bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening for Diabetes-Related Distress in an Outpatient Endocrine Clinic
Authors: Grandison Jheneale Renee , Callender Kimberly , Onumah Barbara Mensah 
Published: May 2021

Abstract
Background: Identification and treatment of diabetes-related distress (DD) are essential for diabetes management, quality of life, and reducing health care costs for people with diabetes. There is no standardized workflow for DD screening in an outpatient endocrine clinic that manages approximately 2000 persons with diabetes.
Aim: This quality improvement (QI) project aims to implement a DD screening and referral program in an outpatient endocrine clinic.
Methods: The Mobilize, Assess, Plan, Implement, Track (MAP-IT) model was used to design the QI project. Patients without a diagnosis of diabetes, age less than 18 years, and pregnant women were excluded from the screening. DD was measured using the Problem Areas in Diabetes-5 (PAID-5) scale (0 - 20) points (1). An ambulatory systems analyst created a flowsheet in Epic for the PAID-5 questionnaire and routed the PAID-5 to MyChart. During the implementation phase, patients completed the PAID-5 on MyChart one week before their appointment or in-person during the encounter. Providers referred patients with a PAID-5 score ≥ 8 to a mental health provider (MHP). The primary outcomes were PAID-5 screening compliance and mental health referral compliance. Secondary outcomes include PAID-5 scores and hemoglobin A1C value percentage; changes in the PAID-5 scores and A1C values were compared pre- and post-intervention.
Results: The project was implemented on August 31st, 2020. As of October 29th, 2020, the PAID-5 screening compliance was 66% (n = 385/585). The patient sample was 57% female and 43% male. It was identified that 113 (29%) patients had a PAID-5 score ≥ 8. Of these, only 33 (29%) patients received a referral to a MHP. Thirty-three patients (29%) refused a referral, and 5% were already seeing a MHP. Pre-intervention, the average PAID-5 score was 5, and the average baseline A1C value was 8% (&lt; 5.7%).
Conclusion: Based on the preliminary data, screening for DD in adults with diabetes utilizing the PAID-5 questionnaire is feasible and can facilitate the referral of distressed patients to mental health providers. Long-term implications for the practice change include a holistic and comprehensive approach to the management of diabetes and diabetes-related outcomes, including reduction of PAID-5 scores and A1C values in individuals referred to a MHP.
References: (1) McGuire, B. E., Morrison, T. G., Hermanns, N., Skovlund, S., Eldrup, E., Gagliardino, J., Kokoszka, A., Mathews, D., Pibernik, M., Rodriguez, J., Wit, M., & Snoek, F. J. (2010). Short-form measures of diabetes-related emotional distress: The Problem Areas in Diabetes Scale (PAID)-5 and PAID-1. Diabetologia, 53(1), 66–69. https://doi.org/10.1007/s00125-009-1559-5
The Use of Omnipod® 5 Automated Insulin Delivery System in Adults With Type 2 Diabetes With Suboptimal Glycemic Management: From Injections to Closed-Loop Therapy
Authors: Bode Bruce W , Peters Anne , Carlson Anders L , Dumais Bonnie , Lowen Steven , Vienneau Todd , Huyett Lauren , Ly Trang T 
Published: May 2021

Abstract
Advances in automated insulin delivery (AID), integrating continuous glucose monitoring (CGM), insulin pump therapy, and dynamic insulin modulation, have mostly centered on type 1 diabetes. Very little data exists to characterize the use of AID in adults with type 2 diabetes in the outpatient setting despite the significant burden of disease. The increasing adoption of diabetes technology by this heterogenous population suggests that clinical evaluation of AID in type 2 diabetes is necessary. In this study, we seek to enroll adults with type 2 diabetes, previously on either multiple daily injections (MDI) or basal insulin only (pump naïve), both CGM users and CGM naïve, with A1C &gt; 8%, to start AID using the tubeless, on-body Omnipod 5 system with insulin pod and Dexcom G6 sensor. This system has the novel feature1 of customizable glucose targets from 110-150mg/dL, which is useful for gradual reduction of mean glucose levels in patients acclimated to hyperglycemic ranges. In addition, the system adapts to the persistent hyperglycemia commonly seen in type 2 diabetes by increasing insulin delivery with each pod change. This feasibility study will enroll a minimum of 24 participants, following them through a 2-week baseline assessment and then an 8-week period of Omnipod 5 use in Automated Mode, all via the outpatient setting.
To date, 3 participants have enrolled and are currently using the system: age (mean±SD) 54±12y, weight 79.7±9.0kg, baseline A1C 9.3±0.2% (range 9.1–9.5%), and duration of diabetes 18.3±12.4y. Previous anti-hyperglycemic agents including metformin and GLP-1R agonists were continued.
Participants have used Omnipod 5 in Automated Mode ranging from 26 to 53 days. In the preliminary analysis of Automated Mode use, mean glucose of 194±33 mg/dL was achieved, corresponding to a glucose management indicator (GMI) of 8.0±0.8%. Time in range, 70-180mg/dL, was 49.0±19.2%, time &lt;70mg/dL was 0.2±0.2%, &gt;180mg/dL was 50.8±19.4%, and ≥250mg/dL was 19.3±15.6%. Average total daily insulin use was 77.9±41.4 units/day. In the most recent 14 days of use, GMI was further decreased to 7.6±0.5%, and time in range further increased to 57.6±14.1%. There have been no serious adverse events, including severe hypoglycemia, reported in over 110 person-days of system use to date.
At completion, this study will provide a novel evaluation of the safety and effectiveness of AID in adults with type 2 diabetes with suboptimal glycemic management, despite the concomitant use of adjuvant anti-hyperglycemic agents.
Reference: 1. Forlenza et. al. First outpatient evaluation of a tubeless automated insulin delivery system with customizable glucose targets in children and adults with type 1 diabetes. Diabetes Technol Ther 2021.
Trends in Type 2 Diabetes Mortality, Prevalence and Disability-Adjusted Life-Years in the United Kingdom and European Union Countries: 1990–2019
Authors: Goodall Richard , Alazawi Andrew , Hughes Will , Bravis Vassiliki , Salciccioli Justin D , Marshall Dominic C , Crowley Conor , Shalhoub Joseph 
Published: May 2021

Abstract
Aims: To compare the trends in prevalence and mortality from type 2 diabetes mellitus (T2DM) in the UK and European Union (EU) countries. Methods: This observational study used data obtained from the Global Burden of Disease (GBD) Study. T2DM age-standardised prevalence rates per 100,000 (ASPRs), age-standardised mortality rates per 100,000 (ASMRs) and disability-adjusted life-year rates per 100,000 (DALYs) were extracted from the GBD online results tool for the UK and each EU country, for the years 1990-2019. Trends were analysed using Joinpoint regression analysis. Results: Between 1990 and 2019, increases in T2DM ASPRs were observed for all EU countries. The highest relative increases in ASPRs were observed in Luxembourg (males +269.1%, females +219.2%), Ireland (males +191.9%, females +165.7%) and the UK (males +128.6%, females +114.6%). The T2DM prevalence increases in the UK have plateaued from 2015/16-2019 for both sexes, with insignificant increases in estimated annual percentage changes of +0.9% and 0% for males and females, respectively. Mortality trends were non-uniform across EU countries, with ASMRs increasing over the 30-year period studied in 11 countries for males and in 4 countries for females. The UK observed the highest relative decrease in ASMRs for males (-46.9%). For females, the largest relative decrease in ASMRs was in Cyprus (-67.6%). Mortality-to-incidence ratios decreased in all countries except for males in Latvia and females in Denmark, with the lowest mortality-to-incidence ratios in 2019 being observed in the UK and Finland. DALYs increased in 25 countries for males and 17 countries for females between 1990 and 2019. Conclusions:
T2DM prevalence rates have increased across Europe over the last 30 years, however mortality trends are variable. The prevalence of T2DM has increased more in the UK and Ireland between 1990-2019 than in any EU country, for both males and females, with the exception of Luxembourg. Contrastingly, the UK has observed large relative decreases in T2DM mortality rates. Primary prevention strategies in at risk populations should continue to be a focus for preventing T2DM in at risk groups in the UK and Europe.
Bisacodyl in Stimulant Laxatives Can Induce Estrogen Agonist/Antagonist Activity in Breast Cancer Cells in Culture
Authors: Ngo Lynda , Baer Caroline , Ragland Emily , Ma Peng , Zhang Changde , Wiese Thomas E 
Published: May 2021

Abstract
Exposure to xenobiotic estrogens has the potential to induce estrogen activity that may contribute to a range of undesired physiological effects including the stimulation of estrogen responsive tumors. We have previously determined that extracts of OTC medications containing the stimulant laxative bisacodyl induce estrogenic activity in tissue culture bioassays. In this study, we tested the hypothesis that bisacodyl is responsible for the estrogen activity of these extracts and then characterized these effects. Ethanol extracts and dilutions were prepared from OTC medications containing Bisacodyl (1 gm:1 ml). The estrogen agonist and antagonist activity of each extract, as well as bisacodyl and then metabolite DA-bisacodyl was determined using the T47dkbluc estrogen reporter gene and the MCF-7 E3 estrogen responsive proliferation assays. LC-MS analysis was used to determine bisacodyl and DA-bisacodyl concentration in extracts as well as to trace the metabolism of bisacodyl to DA-bisacodyl in the cell culture bioassays. Molecular modeling “docking” simulations of the interactions of bisacodyl and the metabolite DA-bisacodyl with the estrogen receptor (ER) ligand binding domain was performed using MOE from Chemical Computing Group. Bisacodyl and the metabolite DA-bisacodyl induced mixed agonist/antagonist activity in MCF-7 E3 estrogen responsive proliferation assay similar to 4OH-tamoxifen. At the same time, both compounds stimulated only minimal estrogen activity in the T47dkbluc estrogen reporter gene assay. LC-MS analysis determinations identified that almost all bisacodyl was converted to the dihydroxy metabolite DA-bisacodyl in cell culture bioassays. Molecular modeling “docking” simulations determined that while bisacodyl does not fit into the agonist (estradiol) or antagonist (4OH-tamoxifen) conformations of the estrogen receptor ligand binding site, the metabolite DA-bisacodyl may fit into the antagonist induced binding pocket of the ER in a reasonable way. This study characterizes the observed estrogen activity of extracts from OTC medications containing bisacodyl as resulting from the bisacodyl metabolite DA-bisacodyl interacting with the estrogen receptor. Thus, bisacodyl is an OTC medication active ingredient that has potential to induce side effects and or toxicity involving estrogen signalling. The capacity for medications containing bisacodyl or other estrogenic substances to induce estrogen activity in patients is unclear. At the same time, consumers and practitioners should be aware of the potential estrogen activity of bisacodyl containing products.
Deep template-based protein structure prediction
Authors: Wu Fandi , Xu Jinbo 
Published: May 2021

Motivation
Protein structure prediction has been greatly improved by deep learning, but most efforts are devoted to template-free modeling. But very few deep learning methods are developed for TBM (template-based modeling), a popular technique for protein structure prediction. TBM has been studied extensively in the past, but its accuracy is not satisfactory when highly similar templates are not available.

Results
This paper presents a new method NDThreader (New Deep-learning Threader) to address the challenges of TBM. NDThreader first employs DRNF (deep convolutional residual neural fields), which is an integration of deep ResNet (convolutional residue neural networks) and CRF (conditional random fields), to align a query protein to templates without using any distance information. Then NDThreader uses ADMM (alternating direction method of multipliers) and DRNF to further improve sequence-template alignments by making use of predicted distance potential. Finally, NDThreader builds 3D models from a sequence-template alignment by feeding it and sequence coevolution information into a deep ResNet to predict inter-atom distance distribution, which is then fed into PyRosetta for 3D model construction. Our experimental results show that NDThreader greatly outperforms existing methods such as CNFpred, HHpred, DeepThreader and CEthreader. NDThreader was blindly tested in CASP14 as a part of RaptorX server, which obtained the best average GDT score among all CASP14 servers on the 58 TBM targets.
Predictors of stillbirth among women who had given birth in Southern Ethiopia, 2020: A case-control study
Authors: Abebe Haimanot , Shitu Solomon , Workye Haile , Mose Ayenew 
Published: May 2021

Background
Although the rate of stillbirth has decreased globally, it remains unacceptably high in low- and middle-income countries. Only ten countries including Ethiopia attribute more than 65% of global burden of still birth. Ethiopia has the 7th highest still birth rate in the world. Identifying the predictors of stillbirth is critical for developing successful interventions and monitoring public health programs. Although certain studies have assessed the predictors of stillbirth, they failed in identify the proximate predictors of stillbirth. In addition, the inconsistent findings in identify the predictors of stillbirth, and the methodological limitations in previously published works are some of the gaps. Therefore, this study aimed to identify the predictors of stillbirth among mothers who gave birth in six referral hospitals in Southern, Ethiopia.

Methods
A hospital-based unmatched case-control study was conducted in six referral hospitals in Southern, Ethiopia from October 2019 to June 2020. Consecutive sampling techniques and simple random techniques were used to recruit cases and controls respectively. A structured standard tool was used to identify the predictors of stillbirth. Data were entered into Epi Info 7 and exported to SPSS 23 for analysis. A multivariable logistic regression model was used to identify the independent predictors of stillbirth. The goodness of fit was tested using the Hosmer and Lemeshow goodness-of-fit. In this study P-value < 0.05 was considered to declare a result as a statistically significant association.

Results
In this study 138 stillbirth cases and 269 controls were included. Women with multiple pregnancy [AOR = 2.98, 95%CI: 1.39–6.36], having preterm birth [AOR = 2.83, 95%CI: 1.58–508], having cesarean mode of delivery [AOR = 3.19, 95%CI: 1.87–5.44], having no ANC visit [AOR = 4.17, 95%CI: 2.38–7.33], and being hypertensive during pregnancy [AOR = 3.43, 95%CI: 1.93–6.06] were significantly associated with stillbirth.

Conclusions
The predictors of stillbirth identified are manageable and can be amenable to interventions. Therefore, strengthening maternal antenatal care utilization should be encouraged by providing appropriate information to the mothers. There is a need to identify, screen, and critically follow high-risk mothers: those who have different complications during pregnancy, and those undergoing cesarean section due to different indications.
Efficacy and safety of Chinese herbal footbaths for the treatment of dysmenorrhea: Protocol for a systematic review and meta-analysis
Authors: Xiao Min , Liu Lizhou , Tumilty Steve , Liu Dan , You Yanyan , Chen Yunhui , Tang Songqi , Huang Wei , Baxter George David 
Published: May 2021

BackgroundChinese herbal footbaths are an external therapy of traditional Chinese medicine that has been widely used to treat dysmenorrhea. This review aims to systematically evaluate its efficacy and safety for the treatment of dysmenorrhea.MethodsDatabases of PubMed, EMBASE, Cochrane Library, CIHAHL, Web of Science, Chinese National Knowledge Infrastructure(CNKI), Chinese Scientific Journals Database (VIP), Wanfang Database, China Biomedical Literature Database(CBM), and Chinese Biomedical Literature Service System (SinoMed) will be searched from the inception to September 30, 2020. The eligible randomized controlled trials (RCTs) will be identified and included. The primary outcomes include pain intensity measured by validated scales of visual analog scale, numeric rating scale, and response rate of symptom reduction. The secondary outcomes are scores on validated pain questionnaires, quality of life measured by SF-36 or other validated scales, and adverse events. Study selection, data extraction, and assessment of bias risk will be conducted by two reviewers independently. RevMan software (V.5.3.5) will be utilized to perform data synthesis. Subgroup and sensitivity analysis will be performed when necessary. The strength of the evidence will be evaluated with the Grading of Recommendations Assessment, Development and Evaluation System.ResultsA high-quality synthesis of current evidence of Chinese herbal footbaths for patients with dysmenorrhea will be provided in this study.ConclusionThis systematic review will provide evidence of whether Chinese herbal footbaths are an effective and safe intervention for the treatment of dysmenorrhea.Systematic review registrationPROSPERO CRD42020188256.
Depression and its determinants among adolescents in Jimma town, Southwest Ethiopia
Authors: Girma Shimelis , Tsehay Mekonnen , Mamaru Almaz , Abera Mubarek 
Published: May 2021

Objectives
To determine the prevalence and socio-demographic and parental-related factors of depression among school adolescents in Jimma town, southwest Ethiopia.

Methods
Using a cross-sectional survey, 546 school adolescents were screened for depression using the patient health questionnaire (PHQ-9) from five randomly selected public and private schools. Oslo social support scale, adverse childhood experience tool, and socio-demographic questionnaire were used to gather data on risk factors. Linear regression analysis was used, and unstandardized beta (β) coefficients with 95% confidence intervals (CI) were reported to declare statistical significance.

Results
A total of 546 adolescents participated in the study, with a response rate of 97.3%. The mean (±SD) age of participants was 16.8 ± 1.3 years. The majority (81%) of the adolescents were attending day classes at public schools. The prevalence of depression was found to be 28% using the patient health questionnaire. Based on the PHQ-9 depression severity scale, 18.5% and 8.2% of the adolescent had moderate and moderate to severe depression while 1.3% had severe depression. In the final multivariate linear regression analysis, it was found that sex, rural residence, low social support, being in higher grade level, and adverse childhood experience were found to be independently associated with a higher score of depression.

Conclusion
One in three adolescents was found to have a depressive syndrome. We recommend schools to integrate school mental health service that contains routine screening and intervention services. Moreover, efforts are needed to sensitize and educate the communities on child protection, social support, and safeguarding to effectively tackle the magnitude of adolescent depression.
Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain
Authors: Riffel Johannes H. , Siry Deborah , Salatzki Janek , Andre Florian , Ochs Marco , Weberling Lukas D. , Giannitsis Evangelos , Katus Hugo A. , Friedrich Matthias G. 
Published: May 2021

Background
Cardiovascular magnetic resonance (CMR) is the current reference standard for the quantitative assessment of ventricular function. Fast Strain-ENCoded (fSENC)-CMR imaging allows for the assessment of myocardial deformation within a single heartbeat. The aim of this pilot study was to identify obstructive coronary artery disease (oCAD) with fSENC-CMR in patients presenting with new onset of chest pain.

Methods and results
In 108 patients presenting with acute chest pain, we performed fSENC-CMR after initial clinical assessment in the emergency department. The final clinical diagnosis, for which cardiology-trained physicians used clinical information, serial high-sensitive Troponin T (hscTnT) values and—if necessary—further diagnostic tests, served as the standard of truth. oCAD was defined as flow-limiting CAD as confirmed by coronary angiography with typical angina or hscTnT dynamics. Diagnoses were divided into three groups: 0: non-cardiac, 1: oCAD, 2: cardiac, non-oCAD. The visual analysis of fSENC bull´s eye maps (blinded to final diagnosis) resulted in a sensitivity of 82% and specificity of 87%, as well as a negative predictive value of 96% for identification of oCAD. Both, global circumferential strain (GCS) and global longitudinal strain (GLS) accurately identified oCAD (area under the curve/AUC: GCS 0.867; GLS 0.874; p<0.0001 for both), outperforming ECG, hscTnT dynamics and EF. Furthermore, the fSENC analysis on a segmental basis revealed that the number of segments with impaired strain was significantly associated with the patient´s final diagnosis (p<0.05 for all comparisons).

Conclusion
In patients with acute chest pain, myocardial strain imaging with fSENC-CMR may serve as a fast and accurate diagnostic tool for ruling out obstructive coronary artery disease.
Os Sertões de Araraquara
Authors: Leite Jorge , Nadin Odair Luiz 
Published: May 2021

No presente artigo objetiva-se apresentar um recorte de uma pesquisa em desenvolvimento no âmbito da Toponímia Rural Humana, o qual ocupa-se da análise de escrituras do período entre 1855-1858 de propriedades rurais da cidade de Araraquara – SP. Nesse domínio, seguindo os pressupostos teórico-metodológicos de Dick (1990; 1992), extrai-se o corpus a partir dos mapas oficiais do IBGE escala 1:50.000 (2010), do Instituto Nacional de Colonização e Reforma Agrária – INCRA, e do Registros de propriedades do munícipio de Araraquara (1855-1858), que foram analisados, segundo a motivação, seguindo o modelo taxionômico de Dick (1992). Ao entrelaçar a Toponímia com a História e a Geografia, foi atestado que elementos de natureza circundante possuem grande influência na denominação de espaços geográficos, e em pontos de referência nas cartas analisadas. Além disso, os topônimos apresentados são todos conservados até 2020, o que comprova que a partir de uma análise histórico-linguística, é possível compreender a verdade do nome de lugar.
Entre caminhos e nomes
Authors: Mendes Letícia Rodrigues Guimarães 
Published: May 2021

A linguagem, por seu valor e relevância para o homem e a sociedade, sempre foi alvo de inúmeros estudos. Abordagens atuais enfocam a língua como algo intimamente relacionado à cultura, às formas as quais o indivíduo possui de enxergar, habitar e interpretar o mundo e o ambiente em que está inserido. O presente artigo apresenta um recorte dos resultados parciais de uma pesquisa de doutorado em andamento, desenvolvida na Faculdade de Letras da UFMG sobre a toponímia urbana na cidade de Pedro Leopoldo (MG), com contribuições que integram os objetivos do ATEMIG – Atlas Toponímico do Estado de Minas Gerais. Tem como foco o estudo dos nomes dos logradouros daquela cidade e a relação léxico-ambiente-cultura, apoiada nos estudos de Leite de Vasconcelos (1928); Meillet (1948); Dauzat (1951); Sapir (1961); Labov (1968); Biderman (1981; 2001); Guérios (1994), Dick (1990a; 1990b; 1997; 2006), Duranti (2000), entre outros.