bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced False Positives in Autism Screening Via Digital Bio-markers Inferred from Deep Co-morbidity Patterns
Authors: Chattopadhyay Ishanu , Onishchenko Dmytro , Huang Yi , Smith Peter J. , Msall Michael M. , Horne James van 
Published: March 2021

Abstract
Autism spectrum disorder (ASD) is a developmental disability associated with significant social and behavioral challenges. There is a need for tools that help identify children with ASD as early as possible. Our current incomplete understanding of ASD pathogenesis, and the lack of reliable biomarkers hampers early detection, intervention, and developmental trajectories. In this study we develop and validate machine inferred digital biomarkers for autism using individual diagnostic codes already recorded during medical encounters. Our risk estimator identifies children at high risk with a corresponding area under the receiver operating characteristic curve (AUC) exceeding 80% from shortly after two years of age for either sex, and across two independent databases of patient records. Thus, we systematically leverage ASD co-morbidities - with no requirement of additional blood work, tests or procedures - to compute the Autism Co-morbid Risk Score (ACoR) which predicts elevated risk during the earliest childhood years, when interventions are the most effective. By itself, ACoR has superior performance to common questionnaires-based screenings such as the M-CHAT/F, and has the potential to reduce socio-economic, ethnic and demographic biases. In addition to superior standalone performance, independence from questionnaire based screening allows us to further boost performance by conditioning on the individual M-CHAT/F scores - we can either halve the false positive rate of current screening protocols or boost sensitivity to over 60%, while maintaining specificity above 95%. Adopted in practice, ACoR could significantly reduce the median diagnostic age for ASD, and reduce long post-screen wait-times experienced by families for confirmatory diagnoses and access to evidence based interventions.
Organisational Implementation Climate in implementing internet-based Cognitive Behaviour Therapy for depression
Authors: Vis Christiaan , Kleiboer Annet , Mol Mayke , Pedersen Claus Duedal , Finch Tracy , Smit Jan , Riper Heleen 
Published: March 2021

Abstract
Background. Internet-based Cognitive Behaviour Therapy (iCBT) services for depression have been implemented in routine care in 14 European regions. This study aimed to advance understanding of the nature and value of organisational implementation climate in implementing iCBT services from the perspectives of implementers and service deliverers.Methods. A mixed method approach was applied. Based on concept mapping, a workshop with implementers was conducted to qualitatively conceptualise organisational implementation climate conducive to optimizing iCBT use in routine practice. Mental health service deliverers involved in the provision of iCBT services were invited to participate in a cross-sectional survey assessing levels of satisfaction and usability of iCBT, and of the organisational implementation climate. Associations between satisfaction, usability and implementation climate were explored.Results. 16 implementers representing 14 service delivery organisations participated in the workshop. The top-3 characteristics of a strong organisational implementation climate included: (1) clear roles and skills of implementers, (2) feasible implementation targets, and (3) a dedicated implementation team. The top-3 tools for creating a good implementation climate included: (1) job performance feedback, (2) progress monitoring in achieving implementation targets, and (3) guidelines for assessing the impact of iCBT. 111 respondents (73% female) completed the survey. Respondents were generally satisfied delivering iCBT services (MCSQ = 9.11, SD = 1.96, range = 3-15, n = 108) and found their usability slightly below average (MSUS = 63.76, SD = 15.53, range = 0-100, n = 103). They regarded their organisational implementation climate as supportive in implementing iCBT services (MICS = 43.21, SD = 5.62, range = 12-60, n = 89). Organisational implementation climate was weakly associated with usability (r = 0.25, p =.03) and moderately with satisfaction (r = .51, p £ .00).Conclusions. Organisational implementation climate as part of the wider organisational context in which implementation processes take place, is a relevant factor to implementers and service deliverers in implementing iCBT in routine care. The qualitative conceptual findings align with the quantitative approach applied in this study for measuring organisational implementation climate. Implementers can use various practical tools to shape organisational implementation climate to increase acceptance and improve implementation of iCBT in mental health care.
­ Apatinib combined with PD-L1 blockade synergistically enhances antitumor immune responses and promotes HEV formation in gastric cancer
Authors: Zhang Yu , Wang Fei , Sun Hao-ran , Huang Ya-kai , Gao Jian-peng , Huang Hua 
Published: March 2021

Abstract
Purpose
Apatinib, an antiangiogenic drug, has showed beneficial effects only in a fraction of advanced gastric cancer (GC) patients. Given the recent success of immunotherapies, combination of apatinib with immune checkpoint inhibitor may provide sustained and potent antitumor responses.
Methods
Immunocompetent mice with subcutaneous MFC tumors grown were given combination of apatinib and anti-PD-L1 antibody therapy. GC tissues from patients undergoing curative resection in China were collected, and the density of HEVs, MSI status and tumor-infiltrated lymphocytes were analyzed by immunohistochemical staining.
Results
Combined apatinib and PD-L1 blockade therapy synergistically delayed tumor growth and increased survival in MFC-bearing immunocompetent mice. The combination therapy promoted antitumor immunity by increasing the ratio of CD8+ cytotoxic T cells to Foxp3+ Treg cells, the accumulation of CD20+ B cells and the Th1/Th2 cytokine ratio (IFN-γ/IL-10). The combination therapy induced the formation of HEVs through activation of LTβR signaling, thus promoting CD8+ cytotoxic T cell and CD20+ B cell infiltration in tumors. In clinical GC samples, the density of HEVs positively correlated with the intratumoral infiltration of CD8+ cytotoxic T cells and CD20+ B cells. MSI-high GC showed a higher density of HEVs, CD8+ cytotoxic T cells and CD20+ B cells than MSS/MSI-low GC. GC patients with high densities of HEVs, CD8+ cytotoxic T cells and CD20+ B cells had an improved prognosis with superior overall survival.
Conclusion
Combining apatinib with PD-L1 blockade treatment synergistically enhances antitumor immune responses and promotes HEV formation in GC.
TGF-β and CCL18 as indicators for predicting and monitoring the development of pulmonary fibrosis in patients with COVID-19
Authors: Zong Ming , Zheng Liang , Zhou Huan , Lu Liu , He Long , Wu Xiaodong , Chen Nianzhen , Wang Lan , Yuan Jiayi , Jiang Erpeng , Shi Yan , Li Qiang , Fan Lieying , Liu Zhongmin 
Published: March 2021

Abstract
Background

Many COVID-19 patients have been discharged, but lung injury, including pulmonary fibrosis, might lead to long-term impairment. This study aimed to evaluate predictors and monitors of pulmonary fibrosis in patients with COVID-19.
Methods

Thirty-five convalescent patients with severe COVID-19, after appropriate medical treatments, were recruited. According to evidence of fibrosis on initial computed tomography (CT), the patients were divided into mild-to-moderate and severe groups. Levels of transforming growth factor beta (TGF-β), chemokine ligand 18 (CCL18), type III procollagen peptide (PⅢP), hyaluronic acid (HA), laminin (LN), and type IV collagen (CⅣ) were determined. Laboratory tests, clinical data, and CT features at different stages were collected and analyzed, and the prognostic performance of these parameters was evaluated.
Results

Severe fibrosis was found in 76.29% (26/35) of patients. However, most baseline laboratory characteristics were normal. Fibrosis indicators (TGF-β: 66.67 ± 158.57 vs 55.84 ± 126.43 pg/mL, P = 0.006; CCL18: 364.27 ± 167.70 vs 84.47 ± 60.67 ng/mL, P = 0.000; PⅢP: 54.12 ± 55.34 vs 17.15 ± 2.48 ng/mL, P = 0.000; HA: 122.47 ± 78.84 vs 59.74 ± 18.01 ng/mL, p = 0.000; LN: 55.43 ± 46.44 vs 24.25 ± 7.79 ng/mL, P = 0.000; CⅣ: 24.77 ± 14.97 vs 15.32 ± 1.15 ng/mL, P = 0.001) were elevated in patients compared with controls. Over 90 days’ follow-up, HRCT scores gradually decreased from 22.48 ± 16.13 to 10.33 ± 11.11 (P < 0.001), and mMRC scores decreased from 3.27 ± 0.32 to 1.48 ± 0.33, and all fibrosis indicators, except for PⅢP, gradually declined with the improvement of pulmonary fibrosis. Moreover, TGF-β and CCL18 levels were lower in the mild-to-moderate than severe fibrosis group (88.16 ± 97.45 vs 205.93 ± 170.57 pg/mL, P = 0.024; 241.84 ± 125.37 vs 366.64 ± 161.06 ng/mL, P = 0.038), and patients with elevated baseline levels of serum TGF-β and CCL18 had longer rehabilitation times.
Conclusions

TGF-β and CCL18 may be promising biomarkers for predicting and monitoring the development of pulmonary fibrosis in patients with COVID-19.
Lesão por armlock em atleta amador de jiu-jitsu: relato de caso
Authors: Alves Rezende Luis Guilherme Rosifini , Shimaoka Filipe Jun , Shimabukuro Gunter Shin Iti Takamori , Mandarano-Filho Luiz Garcia , Mazzer Nilton , Barbieri Cláudio Henrique 
Published: March 2021

O jiu-jitsu brasileiro é uma modalidade de arte marcial que utiliza o princípio da imobilização para a execução de seus golpes. Este esporte tem apresentado aumento do número de praticantes nas últimas duas décadas. Isto implica no aumento do número de lesões, principalmente quando se considera o perfil dos atletas amadores. As lesões do cotovelo no jiu-jitsu estão entre as lesões mais comuns nesta modalidade esportiva. O mecanismo de trauma mais observado é a hiperextensão forçada durante a aplicação da chave de braço (armlock ou armbar). Apresentamos um relato de caso de um paciente de 26 anos com uma lesão aguda do complexo ligamentar medial por chave de braço durante uma luta de jiu-jitsu. O paciente foi submetido ao tratamento conservador, com imobilização e fortalecimento da musculatura flexo-pronadora. Realizou-se o retorno gradual ao esporte, apresentando bom resultado funcional do cotovelo e do membro superior após quatro anos de seguimento.
Characterization of carbon phases in Yamato 74123 ureilite to constrain the meteorite shock history
Authors: Barbaro Anna , Nestola Fabrizio , Pittarello Lidia , Ferrière Ludovic , Murri Mara , Litasov Konstantin D. , Christ Oliver , Alvaro Matteo , Domeneghetti M. Chiara 
Published: March 2021

Abstract
The formation and shock history of ureilite meteorites, a relatively abundant type of primitive achondrites, has been debated for decades. For this purpose, the characterization of carbon phases can provide further information on diamond and graphite formation in ureilites, shedding light on the origin and history of this meteorite group. In this work, we present X-ray diffraction and micro-Raman spectroscopy analyses performed on diamond and graphite occurring in the ureilite Yamato 74123 (Y-74123). The results show that nano- and microdiamonds coexist with nanographite aggregates. This, together with the shock-deformation features observed in olivine, such as mosaicism and planar fractures, suggest that diamond grains formed by a shock event (≥15 GPa) on the ureilitic parent body (UPB). Our results on Y-74123 are consistent with those obtained on the NWA 7983 ureilite and further support the hypothesis that the simultaneous formation of nano- and microdiamonds with the assistance of a Fe-Ni melt catalysis may be related to the heterogeneous propagation and local scattering of the shock wave. Graphite geothermometry revealed an average recorded temperature (Tmax) of 1314 °C (±120 °C) in agreement with previously estimated crystallization temperatures reported for graphite in Almahata Sitta ureilite.
The Relationship between Culture and Social Capital with the Sustainability of Microfinance
Authors: Firdaus Nur 
Published: March 2021

Poverty has been the biggest problem around the world, and one of the innovative solutions offered is microfinance. Since the success story of Grameen Bank has been widely spread, many countries decided to adopt microfinance programs to alleviate poverty. Microfinance is then believed as an effective instrument that can answer the poverty challenges. Several studies have analysed the impact of microfinance on poverty reduction, but the results varied. Some support that microfinance can improve the poor, but other criticise and argue that microfinance does not play a significant role to reduce the poverty rate and even undermine the poor. This article aims to analyse factors, namely culture and social capital, that can influence the sustainability of microfinance performance. The assumption used in this article is that the success of microfinance cannot be separated from the borrowers’ background that influences their behaviours towards microfinance. The article summarised a number of studies that have discussed this issue using a qualitative approach. The findings show that culture and social capital have an impact on the sustainability of microfinance, but the impacts depend on the condition of cultures and social capital in a society. However, additional supports are needed and should not be ignored to accelerate the impact of microfinance.
Predictors associated with and the prevalence of condylomata acuminata infection among people in Southern Brazil
Authors: Peder Leyde Daiane de , Silva Claudinei Mesquita da , Madeira Heloise Skiavine , Malizan Josi Any , Nascimento Bruna Larissa , Horvath Josana Dranka , Silva Eraldo Schunk , Teixeira Jorge Juarez Vieira 
Published: March 2021

Objectives: To estimate the prevalence of condylomata acuminata/HPV and evaluate associated predictors in infected patients. Methods: In this cross-sectional and retrospective study, medical records of patients who attended a public health referral center located in Southern Brazil, Parana, between April 2012 and March 2017 were reviewed. Epidemiological, clinical, and laboratory data were analyzed using the chi-square and odds ratio (OR) with 95% confidence interval (CI). Results: The overall prevalence of condylomata acuminata/HPV in 3,447 patients was 33.1% (n = 1,140). Coinfection of condylomata/HPV with other STI was noted in 23.7% (n = 270) of cases. The population was characterized by a high prevalence (43.8%) in patients aged < 20 years, women (37.4%), white (33.3%), educational level with more than 8 years of study (33.7%), widowed (39.2%), heterosexual (36.7%), and ages between 13 and 19 years at first sexual intercourse (41.1%). A significant association was observed between male sex and multiple partners and between male sex and irregular use of condoms (p < 0.001). The predictors associated with HPV infection were the age group of up to 29 years (OR 2.0, 95% CI 1.3–3.7, p < 0.013) and homosexual/bisexual (OR 0.2, 95% CI 0.12–0.66, p = 0.003). Conclusion: The findings showed a high prevalence of condylomata acuminata in a public health center study, with emphasis on the age range below the third decade of life and sexual behavior predictors. These predictors are important for the determination of preventive measures against the transmission of infection and the development of cancer.
A Smartphone App (TRIANGLE) to Change Cardiometabolic Risk Behaviors in Women Following Gestational Diabetes Mellitus: Intervention Mapping Approach
Authors: Potzel Anne Lotte , Gar Christina , Seissler Jochen , Lechner Andreas 
Published: March 2021

Background
Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is associated with an increased risk for the development of cardiometabolic diseases. Behavioral interventions can reduce this risk, but current solutions insufficiently address the requirements for such a program. The systematic development of a scalable mobile health (mHealth) promotion program for mothers during the first years post-GDM may contribute to solving this problem.

Objective
The aim of this project was to systematically plan and develop a theory- and evidence-based mHealth intervention to change cardiometabolic risk behaviors in women during the first 5 years post-GDM that meets women’s expected standards of commercial health apps.

Methods
The intervention mapping steps 1 to 4 structured the systematic planning and development of the mHealth program described in this paper. Steps 1 and 2 led to a theory- and evidence-based logic model of change for cardiometabolic health. Based on this model, the prevention program was designed (step 3) and produced (step 4) in cooperation with industrial partners to ensure a high technological standard of the resulting smartphone app for the iPhone (Apple Inc). Step 4 included a user study with women during the first 5 years post-GDM once a beta version of the app (“TRIANGLE”) was available. The user study comprised 2 test rounds of 1 week (n=5) and 4 weeks (n=6), respectively. The tests included validated questionnaires on user acceptance, user logs, and think-alouds with semistructured interviews.

Results
The novel TRIANGLE app is among the first self-paced smartphone apps for individual habit change in the 3 lifestyle areas of physical activity, nutrition, and psychosocial well-being. The 3 core features—a challenge system, human coaching, and a library—address 11 behavioral determinants with 39 behavior change methods to support lifestyle changes. Participants in the user study showed a high acceptance, high perceived quality, and high perceived impact of the TRIANGLE app on their health behaviors. Participants tested the app regularly, used it intuitively, and suggested improvements. We then adapted the TRIANGLE app according to the insights from the user study before the full TRIANGLE program production.

Conclusions
The intervention mapping approach was feasible to plan and develop an innovative and scalable smartphone solution for women during the first 5 years post-GDM. The resulting TRIANGLE intervention has the potential to support behavior change for cardiometabolic disease prevention. However, the app needs further refinement and testing in clinical trials. Intervention mapping steps 5 (implementation plan) and 6 (evaluation plan) may support the integration of the TRIANGLE intervention into routine care.

Trial Registration
German Clinical Trials Register DRKS00012736; https://www.drks.de/DRKS00012736
Influence of pharmaceutical services organization on the availability of essential medicines in a public health system
Authors: Rocha Wenderson Henrique , Teodoro Juliana Álvares , Assis Acurcio Francisco de , Guerra Augusto Afonso , Gomes Moura Isabel Cristina , Godman Brian , Kurdi Amanj , Rezende Macedo do Nascimento Renata Cristina , Almeida Alessandra Maciel 
Published: March 2021

Objective:
To evaluate the influence of organizational structure and technical-management activities on the availability of essential medicines in the primary healthcare.
Materials & methods:
Cross-sectional, exploratory and evaluative study. The availability was evaluated according to parameters established by the WHO.
Results:
The average availability of standardized essential medicines was 83.3 and 73.3% for medicines purchased centrally by the Brazilian government. Among the therapeutic groups evaluated, the lowest average availability were for the tuberculostatics (24.1%) and psychotropic/special control medicines (30.3%).
Conclusion:
The availability of essential medicines was positively influenced by the presence of the pharmacist and by the computerized system deployed, and negatively associated with essential medicines purchased centrally by the federal government, especially in the smaller municipalities.
Preparation and Characterization of Artemether Solid Dispersion by Spray Drying Technique
Authors: Dabhade Dhiraj , Wadher Kamlesh , Bute Shrikant , Naidu Nikita , Umekar Milind , Anantwar Sanjay 
Published: March 2021

Introduction: Artemether, a BCS class IV drug (poorly water soluble and poorly permeable, less bioavailability) but is found to be effective against falciparum malaria. Preparation of water soluble formulation could be the technique to improve bioavailability of such drug. The most ideally used technique to enhance the solubility and dissolution of poorly water soluble drugs is Solid dispersion method.
Method: The objective of the study was to enhance the solubility and dissolution rate of Artemether by preparing solid dispersions using Soluplus, at different ration of 1:1, 1:2, 1:3 and 1:4 using spray drying technology. Prepared Solid dispersions were characterized by Fourier transform infrared spectroscopy and differential scanning calorimetry.
Results: The spray-dried solid dispersions found to be having less crystallinity and showed higher dissolution rates. Solubility study data showed the optimum drug/Soluplus ratio to be 1:3. The dissolution studies of Solid dispersions in 1.2 pH and 6.8 pH buffer showed higher drug release as compared to pure drug.
Conclusion: Thus we conclude that an amorphous solid dispersion of Artemether could be a better option for enhancing the dissolution rate of drug
Keywords: solid dispersion, artemether, soluplus, solubility enhancement
Formulation of Metformin Sustained Release Tablet Using Natural Polymer
Authors: Siddiqui Mehak , Omray L. K. , Soni Pushpendra 
Published: March 2021

The overall objective of the present work was to develop an oral sustained-release (SR) Metformin tablet that is prepared by the direct compression method by using hydrophilic hydroxyl propyl methyl cellulose (HPMC) and Guar gum polymer alone as well as in combination at different concentrations. Metformin is a biguanide that has a relatively short plasma half-life. It has low absolute bioavailability. All the properties were evaluated for thickness, weight variation, hardness and drug content uniformity and in vitro drug release. The mean dissolution time is used to characterize the drug release rate from a dosage form that indicates the drug release-retarding efficiency of the polymer. The hydrophilic matrix of HPMC alone could not control the Metformin release effectively for 12 h but when combined with Guar gum, it could slow down the release of drug and, thus, can be successfully employed for formulating Sustain Release matrix tablets.
Keywords: Guar gum, hydroxylpropylmethylcellulose, matrix tablets, release kinetics,
Ethnobotanical Profiling and Floristic Diversity of the Miyawaki Plantation in Saurashtra University Campus, Rajkot
Authors: Lagariya Vijay J. , Kaneria Mital J. 
Published: March 2021

The investigation was carried out in order to explore the existing floristic composition of the Miyawaki plantation, recently developed in the Saurashtra University campus, Rajkot. The main aspect of the study is to prepare an ethnobotanical and pharmacological inventory of the recorded plant species from the study area. The fieldwork was conducted for a period of four months regularly in the study area. This study revealed that most of the species as documented are total 71 plant species belonging to 62 genera and 32 families, could be used for the various medicinal purposes from Miyawaki plantation. Present investigation provides a huge lump of ethnobotanical significance and it is an urgent need to document uses of plants for future domestication.
Keywords: Miyawaki, Ethnobotany, Plantation, Floristic diversity, Medicinal plants