bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of professionally facilitated peer support for family carers of people with dementia in a WeChat virtual community
Authors: Han Jing , Guo Guifang , Hong Li 
Published: March 2020

Introduction Dementia is an important issue affecting families and society. Family carers face challenges accessing support due to homebound duties of caring for people with dementia. Internet-based support provides feasible and accessible opportunities. Methods A single-group repeated-measures study was conducted with carers who provide primary care or regularly participate in care for relatives with dementia in a WeChat virtual community. Interventions included three to six months of peer and professional support, included peer emotional support, lectures and consultation, technique support and articles. Self-administered online questionnaires were used pre and post intervention to collect carers’ feedback on activities, indicators of depression, helplessness, perceived stress, carer burden, distress caused by responsive behaviours and self-efficacy. Results A total of 159 carers participated. Of these, 136 (85.5%) were active members according to the amount of information shared in community. A total of 92.4% of carers thought the help and support from the community were important or very important. There were statistically significant differences after intervention for depression ( p < 0.05), perceived stress ( p < 0.05), helplessness ( p < 0.001), self-efficacy total score ( p < 0.05) and two domains of gathering information and obtaining support ( p < 0.05). There was no statistically significant decrease after intervention for distress caused by responsive behaviours and carer burden ( p>0.05). Discussion Professional facilitated peer support based on WeChat virtual community is feasible and acceptable for family carers of people with dementia. It can reduce carers’ perceived pressure, helplessness and depression, and improve self-efficacy compared to pre participation.
In the Era of the Leeds Protocol: A Systematic Review and A Meta-Analysis on the Effect of Resection Margins on Survival Among Pancreatic Ductal Adenocarcinoma Patients
Authors: Kurlinkus B. , Ahola R. , Zwart E. , Halimi A. , Yilmaz B. S. , Ceyhan G. O. , Laukkarinen J. 
Published: March 2020

Background and Aims: A positive resection margin is considered to be a factor associated with poor prognosis after pancreatic ductal adenocarcinoma resection. However, analysis of the resection margin is dependent on the pathological slicing technique. The aim of this systematic review and meta-analysis was to study the impact of resection margin on the survival of pancreatic ductal adenocarcinoma patients whose specimens were analyzed using the axial slicing technique. Material and Methods: A systematic search in the PubMed, Cochrane, and Embase datasets covering the time period from November 2006 to January 2019 was performed. Only studies with axial slicing technique (Leeds Pathology Protocol or Royal College of Pathology Protocol) were included in the final database. Meta-analysis between the marginal distance and survival was performed with the Inverse Variance Method in RevMan. Results: The systematic search resulted in nine studies meeting the inclusion criteria. The median survival for a resection margin 0 mm ranged from 12.3 to 23.4 months, for resection margin <0.5 mm 16 months, for resection margin <1 mm ranged from 11 to 27.5 months, for resection margin <1.5 mm ranged from 16.9 to 21.2 months, and for resection margin >2 mm ranged from 53.9 to 63.1 months. Five studies were eligible for meta-analysis. The pooled multivariable hazard ratio favored resection margin ⩾1 mm (hazard ratio: 1.32 and 95% confidence interval: 1.03–1.68, p = 0.03). Conclusion: Resection margins ⩾1 mm seem to lead to better survival in pancreatic ductal adenocarcinoma patients than resection margin <1 mm. However, there is not enough data to evaluate the effect of oncologic therapy or to analyze the impact of other resection margin distances on survival.
Vascular Anatomy of the Inferior Turbinate and Its Clinical Implications
Authors: Scott John R. , Psaltis Alkis J. , Wormald Peter-John 
Published: March 2020

Background Published reports on the vascular anatomy of the inferior turbinate (IT) are limited. Historical papers report the IT artery as a tributary off the posterior lateral nasal artery (PLNA), but this has not been our clinical experience. Objective The purpose of this study was to examine the arterial blood supply to and the branching pattern within the IT. We discuss this is the context of IT surgery and relate it to postoperative bleeding complication rates. Methods Endoscopic dissection was performed on 16 cadaver heads (24 sides) to determine the origin of the IT artery. Intraoperative surgical videos were analyzed in 50 patients to uncover the vascular branching pattern within the IT. A retrospective review of bleeding complications in patients undergoing IT reduction surgery was also conducted. Results In 17 of 24 sides (70.8%), the IT artery arose either exclusively (54.2%) or partly (16.6%) off the descending palatine artery (DPA). As a branch off the DPA, the IT artery exited the pterygopalatine fossa through a foramen located 7.7 ± 3.0 mm from posterior edge of the IT, 8.4 ± 3.1 mm above the nasal floor and 1.6 ± 2.1 mm below the insertion of the IT bone onto the lateral nasal wall. The mean number of arteries cascading within the IT was 2.7 ± 0.5. Moreover, 112 patients underwent IT reduction surgery and 2 (1.8%) experienced postoperative epistaxis. Conclusion The IT artery has major contributions from the DPA. Most commonly 3 arteries branch within the IT. Knowledge of this vascular anatomy may minimize bleeding associated with IT reduction surgery.
Deep sedation as temporary bridge to definitive treatment of ventricular arrhythmia storm
Authors: Bundgaard Johan S , Jacobsen Peter K , Grand Johannes , Lindholm Matias G , Hassager Christian , Pehrson Steen , Kjaergaard Jesper , Bundgaard Henning 
Published: March 2020

Background:Electrical storm and incessant ventricular tachycardia (VT) are characterized by the clustering of episodes of VT or ventricular fibrillation (VF) and are associated with a poor prognosis. Autonomic nervous system activity influences VT threshold, and deep sedation may be useful for the treatment of VT emergencies.Methods:We reviewed data from conscious patients admitted to our intensive care unit (ICU) due to monomorphic VT, polymorphic VT or VF at our tertiary center between 2010 and 2018.Results:A total of 46 conscious patients with recurrent ventricular arrhythmia, refractory to initial treatment, were referred to the ICU. The majority (n = 31) were stabilized on usual care. The remaining treatment-refractory 15 patients (57 years (range 9–74), 80% males, seven with implantable cardioverter-defibrillators) with VT/VF storm (n = 11) or incessant VT (n = 4) due to ischemic heart disease (n = 10), cardiomyopathy (n = 2), primary arrhythmia (n = 2) and one patient post valve surgery, were deeply sedated and intubated. A complete resolution of VT/VF within minutes to hours was achieved in 12 patients (80%), partial resolution in two (13%) and one (7%) patient died due to ventricular free-wall rupture. One patient with recurrent VT episodes needing repeated deep sedation developed necrotic caecum. No other major complications were seen. Thirteen (87%) patients were alive after a mean follow-up of 3.7 years.Conclusion:Deep sedation was effective and safe for the temporary management of malignant VT/VF refractory to usual treatment. In emergencies, deep sedation may be widely accessible at both secondary and tertiary centers and a clinically useful bridge to definitive treatment of VT.
Evaluation of a digital platform that engages stakeholders in the co-creation of healthcare innovations: A mixed-methods study
Authors: Tončinić Sara , de Wildt-Liesveld Renée , Vrijhoef Hubertus JM 
Published: March 2020

Introduction Engaging public and patients in the decision-making processes is on the agenda of many healthcare systems towards sustainable healthcare delivery. While many engagement initiatives are performed face-to-face, an increasing number is conducted online. An example of the latter is the Dutch digital platform Gezonde Mening that engages patients, healthcare professionals and other stakeholders in the co-creation of healthcare innovations. This study aimed to evaluate the effectiveness of stakeholder engagement performed on Gezonde Mening by focusing on the process of planning, execution and transition of engagement activities. Methods A mixed-methods study was performed by conducting eight semi-structured interviews with developers and funders of Gezonde Mening and an assessment of the psychometric properties of two questionnaires administrated via Gezonde Mening to seek stakeholders’ inputs. While the interviews were analysed deductively and inductively, data from the assessment of psychometric properties were analysed in a descriptive quantitative manner. Data were interpreted through triangulation. Results Assessment of the planning of stakeholder engagement identified needs for having more stakeholders on the platform to enable subgroup analysis and robust insights. Moreover, questionnaires administered by Gezonde Mening showed low validity and reliability. Assessment of the execution of stakeholder engagement indicated that stakeholders are sufficiently informed about engagement. Assessment of the transition of engagement activities showed needs to provide direct results to stakeholders and allow their evaluation of the platform. Conclusion Gezonde Mening digital platform facilitates communication between innovators and stakeholders during engagement activities. However, the study identified room for improvement regarding the planning and transition activities.
Youth Single-Sport Specialization in Professional Baseball Players
Authors: Buckley Patrick S. , Ciccotti Michael C. , Bishop Meghan , Kane Patrick , Selverian Stephen , Exume Dominique , D'Angelo John , Emper William , Freedman Kevin B. , Hammoud Sommer , Cohen Steven B. , Ciccotti Michael G. 
Published: March 2020

Background: An increasing number of youth baseball athletes are specializing in playing baseball at younger ages. Purpose: The purpose of our study was to describe the age and prevalence of single-sport specialization in a cohort of current professional baseball athletes. In addition, we sought to understand the trends surrounding single-sport specialization in professional baseball players raised within and outside the United States (US). Study Design: Cross-sectional study; Level of evidence, 3. Methods: A survey was distributed to male professional baseball athletes via individual team athletic trainers. Athletes were asked if and at what age they had chosen to specialize in playing baseball at the exclusion of other sports, and data were then collected pertaining to this decision. We analyzed the rate and age of specialization, the reasons for specialization, and the athlete’s perception of injuries related to specialization. Results: A total of 1673 professional baseball athletes completed the survey, representing 26 of the 30 Major League Baseball (MLB) organizations. Less than half (44.5%) of professional athletes specialized in playing a single sport during their childhood/adolescence. Those who reported specializing in their youth did so at a mean age of 14.09 ± 2.79 years. MLB players who grew up outside the US specialized at a significantly earlier age than MLB players native to the US (12.30 ± 3.07 vs 14.89 ± 2.24 years, respectively; P < .001). Additionally, MLB players raised in the US recalled a significantly higher incidence of sustaining an injury attributed to specializing in baseball than MLB athletes raised outside the US (27.7% vs 20.6%, respectively; P = .05). Conclusion: This study challenges the current trends toward early youth sport specialization, finding that the majority of professional baseball athletes studied did not specialize as youth and that those who did specialize did so at a mean age of 14 years. With the potential cumulative effects of pitching and overhead throwing on an athlete’s arm, the trend identified in this study toward earlier specialization within baseball is concerning.
Antibodies that conformationally activate ADAMTS13 allosterically enhance metalloprotease domain function
Authors: Schelpe An-Sofie , Petri Anastasis , Roose Elien , Pareyn Inge , Deckmyn Hans , De Meyer Simon F. , Crawley James T. B. , Vanhoorelbeke Karen 
Published: March 2020

Abstract
Plasma ADAMTS13 circulates in a folded conformation that is stabilized by an interaction between the central Spacer domain and the C-terminal CUB (complement components C1r and C1s, sea urchin protein Uegf, and bone morphogenetic protein-1) domains. Binding of ADAMTS13 to the VWF D4(-CK) domains or to certain activating murine monoclonal antibodies (mAbs) induces a structural change that extends ADAMTS13 into an open conformation that enhances its function. The objective was to characterize the mechanism by which conformational activation enhances ADAMTS13-mediated proteolysis of VWF. The activating effects of a novel anti-Spacer (3E4) and the anti-CUB1 (17G2) mAbs on the kinetics of proteolysis of VWF A2 domain fragments by ADAMTS13 were analyzed. mAb-induced conformational changes in ADAMTS13 were investigated by enzyme-linked immunosorbent assay. Both mAbs enhanced ADAMTS13 catalytic efficiency (kcat/Km) by ∼twofold (3E4: 2.0-fold; 17G2: 1.8-fold). Contrary to previous hypotheses, ADAMTS13 activation was not mediated through exposure of the Spacer or cysteine-rich domain exosites. Kinetic analyses revealed that mAb-induced conformational extension of ADAMTS13 enhances the proteolytic function of the metalloprotease domain (kcat), rather than augmenting substrate binding (Km). A conformational effect on the metalloprotease domain was further corroborated by the finding that incubation of ADAMTS13 with either mAb exposed a cryptic epitope in the metalloprotease domain that is normally concealed when ADAMTS13 is in a closed conformation. We show for the first time that the primary mechanism of mAb-induced conformational activation of ADAMTS13 is not a consequence of functional exosite exposure. Rather, our data are consistent with an allosteric activation mechanism on the metalloprotease domain that augments active site function.
Efficient identification of multiple pathways: RNA-Seq analysis of livers from 56Fe ion irradiated mice
Authors: Nia Anna M. , Chen Tianlong , Barnette Brooke L. , Khanipov Kamil , Ullrich Robert L. , Bhavnani Suresh K. , Emmett Mark R. 
Published: March 2020

AbstractBackgroundmRNA interaction with other mRNAs and other signaling molecules determine different biological pathways and functions. Gene co-expression network analysis methods have been widely used to identify correlation patterns between genes in various biological contexts (e.g., cancer, mouse genetics, yeast genetics). A challenge remains to identify an optimal partition of the networks where the individual modules (clusters) are neither too small to make any general inferences, nor too large to be biologically interpretable. Clustering thresholds for identification of modules are not systematically determined and depend on user-settable parameters requiring optimization. The absence of systematic threshold determination may result in suboptimal module identification and a large number of unassigned features.ResultsIn this study, we propose a new pipeline to perform gene co-expression network analysis. The proposed pipeline employs WGCNA, a software widely used to perform different aspects of gene co-expression network analysis, and Modularity Maximization algorithm, to analyze novel RNA-Seq data to understand the effects of low-dose56Fe ion irradiation on the formation of hepatocellular carcinoma in mice. The network results, along with experimental validation, show that using WGCNA combined with Modularity Maximization, provides a more biologically interpretable network in our dataset, than that obtainable using WGCNA alone. The proposed pipeline showed better performance than the existing clustering algorithm in WGCNA, and identified a module that was biologically validated by a mitochondrial complex I assay.ConclusionsWe present a pipeline that can reduce the problem of parameter selection that occurs with the existing algorithm in WGCNA, for applicable RNA-Seq datasets. This may assist in the future discovery of novel mRNA interactions, and elucidation of their potential downstream molecular effects.
Phylogenetic relationship between Australian Fusarium oxysporum isolates and resolving the species complex using the multispecies coalescent model
Authors: Achari Saidi R. , Kaur Jatinder , Dinh Quang , Mann Ross , Sawbridge Tim , Summerell Brett A. , Edwards Jacqueline 
Published: March 2020

AbstractBackgroundTheFusarium oxysporumspecies complex (FOSC) is a ubiquitous group of fungal species readily isolated from agroecosystem and natural ecosystem soils which includes important plant and human pathogens. Genetic relatedness within the complex has been studied by sequencing either the genes or the barcoding gene regions within those genes. Phylogenetic analyses have demonstrated a great deal of diversity which is reflected in the differing number of clades identified: three, five and eight. Genetic limitation within the species in the complex has been studied through Genealogical Concordance Phylogenetic Species Recognition (GCPSR) analyses with varying number of phylogenetic ‘species’ identified ranging from two to 21. Such differing views have continued to confuse users of these taxonomies.ResultsThe phylogenetic relationships between AustralianF. oxysporumisolates from both natural and agricultural ecosystems were determined using three datasets: whole genome, nuclear genes, and mitochondrial genome sequences. The phylogenies were concordant except for three isolates. There were three concordant clades from all the phylogenies suggesting similar evolutionary history for mitochondrial genome and nuclear genes for the isolates in these three clades. Applying a multispecies coalescent (MSC) model on the eight single copy nuclear protein coding genes from the nuclear gene dataset concluded that the three concordant clades correspond to three phylogenetic species within the FOSC. There was 100% posterior probability support for the formation of three species within the FOSC. This is the first report of using the MSC model to estimate species within theF. oxysporumspecies complex. The findings from this study were compared with previously published phylogenetics and species delimitation studies.ConclusionPhylogenetic analyses using three different gene datasets from AustralianF. oxysporumisolates have all supported the formation of three major clades which delineated into three species. Species 2 (Clade 3) may be calledF. oxysporumas it contains the neotype forF. oxysporum.
Overexpression of GmNFYA5 confers drought tolerance to transgenic Arabidopsis and soybean plants
Authors: Ma Xiao-Jun , Yu Tai-Fei , Li Xiao-Hui , Cao Xin-You , Ma Jian , Chen Jun , Zhou Yong-Bin , Chen Ming , Ma You-Zhi , Zhang Jun-Hua , Xu Zhao-Shi 
Published: March 2020

AbstractBackgroundCrop productivity is challenged by abiotic stresses, among which drought stress is the most common.NF-Ygenes, especiallyNF-YAgenes, regulate tolerance to abiotic stress.ResultsSoybean NF-Y geneGmNFYA5was identified to have the highest transcript level among all 21NF-YAgenes in soybean (Glycine maxL.) under drought stress. Drought-induced transcript ofGmNFYA5was suppressed by the ABA synthesis inhibitor naproxen (NAP).GmNFYA5transcript was detected in various tissues at vegetative and reproductive growth stages with higher levels in roots and leaves than in other tissues, which was consist with theGmNFYA5promoter: GUS fusion assay. Overexpression ofGmNFYA5in transgenic Arabidopsis plants caused enhanced drought tolerance in seedlings by decreasing stomatal aperture and water loss from leaves. Overexpression and suppression ofGmNFYA5in soybean resulted in increased and decreased drought tolerance, respectively, relative to plants with an empty vector (EV). Transcript levels of ABA-dependent genes (ABI2,ABI3,NCED3,LEA3,RD29A,P5CS1,GmWRKY46,GmNCED2andGmbZIP1) and ABA-independent genes (DREB1A,DREB2A,DREB2B,GmDREB1,GmDREB2andGmDREB3) in transgenic plants overexpressingGmNFYA5were higher than those of wild-type plants under drought stress; suppression ofGmNFYA5transcript produced opposite results. GmNFYA5 probably regulated the transcript abundance ofGmDREB2andGmbZIP1by binding to the promoters in vivo.ConclusionsOur results suggested that overexpression ofGmNFYA5improved drought tolerance in soybean via both ABA-dependent and ABA-independent pathways.
Unusual accumulation of a wide array of antimicrobial resistance mechanisms in a patient with cytomegalovirus-associated hemophagocytic lymphohistiocytosis: a case report
Authors: Hasan Mohammad Rubayet , Sundaram Manu Somasundaram , Sundararaju Sathyavathi , Tsui Kin-Ming , Karim Mohammed Yousuf , Roscoe Diane , Imam Omar , Janahi Mohammad A. , Thomas Eva , Dobson Simon , Tan Rusung , Tang Patrick , Lopez Andres Perez 
Published: March 2020

Abstract
Background
Infections with multidrug-resistant organisms (MDRO) pose a serious threat to patients with dysregulated immunity such as in hemophagocytic lymphohistiocytosis (HLH), but such infections have rarely been comprehensively characterized. Here, we present a fatal case of HLH secondary to cytomegalovirus (CMV) infection complicated by both anti-viral drug resistance and sepsis from multiple MDROs including pandrug-resistant superbug bacteria.

Case presentation
A previously healthy, six-year-old boy presented with a 45-day history of fever prior to a diagnosis of hemophagocytic lymphohistiocytosis and hemorrhagic colitis, both associated with CMV. On hospital admission, the patient was found to be colonized with multiple, multidrug-resistant (MDR) bacteria including vancomycin-resistant enterococci (VRE) and carbapenamase-producing organisms (CPO). He eventually developed respiratory, urine and bloodstream infections with highly drug-resistant, including pandrug-resistant bacteria, which could not be controlled by antibiotic treatment. Antiviral therapy also failed to contain his CMV infection and the patient succumbed to overwhelming bacterial and viral infection. Whole genome sequencing (WGS) of the MDR bacteria and metagenomic analysis of his blood sample revealed an unusual accumulation of a wide range of antimicrobial resistance mechanisms in a single patient, including antiviral resistance to ganciclovir, and resistance mechanisms to all currently available antibiotics.

Conclusions
The case highlights both the risk of acquiring MDR superbugs and the severity of these infections in HLH patients.