bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Frequency of Antibiotic Prescription in Children With Undifferentiated Febrile Illness in Kenya
Authors: Hooft Anneka M , Ndenga Bryson , Mutuku Francis , Otuka Victoria , Ronga Charles , Chebii Philip K , Maina Priscillah W , Jembe Zainab , Lee Justin , Vu David M , Mukoko Dunstan , LaBeaud A Desiree 
Published: September 2020

Abstract

Background
In low-resource, malaria-endemic settings, accurate diagnosis of febrile illness in children is challenging. The World Health Organization (WHO) currently recommends laboratory-confirmed diagnosis of malaria prior to starting treatment in stable children. Factors guiding management of children with undifferentiated febrile illness outside of malaria are not well understood.

Methods
This study examined clinical presentation and management of a cohort of febrile Kenyan children at 5 hospital/clinic sites from January 2014 to December 2017. Chi-squared and multivariate regression analyses were used to compare frequencies and correlate demographic, environmental, and clinical factors with patient diagnosis and prescription of antibiotics.

Results
Of 5735 total participants, 68% were prescribed antibiotic treatment (n = 3902), despite only 28% given a diagnosis of bacterial illness (n = 1589). Factors associated with prescription of antibiotic therapy included: negative malaria testing, reporting head, ears, eyes, nose and throat (HEENT) symptoms (ie, cough, runny nose), HEENT findings on exam (ie, nasal discharge, red throat), and having a flush toilet in the home (likely a surrogate for higher socioeconomic status).

Conclusion
In a cohort of acutely ill Kenyan children, prescription of antimalarial therapy and malaria test results were well correlated, whereas antibiotic treatment was prescribed empirically to most of those who tested malaria negative. Clinical management of febrile children in these settings is difficult, given the lack of diagnostic testing. Providers may benefit from improved clinical education and implementation of enhanced guidelines in this era of malaria testing, as their management strategies must rely primarily on critical thinking and decision-making skills.
Spatial Heterogeneity of Enteric Fever in 2 Diverse Communities in Nepal
Authors: Tamrakar Dipesh , Vaidya Krista , Yu Alexander T , Aiemjoy Kristen , Naga Shiva Ram , Cao Yanjia , Bern Caryn , Shrestha Rajeev , Karmacharya Biraj M , Pradhan Sailesh , Qamar Farah Naz , Saha Samir , Date Kashmira , Longley Ashley T , Hemlock Caitlin , Luby Stephen , Garrett Denise O , Bogoch Isaac I , Andrews Jason R 
Published: September 2020

Abstract

Background
Typhoid fever is endemic in the urban Kathmandu Valley of Nepal; however, there have been no population-based studies of typhoid outside of this community in the past 3 decades. Whether typhoid immunization should be prioritized in periurban and rural communities has been unclear.

Methods
We performed population-based surveillance for enteric fever in 1 urban catchment (Kathmandu) and 1 periurban and rural catchment (Kavrepalanchok) as part of the Surveillance for Enteric Fever in Asia Project (SEAP). We recruited individuals presenting to outpatient and emergency departments at 2 study hospitals with suspected enteric fever and performed blood cultures. Additionally, we conducted a household survey in each catchment area to characterize care seeking for febrile illness. We evaluated spatial heterogeneity in febrile illness, care seeking, and enteric fever incidence.

Results
Between September 2016 and September 2019, we enrolled 5736 participants with suspected enteric fever at 2 study hospitals. Among these, 304 (5.3%) were culture positive for Salmonella Typhi (249 [81.9%]) or Paratyphi A (55 [18.1%]). Adjusted typhoid incidence in Kathmandu was 484 per 100 000 person-years and in Kavrepalanchok was 615 per 100 000 person-years. While all geographic areas for which estimates could be made had incidence &gt;200 per 100 000 person-years, we observed spatial heterogeneity with up to 10-fold variation in incidence between communities.

Conclusions
In urban, periurban, and rural communities in and around Kathmandu, we measured a high but heterogenous incidence of typhoid. These findings provide some support for the introduction of conjugate vaccines in Nepal, including outside urban areas, alongside other measures to prevent enteric fever.
A community-based topological distance for brain-connectome classification
Authors: Villareal–Haro Juan Luis , Ramirez–Manzanares Alonso , Pichardo-Corpus Juan Antonio 
Published: September 2020

Abstract
Measuring differences among complex networks is a well-studied research topic. Particularly, in the context of brain networks, there are several proposals. Nevertheless, most of them address the problem considering unweighted networks. Here, we propose a metric based on modularity and Jaccard index to measure differences among brain-connectivity weighted networks built from diffusion-weighted magnetic resonance data. We use a large dataset to test our metric: a synthetic Ground Truth network (GT) and a set of networks available from a tractography challenge, three sets computed from GT perturbations, and a set of classic random graphs. We compare the performance of our proposal with the most used methods as Euclidean distance between matrices and a kernel-based distance. Our results indicate that the proposed metric outperforms those previously published distances. More importantly, this work provides a methodology that allows differentiating diverse groups of graphs based on their differences in topological structure.
Habitat ecology of Nearctic–Neotropical migratory landbirds on the nonbreeding grounds
Authors: Albert Steven , Wolfe Jared D , Kellerman Jherime , Sherry Thomas , Stutchbury Bridget J M , Bayly Nicholas J , Ruiz-Sánchez Angelina 
Published: September 2020

AbstractOf the approximately 716 bird species that breed in North America, 386 (54%) are considered Nearctic–Neotropical migrants by the U.S. Fish and Wildlife Service. In the past 50 yr, scores of these migratory species, including some once considered common, have declined dramatically. Nearctic–Neotropical migrants normally spend 6–8 months in tropical habitats, making the identification, availability, and management of Neotropical habitats critical issues for their conservation. Yet, for most species, complete and nuanced information about their use of tropical habitats and the relative effects of breeding vs. wintering conditions on survival, productivity, and population trends is not available, though many studies point to Neotropical overwintering habitats as being a strong driver of population change. Particularly important for long-distance Nearctic–Neotropical migrants is an understanding of how “carry-over effects” arise and influence population trends when conditions on wintering grounds and tropical stopover areas affect subsequent reproductive performance on breeding grounds. For example, why some species show strong carry-over effects from tropical habitats while others do not is not fully understood. In recent years, many studies have offered insights into these issues by taking advantage of new scientific methods and technological innovations. In this review, we explore threats facing North American breeding birds that migrate to the Neotropics, summarize knowledge of habitat selection and use on the wintering grounds, describe how conditions at one point in the annual cycle may manifest in subsequent seasons or life history stages, and discuss conservation concerns such as climate change and the potential for phenological mismatch.
MicroRNA Levels in Exhaled Breath Condensate of Patients with Esophageal Atresia
Authors: Soyer T , Birben E , Türer Ö B , Kahveci M , Tuğcu G D , Soyer Ö U , Yalçın E , Doğru D , Özçelik U , Kiper N , Şekerel B E , Tanyel F C 
Published: September 2020

Abstract
MicroRNAs (miRNAs) are noncoding RNAs that play an important role in the regulation of inflammation and have not been evaluated in exhaled breath condensates (EBC) of patients with esophageal atresia and tracheoesophageal fistula (EA–TEF). It is aimed to evaluate the levels of miRNA-21 and miRNA-24 in EBC of patients with EA–TEF.
Patients who received surgery for EA–TEF (EA) were assessed for age, sex, types of anomaly, surgical treatments, and respiratory problems. A 500–1000 mL of EBC was obtained from each participant with EcoScreen. The levels of miRNA-21 and miRNA-24 in the EBC were analyzed by real-time polymerase chain reaction and compared between the EA group and the control group consisting of healthy children with no history of respiratory problems (n = 17). The levels of miRNAs in relation to respiratory problems and gastroesophageal reflux (GER) were also assessed. A total of 19 patients were enrolled in the EA group with a mean age of 7.8 ± 3.2 years and a male-to-female ratio of 10:9 EA cases had significantly lower levels of miRNA-21 (P &lt; 0.05) compared to that in control group. The miRNA-24 levels did not differ between groups (P &gt; 0.05). EA patients with positive pH testing for GER (n = 6) and fundoplication (n = 6) had higher levels of miRNA-21 than those with normal pH testing and without fundoplication, respectively (n = 13, P &lt; 0.05). The levels of miRNA-21 and miRNA-24 did not differ between patients with and without proton pump inhibitor treatment (P &gt; 0.05).
The lower levels of miRNA-21 in the EBC of EA patients suggest a hyperreactive airway problem, which may be associated with GER and its surgical treatment.
Pleural complications in patients with coronavirus disease 2019 (COVID-19): how to safely apply and follow-up with a chest tube during the pandemic?
Authors: Ceylan Kenan Can , Batihan Guntug , Yazgan Serkan , Gürsoy Soner , Kıraklı Sami Cenk , Ataman Sena 
Published: September 2020

Abstract

OBJECTIVES

Severe acute respiratory syndrome coronavirus 2, a novel coronavirus, affects mainly the pulmonary parenchyma and produces significant morbidity and mortality. During the pandemic, several complications have been shown to be associated with coronavirus disease 2019 (COVID-19). Our goal was to present a series of patients with COVID-19 who underwent chest tube placements due to the development of pleural complications and to make suggestions for the insertion and follow-up management of the chest tube.

METHODS
We retrospectively collected and analysed data on patients with laboratory-confirmed COVID-19 in our hospital between 11 March and 15 May 2020. Patients from this patient group who developed pleural complications requiring chest tube insertion were included in the study.

RESULTS
A total of 542 patients who were suspected of having COVID-19 were hospitalized. The presence of severe acute respiratory syndrome coronavirus 2 was confirmed with laboratory tests in 342 patients between 11 March and 15 May 2020 in our centre. A chest tube was used in 13 (3.8%) of these patients. A high-efficiency particulate air filter mounted double-bottle technique was used to prevent viral transmission.

CONCLUSIONS
In patients with COVID-19, the chest tube can be applied in cases with disease or treatment-related pleural complications. Our case series comprised a small group of patients, which is one of its limitations. Still, our main goal was to present our experience with patients with pleural complications and describe a new drainage technique to prevent viral transmission during chest tube application and follow-up.
Steroidal and non-steroidal mineralocorticoid receptor antagonists in cardiorenal medicine
Authors: Agarwal Rajiv , Kolkhof Peter , Bakris George , Bauersachs Johann , Haller Hermann , Wada Takashi , Zannad Faiez 
Published: September 2020

Abstract
This review covers the last 80 years of remarkable progress in the development of mineralocorticoid receptor (MR) antagonists (MRAs) from synthesis of the first mineralocorticoid to trials of nonsteroidal MRAs. The MR is a nuclear receptor expressed in many tissues/cell types including the kidney, heart, immune cells, and fibroblasts. The MR directly affects target gene expression—primarily fluid, electrolyte and haemodynamic homeostasis, and also, but less appreciated, tissue remodelling. Pathophysiological overactivation of the MR leads to inflammation and fibrosis in cardiorenal disease. We discuss the mechanisms of action of nonsteroidal MRAs and how they differ from steroidal MRAs. Nonsteroidal MRAs have demonstrated important differences in their distribution, binding mode to the MR and subsequent gene expression. For example, the novel nonsteroidal MRA finerenone has a balanced distribution between the heart and kidney compared with spironolactone, which is preferentially concentrated in the kidneys. Compared with eplerenone, equinatriuretic doses of finerenone show more potent anti-inflammatory and anti-fibrotic effects on the kidney in rodent models. Overall, nonsteroidal MRAs appear to demonstrate a better benefit–risk ratio than steroidal MRAs, where risk is measured as the propensity for hyperkalaemia. Among patients with Type 2 diabetes, several Phase II studies of finerenone show promising results, supporting benefits on the heart and kidneys. Furthermore, finerenone significantly reduced the combined primary endpoint (chronic kidney disease progression, kidney failure, or kidney death) vs. placebo when added to the standard of care in a large Phase III trial.
Evolved to vary: genome and epigenome variation in the human pathogenHelicobacter pylori
Authors: Ailloud Florent , Estibariz Iratxe , Suerbaum Sebastian 
Published: September 2020

ABSTRACTHelicobacter pylori is a Gram-negative, spiral shaped bacterium that selectively and chronically infects the gastric mucosa of humans. The clinical course of this infection can range from lifelong asymptomatic infection to severe disease, including peptic ulcers or gastric cancer. The high mutation rate and natural competence typical of this species are responsible for massive inter-strain genetic variation exceeding that observed in all other bacterial human pathogens. The adaptive value of such a plastic genome is thought to derive from a rapid exploration of the fitness landscape resulting in fast adaptation to the changing conditions of the gastric environment. Nevertheless, diversity is also lost through recurrent bottlenecks and H. pylori’s lifestyle is thus a perpetual race to maintain an appropriate pool of standing genetic variation able to withstand selection events. Another aspect of H. pylori’s diversity is a large and variable repertoire of restriction-modification systems. While not yet completely understood, methylome evolution could generate enough transcriptomic variation to provide another intricate layer of adaptive potential. This review provides an up to date synopsis of this rapidly emerging area of H. pylori research that has been enabled by the ever-increasing throughput of Omics technologies and a multitude of other technological advances.
When evidence is lacking: a mixed-methods approach for the development of practice guidance in liver transplantation
Authors: VanWagner Lisa B , Aghaulor Blessing , Hussain Tasmeen , Kosirog Megan , Campbell Patrick , Pine Stewart , Daud Amna , Finn Daniel J , Levitsky Josh , Lloyd-Jones Donald M , Holl Jane L 
Published: September 2020

Abstract

Background
Most interventions for conditions with a small cohort size, such as transplantation, are unlikely to be part of a clinical trial. When condition-specific evidence is lacking, expert consensus can offer more precise guidance to improve care. Management of cardiovascular risk in liver-transplant recipients is one example for which clinicians have, to date, adapted evidence-based guidelines from studies in the general population. However, even when consensus is achieved, implementation of practice guidance is often inadequate and protracted. We report on a novel mixed-methods approach, the Northwestern Method©, for the development of clinical-practice guidance when condition-specific evidence is lacking. We illustrate the method through the development of practice guidance for managing cardiovascular risk in liver-transplant recipients.

Methods
The Northwestern Method© consists of (i) adaptation of relevant, existing, evidence-based clinical-practice guidelines for the target population; (ii) consensus by experts of the proposed practice guidance; (iii) identification of barriers to guidance adherence in current practice; and (iv) recommendation for implementation and dissemination of the practice guidance. The method is based on an iterative, user-centered approach in which the needs, wants, and limitations of all end users, including patients, are attended to at each stage of the design and development process.

Conclusions
The Northwestern Method© for clinical-practice-guidance development uses a mixed-methods approach to bring together broad representation from multiple disciplines and practice settings to develop consensus considering the unique needs and preferences of patients, caregivers, and practitioners who are directly impacted by clinical-practice-guidance recommendations. We hypothesize that a priori involvement of end users in the guidance-development process will lead to sustainable implementation of guidance statements into clinical practice.
Between-Generation Phenotypic and Epigenetic Stability in a Clonal Snail
Authors: Smithson Mark , Thorson Jennifer L M , Sadler-Riggleman Ingrid , Beck Daniel , Skinner Michael K , Dybdahl Mark 
Published: September 2020

AbstractEpigenetic variation might play an important role in generating adaptive phenotypes by underpinning within-generation developmental plasticity, persistent parental effects of the environment (e.g., transgenerational plasticity), or heritable epigenetically based polymorphism. These adaptive mechanisms should be most critical in organisms where genetic sources of variation are limited. Using a clonally reproducing freshwater snail (Potamopyrgus antipodarum), we examined the stability of an adaptive phenotype (shell shape) and of DNA methylation between generations. First, we raised three generations of snails adapted to river currents in the lab without current. We showed that habitat-specific adaptive shell shape was relatively stable across three generations but shifted slightly over generations two and three toward a no-current lake phenotype. We also showed that DNA methylation specific to high-current environments was stable across one generation. This study provides the first evidence of stability of DNA methylation patterns across one generation in an asexual animal. Together, our observations are consistent with the hypothesis that adaptive shell shape variation is at least in part determined by transgenerational plasticity, and that DNA methylation provides a potential mechanism for stability of shell shape across one generation.
Societal Views of Older Adults as Vulnerable and a Burden to Society During the COVID-19 Outbreak: Results From an Israeli Nationally Representative Sample
Authors: Cohn-Schwartz Ella , Ayalon Liat 
Published: September 2020

Abstract

Objectives
To examine the factors associated with older adults’ perceptions of ageism in society during the COVID-19 outbreak, in particular the portrayal of older people as a burden and as vulnerable.

Method
Data are based on a nationally representative survey of adults aged 50+ in Israel, conducted during the COVID-19 outbreak (N = 888). Regression models predicted perceptions of societal ageism. The independent variables were dying anxiety, experiences of age-based discriminations, and social resources.

Results
Participants who believed older adults were perceived as a burden during the COVID-19 outbreak had higher dying anxiety and reported more age-based discrimination. Living with children and contact with family were protective against perceptions of adults as a burden. Participants who believed older adults were perceived as vulnerable had higher dying anxiety and were less likely to live with children.

Discussion
The daily lives of older adults can impact their perceptions of societal ageism during the COVID-19 outbreak.
Is Loneliness Adaptive? A Dynamic Panel Model Study of Older U.S. Adults
Authors: Das Aniruddha 
Published: September 2020

AbstractObjectivesRecent evolutionary psychological theory proposes that loneliness is an adaptive mechanism, designed to trigger maintenance and repair of social ties. No population representative analyses have probed loneliness effects on sociality. The present study addressed this gap.MethodData were from the 2006, 2010, 2014, and 2018 waves of the Health and Retirement Study, nationally representative of U.S. adults over age 50. Recently developed cross-lagged models with fixed effects were used to test prospective within-person associations of loneliness with specific dimensions of sociality, taking into account reverse causality as well as all time-invariant confounders with stable effects. Both gender-combined and -specific analyses were conducted.ResultsLoneliness did not consistently predict overall sociality: sparse linkages were found only among women. The same null pattern held with family ties. Non-family ties, in contrast, were associated with prior loneliness, but in a gender-specific way. Loneliness positively predicted women’s social interactions with friends, but seemed linked to withdrawal from these relationships among men. There were indications that lonely men instead used religious attendance as a social outlet.DiscussionLoneliness seems to induce domain- and gender-specific sociality responses. Findings suggest implications for evolutionary models of sociality as well as for psychosocial and physical health. Pending replication in independent samples, inferences remain tentative.
The structure of the sedimentary cover and crystalline crust in the Sichuan Basin and its tectonic implications
Authors: Wei Zigen , Chu Risheng , Chen Ling , Wu Shanshan , Jiang Hui , He Bin 
Published: September 2020

SUMMARY
The Sichuan Basin, located to the east of the Tibetan Plateau, experienced successive marine and continental depositions since the Sinian. Structures of the sedimentary cover and crystalline crust, for example, thickness and Vp/Vs ratio, are of great significance to study the basin's properties and evolution, which have not been investigated simultaneously. In this paper, we extended the traditional single-layer H–k stacking method of receiver functions to a multilayer H–k stacking approach and applied it to invert for thickness and Vp/Vs ratio of the sedimentary cover and crystalline crust beneath 14 seismic stations in the Sichuan Basin. The observed thickness and Vp/Vs ratio of the sedimentary cover range from 4.2 to 7.5 km and from 1.86 to 2.55, respectively, suggesting unconsolidated sediments containing water or other fluids. Two-layer sedimentary cover was observed beneath eight stations, probably corresponding to the sediment in the Phanerozoic and Precambrian. The observed thickness and Vp/Vs ratio of the crystalline crust range from 33.4 to 41.8 km and from 1.61 to 1.78, respectively, suggesting typical cratonic crust in the Sichuan Basin. Theoretical analyses of H–k stacking were further performed for different types of sedimentary basins, and the results suggest that the multilayer H–k stacking is more effective to study basin's structure with a thick sedimentary layer and thin subsediment crust.