bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hyperventilation Syndrome: Investigating the Relationship Between Nijmegen Questionnaire, Vestibular Function Tests, and Patient Symptoms
Authors: Williams Christopher Y. K. , Williams Robert W. K. , Knight Richard , Hashmi Syed , Donnelly Neil , Bance Manohar 
Published: December 2019

Objective:
To explore the Nijmegen Questionnaire (NQ) and its relationship to vestibular function tests and symptoms in patients with dizziness; to compare patient characteristics between those with a positive Nijmegen score and patients clinically diagnosed with hyperventilation syndrome (HVS).

Study Design:
Retrospective case series.

Setting:
Tertiary neurotology referral center.

Patients:
Patients seen at vestibular assessment were grouped according to positive (≥24) or negative (<24) Nijmegen scores; secondary analysis was performed on patients grouped by a clinical diagnosis of hyperventilation syndrome.

Intervention(s):
NQ, vestibular function tests, hospital anxiety and depression scale (HADS), vestibular rehabilitation benefit questionnaire (VRBQ).

Main Outcome Measure(s):
Medical records of patients presenting for vestibular assessment from January to December 2017 were retrospectively reviewed. Demographic data, self-reported questionnaire results, HVS diagnosis, vestibular test results, and reported symptoms were recorded.

Results:
In total, 359 patients presented for vestibular assessment with completed NQ. One hundred thirty nine patients (39%) had a positive (≥24) Nijmegen score. In 34 patients, a diagnosis of hyperventilation syndrome was recorded; 10 of these patients did not have a positive Nijmegen score.
There was no significant difference found in either vestibular lesion type or compensation status between patients with positive and negative Nijmegen scores (p > 0.05). Symptoms commonly described by patients with positive Nijmegen scores include “blurred vision,” “tingling,” “anxiety,” “shortness of breath,” “palpitations,” “panic,” “numbness,” “chest pain,” and “chest tightness.” In contrast, when grouped by HVS diagnosis, patients with HVS were significantly more likely to have No Lesion detected on vestibular function testing (p = 0.0366). “Panic,” “anxiety,” and “tingling” were the only significant symptoms reported more often in the HVS diagnosis group, while “nausea/vomiting” and “vertigo” were reported significantly less frequently compared with the non-HVS diagnosis group.

Conclusions:
Hyperventilation is a complex stimulus, with some effects manifesting in neurotology clinics. This study reveals discrepancies in both vestibular assessment findings and symptom profiles between patients with a positive screening score in the NQ and patients clinically diagnosed with hyperventilation syndrome. This data will inform clinicians’ interpretation of the NQ in the neurotologic setting.
Frequency and Predictors of Successful Transition of Care for Young Adults With Childhood Celiac Disease
Authors: Reilly Norelle R. , Hammer Marissa L. , Ludvigsson Jonas F. , Green Peter H. 
Published: December 2019

ABSTRACTObjectives:Transition from pediatric to adult care for individuals with chronic conditions is important to prevent gaps in care, though this has not been well‐studied in celiac disease (CD). The aim of this study was to discern rates and predictors of successful transition of care for young adults with childhood‐diagnosed CD.Methods:An anonymous 21‐question online survey was sent to individuals on our center's email contact list seeking responses from those ages 18 to 25 years diagnosed with CD before age 18 years. Information collected included method of diagnosis, demographics, CD‐related care, reasons for not seeking care, and symptoms.Results:Respondents (n = 98), 70% women, had a median age of 21 years (IQR 19‐‐23 years). The majority were full or part‐time students (67%; 95% CI 59%–77%). Only 31% of respondents had successfully transitioned to an adult CD provider. Some 37% (95% CI 29%–48%) were not receiving any CD medical care. An older age at diagnosis was associated with successful transition to adult gastroenterology (P = 0.002) as well as with greater symptom scores (P = 0.002). Receiving a referral for ongoing adult CD care predicted successful transition to an adult provider (odds ratio [OR] 3.92, 95% CI 1.58–9.72).Conclusions:Transition of care for young adults with CD is inconsistent, particularly among asymptomatic patients. Receipt of a referral for an adult provider significantly improves follow‐up rates.
Psychometric Testing of a Patient Empowerment, Engagement, and Activation Survey
Authors: Stichler Jaynelle F. , Pelletier Luc R. 
Published: December 2019

Background:
Patient or person-centered care has become a widely used philosophical framework and yet has varying definitions and characteristics. Person-centered care has recently been conceptualized as patient empowerment, engagement, and activation with studies citing positive outcomes.

Purpose:
This study reports the psychometric properties of the Patient Empowerment, Engagement, and Activation Survey.

Methods:
An instrument development and testing approach was used.

Results:
A 21-item survey was developed demonstrating respectable Cronbach α coefficients for the total scale (α = 0.88) and for each subscale: Empowerment (α = 0.71), Engagement (α = 0.81), and Activation (α = 0.76). A regression analysis with 1 item, “I am ready to be discharged” as the dependent variable and all other items as independent variables explained 65% of the variance in readiness for discharge (P < .001).

Discussion:
The Patient Empowerment, Engagement, and Activation Survey can be used to evaluate patients' perspectives of care quality (empowerment and engagement) and readiness for discharge (activation).
DSM-5 Personality Disorders and Traits in Patients With Severe Health Anxiety
Authors: Skjernov Mathias , Bach Bo , Fink Per , Fallon Brian , Soegaard Ulf , Simonsen Erik 
Published: December 2019

Abstract
Severe health anxiety (SHA)/hypochondriasis (HY) is often associated with personality pathology; however, studies report inconsistent results. In general populations, 12% have a personality disorder (PD). We assessed physician-referred psychiatric outpatients with SHA enrolled for a treatment study (n = 84) with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) axis II (SCID-II), Personality Inventory for DSM-5 (PID-5), Whiteley Index 7, and Short Health Anxiety Inventory, and the healthy controls (n = 84) with PID-5 only. There were 71.4% of the patients who met criteria for PDs: avoidant (22.6%), obsessive-compulsive (16.7%), depressive (16.7%), dependent (7.1%), paranoid (3.6%), borderline (2.4%), and not otherwise specified (32.1%). Severity of personality pathology was associated with severity of health anxiety. In group comparisons, PID-5 trait domains of negative affectivity, detachment, low antagonism, and low disinhibition, and facets of anxiousness, separation insecurity, and low attention seeking emerged as unique predictors of SHA. Personality pathology is common among individuals with SHA/HY. Further research is needed to understand the nature of the relationship between health anxiety and personality pathology and to determine whether treatments that target both SHA/HY and personality pathology will improve short- and long-term outcomes.
Stress Ulcer Prophylaxis in Critically Ill Children: A Multicenter Observational Study
Authors: Duffett Mark , Chan Alice , Closs Jordan , McGloin Rumi , McKelvie Greg , Pong Sandra , Seto Winnie , Slaney Heather , Vaninetti Gina , Vanniyasingam Thuva 
Published: December 2019

Objective:
To describe current stress ulcer prophylaxis practice in Canadian PICUs.

Design:
Multicenter cohort study. We defined stress ulcer prophylaxis as the use of a proton-pump inhibitor, histamine-2 receptor antagonist, or sucralfate within the first 2 PICU days among children who had not been on these medications at home and had no evidence of gastrointestinal bleeding.

Setting:
Seven PICUs in Canada.

Patients:
Three hundred seventy-eight children requiring mechanical ventilation.

Interventions:
None.

Measurements and Main Results:
Children were ventilated for a median (interquartile range) of 2 days (1–6 d) and stayed in the PICU for a median (interquartile range) of 4 days (2–10 d). The median (interquartile range) age was 1.3 years (0.3–6.7 yr). Seventy percent of all children received acid suppression during their PICU stay. One hundred sixty-seven (54%) of the 309 children eligible for stress ulcer prophylaxis received it. Histamine-2 receptor antagonists were the most frequently used class (66%), followed by proton-pump inhibitors (47%) and sucralfate (4%), and 20% received more than one class. Stress ulcer prophylaxis was continued on the PICU transfer orders for 34% of these children. Children who received prophylaxis were older and had a higher Pediatric Risk of Mortality III score, more often received nonsteroidal anti-inflammatory drugs and systemic corticosteroids and received less enteral nutrition. In multivariate analysis, age and invasive mechanical ventilation were independently associated with an increased likelihood of receiving stress ulcer prophylaxis and receiving feeds was independently associated with a decreased likelihood of receiving stress ulcer prophylaxis. Gastrointestinal bleeding was reported in 21 (6%) of 378 children; three (0.8%) were clinically important. Eighteen percent were treated for a new respiratory tract infection, and 1% developed Clostridium difficile–associated diarrhea.

Conclusions:
Stress ulcer prophylaxis is common in Canadian PICUs. Clinically important gastrointestinal bleeding and C. difficile–associated diarrhea are rare, and the utility of routine prophylaxis should be examined.
Viral suppression and factors associated with failure to achieve viral suppression among pregnant women in South Africa
Authors: Woldesenbet Selamawit A. , Kufa Tendesayi , Barron Peter , Chirombo Brian C. , Cheyip Mireille , Ayalew Kassahun , Lombard Carl , Manda Samuel , Diallo Karidia , Pillay Yogan , Puren Adrian J. 
Published: December 2019

Objective:
To describe viral load levels among pregnant women and factors associated with failure to achieve viral suppression (viral load ≤50 copies/ml) during pregnancy.

Design:
Between 1 October and 15 November 2017, a cross-sectional survey was conducted among 15–49-year-old pregnant women attending antenatal care (ANC) at 1595 nationally representative public facilities.

Methods:
Blood specimens were taken from each pregnant woman and tested for HIV. Viral load testing was done on all HIV-positive specimens. Demographic and clinical data were extracted from medical records or self-reported. Survey logistic regression examined factors associated with failure to achieve viral suppression.

Result:
Of 10 052 HIV-positive participants with viral load data, 56.2% were virally suppressed. Participants initiating antiretroviral therapy (ART) prior to pregnancy had higher viral suppression (71.0%) by their third trimester compared with participants initiating ART during pregnancy (59.3%). Booking for ANC during the third trimester vs. earlier: [adjusted odds ratio (AOR) 1.8, 95% confidence interval (CI):1.4–2.3], low frequency of ANC visits (AOR for 2 ANC visits vs. ≥4 ANC visits: 2.0, 95% CI:1.7–2.4), delayed initiation of ART (AOR for ART initiated at the second trimester vs. before pregnancy:2.2, 95% CI:1.8–2.7), and younger age (AOR for 15–24 vs. 35–49 years: 1.4, 95% CI:1.2–1.8) were associated with failure to achieve viral suppression during the third trimester.

Conclusion:
Failure to achieve viral suppression was primarily associated with late ANC booking and late initiation of ART. Efforts to improve early ANC booking and early ART initiation in the general population would help improve viral suppression rates among pregnant women. In addition, the study found, despite initiating ART prior to pregnancy, more than one quarter of participants did not achieve viral suppression in their third trimester. This highlights the need to closely monitor viral load and strengthen counselling and support services for ART adherence.
Global Burden of Craniofacial Disorders: Where Should Volunteering Plastic Surgeons and Governments Focus Their Care?
Authors: Davé Dattesh R. , Nagarjan Neeraja , Canner Joseph K. , Kushner Adam L. , Wong Granger B. 
Published: December 2019

Purpose:
Approximately 11% of the global burden of disease is surgically treatable. When located within the head, face, and neck region, plastic surgeons are particularly trained to treat these conditions. The purpose of this study was to describe the etiology, disability, and barriers to receiving care for diseases of the head, face, mouth, and neck region across 4 low-and-middle-income countries.

Methods:
The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cluster randomized, cross-sectional, national survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. The survey identifies demographic characteristics, etiology, disease timing, proportion seeking/receiving care, barriers to care, and disability.

Results:
Across the 4 countries, 1413 diseases of head, face, mouth, and neck region were identified. Masses (22.13%) and trauma (32.8%) were the most common etiology. Nepal reported the largest proportion of masses (40.22%) and Rwanda reported the largest amount of trauma (52.65%) (P < 0.001). Rwanda had the highest proportion of individuals seeking (89.6%) and receiving care (83.63%) while Sierra Leone reported the fewest (60% versus 47.77%, P < 0.001). In our multi-variate analysis literacy and chronic conditions were predictors for receiving care while diseases causing the greatest disability predicted not receiving care (ORa .58 and .48 versus 1.31 P < 0.001).

Conclusions:
The global volunteering plastic surgeon should be prepared to treat chronic craniofacial conditions. Furthermore, governments should address structural barriers, such as health illiteracy and lack of access to local plastic surgery care by supporting local training efforts.
Btk SH2-kinase interface is critical for allosteric kinase activation and its targeting inhibits B-cell neoplasms
Authors: Duarte Daniel P. , Lamontanara Allan J. , La Sala Giuseppina , Jeong Sukyo , Sohn Yoo-Kyoung , Panjkovich Alejandro , Georgeon Sandrine , Kükenshöner Tim , Marcaida Maria J. , Pojer Florence , De Vivo Marco , Svergun Dmitri , Kim Hak-Sung , Dal Peraro Matteo , Hantschel Oliver 
Published: December 2019

ABSTRACTBruton’s tyrosine kinase (Btk) is a key component for B-cell maturation and activation. Btk loss-of-function mutations cause human X-linked agammaglobulinemia (XLA). In contrast, constitutive Btk signaling drives several B-cell neoplasms, which may be treated with tyrosine kinase inhibitors (TKIs). Here, we uncovered the molecular mechanism by which a subset of XLA mutations in the SH2 domain strongly perturbs Btk activation. Using a combination of molecular dynamics (MD) simulations and small-angle X-ray scattering (SAXS), we discovered an allosteric interface between the SH2 and kinase domain to which multiple XLA mutations map and which is required for Btk activation. As allosteric interactions provide unique targeting opportunities, we developed an engineered repebody protein binding to the Btk SH2 domain and able to disrupt the SH2-kinase interaction. The repebody prevented activation of wild-type and TKI-resistant Btk, inhibited Btk-dependent signaling and proliferation of malignant B-cells. Therefore, the SH2-kinase interface is critical for Btk activation and a targetable site for allosteric inhibition.
Thrombospondin-1 Promotes Circuit-Specific Synapse Formation via β1-Integrin
Authors: Koh Sehwon , Roy Suva , Eroglu Oznur , Strader Samuel , Chen William J. , Kay Jeremy N. , Field Greg D. , Eroglu Cagla 
Published: December 2019

SUMMARYGlial cells regulate synaptic connectivity during development, but whether they selectively instruct the formation of specific synaptic circuits is not known. Here we show that the major perisynaptic glia of the retina, the Muller glia (MG), control the proper establishment of the direction-selective (DS) circuit by a synaptogenic protein, Thrombospondin 1 (TSP1). We found that TSP1 promotes excitatory synapse formation specifically in on-off Direction-Selective retinal Ganglion Cells (ooDSGCs). Lack of TSP1 leads to reduced synapse formation within the inner plexiform sublayers containing DS-circuit, resulting in deficits of ooDSGC function. Even though pan-TSP receptor, α2δ-1, interaction is required for TSP1-induced synapse formation, the ooDSGC-subtype specificity of TSP1 is conferred by a second neuronal TSP1 receptor, β1-Integrin. Furthermore, conditional deletion of β1-Integrin in ooDSGCs results in diminished excitatory synapse formation without disturbing laminar organization showing that MG-secreted TSP1 controls circuit-specific synapse formation via β1-Integrin.
Distinct architecture and composition of mouse axonemal radial spoke head revealed by cryo-EM
Authors: Zheng Wei , Li Fan , Ding Zhanyu , Liu Hao , Zhu Lei , Li Jiawei , Gao Qi , Fu Zhenglin , Peng Chao , Yan Xiumin , Zhu Xueliang , Cong Yao 
Published: December 2019

AbstractThe radial spoke (RS) transmits mechanochemical signals from the central pair apparatus (CP) to axonemal dynein arms to coordinate ciliary motility. The RS head, directly contacting with CP, differs dramatically in morphology between protozoan and mammal. Here we show the murine RS head is compositionally distinct from the Chlamydomonas one. Our reconstituted murine RS head core complex consists of Rsph1, Rsph3b, Rsph4a, and Rsph9, lacking Rsph6a whose orthologue exists in the Chlamydomonas RS head. We present the unprecedented cryo-EM structure of RS head core complex at 4.5-Å resolution and identified the subunit location and their interaction network. In this complex, Rsph3b, Rsph4a, and Rsph9 forms a compact body with Rsph4a serving possibly as an assembly scaffold and Rsph3b in a location that might link the head with stalk. Interestingly, two Rsph1 subunits constitute the two stretching-arms possibly for optimized RS-CP interaction. We also propose a sawtooth model for the RS-CP interaction. Our study suggests that the RS head experiences profound remodeling to probably comply with both structural and functional alterations of the axoneme during evolution.
Phage steering of antibiotic-resistance evolution in the bacterial pathogen Pseudomonas aeruginosa
Authors: Gurney James , Pradier Léa , Griffin Joanne S. , Gougat-Barbera Claire , Chan Benjamin K. , Turner Paul E. , Kaltz Oliver , Hochberg Michael E. 
Published: December 2019

AbstractAntimicrobial resistance is a growing global concern and has spurred increasing efforts to find alternative therapeutics. Bacteriophage therapy has seen near constant use in eastern Europe since its discovery over a century ago. One promising approach is to use phages that not only reduce bacterial pathogen loads, but also select for phage resistance mechanisms that trade-off with antibiotic resistance – so called ‘phage steering’. Recent work has shown that phage OMKO1 can interact with efflux pumps and in so doing select for both phage resistance and antibiotic sensitivity. We tested the robustness of this approach to three different antibiotics in vitro and one in vivo. We show that in vitro OMKO1 can reduce antibiotic resistance either in the absence or the presence of antibiotics. Our in vivo experiment showed that phage increased the survival times of wax moth larvae and increased bacterial sensitivity to erythromycin, both in the absence and presence of the antibiotic. We discuss the implications of our findings for future research on this promising therapeutic approach using OMKO1.
Establishment Process of a Magic Trait Allele subject to Both Divergent Selection and Assortative Mating
Authors: Sakamoto T. , Innan H. 
Published: December 2019

ABSTRACTSexual selection and divergent selection are among the major driving forces of reproductive isolation, which could eventually result in speciation. A magic trait is defined such that a single trait is subject to both divergent selection and sexual selection through phenotype-based assortative mating. We are here interested in the evolutionary behavior of alleles in a genetic locus responsible for a magic trait. We assume that, in a pair of homogeneous subpopulations, a mutant allele arises at the magic trait locus, and theoretically obtain the probability that the new allele establishes in the population. We also consider the trajectory of allele frequency along the establishment. Divergent selection simply favors the new allele to fix where it is beneficial, whereas assortative mating works against rare alleles. It is theoretically demonstrated that the fate of the new allele is determined by the relative contributions of the two selective forces, divergent selection and assortative mating, when the allele is rare so that the two selective forces counteract. We also show that random genetic drift also plays an important role. The theoretical results would contribute to improve our understanding of how natural selection initiates speciation.
Transcriptome analysis reveals salinity responses in four Tartary buckwheat cultivars
Authors: Song Jin-Nan , Liu Xue-Hua , Wang Ya-Qi , Yang Hong-Bing 
Published: December 2019

Disclaimer StatementThe authors have withdrawn this manuscript (BIORXIV/2019/869263) entitled Transcriptome analysis reveals salinity responses in four Tartary buckwheat cultivars because it requires adding new data and further modifications. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
Polyandry and paternity affect disease resistance in eusocial wasps: support for the parasite–pathogen hypothesis
Authors: Saga Tatsuya , Okuno Masaki , Loope Kevin J. , Tsuchida Koji , Ohbayashi Kako , Shimada Masakazu , Okada Yasukazu 
Published: December 2019

AbstractPolyandry (multiple mating by females) is a central challenge for understanding the evolution of eusociality. Several hypotheses have been proposed to explain its observed benefits in eusocial Hymenoptera, and one, the parasite–pathogen hypothesis, proposes that high genotypic variance among workers for disease resistance prevents catastrophic colony collapse. We tested the parasite–pathogen hypothesis in the polyandrous waspVespula shidai. We infected isolated workers with the entomopathogenic fungusBeauveria bassianaand quantified their survival in the laboratory. Additionally, we conducted paternity analysis of the workers using nine microsatellite loci to investigate the relationship between survival and matriline/patriline of the workers. As predicted by the parasite–pathogen hypothesis, nestmate workers of different patrilines showed differential resistance toB. bassiana. We also demonstrated variations in virulence among strains ofB. bassiana. Our results are the first to directly support the parasite–pathogen hypothesis in eusocial wasps and suggest that similar evolutionary pressures drove the convergent origin and maintenance of polyandry in ants, bees, and wasps.