bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Diagnostic Efficiency in Children Aged 12-39 Months Referred for Autism Spectrum Disorder (ASD)
Authors: Lemay JF , Langenberger S , Amin P 
Published: September 2022

Abstract
BACKGROUND: Early diagnosis and intervention for ASD is important. The increasing prevalence of ASD in Canada is challenging teams performing ASD diagnostic evaluations to keep pace with demand. In October 2013, the ASD clinic at our Pediatric Tertiary Care Centre (PTCC) faced a waitlist of more than twelve months for children under 39 months of age; it became necessary to engage in a quality improvement with the aim of looking for efficiencies with a focus of reducing our waitlist.
OBJECTIVES: To present a) two years of experience (Jan. 2014-Dec. 2015) using our diagnostic assessment model for evaluation of children aged 12-39 months referred for ASD evaluation to PTCC, and b) psychometric performance of RITA-T (Rapid Interactive Test for Autism in Toddlers-developed by Choueiri/Wagner – Boston).
DESIGN/METHODS: This quality improvement project incorporated evidence-based practice with process improvement methodology. Our team utilized a Plan-Do-Study-Act (PDSA) approach in the development of a ‘new’ ASD standardized diagnostic process. Our new model included: a) an initial mandatory parent education session followed one week later by b) a child visit using the face-to-face ‘level 2 screening tool’ (RITA-T) + completion of M-CHAT (questionnaire) followed in 7-10 days by c) an ASD diagnostic evaluation appointment, and finally 5-7 days after evaluation d) an “After ASD Diagnosis” parent group session.
RESULTS: We assessed a total of 173 patients (81% male, mean age 30.74±5.53 mo., interval 15.4-39.0 mo.). The diagnostic process was completed within a max 30-day cycle (previously a period &gt;4 months) and required less hours/child (12 vs. 20 hours – overall 40% net gain or 1384 hours). Waitlist was reduced to &lt;1 month (compared to &gt;12 mo. in Oct. 2013). A total of 143 children (82.7% of total cohort; 116 male/27 female) were diagnosed with ASD. The discriminative properties of RITA-T were calculated: Sensitivity: 0.99; Specificity 0.53; Positive Predictive Value 0.91; Negative Predictive Value: 0.94.
CONCLUSION: By following a combination of quality improvement methodology with evidence-based practice, we successfully reduced wait and cycle times at our PTCC for children aged 12-39 months referred for ASD diagnostic assessment. RITA-T showed very good discriminative properties and was instrumental in the overall process improvement. This sustainable diagnostic approach promoted practice innovation. Consequently, patients are now able to access critical community supports and resources in a timely manner.
Better Beginnings: At Risk Moms; What Are We Missing?
Authors: Lamond A , Drover A 
Published: September 2022

Abstract
BACKGROUND: Since 2005, the number of infants born to mothers using substances has increased 4-fold in an eastern Canadian province. These babies may be at risk of medical problems including a withdrawal syndrome called “neonatal abstinence syndrome”. Previous research has shown that mothers using substances may experience increased rates of domestic violence, mental illness and housing and food insecurity. Currently, these determinants of health are not routinely recorded on medical charts of pregnant women who are patients at the province’s largest maternity facility.
OBJECTIVES: The primary goal of this study is to determine the prevalence of smoking, alcohol use, substance use, domestic violence and food/ housing insecurity in mothers delivering in an eastern Canadian province maternity hospital.
DESIGN/METHODS: This is a quantitative study involving all postpar-tum women delivering at the major delivery facility in province over a two month period (N=150). Participants were asked to complete an online, anonymous survey about their food/housing situation, domestic violence and substance use before and during pregnancy, as well as sociodemo-graphic questions.
RESULTS: Food and Housing Insecurity: The results of the study showed increased healthy eating behaviours during pregnancy; however the number of participants reliant on food banks remained at 4%. Our study found that while the majority of participants lived in a permanent residence, 2% of mothers used shelters or lived in a non-permanent residence. Mental health and Domestic Violence: While the majority of mother felt respected by their partner, family and friends, a significant amount reported feelings of isolation during pregnancy (12%). Women experiencing domestic violence stayed consistent before and during pregnancy at 2%. Smoking: Cigarette use in this population was slightly decreased from previous reports by the provincial perinatal program (12% vs. 14.9% reported) with rates of exposure to cigarette smoke much higher (24.7% vs. 6.4% reported). Alcohol use: Maternal reporting alcohol use during pregnancy was substantially increased from previous reports (13.3% vs. 0.9% reported). Those who reported consuming alcohol most frequently reported 1-2 drinks about 1-3 times per month. Substance Use: Currently, no reports within the province have captured the number of mothers using substances. This study shows approximately 5% of mothers using either marijuana, street/illicit drugs or methadone. Limitations: Mothers who did not speak English were excluded from the study.
CONCLUSION: The findings of this research indicate that important determinants of health are not being adequately recorded in Provincial databases thus programs are lacking.
Gender and Educational Inequalities in Extending Working Lives: Late-Life Employment Trajectories Across Three Decades in Seven Countries
Authors: Turek Konrad , Henkens Kene , Kalmijn Matthijs 
Published: September 2022

Abstract
Public policies encourage later retirement, but they often do not account for discrepancies in the capacity for extending working lives. This paper studies trends and inequalities in extending working lives between 1990 and 2019 from gender and education perspectives in seven countries (Australia, Germany, Russia, South Korea, Switzerland, United Kingdom, and United States). The three-decade-long data provide insights into the societal transition toward extended employment that began in the mid-1990s. Using latent class growth analysis, we identify five universal trajectories representing late-life employment in all countries: Early, Standard and Late Exit patterns, and stable Nonemployment and Late Employment patterns. Regression analyses show that Non-Employment dominated the 1990s, but it significantly declined, giving space to Late Employment as one of the major employment pathways. Gender and educational differences are considerable and stable and constitute important stratification markers of late careers. Progress toward later employment affects all analyzed countries but in different ways, suggesting the simple generalizations of one-country findings can be risky. We discuss the risks of universal progress toward extending employment that can bring unequal results and negative consequences for vulnerable groups. This study also contributes methodologically by exploring the trajectory-oriented perspective on late careers.
Reverse Flow Shunt Restricted Free Venous Flap for a Ring Avulsion Injury
Authors: Yassin Ahmed M. , Kokkinos Constantinos , Gorman Mark , Gnanalingham Sathyan , Nikkhah Dariush 
Published: September 2022

Summary:
Arterialized venous flaps can be an excellent option for reconstruction of digital defects. Previously, they remained unpopular owing to the high rate of venous congestion. Different techniques of restriction of the arteriovenous shunting have been described to mitigate this problem. In this article, the authors discuss a unique case whereby a reverse flow shunt restricted venous flap was used in an Urbaniak type III ring avulsion.
Examining 5-Year Cervical Cytology Progression Among Minority Women Living With HIV and Baseline Negative Cytology
Authors: Sanchez-Covarrubias Alex P. , Crane Joshua , Montgomerie Emily K. , Potter JoNell E. , Duthely Lunthita M. , Bahadue Felicia , Jeudin Patricia P. 
Published: September 2022

Objective
Women living with HIV (WLWH) have increased risk of human papillomavirus (HPV) infection, precancers, and invasive cervical cancers. This study aims to determine the rate of cervical cytologic progression and related factors in minority WLWH across 5 years.

Materials and Methods
We used our HIV clinic database, complemented with a retrospective chart review to identify WLWH with a baseline negative cervical cytology between 2009 and 2012 and 5-year follow-up. Data included race/ethnicity, age, years living with HIV, AIDS status, viral load, history of smoking, drug use, and HPV status. Multivariate logistic regression tested progression of negative cytology to low-grade/high-grade squamous intraepithelial lesions (LGSIL/HGSIL).

Results
Among 162 WLWH, 42% were African American, 30% non-Hispanic African Caribbean, and 26% Hispanic. At baseline, 21% had detectable viral load (>200 cp/mL), mean age was 44.8 (±11 years), and mean years living with HIV was 9.6 (±6.9). After 5 years, 19% of the cohort progressed to LGSIL/HGSIL. Human papillomavirus was detected consistently among women with cytologic changes (30% vs 7%, p < .01). Significant factors that predicted higher likelihood of progression to LGSIL/HGSIL were detection of HPV (adjusted odds ratios = 5.11 [1.31–19.93]; p = .02), and Centers for Disease Control and Prevention–defined AIDS status (adjusted odds ratios = 4.28 [1.04–17.63]; p = .04). Of the women who maintained negative cytology at 1 to 2 years (n = 102), 5 women (5%) progressed during the following 3 years before the recommended follow-up.

Conclusions
Human papillomavirus detection and AIDS status were significant factors predicting progression to LGSIL/HGSIL among minority WLWH. Providers screening WLWH for cervical intraepithelial neoplasia should carefully decide screening intervals for minority populations.
Tree nut allergy: a systematic review
Authors: Chu Derek K. 
Published: September 2022

Purpose of review
Systematic scoping review, focusing on randomized clinical trials of recent research addressing tree nut allergy.

Recent findings
This review addresses published, unpublished, and re-analyzed studies on tree nut allergy definition, epidemiology, etiology, diagnosis, prognosis, and therapy.

Summary
The importance of tree nut allergy spans nations, economies, and cultures. While broad themes in epidemiology, etiology, diagnosis, prognosis, and therapy are emerging, the next major advance in tree nut allergy will require large, robust studies to deliver results important to patients and families.
Correlation of Anti-Tissue Transglutaminase Antibodies With the Mucosal Changes and IgA Status of Children With Celiac Disease
Authors: Donat Ester , Roca María , Castillejo Gemma , Sánchez-Valverde Félix , García-Burriel Jose Ignacio , Martínez-Ojinaga Eva , Eizaguirre Francisco Javier , Barrio Josefa , Cilleruelo Mª Luz , Pérez-Solís David , Ochoa-Sangrador Carlos , Vecino-López Raquel , Miranda-Cid Mª del Carmen , García-Calatayud Salvador , Torres-Peral Ricardo , Juste Mercedes , Armas Honorio , Barros-García Patricia , Leis Rosaura , Solaguren Rosa , Salazar José Carlos , García-Romero Ruth , Ortigosa Luis , Peña-Quintana Luis , Urruzuno Pedro , Codoñer-Franch Pilar , Garcia-Casales Zuriñe , Masiques Maria Llüisa , Galicia-Poblet Gonzalo , Crehuá-Gaudiza Elena , Balmaseda Elena , Rubio-Santiago Javier , Polanco-Allué Isabel , Román-Riechmann Enriqueta , Ribes-Koninckx Carmen ,   Coeliac Disease Working Group of the Spanish Gastroenterology, Hepatology, Paediatric Nutrition Society (SEGHNP)
Published: September 2022

Objectives:
The objective of this study was to assess the association between serological markers and changes of the intestinal mucosa in children with celiac disease (CD).

Methods:
Clinical data from CD patients under 15 years old were collected from the participating centers in an on-line multicenter nationwide observational Spanish registry called REPAC-2 (2011–2017). Correlation between anti-tissue transglutaminase antibodies (t-TGA) levels and other variables, including mucosal damage and clinical findings (symptoms, age, and gender), was assessed.

Results:
A total of 2955 of 4838 patients had t-TGA and a small bowel biopsy (SBB) performed for CD diagnosis. A total of 1931 (66.2%) patients with normal IgA values had a Marsh 3b-c lesion and 1892 (64.9%) had t-TGA Immunoglobulin A (IgA) ≥ 10 times upper limit of normal (ULN). There is a statistically significant association between t-TGA IgA levels and the degree of mucosal damage (P < 0.001), the higher the t-TGA IgA levels the more severe the mucosal damage. Those patients who reported symptoms had more severe mucosal damage (P = 0.001). On the contrary, there was a negative association between age and changes of the intestinal mucosa (P < 0.001). No association was found with gender. Regarding the IgA-deficient patients, 47.4% (18 cases) had t-TGA Immunoglobulin A (IgA) ≥ 10 times ULN and a Marsh 3b-c lesion was observed in 68.4% (26 patients). No statistical relation was found between t-TGA IgG levels and the changes of the intestinal mucosa, neither a relation with age, gender, or symptoms.

Conclusions:
There is a positive correlation between t-TGA IgA levels and the severity of changes of the intestinal mucosa. Such correlation was not found in IgA-deficient patients who had positive t-TGA IgG serology. The results in this group of patients support the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition recommendations about the need of performing a SBB in IgA-deficient individuals despite high t-TGA IgG levels.
The construction of neurogenesis-related ceRNA network of ischemic stroke treated by oxymatrine
Authors: Zhang Xiaoling , Yao Wentao , Zhao Wannian , Sun Yingru , Wu Zongkai , He Weiliang , Ji Yingxiao , Gao Yaran , Niu Xiaoli , Li Litao , Wang Hebo 
Published: September 2022

Background
Known as a disease associated with high mortality, disability and a significant financial burden, ischemic stroke ranks as one of the three diseases threatening human health. Recent advances in omics technology created opportunities to uncover the mechanism in ischemic stroke occurrence and treatment. In this study, we aimed to construct the competitive endogenous RNA (ceRNA) networks of ischemic stroke treated by oxymatrine intervention.

Method
The middle cerebral artery occlusion (MCAO) mouse model of ischemic stroke was constructed, and oxymatrine was administered. Then RNA-Sequencing was performed and integrated analysis of mRNAs, lncRNAs and circRNAs was conducted to reveal the pharmacology of oxymatrine. Functional enrichment analysis was performed to explore the underlying mechanism of differentially expressed (DE) mRNAs. The protein-protein interaction (PPI) network of neurogenesis-related genes and long noncoding RNAs (lncRNAs)/circular RNAs (circRNAs) based ceRNA networks were constructed.

Results
First, this study revealed the DE-mRNAs, DE-lncRNAs and DE-circRNAs between Oxymatrine treated group and the MCAO group. Then, the common 1231 DE-mRNAs, 32 DE-lncRNAs and 31 DE-circRNAs with opposite trends were identified. The Kyoto Encyclopedia of Genes and Genomes to identify the functional enrichment of 1231 DE-mRNAs were enriched in neurogenesis-related biological processes. Based on neurogenesis-related DE-mRNAs, the PPI network was constructed, and hub genes were identified based on centrality. Finally, both the lncRNA-based and circRNAs-based ceRNA networks were constructed.

Conclusion
In summary, this study identified novel coding and noncoding ischemic stroke targets of oxymatrine-treated MCAO. Most importantly, we identified lncRNAs and circRNAs candidates as potential oxymatrine targets and constructed the neurogenesis-related ceRNA networks.
The Genomic Landscape of Rare Disorders in the Middle East
Authors: Naofal Maha El , Ramaswamy Sathishkumar , Alsarhan Ali , Nugud Ahmed , Taylor Alan , Jain Ruchi , Halabi Nour , Yaslam Sawsan , Alfalasi Roudha , Shenbagam Shruti , Bitzan Martin , Yavuz Lemis , Wafadari Deena , Abulhoul Hamda , Shankar Shiva , Maazmi Munira Al , Rizk Ruba , Alloub Zeinab , Elbashir Haitham , Babiker Mohamed O. E. , Chencheri Nidheesh , AlBanna Ammar , Sultan Meshal , Bitar Mohamed El , Kherani Safeena , Thalange Nandu , Alshryda Sattar , Donato Roberto Di , Tzivinikos Christos , Majid Ibrar , Freeman Alexandra F. , Gonzalez Corina , Khan Arif O. , Hamdan Hisham , Abuhammour Walid , Awadhi Mohamed Al , Khayat Abdulla Al , Alsheikh-Ali Alawi , Tayoun Ahmad N. Abou 
Published: September 2022

AbstractBACKGROUNDRare diseases collectively impose significant burden on healthcare systems, especially in underserved regions, like the Middle East, which lack access to genomic diagnostic services and the associated personalized management plans.METHODSWe established a clinical genomics and genetic counselling facility, within a multidisciplinary tertiary paediatric center, in the United Arab Emirates to locally diagnose and manage patients with rare diseases. Clinical genomic investigations included exome-based sequencing, chromosomal microarrays, and/or targeted testing. We assessed the diagnostic yield and implications for clinical management among this population.RESULTSWe present data on 529 patients with rare diseases (47% females; Average age, 4 years) representing 41 countries primarily from the Arabian Peninsula, the Levant, Africa, and Asia. The cumulative diagnostic yield was 35.7% (95% CI, 31.8% - 39.9%) and was higher for genomic sequencing-based testing than chromosomal microarrays (41.2% versus 16.9%, P=0.0001) across all indications, consistent with the higher burden of single gene disorders. Of the 124 Mendelian disorders identified in this cohort, the majority (N = 110) were encountered only once, and those with recessive inheritance accounted for ~60% of sequencing diagnoses. Of patients with positive genetic findings (N = 189), 71.9% were less than 5 years of age, and 65.6% were offered modified management and/or intervention plans. Interestingly, 18.5% of patients with positive genetic findings received delayed diagnoses (age range 7 – 37 years), most likely due to lack of access to genomic investigations in this region. One such genetic finding ended over a 10-year long diagnostic odyssey, leading to a life-threatening diagnosis in one patient, who was then successfully treated using an experimental allogenic bone marrow transplant. Finally, we present cases with candidate genes within regions of homozygosity, likely underlying novel recessive disorders.CONCLUSIONSEarly access to genomic diagnostics for patients with suspected rare disorders in the Middle East is likely to improve clinical outcomes while driving gene discovery in this historically underrepresented population.
Lung remodeling regions in long-term Covid-19 feature basal epithelial cell reprogramming
Authors: Wu Kangyun , Zhang Yong , Austin Stephen R. , Declue Huqing Yin , Byers Derek E. , Crouch Erika C. , Holtzman Michael J. 
Published: September 2022

AbstractRespiratory viruses, including SARS-CoV-2, can trigger chronic lung disease that persists and even progresses after expected clearance of infectious virus. To gain an understanding of this process, we examined a series of consecutive fatal cases of Covid-19 that came to autopsy at 27-51 d after hospital admission. In each patient, we identify a stereotyped bronchiolar-alveolar pattern of lung remodeling with basal epithelial cell hyperplasia and mucinous differentiation. Remodeling regions also feature macrophage infiltration and apoptosis and a marked depletion of alveolar type 1 and 2 epithelial cells. This entire pattern closely resembles findings from an experimental model of post-viral lung disease that requires basal-epithelial stem cell growth, immune activation, and differentiation. The present results thereby provide evidence of possible basal epithelial cell reprogramming in long-term Covid-19 as well and thereby a pathway for explaining and correcting lung dysfunction in this type of disease.
Children’s syntax is supported by the maturation of BA44 at 4 years, but of the posterior STS at 3 years of age
Authors: Klein Cheslie C. , Berger Philipp , Goucha Tomás , Friederici Angela D. , Wiesmann Charlotte Grosse 
Published: September 2022

AbstractWithin the first years of life, children learn major aspects of their native language. However, the ability to process complex sentence structures, a core faculty in human language called syntax, has been found to emerge only slowly. A milestone in the acquisition of syntax is reached around the age of 4, when children learn a variety of syntactic concepts, including, for example, subordinate clauses. Here, we ask which maturational changes in the child’s brain underlie the emergence of syntactic abilities around this critical age. We relate markers of cortical brain maturation to 3- and 4-year-olds’ syntactic in contrast to other language abilities. Our results show that distinct cortical brain areas support syntax in the two age groups: While 3-year-old children’s syntactic abilities were associated with increased surface area in the most posterior part of the left superior temporal sulcus, 4-year-old children showed an association with cortical thickness in the left posterior part of Broca’s area, i.e. BA44. The present findings suggest that syntactic abilities rely on the maturation of distinct cortical regions in 3- compared to 4-year-olds. The observed shift to more mature regions involved in syntax may underlie the behavioral milestones in syntax acquisition around 4 years of age.
Liquid biomarkers of macrophage dysregulation and circulating spike protein illustrate the biological heterogeneity in patients with post-acute sequelae of COVID-19
Authors: Schultheiß Christoph , Willscher Edith , Paschold Lisa , Gottschick Cornelia , Klee Bianca , Bosurgi Lidia , Dutzmann Jochen , Sedding Daniel , Frese Thomas , Girndt Matthias , Höll Jessica I. , Gekle Michael , Mikolajczyk Rafael , Binder Mascha 
Published: September 2022

AbstractPost-acute sequelae of COVID-19 (PASC) are long-term consequences of SARS-CoV-2 infection that can substantially impair quality of life. Underlying mechanisms ranging from persistent virus to innate and adaptive immune dysregulation have been discussed. Here, we profiled plasma of 181 individuals from the cohort study for digital health research in Germany (DigiHero) including individuals after mild to moderate COVID-19 with or without PASC and uninfected controls. We focused on soluble factors related to monocyte/macrophage biology and on circulating SARS-CoV-2 spike (S1) protein as potential biomarker for persistent viral reservoirs. At a median time of eight months after infection, we found pronounced dysregulation in almost all tested soluble factors including both pro-inflammatory and pro-fibrotic cytokines. These perturbations were remarkably independent of ongoing symptoms, but further correlation and regression analyses suggested PASC specific patterns involving CCL2/MCP-1 and IL-8 as well as long-term persistence of high IL-5 and IL-17F levels. None of the analyzed factors correlated with the detectability or levels of circulating S1 indicating that this represents an independent subset of patients with PASC. This data confirms prior evidence of immune dysregulation and persistence of viral protein in PASC and illustrates its biological heterogeneity that still awaits correlation with clinically defined PASC subtypes.