bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide Among Women and the Role of Women’s Health Care Providers
Authors: Stacy Meaghan , Kremer Mallory , Schulkin Jay 
Published: May 2022

ABSTRACT

Importance
Suicide is a leading cause of death in the United States, with increasing rates among women. Women are more likely to experience suicidal ideation and engage in suicide behavior than men, and risk is elevated at key points where they may engage in care with a women's health care provider.

Objective
This review describes the prevalence of and risk factors for suicide among women and highlights the role of obstetrician-gynecologists in suicide prevention.

Evidence Acquisition
A PubMed, MEDLINE, and PsycINFO search was completed for English-language publications about suicide among women, including subtopics (eg, perinatal suicide, suicide during perimenopause).

Results
There are overlapping risk factors that contribute to suicide among women, including intimate partner violence and substance use. Specific groups of women may present with unique risk factors, such as women veterans, women in rural areas, and women with preexisting mental health diagnoses, particularly serious mental illnesses. Some women at risk for suicide are not seen in clinical settings, and thus community interventions may be beneficial. There are roles for obstetrician-gynecologists within and outside of the clinic to prevent suicide.

Conclusions and Relevance
Obstetrician-gynecologists can save lives by being aware of the prevalence of suicide ideation and behavior among women, understanding risk factors for suicide over the lifespan, regularly screening for these factors, asking directly about suicide ideation and intent, and being aware of clinical and community resources. Outside of the clinic, they can advocate for increased health care access and community-based interventions. These efforts can contribute to the reduction of preventable death and maternal mortality.

Target Audience
Obstetricians and gynecologists, family physicians.

Learning Objectives
After participating in this activity, physicians should be better able to distinguish how the prevalence of suicide in the United States varies across major demographic groups, including women; list factors associated with the greater prevalence of suicidal ideation and behavior among women; and identify the unique suicide risk factors among women across the reproductive life span, including pregnancy and the postpartum period.
Medications Without Borders
Authors: Chang Elizabeth L. , Kline Matthew D. , Sundararajan Radhika , Nguyen Margaret B. 
Published: May 2022

Objective
This study aimed to identify motivating factors in why parents administer imported medications to their children.

Methods
In this qualitative study, we enrolled caregivers of patients younger than 18 years who presented for care at a pediatric emergency department. The study team conducted face-to-face interviews with caregivers in the emergency department and used a semistructured question guide to probe for themes regarding the use of imported medications in children. Interviews were recorded, transcribed, translated if necessary, and coded. We applied grounded theory methodology to assess for themes and adapted the Andersen model of health care utilization to provide a framework for the identified themes.

Results
We completed 30 interviews, 9 of which were conducted in Spanish. Themes surrounding imported medication usage were categorized into predisposing, enabling, and need factors. Predisposing factors included perception that an ill child needs medication to get better, perception of medication quality, and past experiences with medications. Enabling factors included proximity to foreign countries, cost, limited access to primary care, and convenience of obtaining medications. Need factors included utilization of foreign medications for a “simple illness” and utilization of foreign care for a “second opinion.”

Conclusions
Our study used qualitative methodology to gain important insights into the caregiver experience of a diverse patient population. We identify themes not previously published in the medication importation literature. These concepts can provide insights in educational strategies aimed at mitigating the potential dangers of imported medication use in pediatrics.
Emergency Department Visits by Pediatric Patients for Snakebites
Authors: Tadros Allison , Sharon Melinda , Davis Stephen , Quedado Kimberly , Marple Emily 
Published: May 2022

Objectives
Few studies have examined pediatric emergency department (ED) visits for snakebites. This study sought to examine characteristics of pediatric patients presenting to EDs nationally in the United States for snakebites.

Methods
This retrospective cohort study obtained data from the Nationwide Emergency Department Sample for 2006 to 2014. Pediatric patients sustaining a snakebite were identified with International Classification of Diseases, Ninth Revision, E-codes E905.0 or E906.2. Data extracted included age, sex, insurance, disposition, hospital trauma designation, ED charges, and geographic region. Comparative analyses were performed for patients younger than 10 years and aged 10 to 17 years.

Results
There were 24,388 ED visits from 2006 to 2014 by pediatric patients for snakebites: 10,554 were younger than 10 years, and 13,834 were aged 10 to 17 years. Males comprised 62% and 67% of the respective age cohorts. Most patients (younger than 10 years, 68%; aged 10–17 years, 63%) experienced snakebites in the South. Only 14% of those younger than 10 years and 10% of those aged 10 to 17 years were treated at a level 1 trauma center, whereas 50% and 54%, respectively, were treated at hospitals with no trauma designation. The majority of patients were discharged from the ED (younger than 10 years, 72%; aged 10–17 years, 80%). The mean ED charges for snakebite victims younger than 10 years were $5363 and for those aged 10 to 17 years were $4618. Medicaid was the primary insurer of younger patients, whereas private insurance was more common in older patients.

Conclusions
Most pediatric snakebites are seen in nontrauma centers and in the South region and are more commonly male. Most patients were discharged from the ED, with a small percentage being admitted or transferred to another facility.
Single-Dose Dexamethasone Is Not Inferior to 2 Doses in Mild to Moderate Pediatric Asthma Exacerbations in the Emergency Department
Authors: Martin Meghan , Penque Michelle , Wrotniak Brian H. , Qiao Haiping , Territo Heather 
Published: May 2022

Objective
The purpose of this study was to compare the efficacy of a single dose of dexamethasone to 2 doses of dexamethasone in treating mild to moderate asthma exacerbations in pediatric patients. We anticipated that there would not be a difference in the rate of return visits to the emergency department (ED), urgent care, or primary care physician for continued asthma symptoms.

Methods
This was a prospective, randomized, single-center, unblinded, parallel-group randomized clinical trial of patients 2 to 20 years old presenting to a pediatric ED with mild to moderate asthma exacerbations. The patients were randomized to receive 1 or 2 doses of dexamethasone (0.6 mg/kg per dose, maximum of 16 mg). Telephone follow-up interviews were performed on the sixth day after ED visit. The primary outcome measures were return visits to either primary care physician or ED for continued asthma symptoms. Secondary outcomes were days of symptoms, missed school days, and adverse effects.

Results
Of the 318 children initially enrolled, 308 patients met the enrollment criteria. These patients were randomized into 2 groups. There were 116 patients in group 1 and 116 patients in group 2. There was no significant difference between groups regarding return visits (group 1, 12.1%; group 2, 10.3%; odds ratio [OR], 0.892 [95% confidence interval {CI}, 0.377–2.110]), days to symptom resolution (group 1, 2.4; group 2, 2.5; OR, 0.974 [95% 95% CI, 0.838–1.132]), missed school days (group 1, 47%; group 2, 51%; OR, 1.114 [95% CI, 0.613–2.023]), or vomiting (group 1, 8.6%; group 2, 3.4%; OR, 2.424 [95% CI, 0.637–9.228]).

Conclusions
In this single-center, unblinded randomized trial of children and adolescents with mild to moderate acute exacerbations of asthma, there was no difference in the rate of return visits for continued or worsened symptoms between patients randomized to 1 or 2 doses of dexamethasone.
Discrepancies Between the Management of Fever in Young Infants Admitted From Urban General Emergency Departments and Pediatric Emergency Departments
Authors: Jain Priya Narayanan , Lerer Rikah , Choi Jaeun , Dunbar Julie , Eisenberg Ruth , Hametz Patricia , Nassau Stacy , Katyal Chhavi 
Published: May 2022

Introduction/Objective
Most pediatric emergency visits occur in general emergency departments (GED). Our study aims to assess whether medical decision making regarding the management of febrile infants differs in GEDs from pediatric EDs (PED) and deviates from pediatric expert consensus.

Methods
We conducted a retrospective chart review on patients younger than 60 days with fever admitted from 13 GEDs versus 1 PED to a children’s hospital over a 3-year period. Adherence to consensus guidelines was measured by frequency of performing critical components of initial management, including blood culture, urine culture, attempted lumbar puncture, and antibiotic administration (<29 days old), or complete blood count and/or C-reactive protein, blood culture, and urine culture (29–60 days old). Additional outcomes included lumbar puncture, collecting urine specimens via catheterization, and timing of antibiotics.

Results
A total of 176 patient charts were included. Sixty-four (36%) patients were younger than 29 days, and 112 (64%) were 29 to 60 days old. Eighty-eight (50%) patients were admitted from GEDs.
In infants younger than 29 days managed in the GEDs (n = 32), 65.6% (n = 21) of patients underwent all 4 critical items compared with 96.9% (n = 31, P = 0.003) in the PED. In infants 29 to 60 days old managed in GEDs (n = 56), 64.3% (n = 36) patients underwent all 3 critical items compared with 91.1% (n = 51, P < 0.001) in the PED.

Conclusions
This retrospective study suggests that providers managing young infants with fever in 13 GEDs differ significantly from providers in the PED examined and literature consensus. Inconsistent testing and treatment practices may put young infants at risk for undetected bacterial infection.
Efficacy of a Self-managed Cooling Intervention for Pain and Physical Activity in Individuals With Recently Healed Chronic Venous Leg and Diabetic Foot Ulcers
Authors: Kelechi Teresa J. , Mueller Martina , Madisetti Mohan , Prentice Margaret 
Published: May 2022

PURPOSE:
This aim of this study was to evaluate the clinical efficacy of a self-managed cooling intervention in individuals with recently healed venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) on pain reduction and physical activity improvement.

DESIGN:
A 6-month longitudinal randomized controlled trial.

SUBJECTS AND SETTING:
The sample comprised 140 individuals with previously healed VLU and DFU who received care in 3 outpatient wound centers in the Southeastern region of the United States. Participants were randomized to the MUSTCOOL or a placebo cooling patch intervention.

METHODS:
The cooling and placebo interventions comprised cooling or cotton-filled patch application to recently healed skin for 30 minutes, 3 times weekly plus standard of care including compression and leg elevation (participants with VLU) or therapeutic footwear and hygiene (participants with DFU) over a 6-month period. Pain severity and intensity were measured with the Brief Pain Inventory and physical activity with the International Physical Activity Questionnaire, which assessed metabolic equivalent of tasks (METs) in minutes per week. Minutes in walking time per week were assessed with an accelerometer. Data were descriptively analyzed for difference changes in scores from baseline to 6 months post-intervention.

RESULTS:
Data were analyzed for 81 participants randomized to cooling and placebo groups (VLUs, n = 26/29) and DFU (n = 12/16). Slight reductions in VLU pain severity (−0.5, −0.2) and interference (−0.4, −0.5) and minimal reductions in DFU pain severity (0, −0.1) and interference (0.4/0.1) were achieved. However, pain scores were low to moderate at baseline (mean 4, 0-10 with 10 worst pain possible) in both groups. For physical activity, the MET values showed low physical activity in both groups at baseline with slight improvements noted in VLU cooling and placebo groups (73/799) and DFU (1921/225), respectively. Walking time for the VLU groups improved by 1420/2523 minutes; the DFU groups improved 135/157 minutes, respectively. Findings for outcomes were not statistically significant within or between groups.

CONCLUSIONS:
Application of the cooling pack compared to placebo was minimally efficacious in reducing posthealing pain and improving function in this posthealed ulcer population. However for pain, scores were initially low; thus outcomes on pain, while lower, were marginal.

TRIAL REGISTRATION:
The study was prospectively registered with ClinicalTrials.gov on December 10, 2015 (Identifier: NCT02626156), https://clinicaltrials.gov/ct2/show/NCT02626156.
A One-Step Synthesis of DNA Dumbbells Tunnels Short-Read Libraries into a Long-Read Format
Authors: Chang Ya-Hui , Liu Hong-Hsing 
Published: May 2022

AbstractDNA dumbbells have many applications. For example, they can be templates for rolling-circle amplification to produce highly accurate long-read sequences of single molecules. We have developed a highly efficient and simple method for ‘tunneling’ short-read Illumina sequencing libraries into long-read dumbbells. A 5’-exonuclease used in Gibson Assembly converted fixed Illumina P5/P7 sequences into sticky ends. Self-looping oligonucleotides with complementary 3’-overhangs were ligated to form dumbbells. The reaction proceeded in one pot and modified only end nucleotides of input libraries. Resulting dumbbells were ready for Phi29-dependent rolling circle amplification. Demonstrative readouts of full-length 16S rDNA from a standard microbial community, obtained on a Pacific Biosciences (PacBio) platform, confirmed successful tunneling of initially P5/P7-ended sequencing libraries. Twelve fecal samples additionally showed significant correlations between standard and tunneled 16S sequence variants on a PacBio platform.
Magnetic Resonance Imaging Radiomics-Based Model to Identify the Pathological Features and Lymph Node Metastasis in Rectal Cancer
Authors: Chen Peng , Wen Deying , Huang Libin , Ding Jingjing , Yang Wenming , Sun Jiayu , Yang Lie , Zhou Zongguang 
Published: May 2022

AbstractBackgroundPathological features and lymph node staging plays an important role in treatment decision-making. Yet, the preoperative accurate prediction of pathological features and lymph node metastasis (LNM) is challenging.ObjectiveWe aimed to investigate the value of MRI-based radiomics in predicting the pathological features and lymph node metastasis in rectal cancer.MethodsIn this prospective study, a total of 37 patients diagnosed with histologically confirmed rectal cancer who underwent pelvic 3.0T magnetic resonance imaging (MRI) were enrolled. MRI images of both the primary tumor alongside the lymph nodes and specimens were performed with a node-to-node match and labeling. The correlation analysis, least absolute shrinkage, and selection operator (LASSO) logistic regression (LR), backward stepwise LR were mainly used for radiomics feature selection and modeling. The univariate and multivariate backward stepwise LR were used for preoperative clinical predictors selection and modeling.ResultsA total of 487 lymph nodes including 39 metastatic lymph nodes and 11 tumor deposits were harvested from 37 patients. The texture features of the primary tumors could successfully predict tumor differentiation using a well-established model (area under the curve (AUC) = 0.798). Sixty-nine matched lymph nodes were randomly divided into a training cohort (n = 39) and a validation cohort (n = 30).Three independent risk factors were obtained from 56 texture parameters closely related to LNM. A prediction model was then successfully developed, which provided AUC values of 0.846 and 0.733 in the training and test cohort, respectively. Further, tumor deposits produced a higher radiomics score (Rad-score) compared with LNM (P = 0.042).ConclusionThe study provides two non-invasive and quantitative methods, which respectively predict the tumor differentiation and regional LNM for rectal cancer preoperatively. Ultimately, these are favorable when producing treatment protocols for rectal cancer patients.
Independent spatiotemporal effects of spatial attention and background clutter on human object location representations
Authors: Graumann Monika , Wallenwein Lara A. , Cichy Radoslaw M. 
Published: May 2022

1.AbstractSpatial attention helps us to efficiently localize objects in cluttered environments. However, the processing stage at which spatial attention modulates object location representations remains unclear. Here we investigated this question identifying processing stages in time and space in an EEG and fMRI experiment respectively. As both object location representations and attentional effects have been shown to depend on the background on which objects appear, we included object background as an experimental factor. During the experiments, human participants viewed images of objects appearing in different locations on blank or cluttered backgrounds while either performing a task on fixation or on the periphery to direct their covert spatial attention away or towards the objects. We used multivariate classification to assess object location information. Consistent across the EEG and fMRI experiment, we show that spatial attention modulated location representations during late processing stages (>150ms, in middle and high ventral visual stream areas) independent of background condition. Our results clarify the processing stage at which attention modulates object location representations in the ventral visual stream and show that attentional modulation is a cognitive process separate from recurrent processes related to the processing of objects on cluttered backgrounds.
Using Transfer Learning for Automated Microbleed Segmentation
Authors: Dadar Mahsa , Zhernovaia Maryna , Mahmoud Sawsan , Camicioli Richard , Maranzano Josefina , Duchesne Simon 
Published: May 2022

AbstractIntroductionCerebral microbleeds are small perivascular haemorrhages that can occur in both grey and white matter brain regions. Microbleeds are a marker of cerebrovascular pathology, and are associated with an increased risk of cognitive decline and dementia. Microbleeds can be identified and manually segmented by expert radiologists and neurologists, usually from susceptibility-contrast MRI. The latter is hard to harmonize across scanners, while manual segmentation is laborious, time-consuming, and subject to inter- and intra-rater variabiltiy. Automated techniques so far have shown high accuracy at a neighborhood (“patch”) level at the expense of a high number of false positives voxel-wise lesions. We aimed to develop an automated, more precise microbleeds segmentation tool able to use standardizable MRI contrasts.MethodsWe first trained a ResNet50 network on another MRI segmentations task (cerberospinal fluid versus background segmentation) using T1-weighted, T2-weighted, and T2* MRI. We then used transfer learning to train the network for the detection of microbleeds with the same contrasts. As a final step, we employed a combination of morphological operators and rules at the local lesion level to remove false positives. Manual segmentations of microbleeds from 78 participants were used to train and validate the system. We assessed the impact of patch size, freezing weights of the initial layers, mini-batch size, learning rate, as well as data augmentation on the performance of the Microbleed ResNet50 network.ResultsThe proposed method achieved a high performance, with a patch-level sensitivity, specificity, and accuracy of 99.57%, 99.16%, and 99.93%, respectively. At a per lesion level, sensitivity, precision, and Dice similarity index values were 89.1%, 20.1%, and 0.28 for cortical GM; 100%, 100%, and 1.0 for deep GM; and 91.1%, 44.3%, and 0.58 for WM, respectively.DiscussionThe proposed microbleed segmentation method is more suitable for the automated detection of microbleeds with high sensitivity.
Thousands of human non-AUG extended proteoforms lack evidence of evolutionary selection among mammals
Authors: Fedorova Alla D. , Kiniry Stephen J. , Andreev Dmitry E. , Mudge Jonathan M. , Baranov Pavel V. 
Published: May 2022

AbstractThe synthesis of most proteins begins at AUG codons, yet a small number of non-AUG initiated proteoforms are also known. Here we used publicly available ribo-seq data with phylogenetic approaches to identify novel, previously uncharacterised non-AUG proteoforms. Unexpectedly we found that the number of non-AUG proteoforms identified with ribosome profiling data greatly exceeds those with strong phylogenetic support. We identified an association between proteoforms with alternative N-termini and multiple compartmentalisation of corresponding gene products. In dozens of genes N-terminal extensions encode localisation signals, including mitochondrial presequence and signal peptides. While the majority of non-AUG initiated proteoforms occur in addition to AUG initiated proteoforms, in few cases non-AUG appears to be the only start. This suggests that alternative compartmentalisation is not the only function of non-AUG initiation. Taking a conservative approach, we updated annotation of several genes in the latest GENCODE version in human and mouse where non-AUG initiated proteofoms are supported by both, ribosome profiling and phylogenetic evidence. Yet, the number of such extensions is likely much higher. Thousands of non-AUG proteoforms supported only by ribosome profiling suggest that they may evolve neutrally. Indeed, expression of some may not be consequential, i.e. when N-termini is processed or they have identical biochemical properties. Nonetheless they may contribute to immune response as antigen sources. It is also possible that some proteoforms accrued useful functions only recently and evolved under purifying selection in a narrow phylogenetic group. Thus, further characterisation is important for understanding their phenotypical and clinical significance.
Theory and application of an improved species richness estimator
Authors: Tekwa E. W. , Whalen Matthew A. , Martone Patrick T. , O’Connor Mary I. 
Published: May 2022

AbstractSpecies richness is an essential biodiversity variable indicative of ecosystem states and rates of invasion, speciation, and extinction both contemporarily and in fossil records. However, limited sampling effort and spatial aggregation of organisms mean that biodiversity surveys rarely observe every species in the survey area, which introduces bias to the estimated richness and inaccuracy to comparisons of communities across space and time. Here we present a nonparametric, asymptotic, and bias-corrected richness estimator, ΩT, by modelling how spatial abundance characteristics affect observation of species richness. We conduct simulation tests and applied ΩT to a tree census and a seaweed survey. ΩT consistently outperforms common estimators in balancing bias, precision, and difference detection accuracy. Our results provide theoretical insights into how natural and observer-induced variation affects species observation and support ΩT as a promising and application-ready richness estimator for a wide variety of data.