bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Double-Blinded Dose-dependent Study of Metaraminol for Preventing Spinal-Induced Hypotension in Caesarean Delivery
Authors: Xiao Fei , Xu Wen-Ping , Yao Han-Qing , Fan Jia-Ming , Chen Xin-Zhong 
Published: May 2021

Purpose: Prophylactic infusion of a vasopressor is preferred as a rational choice in clinical practice in Cesarean delivery. Metaraminol is one of most common vasopressors used in obstetric clinical practice. However, the dose-response of metaraminol has not been fully determined and the optimal infusion dose is unknown. Therefore, this study aimed to determine the median effective dose (ED50) and 90% effective dose (ED90) of weight-based fixed-rate metaraminol infusions for preventing spinal-anesthesia-induced hypotension in patients having combined spinal-epidural anesthesia for elective Caesarean delivery.Methods: One hundred and seventeen patients with singleton pregnancies were enrolled and randomly allocated into one of five groups in this study. Patients received prophylactic metaraminol infusion at a fixed rate of 0, 0.25, 1.0, 1.75 or 2.5 μg/kg/min in each group immediately after induction with intrathecal 10 mg of hyperbaric bupivacaine mixed with 5 μg of sufentanil. An effective prophylactic dose was defined as no occurrence of hypotension during the period of spinal introduction and neonatal delivery. Values for ED50 and ED90 of prophylactic infusion of metaraminol were calculated using probit regression. Characteristics of spinal anesthesia and side effects were recorded.Results: The ED50 and ED90 values of weight-based fixed rate of metaraminol infusion were 0.64 (95% CI, 0.04–1.00) μg/kg/min and 2.00 (95% CI, 1.58–2.95) μg/kg/min respectively. The incidence of hypotension decreased with an increased infusion rate of metaraminol in the five groups (test for trend, p &lt; 0.001). The incidence of hypotension was similar between group 0 and 0.25, but significant higher than other groups; the incidence of hypotension was also similar between group 1.0 and 1.75, but higher than group 2.5. The incidence of reactive hypertension was significantly higher in group 2.5 compared to the other groups. Physician interventions were more frequent in group 0, 0.25 and 2.5 than in group 1.0 and 1.75 (adjusted p &lt; 0.001). No difference was found in neonatal outcomes, including Apgar score and pH value of the umbilical artery.Conclusion: In summary, we have compared four different prophylactic weight-based infusion doses of metaraminol for preventing post-spinal hypotension in Cesarean delivery. The ED50 and ED90 values of metaraminol infusion for preventing spinal anesthesia-induced hypotension were 0.64 μg/kg/min and 2.00 μg/kg/min, respectively. This finding may be helpful for guiding clinical practice and further research.
Uncovering Prolonged Grief Reactions Subsequent to a Reproductive Loss: Implications for the Primary Care Provider
Authors: Grauerholz Kathryn R. , Berry Shandeigh N. , Capuano Rebecca M. , Early Jillian M. 
Published: May 2021

IntroductionThere is a paucity of clinical guidelines for the routine assessment of maladaptive reproductive grief reactions in outpatient primary care and OB-GYN settings in the United States. Because of the disenfranchised nature of perinatal grief reactions, many clinicians may be apt to miss or dismiss a grief reaction that was not identified in the perinatal period. A significant number of those experiencing a reproductive loss exhibit signs of anxiety, depression, or post-traumatic stress disorder. Reproductive losses are typically screened for and recorded numerically as part of a woman’s well-visit intake, yet this process often fails to identify patients emotionally troubled by a prior pregnancy loss.Materials and MethodsA summative content analysis of 164 recent website blogs from female participants who self-reported having experienced a miscarriage or abortion in their lifetime was conducted. The narratives were reviewed for details regarding the time span between the pregnancy loss and the composition of the blog post. The stories were analyzed for subsequent relationship problems and detrimental mental health conditions. Maladaptive reactions were contrasted for those that indicated a greater than 12 months’ time-lapse and those who had not.ResultsMore than a third (39.6%) of the women reported in the narrative that at least one year or more had passed since experiencing the miscarriage or abortion. For those women, the median time span between the loss and composing the blog was 4 years with a range of 47 years. Mental health conditions attributed to the reproductive loss by those who reported longer bereavement times included subsequent relationship problems, substance misuse, depression, suicidal ideation, and PTSD. The percent of reported maladaptive issues was more than double (136.9% vs. 63.6%) for those who reported that a year or more had passed since the loss of the pregnancy.DiscussionGrief reactions following the loss of a pregnancy may be prolonged or delayed for several months which can contribute to adverse biopsychosocial outcomes. Recognition and treatment of maladaptive grief reactions following a pregnancy loss are critical. Screening methods should be enhanced for clinicians in medical office settings to help identify and expedite the appropriate mental health assistance.
Identifying Subgroups of Patients With Autism by Gene Expression Profiles Using Machine Learning Algorithms
Authors: Lin Ping-I , Moni Mohammad Ali , Gau Susan Shur-Fen , Eapen Valsamma 
Published: May 2021

Objectives: The identification of subgroups of autism spectrum disorder (ASD) may partially remedy the problems of clinical heterogeneity to facilitate the improvement of clinical management. The current study aims to use machine learning algorithms to analyze microarray data to identify clusters with relatively homogeneous clinical features.Methods: The whole-genome gene expression microarray data were used to predict communication quotient (SCQ) scores against all probes to select differential expression regions (DERs). Gene set enrichment analysis was performed for DERs with a fold-change &gt;2 to identify hub pathways that play a role in the severity of social communication deficits inherent to ASD. We then used two machine learning methods, random forest classification (RF) and support vector machine (SVM), to identify two clusters using DERs. Finally, we evaluated how accurately the clusters predicted language impairment.Results: A total of 191 DERs were initially identified, and 54 of them with a fold-change &gt;2 were selected for the pathway analysis. Cholesterol biosynthesis and metabolisms pathways appear to act as hubs that connect other trait-associated pathways to influence the severity of social communication deficits inherent to ASD. Both RF and SVM algorithms can yield a classification accuracy level &gt;90% when all 191 DERs were analyzed. The ASD subtypes defined by the presence of language impairment, a strong indicator for prognosis, can be predicted by transcriptomic profiles associated with social communication deficits and cholesterol biosynthesis and metabolism.Conclusion: The results suggest that both RF and SVM are acceptable options for machine learning algorithms to identify AD subgroups characterized by clinical homogeneity related to prognosis.
Case Report: Treatment of a Comorbid Attention Deficit Hyperactivity Disorder and Obsessive–Compulsive Disorder With Psychostimulants
Authors: Dogan-Sander Ezgi , Strauß Maria 
Published: May 2021

Introduction: Attention deficit hyperactivity disorder (ADHD) is a common disease in childhood and adolescence. In about 60% of pediatric patients, the symptoms persist into adulthood. Treatment guidelines for adult ADHD patients suggest multimodal therapy consisting of psychostimulants and psychotherapy. Many adult ADHD patients also suffer from psychiatric comorbidities, among others obsessive–compulsive disorder (OCD). The treatment of the comorbidity of ADHD and OCD remains challenging as the literature is sparse. Moreover, the impact of psychostimulants on obsessive–compulsive symptoms is still unclear.Case Presentation: Here, we report on a 33-year-old patient with an OCD who was unable to achieve sufficient remission under long-term guideline-based treatment for OCD. The re-examination of the psychological symptoms revealed the presence of adult ADHD as a comorbid disorder. The patient has already been treated with paroxetine and quetiapine for the OCD. Due to the newly established diagnosis of ADHD, extended-release methylphenidate (ER MPH) was administered in addition to a serotonin reuptake inhibitor. After a dose of 30 mg ER MPH, the patient reported an improvement in both the ADHD and the obsessive–compulsive symptoms. After discharge, the patient reduced ER MPH without consultation with a physician due to subjectively described side effects. The discontinuation of medication led to a renewed increase in ADHD and obsessive–compulsive symptoms. The readjustment to ER MPH in combination with sertraline and quetiapine thereafter led to a significant improvement in the compulsive symptoms again.Conclusion: The present case shows that in ADHD and comorbid obsessive–compulsive disorder, treatment with psychostimulants can improve the obsessive–compulsive symptoms in addition to the ADHD-specific symptoms. To our knowledge, this is only the second case report describing a treatment with ER MPH for an adult patient with OCD and ADHD comorbidity in the literature. Further research, especially randomized controlled trials, is needed to standardize treatment options.
Current Status and Prospects of Immunotherapy for Gynecologic Melanoma
Authors: Anko Mayuka , Kobayashi Yusuke , Banno Kouji , Aoki Daisuke 
Published: May 2021

Gynecologic melanomas are rare and have a poor prognosis. Although immunotherapy (immune checkpoint inhibitors) and targeted therapy has greatly improved the systemic treatment of cutaneous melanoma (CM) in recent years, its efficacy in gynecologic melanomas remains uncertain because of the rarity of this malignancy and its scarce literature. This review aimed to evaluate the literature of gynecologic melanomas treated with immunotherapy and targeted therapy through a PubMed search. We identified one study focusing on the overall survival of gynecologic melanomas separately and five case series and nine case reports concentrating on gynecologic melanomas treated with an immune checkpoint inhibitor and/or targeted therapy. Furthermore, the KIT mutation has the highest rate among all mutations in mucosal melanoma types. The KIT inhibitors (Tyrosine kinase inhibitors: TKIs) imatinib and nilotinib could be the treatment options. Moreover, immune checkpoint inhibitors combined with KIT inhibitors may potentially treat cases of resistance to immune checkpoint inhibitors. However, because of the different conditions and a small number of cases, it is difficult to evaluate the efficacy of immunotherapy and targeted therapy for gynecologic melanoma rigorously at this time. Further prospective cohort or randomized trials of gynecologic melanoma alone are needed to assess the treatment with solid evidence.
SPLUS J210428.01−004934.2: An Ultra Metal-poor Star Identified from Narrowband Photometry*
Authors: Placco Vinicius M. , Roederer Ian U. , Lee Young Sun , Almeida-Fernandes Felipe , Herpich Fábio R. , Perottoni Hélio D. , Schoenell William , Ribeiro Tiago , Kanaan Antonio 
Published: May 2021

Abstract
We report on the discovery of SPLUS J210428.01−004934.2, an ultra metal-poor (UMP) star first identified from the narrowband photometry of the Southern Photometric Local Universe Survey (S-PLUS) Data Release 1, in the SDSS Stripe 82 region. Follow-up medium- and high-resolution spectroscopy (with Gemini South and Magellan-Clay, respectively) confirmed the effectiveness of the search for low-metallicity stars using the S-PLUS narrowband photometry. At [Fe/H] = −4.03, SPLUS J2104−0049 has the lowest detected carbon abundance, A(C) = +4.34, when compared to the 34 previously known UMP stars in the literature, which is an important constraint on its stellar progenitor and also on stellar evolution models at the lowest metallicities. Based on its chemical abundance pattern, we speculate that SPLUS J2104−0049 could be a bona fide second-generation star, formed from a gas cloud polluted by a single metal-free ∼ 30M
⊙ star. This discovery opens the possibility of finding additional UMP stars directly from narrowband photometric surveys, a potentially powerful method to help complete the inventory of such peculiar objects in our Galaxy.
Constraining the Regolith Composition of Asteroid (16) Psyche via Laboratory Visible Near-infrared Spectroscopy
Authors: Cantillo David C. , Reddy Vishnu , Sharkey Benjamin N. L. , Pearson Neil A. , Sanchez Juan A. , Izawa Matthew R. M. , Kareta Theodore , Campbell Tanner S. , Chabra Om 
Published: May 2021

Abstract
(16) Psyche is the largest M-type asteroid in the main belt and the target of the NASA Discovery-class Psyche mission. Despite gaining considerable interest in the scientific community, Psyche's composition and formation remain unconstrained. Originally, Psyche was considered to be almost entirely composed of metal due to its high radar albedo and spectral similarities to iron meteorites. More recent telescopic observations suggest the additional presence of low-Fe pyroxene and exogenic carbonaceous chondrites on the asteroid's surface. To better understand the abundances of these additional materials, we investigated visible near-infrared (0.35–2.5 μm) spectral properties of three-component laboratory mixtures of metal, low-Fe pyroxene, and carbonaceous chondrite. We compared the band depths and spectral slopes of these mixtures to the telescopic spectrum of (16) Psyche to constrain material abundances. We find that the best matching mixture to Psyche consists of 82.5% metal, 7% low-Fe pyroxene, and 10.5% carbonaceous chondrite by weight, suggesting that the asteroid is less metallic than originally estimated (∼94%). The relatively high abundance of carbonaceous chondrite material estimated from our laboratory experiments implies the delivery of this exogenic material through low velocity collisions to Psyche's surface. Assuming that Psyche's surface is representative of its bulk material content, our results suggest a porosity of 35% to match recent density estimates.
Catalog of Rose Gall, Herb Gall, and Inquiline Gall Wasps (Hymenoptera: Cynipidae) of the United States, Canada, and Mexico
Authors: Nastasi Louis , Deans Andrew 
Published: May 2021

Cynipidae (Hymenoptera: Cynipoidea) is a diverse group of wasps, many of which are capable of inducing plants to make novel structures, galls, that protect and nourish the wasps' larvae. Other cynipids, especially those species in Ceroptresini and Synergini, are understood to be usurpers of galls made by other cynipids. The North American cynipid fauna has not been fully cataloged since 1979, but there is renewed interest in revising the taxonomy and in doing research that sheds light on the mechanisms of gall induction, the evolution of this life history, and their ecological interactions more broadly. Significant taxonomic changes have impacted the group since 1979, thereby warranting a new catalog.
The current state of knowledge of species classified in Aulacideini, Ceroptresini, Diastrophini, Diplolepidini, Phanacidini, and Synergini in the United States, Canada, and Mexico is summarized in catalog format. We report 323 names, including 170 valid species of rose gall wasps, herb gall wasps, and inquiline gall wasps, classified in 12 genera, from the United States, Canada, and Mexico. Current taxonomic status, distribution, host associations, and vernacular names are listed for each species. The catalog also includes the original description of galls for many species of gall-inducer, as well as atomized characterizations of different gall traits as key-value pairs. For most galling species without existing vernacular names, new vernacular names are proposed.
The Role of Sources and Types of Health Information in Shaping Health Literacy in Cervical Cancer Screening Among African Immigrant Women: A Mixed-Methods Study
Authors: Cudjoe Joycelyn , Gallo Joseph J. , Sharps Phyllis , Budhathoki Chakra , Roter Debra , Han Hae-Ra 
Published: May 2021

Background:
Health literacy is a strong determinant of health outcomes among immigrants. How sources and types of health information influence health literacy in the context of cervical cancer screening among African immigrant women remains unknown.

Objective:
This study was undertaken to explore how various sources and types of health information influence information sharing and health literacy in the context of cervical cancer screening among African immigrant women.

Methods:

Using a mixed-methods approach, a convenience sample of African immigrant women (
N
= 167) completed study surveys followed by semi-structured individual phone interviews with a purposive sub-sample (
n
= 20) of survey participants. The relationship between sources and types of health information and health literacy was assessed using multivariate logistic regression. Emergent themes were identified in the qualitative interviews using content analysis. Qualitative and quantitative data were merged to describe differences and similarities in African immigrant women's experiences and display of health literacy by different sources and types of health information.

Key Results:

Health care providers (78%), women friends (46%), and internet (45%) were the most common sources of health information used by African immigrant women, followed by women relatives (32%), television (22%), social media (17%), and church (16%). Content analysis revealed that the health care provider was rated as the most credible source; personal experiences of family and friends made health information more relatable; and church was the least endorsed source. Health information presented verbally (adjusted odds ratio of 5.51,
p
= .01) was associated with higher health literacy even after controlling for covariates. Most African immigrant women had health information presented in verbal form (80%), with pictures (43%) being the least popular type of health information.

Conclusions:

Study findings suggest that verbal communication is associated with health literacy in the context of cervical cancer screening among African immigrant women. Health interventions that use peer educators (women friends and family) and incorporate verbal communication may be a more effective strategy in promoting positive cervical cancer health behaviors among African immigrant women.

[
HLRP: Health Literacy Research and Practice
. 2021;5(2):e96–e108.]

Plain Language Summary:

For this mixed-methods study, a convenience sample of African immigrant women (
N
= 167) completed study surveys followed by semi-structured individual phone interviews with a purposive sub-sample (
n
= 20) of the survey participants. Study findings show a strong association between verbal communication and health literacy in the context of cervical cancer screening among African immigrant women.
O programa de apoio ao estudante quilombola (PAEQUI) como política de permanência numa universidade na Amazônia (UNIFESSPA-PA)
Authors: Rascke Karla Leandro , Dos Santos Jheyciele Naira , Alencar Maria Cristina Macedo 
Published: May 2021

O trabalho foca a experiência de realização do Programa de Apoio ao Estudante Quilombola (PAEQUI), que constitui uma política preocupada com a permanência de estudantes quilombolas ingressantes na Unifesspa via Processo Seletivo Específico Indígena e Quilombola (PSIQ). O estudo foi realizado com a análise de fontes documentais, notas de campo, relatórios parciais e finais produzidos pelas discentes apoiadoras e pelas coordenadoras, destacando o funcionamento do PAEQUI em dois grupos na unidade 3, campus de Marabá. Objetivou-se analisar os avanços e desafios na implementação dessa política de permanência voltada para os estudantes quilombolas na instituição. Constatou-se que o Programa possui experiências exitosas e desafios quanto a ações articuladas entre a PROEG e as coordenações dos grupos de apoiadores que possibilitem efetivamente o sucesso acadêmico dos discentes apoiados.
ANÁLISE SUBJETIVA DO CONFORTO TÉRMICO NA ESTAÇÃO SECA E CHUVOSA EM UM PARQUE URBANO NA AMAZÔNIA CENTRAL
Authors: Bentes Mandú Tiago , Dos Santos Gomes Ana Carla , Silva dos Santos Marconio , Almeida da Silva Eduardo 
Published: May 2021

O Conforto Térmico (CT) é definido como a condição psicologica que expressa satisfação com o ambiente, onde não se sente sensação de calor ou de frio. Este trabalho teve como objetivo realizar uma análise subjetiva da sensação térmica dos visitantes do Parque Municipal de Santarém-PA, assim como verificar a precisão do modelo do voto médio predito nas estações seca e chuvosa. Foram aplicados 75 questionários semiestruturados em cada estação, que avaliava os parâmetros que constituem o CT humano de acordo com as normas internacionais. Esses questionários foram aplicados no Parque Municipal da cidade de Santarém-Pará. O teste de Mann-Whitney foi utilizado para comparar a percepção térmica dos visitantes do parque a fim de verificar se a sensação apresenta similaridade dentre os períodos, o modelo do Voto Médio Predito (em inglês, PMV) foi empregado para estimar a percepção térmica dos visitantes do parque. Foi possível observar que a sensação de desconforto é a de maior predominância nas duas estações. O teste de Mann-Whitney indica que, de forma geral, a sensação de conforto é a mesma durante as duas estações, e o PMV apresenta desempenho insatisfatório para todos os períodos avaliados. Espera-se que esses resultados possam colaborar no entendimento do CT de Santarém e ajudar no entendimento do microclima em cidades na região amazônica.