bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: III. Biology
Authors: Jeste Dilip V , Malaspina Dolores , Bagot Kara , Barch Deanna M , Cole Steve , Dickerson Faith , Dilmore Amanda , Ford Charles L , Karcher Nicole R , Luby Joan , Rajji Tarek , Pinto-Tomas Adrián A , Young Larry J 
Published: April 2023

Abstract

Background
Social determinants of health (SDoHs) are nonmedical factors that significantly impact health and longevity. We found no published reviews on the biology of SDoHs in schizophrenia-spectrum psychotic disorders (SSPD).

Study Design
We present an overview of pathophysiological mechanisms and neurobiological processes plausibly involved in the effects of major SDoHs on clinical outcomes in SSPD.

Study Results
This review of the biology of SDoHs focuses on early-life adversities, poverty, social disconnection, discrimination including racism, migration, disadvantaged neighborhoods, and food insecurity. These factors interact with psychological and biological factors to increase the risk and worsen the course and prognosis of schizophrenia. Published studies on the topic are limited by cross-sectional design, variable clinical and biomarker assessments, heterogeneous methods, and a lack of control for confounding variables. Drawing on preclinical and clinical studies, we propose a biological framework to consider the likely pathogenesis. Putative systemic pathophysiological processes include epigenetics, allostatic load, accelerated aging with inflammation (inflammaging), and the microbiome. These processes affect neural structures, brain function, neurochemistry, and neuroplasticity, impacting the development of psychosis, quality of life, cognitive impairment, physical comorbidities, and premature mortality. Our model provides a framework for research that could lead to developing specific strategies for prevention and treatment of the risk factors and biological processes, thereby improving the quality of life and increasing the longevity of people with SSPD.

Conclusions
Biology of SDoHs in SSPD is an exciting area of research that points to innovative multidisciplinary team science for improving the course and prognosis of these serious psychiatric disorders.
A novel machine learning system for identifying sleep–wake states in mice
Authors: Fraigne Jimmy J , Wang Jeffrey , Lee Hanhee , Luke Russell , Pintwala Sara K , Peever John H 
Published: April 2023

Abstract
Research into sleep–wake behaviors relies on scoring sleep states, normally done by manual inspection of electroencephalogram (EEG) and electromyogram (EMG) recordings. This is a highly time-consuming process prone to inter-rater variability. When studying relationships between sleep and motor function, analyzing arousal states under a four-state system of active wake (AW), quiet wake (QW), nonrapid-eye-movement (NREM) sleep, and rapid-eye-movement (REM) sleep provides greater precision in behavioral analysis but is a more complex model for classification than the traditional three-state identification (wake, NREM, and REM sleep) usually used in rodent models. Characteristic features between sleep–wake states provide potential for the use of machine learning to automate classification. Here, we devised SleepEns, which uses a novel ensemble architecture, the time-series ensemble. SleepEns achieved 90% accuracy to the source expert, which was statistically similar to the performance of two other human experts. Considering the capacity for classification disagreements that are still physiologically reasonable, SleepEns had an acceptable performance of 99% accuracy, as determined blindly by the source expert. Classifications given by SleepEns also maintained similar sleep–wake characteristics compared to expert classifications, some of which were essential for sleep–wake identification. Hence, our approach achieves results comparable to human ability in a fraction of the time. This new machine-learning ensemble will significantly impact the ability of sleep researcher to detect and study sleep–wake behaviors in mice and potentially in humans.
“I Thought This Was a Ghost Neighborhood”: How Youth Respond to Neighborhood Change
Authors: Rhodes Anna , Young Allison , Darrah-Okike Jennifer 
Published: April 2023

Abstract
Relatively little scholarship centers the experiences of Black youth to understand how young people interact with their neighborhood contexts, evaluate the differences between neighborhoods, and adapt to new neighborhoods. Using interviews with 120 Black youth whose families moved from high-poverty central city neighborhoods into lower-poverty, more racially diverse suburban neighborhoods with the Baltimore Housing Mobility Program, we find that Black youth describe tradeoffs that come with living in both city and suburban neighborhoods. While youth viewed their suburban neighborhoods as safer, the young people encountered new repertoires of socializing and space use after moving to the suburbs, with fewer opportunities to spontaneously hang out with peers. This made it challenging to establish new social ties. In response, youth adopted varied strategies, some aligned with new patterns of socializing, others stayed inside, and some returned to the city to reconnect with friends, even if this involved returning to neighborhoods they perceived as less safe. Our work underscores the idea that neighborhoods do not impose culture on youth in enduring or inflexible ways; rather they offer strategies of action that youth can decide to take up. How youth perceive the qualities of their neighborhoods shapes where and how they choose to spend their time.
Is There an Idealized Target of Sexual Harassment in the MeToo Era?
Authors: Hart Chloe Grace 
Published: April 2023

Abstract
Evidence suggests that Americans became more sympathetic toward people who experienced sexual harassment as the MeToo movement surged. Yet how comprehensive these shifts in public opinion have been remains unclear. I hypothesize that women who experience workplace sexual harassment are judged against the archetype of an idealized target of sexual harassment and deemed less credible when they fall short. Using data from a novel multifactorial survey experiment, I find that net of other factors, a Black woman is deemed less credible than a white woman. A woman is also deemed less credible when she does not assertively confront the harassment in the moment and when she does not report it to her organization. Further, she is deemed less credible when there are no witnesses and when her alleged harasser has not been publicly accused of harassment by others. Her credibility is not affected by a power disparity with the harasser, the presence of alcohol, or a prior romantic relationship with the harasser. Finally, the more facets of the archetype a target conforms to, the more credible she is perceived to be. These results demonstrate a hierarchy of sexual harassment targets, in which some are deemed more credible than others.
A Political Sexual Revolution: Sexual Autonomy in the British Women’s Liberation Movement in the 1970s and 1980s
Authors: Wallhead Emma 
Published: April 2023

Abstract
In the 1970s and 1980s, women across Britain—particularly those in the Women’s Liberation Movement (WLM)—took part in a distinct sexual revolution fuelled by a very specific question—who gets to determine the ways in which I am sexual? The active engagement by women with this question of sexual selfhood belies a historiography of sexual revolution—real or imagined—in which women were the passive beneficiaries (or victims) of technological, cultural, religious, social and/or, economic shifts. Drawing on the writing of women in the feminist press, mainstream media, books, and pamphlets, this article describes the specific contribution of the WLM to shaping new possibilities for a sexuality defined, and controlled, by women. I argue that the WLM combined a powerful political framework with an influential social network to significantly contribute to a far-reaching process of deconstructing and recasting female sexuality and sexual relations.
The role of CD4+, CD8+, CD4+/CD8+ and neutrophile to lymphocyte ratio in predicting and determining COVID-19 severity in Indonesian patients
Authors: Masyeni Sri , Budhitresna Anak Agung Gede , Adiwinata Randy , Wibawa Surya , Nugraha Putu Arya , Antara Jarwa , Asmara Dewa Putu Gede Wedha , Widyaningsih Putu Dyah , Yenny Luh Gede Sri , Widiastika Made , Kahari Siska , Wardhana Clareza Arief , Pasek Arya Widiyana , Putrawan Oka , Santosa Agus , Herawati Sianny , Arisanti Nih Luh Putu Eka , Astini Wining , Fatawy Rois Muqsith , Kameoka Masanori , Nelwan Erni Juwita 
Published: April 2023

ABSTRACT

Background
Biomarkers that are cost-effective and accurate for predicting severe coronavirus disease 2019 (COVID-19) are urgently needed. We would like to assess the role of various inflammatory biomarkers on admission as disease severity predictors and determine the optimal cut-off of the neutrophile-to-lymphocyte ratio (NLR) for predicting severe COVID-19.

Methods
We conducted a cross-sectional study in six hospitals in Bali and recruited real-time PCR-confirmed COVID-19 patients aged &gt;18 y from June to August 2020. Data collection included each patient's demographic, clinical, disease severity and hematological data. Multivariate and receiver operating characteristic curve analyses were performed.

Results
A total of 95 Indonesian COVID-19 patients were included. The highest NLR among severe patients was 11.5±6.2, followed by the non-severe group at 3.3±2.8. The lowest NLR was found in the asymptomatic group (1.9±1.1). The CD4+ and CD8+ values were lowest in the critical and severe disease groups. The area under the curve of NLR was 0.959. Therefore, the optimal NLR cut-off value for predicting severe COVID-19 was ≥3.55, with sensitivity at 90.9% and a specificity of 16.7%.

Conclusions
Lower CD4+ and CD8+ and higher NLR values on admission are reliable predictors of severe COVID-19 among Indonesian people. NLR cut-off ≥3.55 is the optimal value for predicting severe COVID-19.
Spatiotemporal risk assessment and COVID-19 trend estimation in a federative unit in northeastern Brazil
Authors: da Silva Janiel Conceição , de Sousa Giana Gislanne da Silva , de Oliveira Rayanne Alves , Santos Lívia Fernanda Siqueira , Pascoal Livia Maia , Santos Floriacy Stabnow , Rolim Isaura Leticia Tavares Palmeira , Costa Ana Cristina Pereira de Jesus , Serra Maria Aparecida Alves de Oliveira , Fontoura Iolanda Graepp , Bezerra Janaina Miranda , Aragão Francisca Bruna Arruda , Ramos Antônio Carlos Vieira , Lima Cynthia Cardoso Dias , Fontoura Volmar Morais , dos Santos Leonardo Hunaldo , Neto Marcelino Santos 
Published: April 2023

ABSTRACT

Background
Coronavirus disease 2019 (COVID-19) has spread worldwide, causing a high burden of morbidity and mortality, and has affected the various health service systems in the world, demanding disease monitoring and control strategies. The objective of this study was to identify risk areas using spatiotemporal models and determine the COVID-19 time trend in a federative unit of northeastern Brazil.

Methods
An ecological study using spatial analysis techniques and time series was carried out in the state of Maranhão, Brazil. All new cases of COVID-19 registered in the state from March 2020 to August 2021 were included. Incidence rates were calculated and spatially distributed by area, while the spatiotemporal risk territories were identified using scan statistics. The COVID-19 time trend was determined using Prais–Winsten regressions.

Results
Four spatiotemporal clusters with high relative risks for the disease were identified in seven health regions located in the southwest/northwest, north and east of Maranhão. The COVID-19 time trend was stable during the analysed period, with higher rates in the regions of Santa Inês in the first and second waves and Balsas in the second wave.

Conclusions
The heterogeneously distributed spatiotemporal risk areas and the stable COVID-19 time trend can assist in the management of health systems and services, facilitating the planning and implementation of actions toward the mitigation, surveillance and control of the disease.
A Pythium myriotylum Small Cysteine-Rich Protein Triggers Immune Responses in Diverse Plant Hosts
Authors: Wang Nan , Yin Zhiyuan , Wu Yingke , Yang Jishuo , Zhao Yaning , Daly Paul , Pei Yong , Zhou Dongmei , Dou Daolong , Wei Lihui 
Published: April 2023

The oomycete Pythium myriotylum is a necrotrophic pathogen that infects many crop species worldwide, including ginger, soybean, tomato, and tobacco. Here, we identified a P. myriotylum small cysteine-rich protein, PmSCR1, that induces cell death in Nicotiana benthamiana by screening small, secreted proteins that were induced during infection of ginger and did not have a predicted function at the time of selection. Orthologs of PmSCR1 were found in other Pythium species, but these did not have cell death–inducing activity in N. benthamiana. PmSCR1 encodes a protein containing an auxiliary activity 17 family domain and triggers multiple immune responses in host plants. The elicitor function of PmSCR1 appears to be independent of enzymatic activity, because the heat inactivation of PmSCR1 protein did not affect PmSCR1-induced cell death or other defense responses. The elicitor function of PmSCR1 was also independent of BAK1 and SOBIR1. Furthermore, a small region of the protein, PmSCR186-211, is sufficient for inducing cell death. A pretreatment using the full-length PmSCR1 protein promoted the resistance of soybean and N. benthamiana to Phytophthora sojae and Phytophthora capsici infection, respectively. These results reveal that PmSCR1 is a novel elicitor from P. myriotylum, which exhibits plant immunity-inducing activity in multiple host plants. [Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
CE: Febrile Neutropenia in the Chemotherapy Patient
Authors: Foley Anne Marie , Hoffman Megan 
Published: April 2023

ABSTRACT:
Febrile neutropenia is a serious complication of chemotherapy treatment and may present as the only clinical sign of infection. If not addressed in a timely manner, it may progress to multisystem organ failure and may be fatal. Initial assessment of fever in those receiving chemotherapy requires prompt administration of antibiotics, ideally within one hour of presentation. Depending on the clinical status of the patient, antibiotic treatment may occur in the inpatient or outpatient setting. Nurses play an important role in the identification and treatment of patients at high risk for febrile neutropenia through assessment and adherence to clinical practice guidelines. In addition, nurses play an active role in patient education regarding risk factors, protective measures, and signs and symptoms of infection in the immunocompromised oncology patient.
Heavy Menstrual Bleeding Treatment With a Levonorgestrel 52-mg Intrauterine Device
Authors: Creinin Mitchell D. , Barnhart Kurt T. , Gawron Lori M. , Eisenberg David , Mabey R. Garn , Jensen Jeffrey T. 
Published: April 2023

OBJECTIVE:
To evaluate heavy menstrual bleeding treatment outcomes with levonorgestrel 52-mg intrauterine device (IUD) use in participants without body mass index (BMI) or parity restrictions.

METHODS:
Investigators included participants aged 18–50 years with no pelvic or systemic pathology causing heavy menstrual bleeding at 29 U.S. centers in a prospective trial. Participants had up to three screening cycles with menstrual product collection for alkaline hematin blood-loss measurements. Investigators enrolled those with two menses with blood loss of 80 mL or more (values averaged for baseline blood loss), placed the IUD, and followed participants for up to six 28-day cycles. Participants collected any menstrual products used during cycles 3 and 6 for blood-loss measurement. We evaluated outcomes in participants with at least one follow-up assessment for the primary outcome of median absolute blood-loss change and, secondarily, treatment success, defined as the proportion with a final measured blood loss less than 80 mL and at least 50% reduction from baseline. We evaluated exploratory outcomes of differences in blood-loss changes by BMI and parity using Wilcoxon rank sum test.

RESULTS:
Of 105 enrolled participants, 47 (44.8%) had obesity (BMI 30.0 or higher) and 29 (27.6%) were nulliparous. Baseline mean blood loss ranged from 73 to 520 mL (median 143 mL, interquartile range 112–196 mL). Eighty-nine (84.8%) had at least one evaluable follow-up evaluation. Participants had median (interquartile range) absolute blood-loss decreases at cycles 3 (n=86) and 6 (n=81) of 93.3% (86.1–97.7%) and 97.6% (90.4–100%), respectively. At cycle 6, participants without obesity (n=43) and with obesity (n=38) had similar median [interquartile range] decreases (97.6% [91.8–100%] and 97.5% [90.3–100%], respectively; P=.89), with comparable findings for nulliparous (n=25) and parous (n=56) participants (97.0% [91.7–99.1%] and 98.1% [89.9–100%], respectively; P=.43). Treatment success occurred in 81.8% (95% CI 74.2–89.4%) of 99 participants, excluding those with no outcomes due to lost to follow-up or consent withdrawal, and did not vary by BMI or parity. The most common adverse events leading to discontinuation were bleeding or cramping (n=6 [5.7%]) and expulsion (n=5 [4.8%]).

CONCLUSION:
This levonorgestrel 52-mg IUD reduces blood loss by more than 90% over 6 months compared with baseline for most users with heavy menstrual bleeding.

FUNDING SOURCE:
Medicines360.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03642210.
Combined Oral Contraceptive Adherence and Pregnancy Rates
Authors: Creinin Mitchell D. , Jensen Jeffrey T. , Chen Melissa J. , Black Amanda , Costescu Dustin , Foidart Jean-Michel 
Published: April 2023

OBJECTIVE:
To assess the relationship of adherence and pregnancy in participants using an estetrol and drospirenone combined oral contraceptive.

METHODS:
We performed a secondary analysis for which we pooled data from two parallel, multicenter, phase 3 trials (United States and Canada, Europe and Russia) that enrolled participants 16–50 years of age to receive estetrol 15 mg and drospirenone 3 mg in a 24 hormone and four placebo pills regimen for up to 13 cycles. Participants reported pill intake, sexual intercourse, and other contraceptive use on paper diaries. We limited this efficacy analysis to at-risk cycles (one or more reported acts of intercourse and no other contraceptive use) in participants 16–35 years of age at screening. We excluded cycles with other contraceptive use unless pregnancy occurred in that cycle. We assessed primarily the relationship between number of pills not taken per cycle and pregnancies and, secondarily, when pregnancies occurred during product use with a test for trend and χ2 analyses as appropriate.

RESULTS:
Among 2,837 participants in this analysis, 31 on-treatment pregnancies occurred during 26,455 at-risk cycles. Pregnancies occurred in 0.09%, 0.25%, 0.83%, and 1.6% of cycles in which participants reported they took all hormone pills (n=25,613 cycles) or did not take one (n=405 cycles), two (n=121 cycles), and more than two (n=314 cycles) hormone-containing pills, respectively (P<.001). No pregnancies occurred in 2,216 cycles when one or more pills were missed and missed-pill instructions were followed. All pregnancies related to not taking pills occurred in the first three cycles. Pregnancy rates ranged from 0% to 0.21% per cycle with no significant trend by cycle (P=.45).

CONCLUSION:
Pregnancy occurs more frequently when combined oral contraceptive users report not taking all hormone-containing pills per 28-day cycle and exceeds 1% only when more than two pills are not taken. Pregnancies in participants who reported missed pills occurred only when missed-pill instructions were not followed. A 0.09% pregnancy risk per cycle among users of a 24 hormone and four placebo pills formulation who report taking all pills likely approximates a true method-failure rate.

FUNDING SOURCE:
Estetra SRL, an affiliate company of Mithra Pharmaceuticals.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02817828 and NCT02817841.
Considerations in the Management of Functional Neurological Disorders in Patients with Hearing Loss
Authors: Abu Libdeh Amal , Alkalbani Leen , Freedman Daniel , Quezada Julio , Nyp Sarah S. 
Published: April 2023

CASE:
Adam is a 14-year-old adolescent boy with hearing loss who presented to the pediatric neurology clinic accompanied by his father for evaluation of new-onset left hand tremor for a duration of 1 month. An American Sign Language interpreter was present and used throughout the visit.
Adam has bilateral sensorineural hearing loss related to premature birth at 28 weeks' gestation. He uses sign language and attends a school for the hearing impaired. He has been diagnosed with attention-deficit/hyperactivity disorder (ADHD) and a nonspecific learning disorder. His ADHD symptoms are well controlled with a stimulant medication. He is independent in activities of daily living, and there is no concern for intellectual disability. His father is concerned that Adam may have anxiety, but this has not been evaluated.
After careful history, it is found that the tremor was first noted the day after burglars broke into his home and stole precious belongings. Current stressors include difficulties with schoolwork and a strained relationship with an extended family member. There is no family history of tremor.
The tremor was intermittent initially, with episodes lasting around 30 minutes. Over time, the tremor became more persistent. Adam is left-handed, and the tremor is now interfering with handwriting, eating, and other fine motor skills. The tremor worsens when Adam is tired or stressed and improves with relaxation. No tremor has been noted in other body parts. Adam denies any other neurological symptoms, including headache, vision changes, or gait abnormalities.
On examination, Adam seemed anxious but showed no significant distress and had normal vital signs. His general examination was unremarkable. His neurological examination showed intact cranial nerves, apart from the hearing impairment. He had normal muscle tone, intact strength and coordination, and a normal casual gait. Rhythmic shaking of the left upper extremity was present with action, while maintaining posture. Using specific examination techniques, the examiner was able to alter the rhythm of the tremor, and the tremor was noted to subside when the patient was engaged with the examiner. These findings in addition to signs of suggestibility and variable frequency/direction were consistent with a functional etiology.
The diagnosis of a functional neurological disorder manifesting in the form of functional tremor was discussed with the patient and his father with assistance from the sign language interpreter. Counseling regarding management consisting mainly of cognitive behavioral therapy and evaluation of possible coexisting conditions, such as anxiety, was discussed.
What factors would you consider in diagnosis and management of functional neurological disorder in a hearing-impaired child/adolescent?