bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parent training for the treatment of irritability in children and adolescents: a multisite randomized controlled, 3-parallel-group, evaluator-blinded, superiority trial
Authors: Fongaro E. , Picot M. C. , Stringaris A. , Belloc C. , Verissimo A. S. , Franc N. , Purper-Ouakil D. 
Published: November 2022

Abstract
Background
Irritability is common in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and with anxiety/depressive disorders. Although youth irritability is linked with psychiatric morbidity, little is known regarding its non-pharmacological treatments. Developing non-pharmacological treatments for children with severe, chronic irritability is an important target for clinical research. To achieve this goal, we will test the benefits of parent-focused therapies in reducing irritability. The aim of the study is to compare Parent Management Training (PMT) and Non-Violent Resistance Training (NVR) programs with treatment-as-usual (TAU) on the improvement of irritability in children and adolescents with a baseline Parent-rated Affective Reactivity Index of 4 or higher, in the context of ADHD and other emotional and behavioural disorders. Additionally, we will assess (i) improvement of irritability at different times and according to different informants (parents, children, clinicians); (ii) improvement of parental strategies; and (iii) acceptability of the interventions, exploring possible mechanisms of the therapeutic effect.

Methods
Two hundred and seventy participants between 6 and 15 years with ADHD and other emotional and behavioural disorders will be recruited and randomly assigned with their parents to the PMT, NVR, and TAU groups. PMT and NVR programs have 10 online sessions and two booster sessions at 1 and at 3 months. The primary outcome measure is the change from baseline at 3 months after completion of the program of the Clinician-rated Affective Rating Scale (CL-ARI) assessed by a blind evaluator. Secondary outcome measures include the change from baseline from those scales: the CL-ARI, the Clinical Global Impression Improvement scale, the Parenting and Familial Adjustment Scales, the Child-rated Cranky thermometers and the Parent-rated ARI. We will assess the parent’s expressed emotions and reflexivity during the online five-minute speech sample, clinical dimensions through the Child Behavior Checklist 6–18 and the Inventory of Callous Unemotional traits. Evaluations will be done remotely at baseline and at 1- and 3-months follow-up visits.

Discussion
We expect a benefit in controlling irritability in the treatment groups. This will constitute an important achievement in promoting parental support programs in the treatment of irritability in the context of emotional and behavioural disorders.
Clinicaltrials.gov. Number: NCT05528926. Registered on the 2nd of September, 2022.
Enhancing menaquinone-7 biosynthesis by adaptive evolution of Bacillus natto through chemical modulator
Authors: Zhang Bei , Peng Cheng , Lu Jianyao , Hu Xuechao , Ren Lujing 
Published: November 2022

AbstractMenaquinone-7 (MK-7) is a kind of vitamin K2 playing an important role in the treatment and prevention of cardiovascular disease, osteoporosis and arterial calcification. The purpose of this study is to establish an adaptive evolution strategy based on a chemical modulator to improve MK-7 biosynthesis in Bacillus natto. The inhibitor of 5-enolpyruvylshikimate-3-phosphate synthase (EPSP synthase), glyphosate, was chosen as the chemical modulator to perform the experiments. The final strain ALE-25–40, which was obtained after 40 cycles in 25 mmol/L glyphosate, showed a maximal MK-7 titer of 62 mg/L and MK-7 productivity of 0.42 mg/(L h), representing 2.5 and 3 times the original strain, respectively. Moreover, ALE-25–40 generated fewer spores and showed a higher NADH and redox potential. Furthermore, the mechanism related to the improved performance of ALE-25–40 was investigated by comparative transcriptomics analysis. Genes related to the sporation formation were down-regulated. In addition, several genes related to NADH formation were also up-regulated. This strategy proposed here may provide a new and alternative directive for the industrial production of vitamin K2.
Graphical Abstract
Polypoidal choroidal vasculopathy—characteristics and response to treatment with bevacizumab in caucasian patients
Authors: Zhalka Fidaa El , Moisseiev Elad , Rubowitz Alexander 
Published: November 2022

Abstract
Purpose
To investigate the features and treatment response in Caucasian patients with polypoidal choroidal vasculopathy (PCV), initially treated with bevacizumab.

Methods
45 eyes of 43 treatment-naïve patients with PCV were included in this retrospective study, all uniformly initially treated with three bevacizumab injections monthly. OCT characteristics and clinical parameters were recorded and analyzed at presentation, after the initial 3 bevacizumab injections and at the final follow up period.

Results
Following 3 monthly bevacizumab injections visual acuity significantly improved with a mean gain of one line of vision. Central macular thickness (CMT) significantly improved from a mean of 402.1 ± 130.8 μm at presentation to 322.0 ± 96.8 μm (p < 0.01). Subretinal fluid, intraretinal fluid and submacular hemorrhage significantly improved. 53% were later switched to aflibercept and showed better response in the central macular thickness in comparison to those in which bevacizumab injections were continued. No correlation was found between the presence of pachyvessels or increased choroidal thickness and the improvement in VA or CMT.

Conclusion
Fixed first-line treatment with intravitreal bevacizumab monotherapy in non-Asian PCV patients achieves satisfactory visual and anatomical outcomes.
Acute port congestion and emissions exceedances as an impact of COVID-19 outcome: the case of San Pedro Bay ports
Authors: Vukić Luka , Lai Kee-hung 
Published: November 2022

AbstractIn the second half of 2020, the shift in consumer demand and reduction in containership capacity, as a consequence of the COVID-19 pandemic, contributed to the disruption of the global supply chains, especially on the US West Coast. This article provides an environmental view of acute maritime congestion in Los Angeles and Long Beach anchorage areas aiming to calculate air emissions of anchored ships consistently in a specific month of the year and compare the dynamics of the emission levels with previous years. The findings determine the causes of the increased environmental pollution and conclude on the preservation measures improvement. CO2, SOx, NOx, PM10, and PM2.5 emissions are examined in this study, considering the statistical data on port performance, productivity and competitiveness elements, ship specifications and propulsion, and emission factors of principal pollutants. Results of our mathematical calculation showed an exponential increase of air emissions generated from ships' auxiliary engines and boilers in 2021, compared with the previous periods, reaching more than 45,000 tons of pollutants emitted in November (mainly carbon dioxide). The increased port congestion and pressure upon the environment and human health also exposed the vulnerability of the intermodal chain on the landside, manifested in higher utilization of trucking services inland, contributing to the additional growth of total emissions. The environmental degradation caused by the surge in demand for products carried by container ships coincides with increased social impacts and the requirement for investments in mitigation measures for emissions to reduce the harmful effects of shipping activities.
Sexual intimacy and relationship happiness in living apart together, cohabiting, and married relationships: evidence from Britain
Authors: Ciritel Alexandra-Andreea 
Published: November 2022

AbstractResearch on relationship happiness have traditionally compared cohabiting and married relationships. Studies including LAT relationships are scarce and have disregarded sexual aspects of the relationships. This paper compares how married, cohabitating, and LAT relationships in Britain differ with respect to sexual intimacy (defined as emotional closeness during sex, compatibility in terms of sexual preferences, and interest in having sex with a partner), and relationship happiness. Rich data from the British National Study of Sexual Attitudes and Lifestyles (NATSAL-3, 2010–2012) are used to estimate ordered logistic regression models. Cohabiting individuals share the same levels of sexual intimacy as those married, but they are less happy in their relationship than those married. LAT individuals enjoy overall greater sexual intimacy than coresidential individuals but they are less happy in their relationships. Women in LAT relationships feel less often emotionally close to their partner during sex than married women. By knitting the sex research with the demographic literature, this paper offers new insights in understanding the nature of partnerships, opening up new venues for future research.
Spotting lesions in thorax X-rays at a glance: holistic processing in radiology
Authors: Bilalić Merim , Grottenthaler Thomas , Nägele Thomas , Lindig Tobias 
Published: November 2022

AbstractRadiologists often need only a glance to grasp the essence of complex medical images. Here, we use paradigms and manipulations from perceptual learning and expertise fields to elicit mechanisms and limits of holistic processing in radiological expertise. In the first experiment, radiologists were significantly better at categorizing thorax X-rays when they were presented for 200 ms in an upright orientation than when they were presented upside-down. Medical students, in contrast, were guessing in both situations. When the presentation time was increased to 500 ms, allowing for a couple more glances, the radiologists improved their performance on the upright stimuli, but remained at the same level on the inverted presentation. The second experiment circumvented the holistic processing by immediately cueing a tissue within the X-rays, which may or may not contain a nodule. Radiologists were again better than medical students at recognizing whether the cued tissue was a nodule, but this time neither the inverted presentation nor additional time affected their performance. Our study demonstrates that holistic processing is most likely a continuous recurring process which is just as susceptible to the inversion effect as in other expertise domains. More importantly, our study also indicates that holistic-like processing readily occurs in complex stimuli (e.g., whole thorax X-rays) but is more difficult to find in uniform single parts of such stimuli (e.g., nodules).
Patient experience of moderate asthma attacks: qualitative research in the USA and Germany
Authors: Tabberer Maggie , Wells Jane R. , Chandler Dale , Abetz-Webb Linda , Zhang Shiyuan , Meeraus Wilhelmine , Fowler Andy , Slade David 
Published: November 2022

Abstract
Background
There is limited information available on the impact of moderate asthma exacerbations, often called “asthma attacks” (i.e., those not requiring hospitalisation or treatment with systemic corticosteroids) on patients’ lives. This multi-country qualitative study explored the patient experience of these events.

Methods
Semi-structured concept elicitation interviews were conducted in the USA and Germany with adult patients with asthma who had experienced a moderate asthma exacerbation in the prior 30 days. Physicians with experience in managing patients with asthma were also interviewed. Interviews explored patients’ experience of symptoms and impact of moderate exacerbations and associated exacerbation triggers and treatment patterns. Physicians were also asked about their interpretation of a clinical definition and treatment of a moderate exacerbation.

Results
Twenty-eight patient (n = 20 in the USA, n = 8 in Germany) and six physician (n = 3 in the USA, n = 3 in Germany) interviews were conducted. During their moderate exacerbation, all patients reported experiencing shortness of breath, which many considered to be severe and the most bothersome symptom. Wheezing was also reported by all patients and considered severe by two thirds of patients. Most patients also reported coughing and chest tightness. All or almost all patients reported that moderate exacerbation caused fatigue/tiredness and impacted their physical functioning, emotional functioning, activities of daily living and work/school life. Most patients reported using rescue or maintenance inhalers to alleviate symptoms of the exacerbation. Conceptual saturation (i.e., the point at which no new concepts are likely to emerge with continued data collection) was achieved. Findings were used to develop a patient-focused conceptual model of the experience of moderate asthma exacerbations, outlining concepts related to triggers, symptoms, impact, and treatment from the patient perspective. Physician data was consistent with patient reports and complemented the conceptual model.

Conclusions
Findings from concept elicitation interviews highlight the increased frequency, duration and severity of asthma symptoms and increased rescue medication use during moderate asthma exacerbations compared with the typical daily asthma experience, which have a substantial impact on patients’ lives.
Comparison of malnutrition screening tests in predicting postoperative complications in elderly patients with femur fracture
Authors: Kılıç Orhan , Özkalkanlı Murat Yaşar , Yılmaz Fulya , Altay Taşkın 
Published: November 2022

Abstract
Background
Malnutrition is an important and widespread problem in hospitalised elderly orthopaedic patients. It is an important predictor of morbidity and mortality and has been associated with an increased risk of complications. Although it is a common problem in the elderly, there is neither a universally accepted criterion for the diagnosis of malnutrition nor a screening tool accepted as the gold standard to detect patients at risk of malnutrition. There is still no consensus on which is the most recommended for screening hospitalised patients for nutritional risk. The aim of this study was to search body mass index (BMI) and commonly used nutrition screening tools to detect malnutrition and malnutrition-related complications in elderly femur fracture patients. One hundred nineteen patients of the American Society of Anesthesiologists status I–IV, aged ≥ 65 years undergoing hip surgery, were included in the study.

Results
Mini Nutritional Assessment Short Form (MNA-SF) and Subjective Global Assessment (SGA) have a moderate agreement in the diagnosis of malnutrition. There was a statistically significant relationship between malnutrition and the presence of complications according to MNA-SF. But there was no statistically significant relationship between malnutrition and the presence of complications according to SGA.

Conclusions
According to MNA-SF, there was no significant relationship between malnutrition and the presence of postoperative complications. However, MNA-SF has higher sensitivity than predicting postoperative complications according to SGA. Although both tests can be used for screening malnutrition in elderly patients, complications can be more predicted with the MNA-SF test.
Cross-cultural and clinical validation of the MDHAQ/RAPID3 questionnaire in electronic format for a Brazilian population of patients with rheumatoid arthritis
Authors: Lineburger Ilka Benedet , Brenol Claiton Viegas , Goularte Alice Silveira , Pinheiro Edila Penna , Hirakata Vânia Naomi 
Published: November 2022

Abstract
Background
Patients with rheumatologic diseases are monitored fundamentally through metric tools or index calculated from clinical data and patient exams, which allow us to assess the severity of the disease and guide the therapeutic decision. In rheumatoid arthritis (RA), for treatment to be optimized and considered effective, periodic assessment with composite disease activity index and a 'treat-to-target' approach is required. The Routine Assessment of Patient Index Data 3 (RAPID3) in the Multidimensional Health Assessment Questionnaire (MDHAQ) includes only three measures based on the central patient self-reported dataset and can be used in a 'treat-to-target' approach analogous to the Clinical Disease Activity Index (CDAI) and the Disease Activity Score 28-joints (DAS28). This tool, however, has not undergone cross-cultural or clinical validation in Brazil. In this research, we performed the MDHAQ cross-cultural and clinical validation for the Brazilian population of RA patients.

Methods
The Portuguese version of the MDHAQ was created identically in an electronic questionnaire and underwent a cross-cultural validation process with 38 participants. Test–retest was performed in 29 patients. Further, a clinical validation with 129 Rheumatoid Arthritis patients was performed. Electronic MDHAQ was answered through an online platform. We also collected socioeconomic data as well as other clinical (CDAI, SDAI, DAS28) and functional (HAQ) scores during the face-to-face assessment of patients.

Results
MDHAQ/RAPID3 maintained semantic, idiomatic, as well as conceptual and experience equivalence for the Brazilian population, with 92% acceptance of participants. It showed test–retest reliability, adequate internal consistency (Cronbach's α 0.85) and correlation of the scores obtained with adequate association with the DAS28 gold standard. RAPID3 also had high sensitivity (98%), adequate specificity (48%), high negative predictive value (92%) and negative post-test probability of 8%, attributes expected for a test tool for population screening.

Conclusion
The use of MDHAQ/RAPID3 associated with traditional clinical measures can adequately allow for remote follow-up based on the 'treat-to-target' approach with performance comparable to the gold standard DAS28, being a viable tool in the sample of Brazilian patients with RA in the current context of telehealth.
Watchful waiting for communicating hydrocoele in infants
Authors: Sabra Tarek Abdelazeem , Abdelgawaad Moamen Shalkamy , Abdelmohsen Sarah Magdy , Badawy Amr 
Published: November 2022

Abstract
Background
One of the commonest pediatric surgeries is hydrocele. There are suggestions to wait for spontaneous resolution than to operate these cases without harmful adverse events. Herein, we evaluated the outcome of the watchfulness of these cases over 18 months.

Methods
The study included 93 infants with communicating hydrocele for the Pediatric Surgery Department, Faculty of Medicine (Assiut, Egypt). They were planned to be followed up for 18 months, and indications for intervention included hernia, increasing in size, being tense, and completion of 18 months of follow-up without improvement.

Results
The gestational age of the included patients was 38.5 ± 2.2 weeks and the age at the time of presentation was 50 (7, 495) days. Most cases were bilateral, reducible, and had an intermittent course. After 18 months of follow-up, 60.2% of the patients resolved spontaneously and 39.8% were surgically treated. Age at the time of presentation was higher among operated patients. Patients with reducibility criteria on clinical examination and lack of intermittent course had higher frequency among operated patients (89.2%).

Conclusions
It is safe to wait and not to operate on infants with hydrocele up to 18 months as long as there was no hernia. Higher age at presentation and reducibility on examination are indicators that favor the need for surgery.
The relation of forward head posture with back muscle endurance in primary school children: a cross-sectional study
Authors: Abd-Elshafy Asmaa Hosny , El-Meniawy Gehan Hassan , Abu El Azm Wael S. , El Fakharany Mahmoud S. 
Published: November 2022

Abstract
Background
The goal of this study was to look at the correlation between forwarding head posture and back muscle endurance in 288 primary school healthy active children aged 7–10 years old in public schools in Sheblanga, Benha, Qalubyia governorate (170 boys and 118 girls).

Methods
A cross-sectional study was conducted on elementary school children to see whether there was a link between forwarding head posture and back muscle endurance. The photogrammetry technique of craniovertebral angle (CVA) was employed to quantify forward head position, and the Biering Sorensen test was utilized to evaluate isometric back muscle endurance.

Results
The distribution of head posture in the study group revealed 132 (46%) children with advancing head posture and 156 (54%) children with normal posture. In the study group, the connection between CVA and trunk extensor endurance was moderately significant (r = 0.4, p = 0.0001). The trunk extensor endurance of children with advancing heads was significantly lower than that of children with normal postures (p = 0.0001).

Conclusions
There is a link between forwarding head posture (FHP) and back muscle endurance.
The effects of the duration, intensity and magnitude of far-fault earthquakes on the seismic response of RC bridges retrofitted with seismic bearings
Authors: Mansouri Saman , Kontoni Denise-Penelope N. , Pouraminian Majid 
Published: November 2022

AbstractThis paper investigates the effects of earthquakes’ duration, intensity, and magnitude on the seismic response of reinforced concrete (RC) bridges retrofitted with seismic bearings, such as elastomeric bearings (EB), lead rubber bearings (LRB), and friction pendulum bearings (FPB). In order to investigate the effects of the seismic isolation, the condition of the deck with a rigid connection on the cap beams and abutments (i.e., without isolation) was investigated as the first model. The EB, LRB and FPB bearings are used between the superstructure and substructure of the studied bridge in the second, third and fourth models, respectively. First, the effects of using seismic bearings on the seismic retrofit of an RC bridge under the Tabas earthquake were investigated. The results of the nonlinear dynamic analysis showed that the use of seismic bearings leads to seismic retrofit of the studied bridge, and FPB and LRB had the best results among the studied isolation equipment, respectively. The same models were also studied subjected to the Landers and Loma Prieta earthquakes. The magnitude of the Landers and Tabas earthquakes is equal to 7.3 Richter, and the magnitude of the Loma Prieta earthquake is equal to 6.7 Richter. However, the duration and intensity of the Landers and Loma Prieta earthquakes are much larger than the Tabas earthquake. The Landers and Loma Prieta earthquakes caused instability in the isolated models due to their significant duration and intensity. This issue shows that using seismic bearings is very useful and practical for seismic retrofitting bridges subjected to far-fault earthquakes. According to most seismic codes, selecting earthquakes in far-region of faults is based on just magnitude criterion. However, this study indicates that there are two main factors in the features of far-fault earthquakes, including duration and intensity. Ignoring these factors in selecting earthquakes may lead to the instability of structures. Considering earthquakes’ duration, intensity, and magnitude are vital for selecting earthquakes in the far region of the fault.