bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic Impact of the Rotavirus Vaccine in Korea
Authors: Cho Hyeonseok , Lee Hankil , Kim Dong Soo , Kim Hwang Min , Kim Ji Hong , Kim Ah-Young , Kang Hye-Young 
Published: January 2020

Background:
Since the introduction of 2 rotavirus (RV) vaccines in Korea, the vaccination rate has reached over 80% with out-of-pocket spending in the private market. We investigated the socioeconomic impact of RV vaccines in Korea to assess their value and public health contribution.

Methods:
By using National Health Insurance Service claims data, we compared the epidemiologic and economic characteristics of rotavirus gastroenteritis (RVGE) before and after the introduction of RV vaccines. For each year of the study period, the annual prevalence and national costs of RVGE were estimated based on children under 5 years with at least 1 National Health Insurance Service claims record with a diagnosis of RVGE.

Results:
Compared with the prevaccination period, the prevalence of RVGE decreased in the postvaccination period by 48.9% from 2097 per 100,000 children in 2006 to 1072 per 100,000 children in 2015, implying an increase in the vaccination rate and the prevention effect of the vaccines. The highest reduction was observed among those 12 to <24 months of age (−73.4%), presumably due to the benefit of full vaccination, while children under 2 months, ineligible for the RV vaccine, showed an increase (41.7%). The number of hospitalized RVGE cases per year decreased by 69.0%. The national economic burden of RVGE decreased by 28.6%.

Conclusions:
The substantial reduction in the socioeconomic burden of RVGE after the introduction of RV vaccines confirms their benefit to society. This study would help health policy makers make empirical decisions on incorporating the vaccination into national immunization programs.
Magnetic resonance imaging of neuroinflammation in chronic pain: a role for astrogliosis?
Authors: Jung Changjin , Ichesco Eric , Ratai Eva-Maria , Gonzalez Ramon Gilberto , Burdo Tricia , Loggia Marco L. , Harris Richard E. , Napadow Vitaly 
Published: January 2020

Abstract
Noninvasive measures of neuroinflammatory processes in humans could substantially aid diagnosis and therapeutic development for many disorders, including chronic pain. Several proton magnetic resonance spectroscopy (1H-MRS) metabolites have been linked with glial activity (ie, choline and myo-inositol) and found to be altered in chronic pain patients, but their role in the neuroinflammatory cascade is not well known. Our multimodal study evaluated resting functional magnetic resonance imaging connectivity and 1H-MRS metabolite concentration in insula cortex in 43 patients suffering from fibromyalgia, a chronic centralized pain disorder previously demonstrated to include a neuroinflammatory component, and 16 healthy controls. Patients demonstrated elevated choline (but not myo-inositol) in anterior insula (aIns) (P = 0.03), with greater choline levels linked with worse pain interference (r = 0.41, P = 0.01). In addition, reduced resting functional connectivity between aIns and putamen was associated with both pain interference (whole brain analysis, pcorrected < 0.01) and elevated aIns choline (r = −0.37, P = 0.03). In fact, aIns/putamen connectivity statistically mediated the link between aIns choline and pain interference (P < 0.01), highlighting the pathway by which neuroinflammation can impact clinical pain dysfunction. To further elucidate the molecular substrates of the effects observed, we investigated how putative neuroinflammatory 1H-MRS metabolites are linked with ex vivo tissue inflammatory markers in a nonhuman primate model of neuroinflammation. Results demonstrated that cortical choline levels were correlated with glial fibrillary acidic protein, a known marker for astrogliosis (Spearman r = 0.49, P = 0.03). Choline, a putative neuroinflammatory 1H-MRS-assessed metabolite elevated in fibromyalgia and associated with pain interference, may be linked with astrogliosis in these patients.
Extracorporeal shock-wave lithotripsy: is it still valid in the era of robotic endourology? Can it be more efficient?
Authors: Rassweiler Jens , Rieker Phillip , Rassweiler-Seyfried Marie-Claire 
Published: January 2020

Purpose of review
The aim of the article is to evaluate the actual role of extracorporeal shock-wave lithotripsy (ESWL) in the management of urolithiasis based on the new developments of flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL).

Recent findings
In Western Europe, there is a significant change of techniques used for treatment of renal stones with an increase of FURS and a decrease of ESWL. The reasons for this include the change of indications, technical improvement of the endourologic armamentarium, including robotic assistance. Mostly relevant is the introduction of digital reusable and single-use flexible ureterorenoscopes, whereas micro-PCNL has been abandoned. Some companies have stopped production of lithotripters and novel ideas to improve the efficacy of shock waves have not been implemented in the actual systems. Promising shock-wave technologies include the use of burst-shock-wave lithotripsy (SWL) or high-frequent ESWL. The main advantage would be the very fast pulverization of the stone as shown in in-vitro models.

Summary
The role of ESWL in the management of urolithiasis is decreasing, whereas FURS is constantly progressing. Quality and safety of intracorporeal shock-wave lithotripsy using holmium:YAG-laser under endoscopic control clearly outweighs the advantages of noninvasive ESWL. To regain ground, new technologies like burst-SWL or high-frequent ESWL have to be implemented in new systems.
Simulation and Active Learning Decreases Training Time of an Emergency Triage Assessment and Treatment Course in Pilot Study in Malawi
Authors: Sigalet Elaine L. , Lufesi Norman , Dubrowski Adam , Haji Faizal , Khan Rabia , Grant David , Weinstock Peter , Wishart Ian , Molyneux Elizabeth , Kissoon Niranjan 
Published: January 2020

Objectives
The aim of the Emergency Triage Assessment and Treatment (ETAT) plus trauma course is to improve the quality of care provided to infants and children younger than 5 years. The curriculum was revised and shortened from 5 to 2.5 days by enhancing simulation and active learning opportunities. The aim of this study was to examine the feasibility and value of the new short-form ETAT course by assessing postcourse knowledge and satisfaction.

Methods
We delivered the short-form ETAT course to a group of interdisciplinary health workers in Malawi. Precourse and postcourse knowledge was assessed using a standardized 20 questions short answer test used previously in the 5-day courses. A 13-statement survey with 2 open-ended questions was used to examine participant satisfaction.

Results
Participants' postcourse knowledge improved significantly (P < 0.001) after the shorter ETAT course. Participants reported high levels of satisfaction with the short-form ETAT.

Conclusions
Simulation and other active learning strategies reduced training time by 50% in the short-form ETAT course. Participants with and without previous ETAT training improved their knowledge after participating in the short-form ETAT course. Reduced training time is beneficial in settings already burdened by scarce human resources, may facilitate better access to in-service training, and build capacity while conserving resources in low-resource settings.
Managing and preventing exacerbation of bronchiectasis
Authors: Abo-Leyah Hani , Chalmers James D. 
Published: January 2020

Purpose of review
Pulmonary exacerbations are key events in the natural history of bronchiectasis given their impact on quality of life, prognosis, and their contribution to healthcare costs. Preventing and managing exacerbations is a priority for clinicians and in this review, we discuss measures that should be utilized to achieve this aim.

Recent findings
Experts have proposed a focus on phenotyping and endotyping the bronchiectasis population to overcome the heterogeneity of this condition. Recent large studies of inhaled antibiotics and smaller studies of macrolides, which included exacerbation measures as their primary outcomes, have drawn further attention to this issue.

Summary
Exacerbations are currently treated with prolonged antibiotic treatment (10–14 days). Prevention of exacerbations requires a multidisciplinary approach which includes optimising airway clearance and treating underlying conditions. Patients who continue to experience exacerbations despite these measures may be offered chronic macrolide therapy or additional therapies based on identified treatable traits.
Climate change and intensive land use reduce soil animal biomass through dissimilar pathways
Authors: Yin Rui , Siebert Julia , Eisenhauer Nico , Schädler Martin 
Published: January 2020

AbstractGlobal change drivers, such as climate and land use, may profoundly influence body size, density, and biomass of organisms. It is still poorly understood how these concurrent drivers interact in affecting ecological communities. We present results of an experimental field study assessing the interactive effects of climate change and land-use intensification on body size, density, and biomass of soil microarthropods. We found that both climate change and intensive land use decreased their total biomass. Strikingly, this reduction was realized via two dissimilar pathways: climate change reduced mean body size, while intensive land use decreased population size. These findings highlight that two of the most pervasive global change drivers operate via different pathways when decreasing soil animal biomass. These shifts in soil communities may threaten essential ecosystem functions like organic matter turnover and nutrient cycling in future ecosystems.SignificanceMany important ecosystem functions are determined by the biomass of soil animal, however, how their biomass may respond to climate change and land-use intensification still remains unknown. We conducted a large field study to investigate the potential interaction between these two pervasive global change drivers, and disentangle the pathways where they contribute to the changes in soil animal biomass. Our findings are exceptionally novel by showing detrimental, but largely independent, effects of climate change and land-use intensity on soil animal biomass, and that these independent effects can be explained by two dissimilar pathways: climate change reduced mean body size, while intensive land use decreased population size. Notably, consistent climate change effects under different land-use regimes suggest that (1) the identified pathways may apply to a wide range of environmental conditions, and (2) current extensive land-use regimes do not mitigate detrimental climate change effects on ecosystems.
Seasonally Variant Gene Expression in Full-Term Human Placenta
Authors: Clarkson-Townsend Danielle A. , Kennedy Elizabeth , Everson Todd M. , Deyssenroth Maya A. , Burt Amber A. , Hao Ke , Chen Jia , Pardue Machelle , Marsit Carmen J. 
Published: January 2020

ABSTRACTSeasonal exposures influence human health and development. The placenta, as a mediator of the maternal and fetal systems and a regulator of development, is an ideal tissue to understand the biological pathways underlying relationships between season of birth and later life health outcomes. Here, we conducted a transcriptome-wide association study of season of birth in full-term human placental tissue to evaluate whether the placenta may be influenced by seasonal cues. Of the analyzed transcripts, 583 displayed differential expression between summer and winter births (FDR q<0.05); among these, BHLHE40, MIR210HG, and HILPDA had increased expression among winter births (Bonferroni p<0.05). Enrichment analyses of the seasonally variant genes between summer and winter births indicated over-representation of transcription factors HIF1A, VDR, and CLOCK, among others, and of GO term pathways related to ribosomal activity and infection. Additionally, a cosinor analysis found rhythmic expression for approximately 11.9% of all 17,664 analyzed placental transcripts. These results suggest that the placenta responds to seasonal cues and add to the growing body of evidence that the placenta acts as a peripheral clock, which may provide a molecular explanation for the extensive associations between season of birth and health outcomes.
Primary care consultation length by deprivation and multimorbidity in England
Authors: Gopfert Anya , Deeny Sarah , Fisher Rebecca , Stafford Mai 
Published: January 2020

AbstractBackgroundLonger GP consultations are recommended as one way of improving care for people with multimorbidity. In Scotland, multimorbid patients in deprived areas do not have had longer consultations though their counterparts in the least deprived areas do. This example of the inverse care law has not been examined in England.AimTo assess GP consultation length by socioeconomic deprivation and multimorbidity.Design and SettingRandom sample of 1.2 million consultations from 1st April 2014-31st March 2016 for 185,755 adults in England drawn from the Clinical Practice Research Datalink.MethodConsultation duration was derived from time of opening and closing the patient’s electronic record. Mean duration was estimated by multimorbidity level and type, adjusted for number of consultations and other patient and staff characteristics and patient and practice random effects.ResultsConsultations lasted 10.9 minutes and mean duration increased with number of conditions. Patients with 6+ conditions had 0.9 (95% CI 0.8, 1.0) minutes longer than those with none. Patients with both mental and physical health condition had 0.5 (95% CI 0.4, 0.5) minutes longer than non-multimorbid patients. However, consultations were 0.5 (95% CI 0.4, 0.5) minutes shorter in the most compared with the least deprived fifth of areas at all levels of multimorbidity.ConclusionGPs in England spend longer with patients who have more conditions but at all multimorbidity levels, those in deprived areas have less time per GP consultation. Research is needed to assess the impact of consultation length on patient and system outcomes for people with multimorbidity.
Contrasting Effects of Western vs. Mediterranean Diets on Monocyte Inflammatory Gene Expression and Social Behavior in a Primate Model
Authors: Johnson Corbin S.C. , Shively Carol A. , Michalson Kristofer T. , Lea Amanda J. , DeBo Ryne J. , Howard Timothy D. , Hawkins Gregory A. , Appt Susan E. , Liu Yongmei , McCall Charles E. , Herrington David M. , Ip Edward H. , Register Thomas C. , Snyder-Mackler Noah 
Published: January 2020

AbstractDietary changes associated with industrialization substantially increase the prevalence of chronic diseases, such as obesity, type II diabetes, and cardiovascular disease, which are major contributors to the public health burden. The high prevalence of these chronic diseases is often attributed to an “evolutionary mismatch,” between human physiology and modern nutritional environments. In support of this idea, Western diets enriched with foods that were scarce throughout human evolutionary history (e.g., simple sugars and saturated fats) promote inflammation and disease relative to diets more akin to hunter-gatherer diets, such as a Mediterranean diet; however, the mechanisms linking dietary mismatch to inflammation and chronic disease are poorly understood. We used a macaque model and whole diet manipulations to evaluate one possible mechanism – inflammatory polarization of monocytes – that potentially leads to this evolutionary mismatch. After consuming a Western- or Mediterranean-like diet for 15 months, monocytes from Western diet consumers exhibited a more proinflammatory phenotype, with 40% of their genes differentially expressed (FDR<0.05). Compared to the Mediterranean diet, the Western diet shifted the co-expression of 445 gene pairs, including small RNAs and transcription factors associated with metabolism and adiposity in humans, and dramatically altered animal behavior. For example, Western-fed individuals were more anxious and less socially integrated compared to the Mediterranean-fed subjects. These behavioral changes were also associated with some of the effects of diet on gene expression, suggesting an interaction between diet, central nervous system activity, and monocyte gene expression. The results of this study provide new insights into evolutionary mismatch at the molecular level and uncover new pathways through which Western diets generate inflammation and disease.
Are skyline plot-based demographic estimates overly dependent on smoothing prior assumptions?
Authors: Parag Kris V , Pybus Oliver G , Wu Chieh-Hsi 
Published: January 2020

AbstractIn Bayesian phylogenetics, the coalescent process provides an informative framework for inferring changes in the effective size of a population from a phylogeny (or tree) of sequences sampled from that population. Popular coalescent inference approaches such as theBayesian Skyline Plot, SkyrideandSkygridall model these population size changes with a discontinuous, piecewise-constant function but then apply a smoothing prior to ensure that their posterior population size estimates transition gradually with time. These prior distributions implicitly encode extra population size information that is not available from the observed coalescent data i.e., the tree. Here we present a novel statistic, Ω, to quantify and disaggregate the relative contributions of the coalescent data and prior assumptions to the resulting posterior estimate precision. Our statistic also measures the additional mutual information introduced by such priors. Using Ω we show that, because it is surprisingly easy to over-parametrise piecewise-constant population models, common smoothing priors can lead to overconfident and potentially misleading inference, even under robust experimental designs. We propose Ω as a useful tool for detecting when effective population size estimates are overly reliant on prior assumptions and for improving quantification of the uncertainty in those estimates.
Layer-specific inhibitory microcircuits of layer 6 interneurons in rat prefrontal cortex
Authors: Ding Chao , Emmenegger Vishalini , Schaffrath Kim , Feldmeyer Dirk 
Published: January 2020

AbstractGABAergic interneurons in different cortical areas play important roles in diverse higher order cognitive functions. The heterogeneity of interneurons is well characterized in different sensory cortices, in particular in primary somatosensory and visual cortex. However, the structural and functional properties of the medial prefrontal cortex (mPFC) interneurons have received less attention. In this study, a cluster analysis based on axonal projection patterns revealed four distinct clusters of L6 interneurons in rat mPFC: Cluster 1 interneurons showed axonal projections similar to Martinotti-like cells extending to layer 1, cluster 2 displayed translaminar projections mostly to layer 5, cluster 3 interneuron axons were confined to the layer 6, whereas those of cluster 4 interneurons extend also into the white matter. Correlations were found between neuron location and axonal distribution in all clusters. Moreover, all cluster 1 L6 interneurons showed a monotonically adapting firing pattern with an initial high-frequency burst. All cluster 2 interneurons were fast-spiking, while neurons in cluster 3 and 4 showed heterogeneous firing patterns. Our data suggest that L6 interneurons that have distinct morphological and physiological characteristics are likely to innervate different targets in mPFC thus play differential roles in the L6 microcircuitry and in mPFC-associated functions.
The first eukaryotic kinome tree illuminates the dynamic history of present-day kinases
Authors: van Wijk Leny M. , Snel Berend 
Published: January 2020

AbstractEukaryotic Protein Kinases (ePKs) are essential for eukaryotic cell signalling. Several phylogenetic trees of the ePK repertoire of single eukaryotes have been published, including the human kinome tree. However, a eukaryote-wide kinome tree was missing due to the large number of kinases in eukaryotes. Using a pipeline that overcomes this problem, we present here the first eukaryotic kinome tree. The tree reveals that the Last Eukaryotic Common Ancestor (LECA) possessed at least 92 ePKs, much more than previously thought. The retention of these LECA ePKs in present-day species is highly variable. Fourteen human kinases with unresolved placement in the human kinome tree were found to originate from three known ePK superfamilies. Further analysis of ePK superfamilies shows that they exhibit markedly diverse evolutionary dynamics between the LECA and present-day eukaryotes. The eukaryotic kinome tree thus unveils the evolutionary history of ePKs, but the tree also enables the transfer of functional information between related kinases.
Probiotics for the prevention of antibiotic-associated adverse events in children – a systematic review to inform development of a core outcome set
Authors: Łukasik Jan , Guo Qin , Boulos Leah , Szajewska Hania , Johnston Bradley C. 
Published: January 2020

AbstractIntroductionRoutine use of probiotics during antibiotic therapy in children remains a subject of discussion. To facilitate synthesis of individual study results and guideline formulation, it is important to assess predefined, similar, and clinically important outcomes. Core outcome sets are a proposed solution for this issue. Aim of this review was to document choice, design, and heterogeneity of outcomes in studies that assessed the effects of probiotics used for the prevention of antibiotic-associated adverse events in children.MethodsA systematic literature search covering three major databases was performed. Trials that evaluated oral probiotics’ use concomitant with antibiotic therapy in children were included. Data on outcome definitions, measurement instruments, and follow-up were extracted. The outcomes were assigned to predefined core areas and domains. Data were analyzed descriptively.ResultsThirty-six trials were included in this review. Diarrhea, the most commonly reported outcome, had diagnostic criteria clearly defined only in 20 trials. In total, sixteen different definitions of diarrhea were identified. Diarrhea duration, severity and etiology were reported in 8, 4 and 6 studies, respectively. Nineteen studies assessed gastrointestinal symptoms other than diarrhea. Seven studies reported outcomes related to resource use or the economic impact of the intervention. Only 2 studies assessed outcomes related to life impact. None of the studies predefined adverse events of probiotic use.ConclusionsIdentified outcomes were characterized by substantial heterogeneity. Majority of outcomes were not designed to evaluate endpoints of real-life relevance. Results from this review suggest the need for a new core outcome set consisting of outcomes important for decision-making.