bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attention/Deficit Hyperactivity Disorder in Adolescent and Young Adult Males With Fragile X Syndrome
Authors: Klusek Jessica , O'Connor Shannon L. , Hickey Alexandra , Hills Kimberly J. , Abbeduto Leonard , Roberts Jane E. 
Published: April 2022

Abstract
This study characterized the rates of attention-deficit/hyperactivity disorder (ADHD) in adolescent and young adult males with fragile X syndrome (FXS) using a multi-method approach integrating a DSM-based parent interview (Children's Interview for Psychiatric Syndromes; P-ChIPS, Fristad et al., 1998) and a parent rating scale (Child Behavior Checklist; CBCL, Achenbach, 2001). Thirty-one males with FXS, aged 16–24 years, participated. Forty-two percent met DSM-5 criteria for ADHD and 35% exceeded the CBCL cut-offs. Agreement between the two classification methods was fair (κ = 0.38). Autism symptom severity and nonverbal cognitive ability did not predict ADHD diagnoses/symptoms. Results show high rates of ADHD in males with FXS during late adolescence and young adulthood, which are not accounted for by impaired nonverbal cognitive skills or autism symptom severity. DSM-based ADHD-specific scales are recommended over broadband symptom scales to improve accurate identification.
Change in Maladaptive Behavior Affects Intergenerational Relationships in Fragile X Syndrome
Authors: Lorang Emily , Hong Jinkuk , DaWalt Leann Smith , Mailick Marsha 
Published: April 2022

Abstract
This study investigated the bidirectional effects of change in maladaptive behaviors among adolescents and adults with fragile X syndrome (FXS) and change in their intergenerational family relationships over a 7.5-year period. Indicators of the intergenerational family relationship between premutation carrier mothers and their adolescent or adult son/daughter with FXS included a measure of the quality of the relationship, as well as descriptions provided by mothers of their relationship with their son/daughter (positive remarks, critical remarks). Maladaptive behaviors decreased, maternal positive remarks increased, and maternal critical remarks and relationship quality remained stable over time. Bidirectional effects of change were observed in predicting maladaptive behaviors and maternal positive remarks, although maladaptive behaviors more strongly predicted positive remarks than the reciprocal association. This research suggests prioritizing maladaptive behaviors in the context of family interventions.
How Ohio's proposed abortion bans would impact travel distance to access abortion care
Authors: Chakraborty Payal , Murawsky Stef , Smith Mikaela H. , McGowan Michelle L. , Norris Alison H. , Bessett Danielle 
Published: April 2022

AbstractContextSince March 2021, the Ohio legislature has been actively considering laws that would ban abortion if the United States Supreme Court overturns the Roe v. Wade decision that legalized abortion nationally in 1973.MethodsWe used a national database of publicly advertised abortion facilities to calculate driving distances for Ohioans before and after the activation of proposed abortion bans. Using a legal analysis of abortion laws following the overturn of Roe, we determined which states surrounding Ohio would continue providing abortion care. We calculated distances from each Ohio county centroid to the nearest open abortion facility in three scenarios: (1) as of February 2022, (2) the best‐case post‐Roe scenario (two of the five surrounding states continue to offer abortion care), and (3) worst‐case post‐Roe scenario (no surrounding states continue to offer abortion care). We calculated population‐weighted distances using county‐level data about women aged 15–44 years from the 2019 American Community Survey.ResultsIn February 2022, all Ohio county centroids were at most 99 miles from an abortion facility (median = 50 miles). The best‐case post‐Roe scenario shows 62 of Ohio's 88 counties to be 115–279 miles away from the nearest facility (median = 146). The worst‐case shows 85 counties to be 191–339 miles away from the nearest facility (median = 264). The current average population‐weighted driving distance from county centroid to the nearest facility is 26 miles; the post‐Roe scenarios would increase this to 157 miles (best‐case) or 269 miles (worst‐case).ConclusionsOhio's proposed abortion bans would substantially increase travel distances to abortion care, impacting over 2.2 million reproductive‐aged Ohioans.
Broadband achromatic polarization-insensitive metalens in the mid-wave infrared range
Authors: Xie Yao , Zhang Jianqi , Wang Shiyu , Liu Delian , Wu Xin 
Published: April 2022

Infrared imaging is widely used in astronomical observation, medical diagnosis, and military applications. In recent years, metasurface technology has provided an unparalleled platform for the development of miniaturized and integrated infrared imaging systems. However, metasurfaces normally have inevitable chromatic aberration due to the high phase dispersion of the building blocks, which makes broadband achromatic infrared imaging difficult to realize. In this paper, we propose a polarization-insensitive metalens with a numerical aperture of 0.38 that can eliminate chromatic aberration for unpolarized incidences with the wavelength ranging from 3 to 5 µm. The simulated results show that within the design bandwidth, the proposed device achieves near-diffraction limit focusing and can increase the fill factor of infrared focal plane array pixels by 2.3 times, from 11.1% to 36.4%, with an excellent optical crosstalk performance of about 2.72%. Our work may pave the way for the practical application of achromatic metalenses in mid-wave infrared imaging equipment.
Helicobacter pylori resistance to antibiotics before and after treatment: Incidence of eradication failure
Authors: Nestegard Oddmund , Moayeri Behrouz , Halvorsen Fred-Arne , Tønnesen Tor , Sørbye Sveinung Wergeland , Paulssen Eyvind , Johnsen Kay-Martin , Goll Rasmus , Florholmen Jon Ragnar , Melby Kjetil K. 
Published: April 2022

Background
Increasing prevalence of antibiotic resistance especially to clarithromycin and metronidazole has been observed in Helicobacter pylori (H. pylori).

Aim
To characterize the antimicrobial resistance pattern of H. pylori before and after treatment in a cohort of patients accumulated over a period of 15 years after an unsuccessful eradication treatment had been given comparing sensitivity data from patients with newly diagnosed H. pylori infection. A specific objective was to look for resistance to levofloxacin.

Material and methods
Total of 50 patients newly diagnosed for H. pylori infection treated with omeprazole and amoxicillin/clarithromycin and 42 H pylori treatment-resistant patients treated with omeprazole and amoxicillin/levofloxacin were enrolled in this study. Cultures including antibiotic sensitivity testing were conducted according to standard laboratory routines and thus also in keeping with a European study protocol using E-test gradient strips or disc diffusion methods.

Results
Clarithromycin resistance was more frequently observed in the H. pylori resistant group than in newly diagnosed H. pylori group (39% versus 11%). Regarding metronidazole the distribution was 70% versus 38%, and 8% versus 12% were resistant to tetracycline. No resistance was observed for amoxicillin. After re-treatment of patients belonging to the H. pylori treatment-resistant group, just two patient strains were recovered of which one harbored metronidazole resistance. In the group of newly diagnosed H. pylori, seven patients were culture positive by control after treatment. Two and three patient strains showing resistance to clarithromycin and metronidazole, respectively. None of the strains in our material was classified as resistant to amoxicillin and levofloxacin. Whereas 12% was resistant to tetracycline in the newly diagnosed before treatment.

Conclusion
Clarithromycin resistance was more frequent in the H. pylori treatment-resistant group than strains from patients with newly diagnosed H. pylori infection. No resistance was observed to amoxicillin and levofloxacin. In such cases Therefore levofloxacin may be used provided in vitro sensitivity testing confirms applicability.

Trial registration
ClinicalTrials.gov identifier: NCT05019586.
Antidepressants and health-related quality of life (HRQoL) for patients with depression: Analysis of the medical expenditure panel survey from the United States
Authors: Almohammed Omar A. , Alsalem Abdulaziz A. , Almangour Abdullah A. , Alotaibi Lama H. , Al Yami Majed S. , Lai Leanne 
Published: April 2022

Background
Despite the empirical literature demonstrating the efficacy of antidepressant medications for treatment of depression disorder, these medications’ effect on patients’ overall well-being and health-related quality of life (HRQoL) remains controversial. This study investigates the effect of antidepressant medication use on patient-reported HRQoL for patients who have depression.

Methods
A comparative cohort, secondary database analysis was conducted using data from the United States’ Medical Expenditures Panel Survey for patients who had depression. HRQoL was measured using the SF-12 and reported as physical and mental component summaries (PCS and MCS). A cohort of patients that used antidepressant medications were compared to a cohort of patients that did not. Univariate and multivariate difference-in-differences (D-I-D) analyses were used to assess the significance of the mean difference of change on the PCS and MCS from baseline to follow-up.

Results
On average, 17.5 million adults were diagnosed with depression disorder each year during the period 2005–2016. The majority were female (67.9%), a larger proportion of whom received antidepressant medications (60.5% vs. 51.5% of males). Although use of antidepressants was associated with some improvement on the MCS, D-I-D univariate analysis revealed no significant difference between the two cohorts in PCS (–0.35 vs. –0.34, p = 0.9595) or MCS (1.28 vs. 1.13, p = 0.6405). The multivariate D-I-D analyses ensured the robustness of these results.

Conclusion
The real-world effect of using antidepressant medications does not continue to improve patients’ HRQoL over time. Future studies should not only focus on the short-term effect of pharmacotherapy, it should rather investigate the long-term impact of pharmacological and non-pharmacological interventions on these patients’ HRQoL.
Association of measured quality with financial health among U.S. hospitals
Authors: Enumah Samuel J. , Resnick Andrew S. , Chang David C. 
Published: April 2022

Background
High-quality care is a clear objective for hospital leaders, but hospitals must balance investing in quality with financial stability. Poor hospital financial health can precipitate closure, limiting patients’ access to care. Whether hospital quality is associated with financial health remains poorly understood. The objective of this study was to compare financial performance at high-quality and low-quality hospitals.

Methods
We performed a retrospective observational cohort study of U.S. hospitals using the American Hospital Association and Hospital Compare datasets for years 2013 to 2018. We used multilevel mixed-effects linear and logistic regression models with fixed year effects and random intercepts for hospitals to identify associations between hospitals’ measured quality outcomes—30-day hospital-wide readmission rate and the patient safety indicator-90 (PSI-90)—and their financial margins and risk of financial distress in the same year and the subsequent year. Our sample included 20,919 observations from 4,331 unique hospitals.

Results
In 2018, the median 30-day readmission rate was 15.2 (interquartile range [IQR] 14.8–15.6), the median PSI-90 score was 0.96 (IQR 0.89–1.07), the median operating margin was -1.8 (IQR -9.7–5.9), and 750 (22.7%) hospitals experienced financial distress. Hospitals in the best quintile of readmission rates experienced higher operating margins (+0.95%, 95% CI [0.51–1.39], p < .001) and lower odds of distress (odds ratio [OR] 0.56, 95% CI [0.45–0.70], p < .001) in the same year as compared to hospitals in the worst quintile. Hospitals in the best quintile of PSI-90 had higher operating margins (+0.62%, 95% CI [0.17–1.08], p = .007) and lower odds of financial distress (OR 0.70, 95% CI [0.55–0.89], p = .003) as compared to hospitals in the worst quintile. The results were qualitatively similar for the same-year and lag-year analyses.

Conclusion
Hospitals that deliver high-quality outcomes may experience superior financial performance compared to hospitals with poor-quality outcomes.
Maternal body composition and gestational weight gain in relation to asthma control during pregnancy
Authors: Stevens Danielle R. , Rohn Matthew C. H. , Hinkle Stefanie N. , Williams Andrew D. , Kumar Rajesh , Lipsky Leah M. , Grobman William , Sherman Seth , Kanner Jenna , Chen Zhen , Mendola Pauline 
Published: April 2022

Background
Poor asthma control is common during pregnancy and contributes to adverse pregnancy outcomes. Identification of risk factors for poor gestational asthma control is crucial.

Objective
Examine associations of body composition and gestational weight gain with asthma control in a prospective pregnancy cohort (n = 299).

Methods
Exposures included pre-pregnancy body mass index (BMI), first trimester skinfolds, and trimester-specific gestational weight gain. Outcomes included percent predicted forced expiratory volumes (FEV1, FEV6), forced vital capacity (FVC), peak expiratory flow (PEF), FEV1/FVC, symptoms (activity limitation, nighttime symptoms, inhaler use, and respiratory symptoms), and exacerbations (asthma attacks, medical encounters). Linear and Poisson models examined associations with lung function (β (95% confidence interval (CI)), asthma symptom burden (relative rate ratio (RR (95%CI)), and exacerbations (RR (95%CI)).

Results
Women with a BMI ≥ 30 had lower percent predicted FVC across pregnancy (βThirdTrimester: -5.20 (-8.61, -1.78)) and more frequent night symptoms in the first trimester (RR: 1.66 (1.08, 2.56)). Higher first trimester skinfolds were associated with lower FEV1, FEV6, and FVC, and more frequent night symptoms and inhaler use across pregnancy. Excessive first trimester gestational weight gain was associated with more frequent activity limitation in the first trimester (RR: 3.36 (1.15, 9.80)) and inhaler use across pregnancy (RRThirdTrimester: 3.49 (1.21, 10.02)).

Conclusions
Higher adiposity and first trimester excessive gestational weight gain were associated with restrictive changes in lung function and symptomology during pregnancy.
Childhood obesity as a predictor of type 2 diabetes mellitus in adults: a systematic review and meta-analysis
Authors: Raditya Marco , Cathleen Fabiola , Raharjo Daniell Edward , Kurniawan Kristian 
Published: April 2022

Background Despite government-developed prevention programs, type 2 diabetes mellitus (DM) has continued to increase, suggesting that the programs are ineffective. Other potential risk factors, such as childhood obesity, may influence adult-onset diabetes.
Objective To assess for a potential association between childhood obesity and adult type 2 DM by meta-analysis of the literature.
Methods This review was conducted according to the PRISMA Statements’ Flow Diagram and Checklist to improve quality of reporting. Cohort studies were chosen for their long-term follow-up. Newcastle-Ottawa Scale for Cohorts (NOS-Cohort) was used to assess for bias and quality of the included studies, in addition to the Cochrane Handbook. Analysis was done with forest and funnel plots using RevMan 5.3 software for Macintosh.
Results A total of 237 records with 73,533 participants were retrieved, of which 10 studies were included in our systematic review and 5 studies were included in the meta-analysis. The most common bias based on NOS-Cohort was inadequate follow-up. Forest plot revealed a significant association between childhood obesity and adult diabetes (OR 3.89; 95%CI 2.97-5.09; I2 0%; P<0.00001). Individuals with childhood obesity were 3.89 times more likely to have adult-onset diabetes. Funnel plot assessment was symmetrical. Studies suggested that childhood obesity led to early insulin resistance and adiposity rebound, which promotes adulthood obesity, a diabetic risk factor.
Conclusion Childhood obesity can be used as a predictor for adult-onset diabetes. Early diabetes screening and prevention guidelines should include childhood obesity as a plausible risk factor.
Factors contributing to successful patent ductus arteriosus closure with first pharmacological course
Authors: Okadharma I Gusti Ayu Made Dwisri , Yantie Ni Putu Veny Kartika , Gunawijaya Eka 
Published: April 2022

Background Successful closure of patent ductus arteriosus (PDA) with ibuprofen or paracetamol as the first-line treatment has been reported, but little is known about factors affecting the closure rate.
Objective To identify the closure success rate and contributing factors affecting a first course of pharmacological treatment in neonates with PDA.
Methods A retrospective study was conducted in infants with isolated PDA treated with either ibuprofen or paracetamol and admitted to our neonatal care unit from January 2017 until June 2020. Included infants had PDA on echocardiography and received ibuprofen or paracetamol therapy as the closure treatment. Oral ibuprofen was given at 10 mg/kg on first day, then 5 mg/kg on the 2nd and 3rd days; while paracetamol was given intravenously 15 mg/kg every 6 hours for 3 days. Echocardiographic evaluation was performed 3 days after first course of treatment.
Results In total, 20 of 33 (60.6%) infants achieved PDA closure with the first course of treatment. Earlier age at the start of the first course of treatment (PR 7.7; 95%CI 1.2 to 47.7; P=0.035) and normal birth weight (PR 13.3; 95%CI 2.4 to 72.4; P=0.001) were significant factors contributing to PDA closure. However, PDA size did not affect closure rate (PR 2.0; 95%CI 0.4 to 8.5; P=0.46).
Conclusion Pharmacological treatment seems to have a good success rate for PDA closure, with significant positive associations with earlier age at start of treatment and normal birth weight.
Comparative efficacy, safety, and cost of iron chelation monotherapy vs. combination therapy in pediatric beta-thalassemia major: a single-center retrospective study
Authors: Simorangkir Dewi Sharon , Nafrialdi Nafrialdi , Wahidiyat Pustika Amalia , Soetikno Vivian 
Published: April 2022

Background Iron chelation therapy is used to maintain iron balance in β-thalassemia major patients who undergo repeated blood transfusions.
Objective To compare the efficacy, safety, and cost of iron chelation combination regimens [deferiprone (DFP) + deferoxamine (DFO) or DFP + deferasirox (DFX])] vs. high-dose DFP monotherapy (≥ 90 mg/kg/day) in pediatric β-thalassemia major patients.
Methods This cross-sectional, retrospective study was done at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Retrospective data was obtained from electronic medical records of pediatric b-thalassemia major patients with serum ferritin of ≥ 2,500 ng/mL and/or transferrin saturation of ≥ 60%, who received either combination or monotherapy iron chelation agents. Outcome effectiveness was determined by the reduction of serum ferritin level of at least 80%. Safety was analyzed descriptively. A pharmacoeconomic analysis was performed based on clinical outcomes consisting of effectiveness and direct medical costs.
Results At the end of the study, serum ferritin was reduced in 34.7% of the combination therapy group and 27.5% of the monotherapy group, however there was no significant difference between the two treatments (P=0.391). Nine (19.5%) patients on combination therapy and 17 (21.2%) patients on monotherapy had adverse drug reaction (ADR), with the most frequently reported ADR was elevated transaminase enzyme levels. Cost minimization analysis revealed that monotherapy for 6 months was IDR 13,556,592.64 less expensive than combination therapy (IDR 44,498,732.07); whereas monotherapy for 12 months was IDR 20,162,836.10 less expensive than combination therapy (IDR 78,877,661.12).
Conclusion Combination regimens are as effective as monotherapy regimens in reducing serum ferritin in pediatric β-thalassemia major patients. There is no differences of ADR between combination or monotherapy. The average cost per patient is less expensive with monotherapy compared to combination therapy.
Personalized Research on Diet in Ulcerative Colitis and Crohn's Disease: A Series of N-of-1 Diet Trials
Authors: Kaplan Heather C. , Opipari-Arrigan Lisa , Yang Jiabei , Schmid Christopher H. , Schuler Christine L. , Saeed Shehzad A. , Braly Kimberly L. , Chang Fandi , Murphy Lauren , Dodds Cassandra M. , Nuding Mason , Liu Hao , Pilley Sheri , Stone Julie , Woodward Gisele , Yokois Nancy , Goyal Alka , Lee Dale , Yeh Ann Ming , Lee Peter , Gold Benjamin D. , Molle-Rios Zarela , Zwiener R. Jeff , Ali Sabina , Chavannes Mallory , Linville Tiffany , Patel Ashish , Ayers Travis , Bassett Mikelle , Boyle Brendan , Palomo Pablo , Verstraete Sofia , Dorsey Jill , Kaplan Jess L. , Steiner Steven J. , Nguyen Kaylie , Burgis Jennifer , Suskind David L. ,   for the ImproveCareNow Pediatric IBD Learning Health System
Published: April 2022

INTRODUCTION:
Evidence about specific carbohydrate diet (SCD) for inflammatory bowel disease (IBD) is limited. We conducted 54 single-subject, double-crossover N-of-1 trials comparing SCD with a modified SCD (MSCD) and comparing each with the participant's baseline, usual diet (UD).

METHODS:
Across 19 sites, we recruited patients aged 7–18 years with IBD and active inflammation. Following a 2-week baseline (UD), patients were randomized to 1 of 2 sequences of 4 alternating 8-week SCD and MSCD periods. Outcomes included fecal calprotectin and patient-reported symptoms. We report posterior probabilities from Bayesian models comparing diets.

RESULTS:
Twenty-one (39%) participants completed the trial, 9 (17%) completed a single crossover, and 24 (44%) withdrew. Withdrawal or early completion occurred commonly (lack of response [n = 11], adverse events [n = 11], and not desiring to continue [n = 6]). SCD and MSCD performed similarly for most individuals. On average, there was <1% probability of a clinically meaningful difference in IBD symptoms between SCD and MSCD. The average treatment difference was −0.3 (95% credible interval −1.2, 0.75). There was no significant difference in the ratio of fecal calprotectin geometric means comparing SCD and MSCD (0.77, 95% credible interval 0.51, 1.10). Some individuals had improvement in symptoms and fecal calprotectin compared with their UD, whereas others did not.

DISCUSSION:
SCD and MSCD did not consistently improve symptoms or inflammation, although some individuals may have benefited. However, there are inherent difficulties in examining dietary changes that complicate study design and ultimately conclusions regarding effectiveness.