opposite pattern for lumbar spine osteoporosis (P &lt; 0.001).

Conclusions
We calculated new BMD T-score references at the femoral neck and lumbar spine. We found significant differences in the percentages of individuals classified as having osteoporosis and low bone mass between the updated and existing BMD T-score references.
Murine myeloid cell MCPIP1 suppresses autoimmunity by regulating B-cell expansion and differentiation
Authors: Dobosz Ewelina , Lorenz Georg , Ribeiro Andrea , Würf Vivian , Wadowska Marta , Kotlinowski Jerzy , Schmaderer Christoph , Potempa Jan , Fu Mingui , Koziel Joanna , Lech Maciej 
Published: March 2021

ABSTRACT
Myeloid-derived cells, in particular macrophages, are increasingly recognized as critical regulators of the balance of immunity and tolerance. However, whether they initiate autoimmune disease or perpetuate disease progression in terms of epiphenomena remains undefined.
Here, we show that depletion of MCPIP1 in macrophages and granulocytes (Mcpip1fl/fl-LysMcre+ C57BL/6 mice) is sufficient to trigger severe autoimmune disease. This was evidenced by the expansion of B cells and plasma cells and spontaneous production of autoantibodies, including anti-dsDNA, anti-Smith and anti-histone antibodies. Consequently, we document evidence of severe skin inflammation, pneumonitis and histopathologic evidence of glomerular IgG deposits alongside mesangioproliferative nephritis in 6-month-old mice. These phenomena are related to systemic autoinflammation, which secondarily induces a set of cytokines such as Baff, Il5, Il9 and Cd40L, affecting adaptive immune responses. Therefore, abnormal macrophage activation is a key factor involved in the loss of immune tolerance.
Overall, we demonstrate that deficiency of MCPIP1 solely in myeloid cells triggers systemic lupus-like autoimmunity and that the control of myeloid cell activation is a crucial checkpoint in the development of systemic autoimmunity.
The ROS scavenger PDTC affects adaptation to treadmill running in mice: distinct effects on murine body mass, resting heart rate and skeletal muscle fiber type composition
Authors: Röchner Franziska , Schmitt Angelika , Brändle Anne-Lena , Fragasso Annunziata , Munz Barbara 
Published: March 2021

ABSTRACT
Regular exercise induces a broad spectrum of adaptation reactions in a variety of tissues and organs. However, the respective mechanisms are incompletely understood. In the context of their analysis, animal model systems, specifically rodent treadmill running protocols, play an important role. However, few researchers have studied different aspects of adaptation, such as cardiorespiratory and skeletal muscle training effects, within one set of experiments. Here, we analyzed physiological adaptation to 10 weeks of regular, moderate-intensity, uphill treadmill running in mice, a widely used model for endurance exercise training. To study the effects of reactive oxygen species (ROS), which have been suggested to be major regulators of training adaptation, a subgroup of mice was treated with the ROS scavenger PDTC (pyrrolidine dithiocarbamate). We found that mass gain in mice that exercised under PDTC treatment lagged behind that of all other experimental groups. In addition, both exercise and PDTC significantly and additively decreased resting heart rate. Furthermore, there was a trend towards an enhanced proportion of type 2A skeletal muscle fibers and differential expression of metabolism-associated genes, indicating metabolic and functional adaptation of skeletal muscle fibers. By contrast, there were no effects on grip strength and relative mass of individual muscles, suggesting that our protocol of uphill running did not increase skeletal muscle hypertrophy and strength. Taken together, our data suggest that a standard protocol of moderate-intensity uphill running induces adaptation reactions at multiple levels, part of which might be modulated by ROS, but does not enhance skeletal muscle hypertrophy and force.
Adaptation to Exercise Training in Conduit Arteries and Cutaneous Microvessels in Humans: An Optical Coherence Tomography Study
Authors: ARGARINI RADEN , CARTER HOWARD H. , SMITH KURT J. , NAYLOR LOUISE H. , MCLAUGHLIN ROBERT A. , GREEN DANIEL J. 
Published: March 2021

ABSTRACT

Introduction
Exercise training has antiatherogenic effects on conduit and resistance artery function and structure in humans and induces angiogenic changes in skeletal muscle. However, training-induced adaptation in cutaneous microvessels is poorly understood, partly because of technological limitations. Optical coherence tomography (OCT) is a novel high-resolution imaging technique capable of visualizing cutaneous microvasculature at a resolution of ~30 μm. We utilized OCT to visualize the effects of training on cutaneous microvessels, alongside assessment of conduit artery flow-mediated dilation (FMD).

Methods
We assessed brachial FMD and cutaneous microcirculatory responses at rest and in response to local heating and reactive hyperemia: pretraining and posttraining in eight healthy men compared with age-matched untrained controls (n = 8). Participants in the training group underwent supervised cycling at 80% maximal heart rate three times a week for 8 wk.

Results
We found a significant interaction (P = 0.04) whereby an increase in FMD was observed after training (post 9.83% ± 3.27% vs pre 6.97% ± 1.77%, P = 0.01), with this posttraining value higher compared with the control group (6.9% ± 2.87%, P = 0.027). FMD was not altered in the controls (P = 0.894). There was a significant interaction for OCT-derived speed (P = 0.038) whereby a significant decrease in the local disk heating response was observed after training (post 98.6 ± 3.9 μm·s−1 vs pre 102 ± 5 μm·s−1, P = 0.012), whereas no changes were observed for OCT-derived speed in the control group (P = 0.877). Other OCT responses (diameter, flow rate, and density) to local heating and reactive hyperemia were unaffected by training.

Conclusions
Our findings suggest that vascular adaptation to exercise training is not uniform across all levels of the arterial tree; although exercise training improves larger artery function, this was not accompanied by unequivocal evidence for cutaneous microvascular adaptation in young healthy subjects.
Optimisation of a composite difference metric for prompt error detection in real-time portal dosimetry of simulated volumetric modulated arc therapy
Authors: Bedford James L , Hanson Ian M 
Published: March 2021

Objectives:
In real-time portal dosimetry, thresholds are set for several measures of difference between predicted and measured images, and signals larger than those thresholds signify an error. The aim of this work is to investigate the use of an additional composite difference metric (CDM) for earlier detection of errors.

Methods:
Portal images were predicted for the volumetric modulated arc therapy plans of six prostate patients. Errors in monitor units, aperture opening, aperture position and path length were deliberately introduced into all 180 segments of the treatment plans, and these plans were delivered to a water-equivalent phantom. Four different metrics, consisting of central axis signal, mean image value and two image difference measures, were used to identify errors, and a CDM was added, consisting of a weighted power sum of the individual metrics. To optimise the weights of the CDM and to evaluate the resulting timeliness of error detection, a leave-pair-out strategy was used. For each combination of four patients, the weights of the CDM were determined by an exhaustive search, and the result was evaluated on the remaining two patients.

Results:
The median segment index at which the errors were identified was 87 (range 40–130) when using all of the individual metrics separately. Using a CDM as well as multiple separate metrics reduced this to 73 (35–95). The median weighting factors of the four metrics constituting the composite were (0.15, 0.10, 0.15, 0.00). Due to selection of suitable threshold levels, there was only one false positive result in the six patients.

Conclusion:
This study shows that, in conjunction with appropriate error thresholds, use of a CDM is able to identify increased image differences around 20% earlier than the separate measures.

Advances in knowledge:
This study shows the value of combining difference metrics to allow earlier detection of errors during real-time portal dosimetry for volumetric modulated arc therapy treatment.
Cross-sectional study to assess etiology and associated factors for anaemia during first trimester of pregnancy in Anuradhapura District, Sri Lanka: a protocol
Authors: Amarasinghe Gayani , Mendis Vasana , Agampodi Thilini 
Published: March 2021

Background: Anaemia in pregnancy, which can lead to adverse maternal and fetal outcomes, is a significant global health problem. Despite Sri Lanka’s strong public health system and commitment towards prevention, maternal anaemia remains a major problem in the country. While prevention is focused on iron deficiency, detailed etiological studies on this topic are scarce. Moreover, estimates of socio demographic and economic factors associated with anaemia in pregnancy, which can provide important clues for anaemia control, are also lacking. This study aims to evaluate the hemoglobin distribution, spatial distribution, etiology and associated factors for anaemia in pregnant women in Anuradhapura, Sri Lanka. Methods: This is a cross sectional study of pregnant women in their first trimester registered for antenatal care from July to September 2019 in the Anuradhapura district. The minimal sample size was calculated to be 1866. Initial data collection has already been carried out in special field clinics for pregnant women between June to October 2019. An interviewer-administered questionnaire, a self-completed dietary questionnaire and an examination checklist were used for data collection. In addition, all participants underwent complete blood count testing. Further investigations are being conducted for predicting the etiology of anaemia based on a developed algorithm (such as high-performance liquid chromatography [HPLC] and peripheral blood film analysis). Discussion: Being the largest study on anaemia during pregnancy in a single geographical area in Sri Lanka, this study will provide important clues about geographical clustering of anaemia cases with similar etiology, associated factors and etiologies which would help to develop interventions to improve the health of pregnant women in the area. The possibility of selection bias is a potential limitation associated with the study design.
Spatial distribution analysis of dentists, dental technicians, and dental therapists in Indonesia
Authors: Gofur Nanda Rachmad Putra , Aghasy Achmad Zam Zam , Gofur Aisyah Rachmadani Putri 
Published: March 2021

Background: Access to health services is needed around the world, from healthcare providers to doctors. One of the needs in public health is a system that is accessible for everyone, but, unequal distribution of healthcare provider and health workers, especially in dentistry fields is still a main problem in several countries, including Indonesia. The aim of this study is to analyze the spatial distribution of dentists, dental technicians, and dental therapists. Methods: This spatial analysis study was conducted after obtaining secondary data in Indonesia. All data were collected between September 1st, 2020 and October 1st, 2020 from open access sources of de-identified data. The data of dentists per area, dental technicians per area, and dental therapists per area were calculated for analysis. A spatial distribution map was prepared using the Quantum Geographic Information System (QGIS Desktop, version 3.10.6). Results: The results of this study found a ratio of dentists to members of the population in Indonesia of 1:17,105. The average number of dental technicians that work in the public health centers in each province (dental technicians per area) in Indonesia was calculated to be 0.13. The average number of dental therapists that work in the public health centers in each province (dental therapists per area) in Indonesia was calculated to be 0.40. This spatial autocorrelation illustrates that there is a relationship between values of dentists per area and dental therapists per area between provinces in Indonesia, and shows geographic clustering relationships or patterns that are grouped and have similar characteristics in adjacent locations. This spatial autocorrelation did not occur in the value of dental technicians. Conclusions: From this study we can conclude that there is an unequal distribution of dental personnel in Indonesia.