bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adherence and quality of life assessment in patients with asthma treatment with budesonide/formoterol via the Elpenhaler device: the COMPLETE study
Authors: Exarchos Konstantinos P. , Rovina Nikoletta , Krommidas George , Latsios Dimitrios , Gogali Athena , Kostikas Konstantinos 
Published: June 2022

Abstract
Background
Asthma is a chronic inflammatory disease of the airways that causes recurring episodes of wheezing, breathlessness, chest tightness and coughing. Inhaled drugs on a daily basis are the cornerstone of asthma treatment, therefore, patient adherence is very important.

Methods
We performed a multicenter, open, non-interventional, observational, prospective study of 716 adult patients diagnosed with asthma receiving FDC (Fixed-dose combination) budesonide/formoterol via the Elpenhaler device. We assessed the adherence to treatment at 3 and 6 months (based on the MMAS-8: 8-item Morisky Medication Adherence Scale), the quality of life and change in forced expiratory volume in 1 s (FEV1) from baseline to follow-up.

Results
Approximately 80% of the patients showed medium to high adherence throughout the study. The mean (SD) MMAS-8 score at 6 months was 6.85 (1.54) and we observed a statistically significant shift of patients from the low adherence group to the high adherence group at 6 months. Moreover, after 6 months of treatment with FDC budesonide/formoterol, we observed an increase in the patients’ quality of life that as expressed by a change 2.01 (95%CI 1.93–2.10) units in Mini AQLQ (p < 0.0001) that was more pronounced in the high adherence group. The same trend was also observed in terms of spirometry (mean FEV1 2.58 L (0.85) at the end of the study, increased by 220 mL from baseline) with a higher improvement in the medium and high adherence groups.

Conclusions
Treatment with FDC of budesonide/formoterol via the Elpenhaler device was associated with improvement in asthma-related quality of life and lung function over 6 months that were more prominent in patients with higher adherence.
Trial registration: 2017-HAL-EL-74 (ClinicalTrials.gov Identifier: NCT03300076).
Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand
Authors: Monsomboon Apichaya , Chongwatcharasatit Trisuchon , Chanthong Pratamaporn , Chakorn Tipa , Prapruetkit Nattakarn , Surabenjawong Usapan , Limsuwat Chok , Chaisirin Wansiri , Ruangsomboon Onlak 
Published: June 2022

Abstract
Background
The characteristics and outcomes of palliative patients who visited the Emergency Department (ED) in Thailand, a country in which no standard palliative care system existed, have not been comprehensively studied. We aimed to report the characteristics of ED palliative patients and investigate factors associated with mortality.

Methods
A prospective observational study was conducted at Siriraj Hospital, Bangkok, Thailand, between March 2019 and February 2021 by means of interviewing palliative patients and/or their caregivers and medical record review. Palliative patients with either incurable cancer or other end-stage chronic diseases were included.

Results
A total of 182 patients were enrolled. Their mean age was 73 years, 61.5% were female, and 53.8% had incurable cancer. Of these, 20.3% had previously visited the palliative clinic. Approximately 60% had advanced directives, 4.9% had a living will, and 27.5% had plans on their preferred place of death. The most common chief complaint was dyspnea (43.4%), and the main reason for ED visits was ‘cannot control symptoms’ (80%). At the ED, 17% of the patients had been seen by the palliative care team, and 23.1% died. Although 51% were admitted, 48.9% could not survive to discharge. Cancer, having received morphine, a palliative performance scale > 30, and ED palliative consultation were independently associated with hospital mortality.

Conclusion
The recognition and utilization of palliative care were largely inadequate, especially for non-cancer patients. An improvement and promotion in the palliative care system from the ED through home care are mandatory to improve the quality of life of palliative patients.
Factors associated with uptake of contraceptives among HIV positive women on dolutegravir based anti-retroviral treatment-a cross sectional survey in urban Uganda
Authors: Mbabazi Leah , Nabaggala Mariah Sarah , Kiwanuka Suzanne , Kiguli Juliet , Laker Eva , Kiconco Arthur , Okoboi Stephen , Lamorde Mohammed , Castelnuovo Barbara 
Published: June 2022

AbstractBackgroundIn May 2018, following the preliminary results of a study in Botswana that reported congenital anomalies in babies born to HIV-positive women taking dolutegravir drug, the WHO issued a teratogenicity alert. However, there are scarce data on the impact of this guidance on contraceptive uptake among women taking dolutegravir. We assessed the uptake of contraceptives in HIV-positive women of reproductive age on dolutegravir regimens.MethodsWe conducted a cross-sectional survey from April 2019 to July 2019 in five government health facilities in central Uganda, where dolutegravir-based regimens were offered as the preferred first-line antiretroviral treatment. We randomly selected 359 non-pregnant women aged 15–49 years taking dolutegravir-based regimens and interviewed them using semi-structured interviewer-administered questionnaires. We collected data on demographics, contraceptive use, individual, social, and health system factors. We described patients’ characteristics using descriptive statistics and assessed factors associated with contraceptive uptake using a modified Poisson regression model.ResultsA total of 359 women were included in the study. The mean age was 37 years (standard deviation = 6.8) and overall contraceptive uptake was 38.4%. The most utilized method was injectable method at 58.4% followed by condoms (15%), intrauterine device (10.7%), pills (6.4%), implants (5.4%), and sterilization (0.7%). Predictors for contraceptive uptake were parity of 3–4 children (Adjusted Prevalence Ratio (APR) = 1.48, 95% confidence interval (CI): 1.14, 1.92) in reference to those with 1–2 children. There was reduced contraceptive uptake in women of the age range 40–49 years (APR = 0.45, CI: 0.21–0.94) compared to those aged 15–24 years. Unemployed women were less likely to use contraceptives (APR: 0.6, CI: 0.42- 0.94) than the formally employed. Contraceptive uptake was lower among women who did not discuss family planning with their partners (APR = 0.39, CI: 0.29–0.52) than those who discussed family planning with their partners and women who did not receive family planning counseling (APR = 0.56, CI: 0.34–0.92) than those who received family planning counselling.ConclusionWe observed a low-level uptake of contraceptives, with injectables as the most used method. Family planning counseling and partner discussion on family planning were associated with contraceptive uptake among the women who used dolutegravir-based regimens. There is a need for more strategies to integrate FP services and increase male involvement in HIV care programs.
Using art to raise awareness of breastfed children with medical complexity
Authors: Hookway Lyndsey 
Published: June 2022

Abstract
Background
Current infant feeding support is often targeted at establishing breastfeeding in healthy term infants, or supporting lactation for preterm infants in the neonatal setting. Breastfeeding presents different challenges for children beyond the neonatal period who have a medical complexity. The tendency to focus on breastfeeding as a preventative public health intervention overlooks the fact that mothers and children with medical complexity often require additional and targeted support to continue to breastfeed. Despite this identified need, there is very little research, policy or clinically specific teaching within paediatrics that is nuanced enough to support this vulnerable population.

Raising awareness of breastfed children with medical complexity in paediatrics
While research, policy and embedded Baby Friendly Health Initiative (BFHI) standards in both the maternity and neonatal directorates exists, paediatrics is a separate discipline and contrastingly, has very little lactation support infrastructure. To this end, a doctoral study was commenced aiming to identify the differences for this vulnerable and largely overlooked group. One of the related outputs of the ongoing research is the use of creative methods to raise awareness. This commentary highlights a project with an artist to develop a series of portraits alongside a book and health professional education to increase awareness of these children’s needs.

Conclusions
The breastfeeding needs and challenges of children in the paediatric setting are unique and require additional awareness, creativity and skills to support optimal infant and young child breastfeeding. Using art can connect professionals to the lived experiences of families trying to persevere through medical complexity.
Exploring e-psychonauts perspectives towards cocaine effects and toxicity
Authors: Assi Sulaf , Keenan Aidan , Al Hamid Abdullah 
Published: June 2022

AbstractBackgroundAccording to the World Drug Report, cocaine is the second most used drug globally after cannabis. Online discussion forums enable the understanding of authentic drug users’ experience as it is anonymous. Therefore, this study determined the uses, effects and toxicity of cocaine from the perspectives’ of e-psychonauts.MethodsA qualitative study was conducted using six popular discussion forums. From these discussion forums, 1229 posts from 50 threads were subject to thematic analysis. Hence, the information from these threads were examined carefully for patterns and codes among the data. The codes were then collated into subthemes and themes.ResultsThe four main themes emerging from the study were related to cocaine characteristics and use, e-psychonauts’ knowledge and experience, desired effects and adverse events. The main characteristic associated with cocaine use was purity that was highest in the US being nearest to the source. The most common cutting agent encountered in cocaine samples was levamisole that increased the chances of immunosuppression and cardiovascular toxicity. Purity depended on the source of purchase that included street dealers, dark web and surface web. Hence, e-psychonauts recommended purchase of cocaine from known dealers rather than websites with unknown sources. E-psychonauts mainly used cocaine in social context and parties or to self-medicate against anxiety and depression. Effects desired from cocaine use were mainly euphoria and increased energy. However, tachycardia and myocardial infarction were the main adverse events. It is noteworthy to mention that myocardial infarction was idiosyncratic and was often lethal. Myocardial infarction was more often reported when cocaine was combined with alcohol due to the production of cocaethylene. Social harm was also reported as a consequence for the use of cocaine that resulted in homelessness and broken relationships.ConclusionOnline discussion forums allowed the understanding of e-psychonauts’ experience with cocaine use. Not only it informed about the sources and modalities of use of cocaine but also about the adverse events and social harm associated with cocaine use. The present findings serve as useful information for practitioners and healthcare professionals dealing with cocaine users.
Prenatal genetic diagnosis of tetrasomy 18p from maternal trisomy 18p: a case report
Authors: Peng Can , LinPeng SiYuan , Bu Xiufen , Jiang XuanYu , Hu LanPing , He Jun , Zhou ShiHao 
Published: June 2022

Abstract
Background
Tetrasomy 18p syndrome is a rare chromosomal disorder that is caused by the presence of isochromosome 18p. Most tetrasomy 18p cases are de novo cases and maternal origin of trisomy 18p is a rare condition. At present, only four cases of maternal origin have been reported in worldwide.This is the fifth case of tetrasomy 18p originating from maternal trisomy 18p. The mother of the fetus studied had no apparent disease phenotype.

Case presentation
The current case report is to describe a fetus with confirmed 18p tetrasomy as detected by karyotyping and Single Nucleotide Polymorphism array (SNP array) analysis. However, the fetus showed normal phenotypic features that were observed using ultrasound scans. The mother and maternal grandfather were phenotypically normal and healthy; however, they were diagnosed with trisomy 18p, which was confirmed by conventional karyotyping and SNP array.

Conclusions
We report a case of 18p tetrasomy in a fetus whose mother and grandfather had 18p trisomy. The mother and grandfather were phenotypically normal. Our case report findings provide an important reference for the genetic counseling of trisomy 18p in the future.
Leveraging structural and 2D-QSAR to investigate the role of functional group substitutions, conserved surface residues and desolvation in triggering the small molecule-induced dimerization of hPD-L1
Authors: Ahmed Marawan , Ganesan Aravindhan , Barakat Khaled 
Published: June 2022

AbstractSmall molecules are rising as a new generation of immune checkpoints’ inhibitors, with compounds targeting the human Programmed death-ligand 1 (hPD-L1) protein are pioneering this area of research. Promising examples include the recently disclosed compounds from Bristol-Myers-Squibb (BMS). These molecules bind specifically to hPD-L1 through a unique mode of action. They induce dimerization between two hPD-L1 monomers through the hPD-1 binding interface in each monomer, thereby inhibiting the PD-1/PD-L1 axis. While the recently reported crystal structures of such small molecules bound to hPD-L1 reveal valuable insights regarding their molecular interactions, there is still limited information about the dynamics driving this unusual complex formation. The current study provides an in-depth computational structural analysis to study the interactions of five small molecule compounds in complex with hPD-L1. By employing a combination of molecular dynamic simulations, binding energy calculations and computational solvent mapping techniques, our analyses quantified the dynamic roles of different hydrophilic and lipophilic residues at the surface of hPD-L1 in mediating these interactions. Furthermore, ligand-based analyses, including Free-Wilson 2D-QSAR was conducted to quantify the impact of R-group substitutions at different sites of the phenoxy-methyl biphenyl core. Our results emphasize the importance of a terminal phenyl ring that must be present in any hPD-L1 small molecule inhibitor. This phenyl moiety overlaps with a very unfavorable hydration site, which can explain the ability of such small molecules to trigger hPD-L1 dimerization.
Infants later diagnosed with autism have lower canonical babbling ratios in the first year of life
Authors: Yankowitz L. D. , Petrulla V. , Plate S. , Tunc B. , Guthrie W. , Meera S. S. , Tena K. , Pandey J. , Swanson M. R. , Pruett J. R. , Cola M. , Russell A. , Marrus N. , Hazlett H. C. , Botteron K. , Constantino J. N. , Dager S. R. , Estes A. , Zwaigenbaum L. , Piven J. , Schultz R. T. , Parish-Morris J. ,   The IBIS Network
Published: June 2022

Abstract
Background
Canonical babbling—producing syllables with a mature consonant, full vowel, and smooth transition—is an important developmental milestone that typically occurs in the first year of life. Some studies indicate delayed or reduced canonical babbling in infants at high familial likelihood for autism spectrum disorder (ASD) or who later receive an ASD diagnosis, but evidence is mixed. More refined characterization of babbling in the first year of life in infants with high likelihood for ASD is needed.

Methods
Vocalizations produced at 6 and 12 months by infants (n = 267) taking part in a longitudinal study were coded for canonical and non-canonical syllables. Infants were categorized as low familial likelihood (LL), high familial likelihood diagnosed with ASD at 24 months (HL-ASD) or not diagnosed (HL-Neg). Language delay was assessed based on 24-month expressive and receptive language scores. Canonical babble ratio (CBR) was calculated by dividing the number of canonical syllables by the number of total syllables. Generalized linear (mixed) models were used to assess the relationship between group membership and CBR, controlling for site, sex, and maternal education. Logistic regression was used to assess whether canonical babbling ratios at 6 and 12 months predict 24-month diagnostic outcome.

Results
No diagnostic group differences in CBR were detected at 6 months, but HL-ASD infants produced significantly lower CBR than both the HL-Neg and LL groups at 12 months. HL-Neg infants with language delay also showed reduced CBR at 12 months. Neither 6- nor 12-month CBR was significant predictors of 24-month diagnostic outcome (ASD versus no ASD) in logistic regression.

Limitations
Small numbers of vocalizations produced by infants at 6 months may limit the reliability of CBR estimates. It is not known if results generalize to infants who are not at high familial likelihood, or infants from more diverse racial and socioeconomic backgrounds.

Conclusions
Lower canonical babbling ratios are apparent by the end of the first year of life in ASD regardless of later language delay, but are also observed for infants with later language delay without ASD. Canonical babbling may lack specificity as an early marker when used on its own.
Formal analysis of 2D image processing filters using higher-order logic theorem proving
Authors: Rashid Adnan , Abed Sa’ed , Hasan Osman 
Published: June 2022

AbstractTwo-dimensional (2D) image processing systems are concerned with the processing of the images represented as 2D arrays and are widely used in medicine, transportation and many other autonomous systems. The dynamics of these systems are generally modeled using 2D difference equations, which are mathematically analyzed using the 2D z-transform. It mainly involves a transformation of the difference equations-based models of these systems to their corresponding algebraic equations, mapping the 2D arrays (2D discrete-time signals) over the ($$z_1$$

z
1

,$$z_2$$

z
2

)-domain. Finally, these ($$z_1$$

z
1

,$$z_2$$

z
2

)-domain representations are used to analyze various properties of these systems, such as transfer function and stability. Conventional techniques, such as paper-and-pencil proof methods, and computer-based simulation techniques for analyzing these filters cannot assert the accuracy of the analysis due to their inherent limitations like human error proneness, limited computational resources and approximations of the mathematical expressions and results. In this paper, as a complimentary technique, we propose to use formal methods, higher-order logic (HOL) theorem proving, for formally analyzing the image processing filters. These methods can overcome the limitations of the conventional techniques and thus ascertain the accuracy of the analysis. In particular, we formalize the 2D z-transform based on the multivariate theories of calculus using the theorem prover. Moreover, we formally analyze a generic ($$L_1,L_2$$

L
1

,

L
2

)-order 2D infinite impulse response image processing filter. We illustrate the practical effectiveness of our proposed approach by formally analyzing a second-order image processing filter.
Designing of robust and sensitive assay via encapsulation of highly emissive and stable blue copper nanocluster into zeolitic imidazole framework (ZIF-8) with quantitative detection of tetracycline
Authors: Pirot Shano M. , Omer Khalid M. 
Published: June 2022

AbstractMetal–organic frameworks (MOFs) with high stability and porosity have gained great attention in bioanalysis due to their potential in improving sensitivity and robustness of assays. Herein, to improve both the stability and the emission intensity of Cu nanoclusters (CuNCs), in situ entrapment strategy of CuNCs into zeolitic imidazolate framework-8 (ZIF-8) is described. Blue emissive and stable CuNCs was prepared, for the first time, using thiamine hydrochloride as capping agents, and showed strong and stable emission at 440 nm when excited at 375 nm with fluorescence quantum yields 12%. Encapsulation of CuNC into ZIF-8 showed dramatic enhancement of the fluorescence intensity up to 53% fluorescence quantum yield. Furthermore, the CuNCs@ZIF-8 possesses better stability (more than three months) due to protective and confinement effect of MOFs. Upon the addition of tetracycline to CuNCs@ZIF-8 solution, the blue emission intensity was significantly decreased. The fluorescence ratio (Fo/F) against the concentration of tetracycline exhibited a satisfactory linear relationship from 1.0 to 10.0 µM with a detection limit (LOD) of 0.30 µM. The current probe was applied for quantification of tetracycline in drug sample with satisfactory accuracy and precision.
Graphical abstract
Moho depth and tectonic implications of the western United States: insights from gravity data interpretation
Authors: Shehata Mohammad A. , Mizunaga Hideki 
Published: June 2022

AbstractIn this research, we figure out the lithospheric structures of the western U.S. and assess its tectonic implications with a high resolution using dense gravity data. Gravity data with high spatial resolution enables detailed mapping capabilities, overwhelming other geophysical data. To investigate the physical basis for support of topography in the western U.S., we employed the parker-Oldenburg algorithm to gravity to calculate the depth to Moho. The estimated depth to Moho shows an excellent spatial correlation with the physiographic provinces in the study area following an eastward thicking pattern. Moho of the stable craton reaches 50 km, whereas the western margin shows a shallow Moho of 20 km. Moreover, to assess the tectonic implication of Moho in the study area, we calculated the crustal compensation load to evaluate the isostatic state in the study area. The calculated compensation loads provide isostatic compensation for large-scale crustal structures, such as the broad, elevated Basin and Range Province. To assess the contribution of the crust and mantle to the topographic deformation in the study area, we calculated the crust topography and mantle topography. The Wyoming Craton and Great Plains have negative mantle topography values, contrasting with the relatively constant values in the southern Rockies, Colorado Plateau, and Basin and Range. Crustal topography reveals significant crustal support from the southern Rockies and the Wyoming craton. In addition, we estimated the lithospheric mantle thickness and the depth of the Lithosphere–Asthenosphere Boundary (LAB); the mantle thickness has values reaching 90 km at the stable eastern craton with LAB depth reaching 140 km. This research demonstrates the effect of the tectonic regime on the study area and the implications of this tectonic on the lithospheric structures with a high spatial resolution of a few hundred meters.