bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burden of family caregivers of Down syndrome children: a cross-sectional study
Authors: Alam El-Deen Nadia , Alwakeel Angi A , El-Gilany Abdel-Hady , Wahba Yahya 
Published: August 2020

Abstract

Background
Down syndrome (DS) is the most common chromosomal abnormality encountered by primary care physicians. The demands of families with DS children are significantly high with possible burdens on their primary caregivers.

Objective
To assess the burden of DS children on their family primary caregivers and to identify the variables associated with caregiver burden.

Methods
A cross-sectional study was conducted in Mansoura, Egypt from March 2019 to March 2020 including 457 family primary caregivers and their DS children. Socio-demographic and clinical data were collected through direct interviews. Caregiver burden was assessed by Zarit Burden Interview (ZBI-22) scale. The associations between categorical variables were tested using chi-square test, crude odds ratio and 95% confidence interval. Logistic regression analysis was carried out to detect the variables independently associated with caregiver burden.

Results
More than half (51.9%) of caregivers had no or little burden, 40.7% had mild to moderate burden and 7.4% had moderate to severe burden. Female caregiving, single parent status and DS children of age less than 6 years old, female gender and having congenital heart diseases were the variables independently associated with mild to severe burden with adjusted odds ratios of 4.2, 2.5, 1.5, 2.1 and 1.7, respectively.

Conclusions
Less than half of family primary caregivers of DS children in Mansoura, Egypt suffered from mild to severe burden. Primary care physicians could recognize caregivers at risk of burden using ZBI-22 scale, and provide appropriate social, medical and psychological care for parents and DS children to mitigate this burden.
Response of a methane-driven interaction network to stressor intensification
Authors: Ho Adrian , Mendes Lucas W , Lee Hyo Jung , Kaupper Thomas , Mo Yongliang , Poehlein Anja , Bodelier Paul L E , Jia Zhongjun , Horn Marcus A 
Published: August 2020

ABSTRACTMicroorganisms may reciprocally select for specific interacting partners, forming a network with interdependent relationships. The methanotrophic interaction network, comprising methanotrophs and non-methanotrophs, is thought to modulate methane oxidation and give rise to emergent properties beneficial for the methanotrophs. Therefore, microbial interaction may become relevant for community functioning under stress. However, empirical validation of the role and stressor-induced response of the interaction network remains scarce. Here, we determined the response of a complex methane-driven interaction network to a stepwise increase in NH4Cl-induced stress (0.5–4.75 g L−1, in 0.25–0.5 g L−1 increments) using enrichment of a naturally occurring complex community derived from a paddy soil in laboratory-scale incubations. Although ammonium and intermediates of ammonium oxidation are known to inhibit methane oxidation, methanotrophic activity was unexpectedly detected even in incubations with high ammonium levels, albeit rates were significantly reduced. Sequencing analysis of the 16S rRNA and pmoA genes consistently revealed divergent communities in the reference and stressed incubations. The 16S rRNA-based co-occurrence network analysis revealed that NH4Cl-induced stress intensification resulted in a less complex and modular network, likely driven by less stable interaction. Interestingly, the non-methanotrophs formed the key nodes, and appear to be relevant members of the community. Overall, stressor intensification unravels the interaction network, with adverse consequences for community functioning.
Redo pull-through in total colonic aganglionosis due to residual aganglionosis: a single center’s experience
Authors: Yan Jia-Yu , Peng Chun-Hui , Pang Wen-Bo , Chen Yong-Wei , Ding Cai-Ling , Chen Ya-Jun 
Published: August 2020

Abstract

Background
Reoperation for total colonic aganglionosis (TCA) may be required for residual aganglionosis after an initial radical operation. We aimed to investigate the symptoms, management, and outcomes of patients who required a redo pull-through (Redo PT).

Methods
Nine TCA patients underwent Redo PT at our center between 2007 and 2017. Their medical records were reviewed. Parental telephone interviews that included disease-specific clinical outcomes were conducted, and post-operative complications and long-term outcomes (including height-for-age/weight-for-age and bowel-function score) were compared to those of single-pull-through (Single PT) patients (n = 21).

Results
All the nine Redo PT patients suffered obstruction within 1 month after the initial operation that could not be alleviated by conservative treatment. All abdominal X-ray/contrast barium enemas showed proximal bowel dilatation, indicating residual aganglionosis. The median ages at the initial operation and Redo PT were 200 and 509 days, respectively. Reoperation consisted of an intraoperative frozen biopsy and a modified laparotomic Soave procedure in all patients. Post-operative complications included perianal excoriation (n = 3), intestinal obstruction (n = 2), enterocolitis (n = 2), and rectovestibular fistula (n = 1). Seven Redo PT patients were followed up for a mean time of 7.1 ± 2.3 years; six (85.7%) had good growth and four (57.1%) had good bowel-function recovery. Post-operative complications and long-term outcomes were almost equal between the Redo PT and Single PT groups (all P &gt; 0.05).

Conclusion
TCA patients with recurrent obstructive symptoms and dilated proximal bowel may have residual aganglionosis after an initial operation. Redo PT is effective and provides good long-term outcomes comparable to those of patients who benefited from Single PT.
Genomic Signatures of Honey Bee Association in an Acetic Acid Symbiont
Authors: Smith Eric A , Newton Irene L G 
Published: August 2020

AbstractRecent declines in the health of the honey bee have startled researchers and lay people alike as honey bees are agriculture’s most important pollinator. Honey bees are important pollinators of many major crops and add billions of dollars annually to the US economy through their services. One factor that may influence colony health is the microbial community. Indeed, the honey bee worker digestive tract harbors a characteristic community of bee-specific microbes, and the composition of this community is known to impact honey bee health. However, the honey bee is a superorganism, a colony of eusocial insects with overlapping generations where nestmates cooperate, building a hive, gathering and storing food, and raising brood. In contrast to what is known regarding the honey bee worker gut microbiome, less is known of the microbes associated with developing brood, with food stores, and with the rest of the built hive environment. More recently, the microbe Bombella apis was identified as associated with nectar, with developing larvae, and with honey bee queens. This bacterium is related to flower-associated microbes such as Saccharibacter floricola and other species in the genus Saccharibacter, and initial phylogenetic analyses placed it as sister to these environmental bacteria. Here, we used comparative genomics of multiple honey bee-associated strains and the nectar-associated Saccharibacter to identify genomic changes that may be associated with the ecological transition to honey bee association. We identified several genomic differences in the honey bee-associated strains, including a complete CRISPR/Cas system. Many of the changes we note here are predicted to confer upon Bombella the ability to survive in royal jelly and defend themselves against mobile elements, including phages. Our results are a first step toward identifying potential function of this microbe in the honey bee superorganism.
A Lineage-Specific Paralog of Oma1 Evolved into a Gene Family from Which a Suppressor of Male Sterility-Inducing Mitochondria Emerged in Plants
Authors: Arakawa Takumi , Kagami Hiroyo , Katsuyama Takaya , Kitazaki Kazuyoshi , Kubo Tomohiko 
Published: August 2020

Abstract
Cytoplasmic male sterility (MS) in plants is caused by MS-inducing mitochondria, which have emerged frequently during plant evolution. Nuclear restorer-of-fertility (Rf)genes can suppress their cognate MS-inducing mitochondria. Whereas many Rfs encode a class of RNA-binding protein, the sugar beet (Caryophyllales) Rf encodes a protein resembling Oma1, which is involved in the quality control of mitochondria. In this study, we investigated the molecular evolution of Oma1 homologs in plants. We analyzed 37 plant genomes and concluded that a single copy is the ancestral state in Caryophyllales. Among the sugar beet Oma1 homologs, the orthologous copy is located in a syntenic region that is preserved in Arabidopsis thaliana. The sugar beet Rf is a complex locus consisting of a small Oma1 homolog family (RF-Oma1 family) unique to sugar beet. The gene arrangement in the vicinity of the locus is seen in some but not all Caryophyllalean plants and is absent from Ar. thaliana. This suggests a segmental duplication rather than a whole-genome duplication as the mechanism of RF-Oma1 evolution. Of thirty-seven positively selected codons in RF-Oma1, twenty-six of these sites are located in predicted transmembrane helices. Phylogenetic network analysis indicated that homologous recombination among the RF-Oma1 members played an important role to generate protein activity related to suppression. Together, our data illustrate how an evolutionarily young Rf has emerged from a lineage-specific paralog. Interestingly, several evolutionary features are shared with the RNA-binding protein type Rfs. Hence, the evolution of the sugar beet Rf is representative of Rf evolution in general.
Lithospheric structures of and tectonic implications for the central–east Tibetan plateau inferred from joint tomography of receiver functions and surface waves
Authors: Feng Mei , An Meijian , Mechie James , Zhao Wenjin , Xue Guangqi , Su Heping 
Published: August 2020

SUMMARYWe present an updated joint tomographic method to simultaneously invert receiver function waveforms and surface wave dispersions for a 3-D S-wave velocity (Vs) model. By applying this method to observations from ∼900 seismic stations and with a priori Moho constraints from previous studies, we construct a 3-D lithospheric S-wave velocity model and crustal-thickness map for the central–east Tibetan plateau. Data misfit/fitting shows that the inverted model can fit the receiver functions and surface wave dispersions reasonably well, and checkerboard tests show the model can retrieve major structural information. The results highlight several features. Within the plateau crustal thickness is &gt;60 km and outwith the plateau it is ∼40 km. Obvious Moho offsets and lateral variations of crustal velocities exist beneath the eastern (Longmen Shan Fault), northern (central–east Kunlun Fault) and northeastern (east Kunlun Fault) boundaries of the plateau, but with decreasing intensity. Segmented high upper-mantle velocities have varied occurrences and depth extents from south/southwest to north/northeast in the plateau. A Z-shaped upper-mantle low-velocity channel, which was taken as Tibetan lithospheric mantle, reflecting deformable material lies along the northern and eastern periphery of the Tibetan plateau, seemingly separating two large high-velocity mantle areas that, respectively, correspond to the Indian and Asian lithospheres. Other small high-velocity mantle segments overlain by the Z-shaped channel are possibly remnants of cold microplates/slabs associated with subductions/collisions prior to the Indian–Eurasian collision during the accretion of the Tibetan region. By integrating the Vs structures with known tectonic information, we derive that the Indian slab generally underlies the plateau south of the Bangong–Nujiang suture in central Tibet and the Jinsha River suture in eastern Tibet and west of the Lanchangjiang suture in southeastern Tibet. The eastern, northern, northeastern and southeastern boundaries of the Tibetan plateau have undergone deformation with decreasing intensity. The weakly resisting northeast and southeast margins, bounded by a wider softer channel of uppermost mantle material, are two potential regions for plateau expansion in the future.
Defining ‘older people’ in Chile: challenges in planning policies for ageing populations
Authors: Villalobos Dintrans Pablo , Izquierdo Catalina , Guzmán René , Gálvez María José , Santander Sylvia 
Published: August 2020

Abstract
The concept of older adult is extensively used in day-to-day discussions and public policy. Nonetheless, concrete operational definitions are scarce. This poses a challenge for policymakers when designing initiatives targeted to this population. Chronological age has been traditionally used as the sole criteria for identifying older people (OP). However, there is no consensus about what is the age that should define an elderly. The issue became evident when, in 2018, the Chilean Ministry of Health started a planning process to coordinate health initiatives for OP. Two thresholds had been commonly used—60 and 65 years—and the differences between choosing one and the other were significant. This article intends to structure the debate around age thresholds and the definition of OP in Chile, presenting information and evidence to guide decision-makers when deciding about the issue. Information was based on international guidelines and definitions, laws and practice in the country and epidemiological data. The analysis shows a lack of consensus when dealing with the definition of OP using age thresholds at every level. Results highlight the difficulty of using age as a guide for designing policies for OP and call for a more holistic way for identifying OP as beneficiaries of targeted programmes, considering the heterogeneity of this population and the availability of information. This debate is much needed in many countries that, like Chile, will experience significant demographic changes and face the challenges of healthy ageing.
Mutual information for low-rank even-order symmetric tensor estimation
Authors: Luneau Clément , Barbier Jean , Macris Nicolas 
Published: August 2020

Abstract
We consider a statistical model for finite-rank symmetric tensor factorization and prove a single-letter variational expression for its asymptotic mutual information when the tensor is of even order. The proof applies the adaptive interpolation method originally invented for rank-one factorization. Here we show how to extend the adaptive interpolation to finite-rank and even-order tensors. This requires new non-trivial ideas with respect to the current analysis in the literature. We also underline where the proof falls short when dealing with odd-order tensors.
Hemolytic Membrane Vesicles of Group B Streptococcus Promote Infection
Authors: Armistead Blair , Quach Phoenicia , Snyder Jessica M , Santana-Ufret Verónica , Furuta Anna , Brokaw Alyssa , Rajagopal Lakshmi 
Published: August 2020

AbstractBackgroundGroup B streptococci (GBS) are β-hemolytic, Gram-positive bacteria associated with fetal injury, preterm birth, spontaneous abortion, and neonatal infections. A key factor promoting GBS virulence is the β-hemolysin/cytolysin, a pigmented ornithine rhamnolipid (also known as granadaene) associated with the bacterial surface.MethodsA previous study indicated that GBS produce small structures known as membrane vesicles (MVs), which contain virulence-associated proteins. In this study, we show that GBS MVs are pigmented and hemolytic, indicating that granadaene is functionally active in MVs.ResultsIn addition, MVs from hyperhemolytic GBS induced greater cell death of neutrophils, T cells, and B cells compared with MVs from isogenic nonhemolytic GBS, implicating MVs as a potential mechanism for granadaene-mediated virulence. Finally, hemolytic MVs reduced oxidative killing of GBS and aggravated morbidity and mortality of neonatal mice infected with GBS.ConclusionsThese studies, taken together, reveal a novel mechanism by which GBS deploy a crucial virulence factor to promote bacterial dissemination and pathogenesis.
The Fibrosis-4 Index Is Associated With Need for Mechanical Ventilation and 30-Day Mortality in Patients Admitted With Coronavirus Disease 2019
Authors: Sterling Richard K , Oakes Tavis , Gal Tamas S , Stevens Michael P , deWit Marjolein , Sanyal Arun J 
Published: August 2020

AbstractThe Fibrosis-4 Index (FIB-4), developed to predict fibrosis in liver disease, was used to identify patients with coronavirus disease 2019 who will require ventilator support as well as those associated with 30-day mortality. Multivariate analysis found obesity (odds ratio [OR], 4.5), diabetes mellitus (OR, 2.55), and FIB-4 ≥2.67 (OR, 3.09) independently associated with need for mechanical ventilation. When controlling for ventilator use, sex, and comorbid conditions, FIB-4 ≥2.67 was also associated with increased 30-day mortality (OR, 8.4 [95% confidence interval, 2.23–31.7]). Although it may not be measuring hepatic fibrosis, its components suggest that increases in FIB-4 may be reflecting systemic inflammation associated with poor outcomes.
Participant compensation in global health research: a case study
Authors: Saleh Sepeedeh , Sambakunsi Henry , Nyirenda Deborah , Kumwenda Moses , Mortimer Kevin , Chinouya Martha 
Published: August 2020

Abstract

Background
Compensation for research participants can be provided for reasons including reimbursement of costs; compensation for time lost, discomfort or inconvenience; or expression of appreciation for participation. This compensation involves numerous ethical complexities, at times entailing competing risks. In the context of transnational research, often incorporating contexts of economic inequality, power differentials and post-colonialism, these issues extend into wider questions of ethical research conduct.

Methods
We describe experiences of conducting a community-based study of air pollution in southern Malawi incorporating ethnographic, participatory and air quality monitoring elements. Decisions surrounding participant compensation evolved in response to changing circumstances in the field.

Results
Attention to careful researcher–participant relationships and responsiveness to community perspectives allowed dynamic, contextualised decision-making around participant compensation. Despite widely cited risks, including but not restricted to undue influence of monetary compensation on participation, we learned that failure to adequately recognise and compensate participants has its own risks, notably the possibility of ‘ethics dumping’.

Conclusions
We recommend active engagement with research participants and communities with integration of contextual insights throughout, including participant compensation, as for all elements of research conduct. Equitable research relationships encompass four central values: fairness, care, honesty and respect.
Assessing the Quality and Reliability of Patient Information Regarding First-Aid for Acute Burns on YouTube
Authors: Parizh David , Effendi Maleeh , Dale Elizabeth , Slater Julia 
Published: August 2020

Abstract
Given ever increasing ease of access to technology, the majority of adults first turn to the internet for medical advice. The world wide web is filled with user-generated content within multiple social media platforms that lack a governing body to validate the information’s accuracy and reliability. The authors performed a qualitative review of first-aid burn resources available on YouTube using two validated scales: Modified Discern and Global Quality Scale. A search was conducted using the term “burn treatment” on September 18, 2019. Of 120 reviewed videos, 59 met their inclusion criteria. 36% (n = 21) of the speakers had formal medical training, with only 12% (n = 7) identified as burn care professionals. The mean views originating from nonmedical speakers (162,675) were more than eight times that originating from burn centers (14,975). The quality of the videos was compared by video source, speaker, and specialty. Burn centers had the highest Modified Discern and Global Quality Scale scores, 2.91 and 2.86, respectively (P &lt; .05). Additionally, the authors were able to demonstrate that there was a statistically significant higher quality of videos when the speaker was a burn care professional or had formal medical training. Unfortunately, their review demonstrated that videos originating from hospital systems and burn centers made up a minority of the online media content. These results illustrate an opportunity for improvement by way of increased content creation to bolster the online presence of the burn community and provide patients with more accurate information.
Venous Thromboembolism Chemoprophylaxis in Burn Patients: A Literature Review and Single-Institution Experience
Authors: Liu Alice , Minasian Raquel A , Maniago Ellen , Justin Gillenwater T , Garner Warren L , Yenikomshian Haig A 
Published: August 2020

Abstract
Hospitalized burn patients meet the criteria for Virchow’s triad (endothelial damage, hypercoagulability, and stasis), predisposing them to venous thromboembolism (VTE). Although the disease burden of VTE suggests a need for prevention in this population, unreliable reported VTE rates, costly and complicated prophylaxis regimens, and chemoprophylaxis risks have prevented the establishment of a universal protocol. This paper reviews thromboprophylaxis practices both in the literature and at our own institution. A systematic review was conducted according to PRISMA guidelines identifying studies pertaining to VTE chemoprophylaxis in burn patients. Additionally, medical records of patients admitted to an American Burn Association-verified burn center between June 2015 and June 2019 were retrospectively reviewed for demographics, chemoprophylaxis, and presence of VTE defined as either deep vein thrombosis (DVT) or pulmonary embolism (PE). Thirty-eight studies met inclusion criteria. In the 12 studies that reported VTE incidence, rates ranged widely from 0.25% to 47.1%. The two largest retrospective studies (n = 33,637 and 36,638) reported a VTE incidence of 0.61% and 0.8% in populations with unknown or inconsistently recorded chemoprophylaxis. Throughout the literature, prevention protocols were mixed, though a trend toward using dose-adjusted subcutaneous low molecular weight heparin based on serum anti-factor Xa level was noted. At our burn center, 1,068 patients met study criteria. At-risk patients received a simple chemoprophylaxis regimen of 5000U of subcutaneous unfractionated heparin every 8 hours. No routine monitoring tests were performed to limit cost. Nine cases of DVT and two cases of PE were identified with an incidence of 0.84% and 0.19%, respectively, and a total VTE incidence of 1.03%. Only one patient developed heparin-induced thrombocytopenia (HIT). No cases of other heparin-associated complications were observed. VTE incidence rates reported in the literature are wide-ranging and poorly capture the effect of any one chemoprophylaxis regimen in the burn population. Our center uses a single, safe, and cost-effective protocol effecting a low VTE rate comparable to that of large national retrospective studies.