bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation readiness for evidence-based autism practices in school systems
Authors: Stahmer Aubyn C , Suhrheinrich Jessica , Yu Yue , Melgarejo Melina , Schetter Patricia , Young Greg A 
Published: September 2023

Background The increase in the number of autistic children being identified has led to increased demand on public schools to provide high-quality services. Effectively scaling up evidence-based practice (EBP) use for autistic students is challenging, given the complicated organization of special education. Teachers have significant challenges implementing autism EBP with fidelity. Factors such as implementation leadership and climate and attitudes toward EBP are linked to successful EBP use and may vary at different levels of the education system. Examining mechanisms of successful implementation is a critical step to support scale-up. Method In this observational study, conducted from September 2018 to March 2020, California school personnel ( n = 2273) at multiple levels of the system completed surveys related to implementation climate, leadership, and attitudes toward EBP. Data were collected throughout California at the Special Education Local Plan Areas, County Office of Education, and district and school levels from educators and administrators working in public schools supporting autistic students. Multi-level modeling was conducted to characterize implementation readiness. Results Overall, implementation climate and leadership scores are low across levels with regional levels rated more positively than districts or schools. Attitudes toward EBP were moderate, with those working in schools having the poorest ratings and specialists/trainers and related service providers (e.g., speech-language pathologists) having the highest ratings. Conclusions Outcomes provide a unique opportunity to compare implementation factors across organizational levels with a large, statewide sample. These data provide guidance for developing implementation interventions at multiple levels of the education system to increase readiness for effective scale-up of autism EBP in schools. Personnel and leaders at different organizational levels may need differentiated training targeting improved implementation climate and leadership. Personnel within districts and schools may experience a particular benefit from leadership support for EBP implementation.
Calcitonin gene-related peptide causes migraine aura
Authors: Al-Khazali Haidar M. , Ashina Håkan , Wiggers Astrid , Rose Kathrine , Iljazi Afrim , Christensen Rune Häckert , Schytz Henrik Winther , Amin Faisal Mohammad , Ashina Messoud 
Published: September 2023

Abstract
Background
Although the involvement of calcitonin gene-related peptide (CGRP) in migraines is well-established, its specific role in investigating the aura phase, which often precedes the headache, remains largely unexplored. This study aims to instigate CGRP’s potential in triggering aura, thus establishing its role in the early stages of migraine.

Methods
In this open-label, non-randomized, single-arm trial, 34 participants with migraine with aura received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min on a single experimental day. Participants were required to be free of headache and report no use of acute medications 24 h before infusion start. The primary endpoint was the incidence of migraine aura during the 12-hour observational period after the start of infusion.

Results
Thirteen (38%) of 34 participants developed migraine aura after CGRP infusion. In addition, 24 (71%) of 34 participants developed migraine headache following CGRP infusion.

Conclusions
Our findings suggest that CGRP could play an important role in the early phases of a migraine attack, including during the aura phase. These insights offer a new perspective on the pathogenesis of migraines with aura. They underscore the need for additional research to further explore the role of CGRP in these initial stages of a migraine attack, and potentially inform future development of therapeutic interventions.

Trial registration
ClinicalTrials.gov Identifier: NCT04592952.

Graphical Abstract
SubMDTA: drug target affinity prediction based on substructure extraction and multi-scale features
Authors: Pan Shourun , Xia Leiming , Xu Lei , Li Zhen 
Published: September 2023

Abstract
Background
Drug–target affinity (DTA) prediction is a critical step in the field of drug discovery. In recent years, deep learning-based methods have emerged for DTA prediction. In order to solve the problem of fusion of substructure information of drug molecular graphs and utilize multi-scale information of protein, a self-supervised pre-training model based on substructure extraction and multi-scale features is proposed in this paper.

Results
For drug molecules, the model obtains substructure information through the method of probability matrix, and the contrastive learning method is implemented on the graph-level representation and subgraph-level representation to pre-train the graph encoder for downstream tasks. For targets, a BiLSTM method that integrates multi-scale features is used to capture long-distance relationships in the amino acid sequence. The experimental results showed that our model achieved better performance for DTA prediction.

Conclusions
The proposed model improves the performance of the DTA prediction, which provides a novel strategy based on substructure extraction and multi-scale features.
Physiological, anatomical and quality indexes of root tuber formation and development in chayote (Sechium edule)
Authors: Cheng Shaobo , Liu Yuhang , Su Lihong , Liu Xuanxuan , Chu Qianwen , He Zhongqun , Zhou Xiaoting , Lu Wei , Jiang Chengyao , Zheng Wangang 
Published: September 2023

Abstract
Background
Chayote is an underutilized species of Cucurbitaceae. It is rich in nutrients such as protein, minerals, phenols and its extracts have anti-cardiovascular and anti-cancer effects, making it a versatile plant for both medicinal and culinary purposes. Although research on its root tuber is limited, they are rich in starch and have a structure similar to that of potatoes, cassava, and sweet potatoes. Therefore, they can serve as potential substitutes for potatoes and offer promising prospects as agricultural and industrial resources. However, the physiological and cellular mechanisms of chayote root tuber formation and development are still unclear.

Results
In this study, we observed the growth habit of ‘Tuershao’ (high yield of root tuber). The results revealed that the tuber enlargement period of ‘Tuershao’ lasts approximately 120 days, with the early enlargement phase occurring during 0–30 days, rapid enlargement phase during 30–90 days, and maturation phase during 90–120 days. Physiological indicators demonstrated a gradual increase in starch content as the tuber developed. The activities of sucrose synthase (SUS) and invertase (VIN) showed a consistent trend, reaching the highest level in the rapid expansion period, which was the key enzyme affecting tuber expansion. Moreover, the special petal like structure formed by the secondary phloem and secondary xylem of the tuber resulted in its enlargement, facilitating the accumulation of abundant starch within the thin-walled cells of this structure. Principal component analysis further confirmed that starch content, SUS and VIN activities, as well as the concentrations of calcium (Ca), iron (Fe), and selenium (Se), were the major factors influencing tuber development. Moreover, the low temperature environment not only promoted the growth of ‘Tuershao’ tubers but also enhanced the accumulation of nutritional substances.

Conclusions
These findings contribute to a deeper understanding of the formation and developmental mechanisms of ‘Tuershao’ tubers, providing valuable guidance for cultivation practices aimed at improving crop yield.
Association between independent practice time and patient outcomes in the emergency department: a retrospective study of residents in three urban hospitals in Taiwan
Authors: Chen Yi-Ying , Ko Patrick Chow-In , Chi Chien-Yu , Chong Kah Meng , Chen Yen-Pin , Huang Chien-Hua 
Published: September 2023

Abstract
Background
The purpose of the study was to investigate the relationship between the independent practice time of residents and the quality of care provided in the Emergency Department (ED) across three urban hospitals in Taiwan. The study focused on non-pediatric and non-obstetric complaints, aiming to provide insights into the optimal balance between resident autonomy and patient safety.

Methods
A comprehensive retrospective study was conducted using de-identified electronic health records (EHRs) from the hospital's integrated medical database (iMD) from August 2015 to July 2019. The independent practice time was defined as the duration from the first medical order by a resident to the first modifications by the attending physician. The primary outcome was revisits to the ED within 72 h following discharge. Statistical analysis was conducted using RStudio and pyGAM.

Results
The study identified several factors associated with shorter independent practice times (< 30 minutes), including older patient age, male sex, higher body temperature, higher heart rate, lower blood pressure, and the presence of certain comorbidities. Residents practicing independently for 30–120 minutes were associated with similar adjusted odds of patient revisits to the ED (OR 1.034, 95% CI 0.978–1.093) and no higher risk of 7-day mortality (OR 0.674, 95% CI 0.592–0.767) compared to the group with less autonomy. However, independent practice times exceeding 120 minutes were associated with higher odds of revisiting the ED within 72 h. For the group with 120–210 minutes of independent practice time, the OR was 1.113 (95% CI: 1.025–1.208, p = 0.011). For the group with > 210 minutes, the OR was 1.259 (95% CI: 1.094–1.449, p = 0.001), indicating an increased risk of adverse outcomes as the independent practice time increasing.

Conclusions
The study concludes that while providing residents an independent practice time between 30 to 120 minutes may be beneficial, caution should be exercised when this time exceeds 120 minutes. The findings underscore the importance of optimal supervision in enhancing patient care quality and safety. Further research is recommended to explore the long-term effects of different levels of resident autonomy on patient outcomes and the professional development of the residents themselves.
Ascertaining asthma status in epidemiologic studies: a comparison between administrative health data and self-report
Authors: Rousseau Marie-Claude , Conus Florence , El-Zein Mariam , Benedetti Andrea , Parent Marie-Elise 
Published: September 2023

Abstract
Background
Studies have suggested that agreement between administrative health data and self-report for asthma status ranges from fair to good, but few studies benefited from administrative health data over a long period. We aimed to (1) evaluate agreement between asthma status ascertained in administrative health data covering a period of 30 years and from self-report, and (2) identify determinants of agreement between the two sources.

Methods
We used administrative health data (1983–2012) from the Quebec Birth Cohort on Immunity and Health, which included 81,496 individuals born in the province of Quebec, Canada, in 1974. Additional information, including self-reported asthma, was collected by telephone interview with 1643 participants in 2012. By design, half of them had childhood asthma based on health services utilization. Results were weighted according to the inverse of the sampling probabilities. Five algorithms were applied to administrative health data (having ≥ 2 physician claims over a 1-, 2-, 3-, 5-, or 30-year interval or ≥ 1 hospitalization), to enable comparisons with previous studies. We estimated the proportion of overall agreement and Kappa, between asthma status derived from algorithms and self-reports. We used logistic regression to identify factors associated with agreement.

Results
Applying the five algorithms, the prevalence of asthma ranged from 49 to 55% among the 1643 participants. At interview (mean age = 37 years), 49% and 47% of participants respectively reported ever having asthma and asthma diagnosed by a physician. Proportions of agreement between administrative health data and self-report ranged from 88 to 91%, with Kappas ranging from 0.57 (95% CI: 0.52–0.63) to 0.67 (95% CI: 0.62–0.72); the highest values were obtained with the [≥ 2 physician claims over a 30-year interval or ≥ 1 hospitalization] algorithm. Having sought health services for allergic diseases other than asthma was related to lower agreement (Odds ratio = 0.41; 95% CI: 0.25–0.65 comparing ≥ 1 health services to none).

Conclusions
These findings indicate good agreement between asthma status defined from administrative health data and self-report. Agreement was higher than previously observed, which may be due to the 30-year lookback window in administrative data. Our findings support using both administrative health data and self-report in population-based epidemiological studies.
Establishment of a predictive model for postpartum hemorrhage in twins: a retrospective study
Authors: Qi Sangsang , Fu Xianhu 
Published: September 2023

Abstract
Objective
To explore the risk factors and develop a predictive model for postpartum hemorrhage in twin pregnancies.

Methods
All patients who gave birth at Ningbo Women and Children’s Hospital from January 2018 to August 2022 were recruited. Patients were randomly allocated to a training cohort (n$$=$$
=
1395) validation cohort (n$$=$$
=
650) at a 7:3 ratio. In the training cohort, LASSO regression for screening variables and multifactorial logistic regression analysis were performed to identify independent risk factors for postpartum hemorrhage in twin pregnancies. A nomogram was established based on the results of multiple logistic regression analysis. Nomogram performance was quantified using the receiver operating characteristic curve, Hosmer- Lemeshow test and decision curve analysis.

Results
A total of 2045 patients were included in this study. Multifactorial Logistic regression analysis showed maternal age, assisted reproduction, platelet count, fibrinogen level, albumin level, hypertensive disorders of pregnancy, placenta praevia, number of previous cesarean deliveries, number of previous intrauterine manipulation, and neonatal weight were independent risk factors for postpartum hemorrhage in twin births. The area under curve (AUC) for the training cohort was 0.810 [95$$\%$$
%
CI (0.781, 0.839)], with a sensitivity of 76.5$$\%$$
%
, specificity of 71.0$$\%$$
%
, and positive and negative predictive values of 0.358 and 0.935, respectively, while the AUC for the validation cohort was 0.821 [95$$\%$$
%
CI (0.781, 0.860)], with a sensitivity of 80.9$$\%$$
%
, specificity of 69.49$$\%$$
%
, and positive predictive value and negative predictive value of 0.426 and 0.929, respectively.

Conclusion
The predictive model can effectively and quantitatively assess the risk of postpartum hemorrhage in twin pregnancies and help clinicians to take personalized preventive measures.
Systematic analysis of RNASET2 gene as a potential prognostic and immunological biomarker in clear cell renal cell carcinoma
Authors: Liu Yifu , Zhang Zhicheng , Xi Ping , Chen Ru , Cheng Xiaofeng , Liu Ji , Zhu Qiqi , Nie Yechen , Sun Ting , Gong Binbin , Wang Siyuan 
Published: September 2023

Abstract
Background
RNASET2 has been identified as an oncogene with anti-angiogenic and immunomodulatory effects in a variety of cancers, but its function in clear cell renal cell carcinoma (ccRCC) is still not well understood.

Methods
The RNASET2 expression matrix was extracted from the The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) datasets and analyzed for diagnostic and prognostic value. RNASET2 mRNA expression was detected by quantitative polymerase chain reaction (qPCR) in ccRCC patients and renal cancer cell lines. Wound healing assay, transwell assay, western blotting, and tube formation assays were used to evaluate the function of RNASET2 in renal cancer in vitro. In addition, transcriptome sequencing was performed on knockdown RNASET2 kidney cancer cells to analyze their potential signaling pathways. Moreover, the immune microenvironment and mutational status were evaluated to predict the potential mechanisms of RNASET2 involvement in renal cancer progression. Sensitivity to common chemotherapeutic and targeted agents was assessed according to the Genomics of Drug Sensitivity in Cancer (GDSC) database.

Results
RNASET2 expression was significantly upregulated in ccRCC tissues and renal cancer cell lines, predicting poor prognosis for patients. In vitro experiments showed that silencing RNASET2 inhibited the migration and pro-angiogenic ability of renal cancer cells. Transcriptome sequencing suggested its possible involvement in the remodeling of the immune microenvironment in renal cell carcinoma. Furthermore, bioinformatics analysis and immunohistochemical staining showed that RNASET2 was positively correlated with the infiltration abundance of regulatory T cells. Finally, we mapped the mutational landscape of RNASET2 in ccRCC and found its predictive value for drug sensitivity.

Conclusions
Our results suggest that RNASET2 is a promising biomarker and therapeutic target in ccRCC.
Predictors of bacteremia in febrile infants under 3 months old in the pediatric emergency department
Authors: Guo Bei-Cyuan , Chen Yin-Ting , Chang Yu-Jun , Chen Chun-Yu , Lin Wen-Ya , Wu Han-Ping 
Published: September 2023

Abstract
Introduction
Fever may serve as the primary indicator of underlying infection in children admitted to the pediatric emergency department (PED), especially in high-risk young infants. This study aimed to identify early clinical factors that could help predict bacteremia in young febrile infants.

Methods
The study included infants under 90 days of age who were admitted to the PED due to fever. Patients were divided into two groups based on the presence or absence of bacteremia and further divided into three age groups: (1) less than 30 days, (2) 30 to 59 days, and (3) 60 to 90 days. Several clinical and laboratory variables were analyzed, and logistic regression and receiver operating characteristic (ROC) analyses were used to identify potential risk factors associated with bacteremia in young febrile infants.

Results
A total of 498 febrile infants were included, of whom 6.4% were diagnosed with bacteremia. The bacteremia group had a higher body temperature (BT) at triage, especially in neonates, higher pulse rates at triage, longer fever subsidence time, longer hospital stays, higher neutrophil counts, and higher C-reactive protein (CRP) levels than those of the non-bacteremia group. ROC analysis showed that the best cut-off values for predicting bacteremia in infants with pyrexia were a BT of 38.7 °C, neutrophil count of 57.9%, and CRP concentration of 53.8 mg/L.

Conclusions
A higher BT at triage, increased total neutrophil count, and elevated CRP levels may be useful for identifying bacteremia in young febrile infants admitted to the PED.
Cognitive behavior therapy for autistic adolescents, awareness and care for my autistic traits program: a multicenter randomized controlled trial
Authors: Oshima Fumiyo , Mandy William , Seto Mikuko , Hongo Minako , Tsuchiyagaito Aki , Hirano Yoshiyuki , Sutoh Chihiro , Guan Siqing , Nitta Yusuke , Ozawa Yoshihito , Kawasaki Yohei , Ohtani Toshiyuki , Masuya Jiro , Takahashi Noriko , Sato Noriyuki , Nakamura Shizuka , Nakagawa Akiko , Shimizu Eiji 
Published: September 2023

Abstract
Background
Autistic people demonstrate focused interests, sensitivity to sensory stimulation, and, compared with the general population, differences in social communication and interaction. We examined whether a combination of the Awareness and Care for My Autistic Traits (ACAT) program and treatment-as-usual is more effective than only treatment-as-usual in increasing the understanding of autistic attributes, reducing treatment stigma, and improving mental health and social adaptation among autistic adolescents and their parents/guardians.

Methods
Forty-nine adolescents and their parents/guardians were randomly assigned to either a combination of ACAT and treatment-as-usual or only treatment-as-usual. The combined group received six weekly 100-minute ACAT sessions, while the treatment-as-usual group received no additional intervention. The primary outcome was the change in understanding of autistic attributes (Autism Knowledge Quiz-Child), administered from pre- to post-intervention. The secondary outcomes included the change in Autism Knowledge Quiz-Parent, reduced treatment stigma, and improved mental health and social adaptation among autistic adolescents and their parents/guardians. A primary outcome measure scale was scored by assessors who were blind to the group assignment.

Results
The combined group (both autistic adolescents and their parents/guardians) showed an increase in Autism Knowledge Quiz scores compared to those in the treatment-as-usual group. Autistic adolescents in the combined group also demonstrated a decrease in treatment-related stigma and an improvement in general mental health compared to those in the treatment-as-usual group, while there were no group differences in the change in social adaptation. For parents/guardians, there were no group differences in the change in treatment-related stigma, general mental health, adaptive skills, or attitudes toward their children.

Conclusions
The ACAT program could be an effective treatment modality to increase the understanding of autistic attributes among both autistic adolescents and their parents/guardians. The ACAT program positively affects self-understanding, reduces treatment stigma, and stabilizes behavioral issues for autistic adolescents as a part of mental health measures, but it does not effectively reduce treatment barriers or improve mental health for parents/guardians. Further research should consider whether additional support for parents/guardians could be beneficial.

Trial registration
: The study was registered in UMIN (UMIN000029851, 06/01/2018).