bluuebunny/crossref_metadata_2025_split huggingface dataset:
Institutionalized Children and the Risk of Fetal Alcohol Spectrum Disorder (FASD); A Primer for Clinicians, Adoption Staff and Parents
Authors: Koren Gideon , Ornoy Asher 
Published: February 2021

Objectives: Our objective was to estimate the likelihood of abnormal development among institutionalized children, addressing either the risk in general, or the risk for fetal alcohol spectrum disorder (FASD). Methods: Narrative review of studies measuring developmental effects of these populations. We identified all systematic reviews and meta analyses dealing with the associations between institutionalization of children and their neurodevelopment in general, or between institunalization of children and their likelihood of suffering from FASD. Results: a) In a published meta-analysis the mean IQ/DQ was 84 among institutionalized children, as compared to 104 among children raised in families. Favorable caregiver-child ratios appeared to have a protective effect, whereas longer stays in institutions had a detrimental effect on IQ/DQ. b) A further meta- analysis has shown a positive impact of adoption on children’s cognitive development with adopted children’s displaying remarkably normal cognitive competence as compared to their non-adopted peers. c) The overall pooled prevalence was 6% (60 per 1,000, 95% CI 38-85) for full blown fetal alcohol syndrome (FAS), and 16.9% (95% CI 109-238 per 1,000) for the whole range of FASD. d) The estimated prevalence of FASD was 10-40 fold higher than the 7.7 per 1000 in the general population. Conclusions: A large proportion of adopted institutionalized children may not follow a normal developmental trajectory. If not afflicted by FASD, there is a positive impact of adoption on children’s cognitive development and in general they are comparable to their non- adopted peers.
Coevolution of group-living and aposematism in caterpillars: warning colouration may facilitate the evolution from group-living to solitary habits
Authors: Wang Lingzi , Cornell Stephen J. , Speed Michael P. , Arbuckle Kevin 
Published: February 2021

AbstractBackgroundAnimals use diverse antipredator mechanisms, including visual signalling of aversive chemical defence (aposematism). However, the initial evolution of aposematism poses the problem that the first aposematic individuals are conspicuous to predators who have not learned the significance of the warning colouration. In one scenario, aposematism evolves in group-living species and originally persisted due to kin selection or positive frequency-dependent selection in groups. Alternatively, group-living might evolve after aposematism because grouping can amplify the warning signal. However, our current understanding of the evolutionary dynamics of these traits is limited, leaving the relative merit of these scenarios unresolved.ResultsWe used a phylogenetic comparative approach to estimate phenotypic evolutionary models to enable inferences regarding ancestral states and trait dynamics of grouping and aposematic colouration in a classic model system (caterpillars). We find strong support for aposematism at the root of the clade, and some (but weaker) support for ancestral solitary habits. Transition rates between aposematism and crypsis are generally higher than those between group-living and solitary-living, suggesting that colouration is more evolutionarily labile than aggregation. We also find that the transition from group-living to solitary-living states can only happen in aposematic lineage, suggesting that aposematism facilitates the evolution of solitary caterpillars, perhaps due to the additional protection offered when the benefits of grouping are lost. We also find that the high frequency of solitary, cryptic caterpillars is because this state is particularly stable, in that the transition rates moving towards this state are substantially higher than those moving away from it, favouring its accumulation in the clade over evolutionary time.ConclusionsOur results provide new insights into the coevolution of colour and aggregation in caterpillars. We find support for an aposematic caterpillar at the root of this major clade, and for the signal augmentation hypothesis as an explanation of the evolution of aposematic, group-living caterpillars. We find that colouration is more labile than aggregation behaviour, but that the combination of solitary and cryptic habits is particularly stable. Finally, our results reveal that the transitions from group-living to solitary-living could be facilitated by aposematism, providing a new link between these well-studied traits.
Ensemble bootstrap methodology for forecasting dynamic growth processes using differential equations: application to epidemic outbreaks
Authors: Chowell Gerardo , Luo Ruiyan 
Published: February 2021

AbstractBackgroundEnsemble modeling aims to boost the forecasting performance by systematically integrating the predictive accuracy across individual models. Here we introduce a simple-yet-powerful ensemble methodology for forecasting the trajectory of dynamic growth processes that are defined by a system of non-linear differential equations with applications to infectious disease spread.MethodsWe propose and assess the performance of two ensemble modeling schemes with different parametric bootstrapping procedures for trajectory forecasting and uncertainty quantification. Specifically, we conduct sequential probabilistic forecasts to evaluate their forecasting performance using simple dynamical growth models with good track records including the Richards model, the generalized-logistic growth model, and the Gompertz model. We first test and verify the functionality of the method using simulated data from phenomenological models and a mechanistic transmission model. Next, the performance of the method is demonstrated using a diversity of epidemic datasets including scenario outbreak data of theEbola Forecasting Challengeand real-world epidemic data outbreaks of including influenza, plague, Zika, and COVID-19.ResultsWe found that the ensemble method that randomly selects a model from the set of individual models for each time point of the trajectory of the epidemic frequently outcompeted the individual models as well as an alternative ensemble method based on the weighted combination of the individual models and yields broader and more realistic uncertainty bounds for the trajectory envelope, achieving not only better coverage rate of the 95% prediction interval but also improved mean interval scores across a diversity of epidemic datasets.ConclusionOur new methodology for ensemble forecasting outcompete component models and an alternative ensemble model that differ in how the variance is evaluated for the generation of the prediction intervals of the forecasts.
A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension
Authors: Singh Harjit K. , Kennedy Gerard A. , Stupans Ieva 
Published: February 2021

Abstract
Background
To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension.

Methods
In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in participants’ stages of change with respect to the modifiable health behaviours; diet, exercise, and medication management were assessed. To confirm the behaviour change outcomes, SOC were also assessed in a control group over the same period.

Results
Statistically significant changes in the modifiable health behaviours- medication management (d = 0.19; p = 0.03) and exercise (d = 0.85; p = 0.01) were apparent in participants who received health coaching and were evident through positive changes in the SOC charts. The participants in the control group did not experience significant changes with respect to the SOC. This was parallel to a decrease in mean systolic blood pressure from session one to session four by 7.53 mmHg (p < 0.05, d = − 0.42) in participants who received health coaching. Improvements to medication adherence was also apparent in these participants, evident from the mean scores for the Adherence to Refills and Medications Scale (ARMS), which decreased significantly from a mean of 15.60 to 13.05 (p < 0.05) from session one to four.

Conclusions
Pharmacist health coaching produced promising health outcomes in participants with poorly controlled hypertension. Pharmacists were able to facilitate a positive behaviour change in participants. However, larger participant cohorts are needed to explore these findings further.

Trial registration
Australia New Zealand Clinical Trials Registry ACTRN12618001839291. Date of registration 12/11/2018.
Metal biomarker mixtures and blood pressure in the United States: cross-sectional findings from the 1999-2006 National Health and Nutrition Examination Survey (NHANES)
Authors: Everson Todd M. , Niedzwiecki Megan M. , Toth Daniell , Tellez-Plaza Maria , Liu Haoran , Barr Dana B. , Gribble Matthew O. 
Published: February 2021

AbstractBackgroundThe objective of this study was to identify conditional relationships between multiple metal biomarkers that predict systolic and diastolic blood pressure in the non-institutionalized United States adult population below the age of 60.MethodsWe used inorganic exposure biomarker data and blood pressure data from three cycles (1999–2004) of the National Health and Nutrition Examination Survey (NHANES) to construct regression trees for blood pressure among adults ages 20–60 (adjusted for age, sex, body mass index, race, and smoking status) to identify predictors of systolic (SBP) and diastolic blood pressure (DBP). We also considered relationships among non-Hispanic black, Mexican-American, and white adults separately.ResultsThe following metal exposure biomarkers were conditionally predictive of SBP and/or DBP in the full sample: antimony (Sb), barium (Ba), cadmium (Cd), cesium (Cs), lead (Pb), tungsten (W) and molybdenum (Mo). The highest average SBP (> 120 mmHg) was observed among those with low Sb (≤ 0.21 μg/dL) high Cd (> 0.22 μg/g creatinine) and high Pb (> 2.55 μg/dL) biomarkers. Those with the highest average DBP had high urinary W levels (> 0.10 μg/g creatinine) in combination with either urinary Sb > 0.17 μg/g creatinine or those with urinary Sb ≤ 0.17 μg/g creatinine, but with high blood Pb levels (> 1.35 μg/dL). Predictors differed by ethnicity, with Cd as the main predictor of SBP among non-Hispanic black adults, and Pb not selected by the algorithm as a predictor of SBP among non-Hispanic white adults.ConclusionsCombinations of metal biomarkers have different apparent relationships with blood pressure. Additional research in toxicological experimental models and in epidemiological studies is warranted to evaluate the suggested possible toxicological interactions between Sb, Cd, and Pb; and between W, Sb, and Pb; for cardiovascular (e.g., blood pressure) health. We also think future epidemiological research on inorganic exposure sets in relation to health outcomes like blood pressure might benefit from stratification by race and ethnicity.
Biopsy sampling during self-expandable metallic stent placement in acute malignant colorectal obstruction: a narrative review
Authors: Bennedsgaard Sigrid Skov , Iversen Lene Hjerrild 
Published: February 2021

Abstract
Background
Histopathology is a crucial part of diagnosis and treatment guidance of colorectal cancer. In Denmark, it is not routine to biopsy during self-expandable metallic stent (SEMS) placement as a treatment option for acute colorectal obstruction of unknown etiology. This is due to lack of knowledge about the risks of hemorrhage, and thus the risk to aggravate the deteriorating overview conditions. Therefore, the aim of this study is to investigate whether there is evidence to avoid biopsy sampling during acute SEMS placement.

Methods
The PubMed, Embase, and Cochrane Library databases were searched for relevant studies. Studies were included if they described biopsy sampling in relation to SEMS placement. Additionally, national and international guidelines were scrutinized on Google and by visiting the websites of national and international gastrointestinal societies.

Results
In total, 43 studies were included in the review. Among these, one recommended biopsy during SEMS placement, three advised against biopsy, 23 just reported biopsy was performed during the procedure, and 16 reported biopsy before or after the procedure, or the timing was not specified. Among the 12 included guidelines, only two described biopsy during SEMS placement.

Conclusion
The literature on the subject is limited. In 24 of the 43 included studies, biopsy sampling was done during SEMS placement without reporting a decrease in the technical success rate. The included guidelines were characterized by a general lack of description of whether biopsy during SEMS placement should be performed or not. Prospective studies are needed in order to establish the real risk of hemorrhage, if any, when a biopsy is obtained.
Application of 3D printing and framework internal fixation technology for high complex rib fractures
Authors: Zhou Xuetao , Zhang Dongsheng , Xie Zexin , Yang Yang , Chen Menghui , Liang Zheng , Zhang Guoliang , Li Shujun 
Published: February 2021

Abstract
Objective
To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures.

Methods
Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS).

Results
The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape.

Conclusion
The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.
Comparison of the efficacy of different androgens measured by LC-MS/MS in representing hyperandrogenemia and an evaluation of adrenal-origin androgens with a dexamethasone suppression test in patients with PCOS
Authors: Chen Fu , Chen Minjie , Zhang Weichun , Yin Huihuang , Chen Guishan , Huang Qingxia , Yang Xiaoping , Chen Lan , Lin Chujia , Yin Guoshu 
Published: February 2021

Abstract
Background
The aims of this study were to compare the efficacy of different androgens measured by liquid chromatography-mass spectrometry (LC-MS/MS) in representing hyperandrogenemia and to evaluate adrenal-origin androgens with a dexamethasone suppression test in patients with polycystic ovary syndrome (PCOS).

Methods
One hundred and two patients with PCOS and 41 healthy volunteers were recruited and total serum testosterone (TT), androstenedione (AD), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) were measured by LC-MS/MS. ROC analysis was performed to compare the efficacy of different androgens in representing hyperandrogenemia. Dexamethasone suppression test was performed in 51 patients with PCOS and above indicators were measured after dexamethasone administration. The prediction efficacy of DHEA and DHEA-S at baseline in the dexamethasone suppression test was evaluated with ROC analysis.

Results
The AUCs of TT, AD, free androgen index (FAI) and DHEA-S in ROC analysis for representing hyperandrogenemia were 0.816, 0.842, 0.937 and 0.678, respectively. The optimal cutoff value of TT was 0.337 ng/ml, with a sensitivity of 72.0% and specificity of 82.93%. The optimal cutoff value for AD was 1.309 ng/ml, with a sensitivity of 81.0% and specificity of 73.17%. The optimal cutoff value of the FAI was 2.50, with a sensitivity of 87.0% and specificity of 92.68%. Alternatively, AD or FAI more than the optimal cutoff values as evidence of hyperandrogenemia had the highest sensitivity of 91.18%. The levels of cortisol, DHEA and DHEA-S were all suppressed to narrow ranges after dexamethasone administration. Nine and 8 of 51 patients with PCOS had significant decreases in TT and AD, respectively. DHEA can be used as a indicator for predicting significant decrease of TT in dexamethasone suppression test with cutoff value of 13.28 ng/ml. A total of 27.5% (14/51) of patients had DHEA-S excess, but only 1 of 9 patients who had a significant decrease in TT had elevated level of DHEA-S at baseline.

Conclusions
AD measured by LC-MS/MS can represent hyperandrogenemia in PCOS patients and, combined with TT or FAI, can improve the screening efficiency of hyperandrogenemia. Seventeen percent of PCOS patients had adrenal-origin androgen dominance, with TT significantly decreasing after 2 days of dexamethasone administration. Adrenal-origin androgen dominance was not parallel with DHEA-S excess in patients with PCOS.
Survival and biomarker analysis for ovarian mucinous carcinoma according to invasive patterns: retrospective analysis and review literature
Authors: Hada Taira , Miyamoto Morikazu , Ishibashi Hiroki , Matsuura Hiroko , Sakamoto Takahiro , Kakimoto Soichiro , Iwahashi Hideki , Tsuda Hitoshi , Takano Masashi 
Published: February 2021

Abstract
Background
In ovarian mucinous carcinoma, invasive pattern is the important factor but there were less reposts to investigate it. The aim of this study was to examine the association between prognosis and invasive patterns of ovarian mucinous carcinoma and to investigate the biomarkers of the diagnosis and prognosis immunochemically. Patients with ovarian mucinous carcinoma at our institution between 1984 and 2018 were identified. A pathological review was conducted using the 2020 World Health Organization criteria. The prognosis of infiltrative invasion and expansile invasion of ovarian mucinous carcinoma were retrospectively compared. In addition, immunohistochemical staining was conducted for all cases, and the immunohistochemical differences between the two invasive patterns were compared.

Results
After the pathological review, 25 cases with infiltrative invasion and 24 cases with expansile invasion were included. Ovarian mucinous carcinoma with infiltrative invasion showed significantly worse progression-free survival (PFS, p < 0.01) and overall survival (OS, p < 0.01) than those with expansile invasion. Multivariate analysis demonstrated that the pattern of infiltrative invasion was a worse prognostic factor for PFS (hazard ratio 9.01, p < 0.01) and OS (hazard ratio 17.56, p < 0.01). Immunohistochemically, cytokeratin (CK) 5/6 (p = 0.01), cluster of differentiation (CD) 24 (p = 0.02), and epithelial growth factor receptor (EGFR) (p < 0.01) were statistically related to infiltrative invasion. The PFS (p = 0.04) and OS (p = 0.02) of cases with EGFR-positive OMC were worse than those with negative OMC.

Conclusions
Infiltrative invasion was observed to be a prognostic factor showing worse outcomes for ovarian mucinous carcinoma compared to expansile infiltration. CK5/6, CD24, and EGFR might be biomarkers of the diagnosis.
Innovations with tele-ultrasound in education sonography: the use of tele-ultrasound to train novice scanners
Authors: Drake Anne E. , Hy Jonathan , MacDougall Gordon A. , Holmes Brendan , Icken Lauren , Schrock Jon W. , Jones Robert A. 
Published: February 2021

Abstract
Objectives
Point-of-care ultrasound (POCUS) has become increasingly integrated into medical education given the growing role of evaluative and procedural techniques in practice today. Tele-ultrasound is a new and promising venture that aims to expand medical knowledge and education to previously unreached or underserved areas. This study aimed to determine the non-inferiority of teaching ultrasound remotely using tele-ultrasound via the Philips Lumify (Philips Medical Systems, Bothell, WA) system, which utilizes video conferencing technology and real-time imaging that can be viewed by the operator and educator simultaneously.

Methods
Three commonly used ultrasound exams were taught and evaluated in 56 ultrasound-naive medical participants: Focused Assessment with Sonography in Trauma (FAST), Lower Extremity Deep Venous Thrombosis (LEDVT) screening, and ultrasound-guided vascular access. The participants were randomized into either in-person traditional learning or tele-ultrasound learning with the Philips Lumify (Philips Medical Systems, Bothell, WA) units. The primary outcome of interest was the ability to perform certain tasks for each exam

Results
Competency on each exam was tested across all exams and no inferiority was found between in-person and remote learning (p < 0.05).

Conclusions
Our findings support the use of tele-ultrasound in beginner ultrasound education.
Pesticide traces in local crops of Sancti Spíritus, Cuba: risk assessment study
Authors: López-Dávila Edelbis , Houbraken Michael , De Rop Jasmine , Claus Gregor , Wumbei Abukari , Romero Romero Osvaldo , Spanoghe Pieter 
Published: February 2021

AbstractBackgroundVegetables and rice produced in Cuba may contain residue of pesticides that exceed the maximum residue limits (MRLs). Pesticide residues on crop samples from Sancti Spíritus province were analyzed. Based on these residue data, a risk assessment of consumer exposure was conducted.MethodsSamples collected during the 2017, 2018, and 2019 periods were analyzed using UPLC-MS/MS and GC/ECD chromatography techniques. A deterministic risk assessment was performed, using consumption data collected by the authors. Also, a probabilistic risk assessment was worked out with @RISK for the Monte Carlo simulation.ResultsA broad range of pesticides were detected in the samples. Most of the detected active ingredients were insecticides and fungicides. A considerable part of the detected pesticide residues exceeded the EU and Cuban MRLs. However, the deterministic risk assessment revealed that the consumer risk of pesticide exposure is low. Only in the maximum exposure scenario children and adults were exposed to methamidophos residues in tomatoes higher than the acceptable daily intake.ConclusionsWhen a more realistic consumption (50th percentile) and higher (95th percentile) consumption pattern for tomatoes was assumed, the deterministic risk assessment found no chronic risk for children and adults being exposed to methamidophos present in the tomato samples. Furthermore, the probabilistic risk assessment concerning methamidophos exposure in tomato for children and adult strata showed no risk. To perform in the future a more accurate risk assessment for Cuban consumers it is important to have more detailed consumption data and an expanded dataset of the residues in different crops.