bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving parents’ knowledge of early signs of pediatric eye disease: A double-blind RCT
Authors: Staffieri Sandra E. , Rees Gwyneth , Sanfilippo Paul G. , Cole Stephen , Mackey David A. , Hewitt Alex W. 
Published: October 2019

ABSTRACTBackground and ObjectivesEarly diagnosis and intervention is essential to achieve optimal outcomes for most pediatric eye diseases. Educating parents/caregivers to recognize early signs of disease and consult a healthcare professional is critical to achieving this aim. We evaluate the effectiveness of an eye-health information pamphlet on parents’ level of concern and their help-seeking intention if they observed leukocoria or strabismus.MethodsPregnant women attending a metropolitan antenatal clinic were recruited to the study. Participants were randomly assigned to receive a pamphlet on either pediatric eye health (intervention) or strategies for play (control). The primary outcome measure was a change in the parents’ level of concern if they observed leukocoria or strabismus. The secondary outcome measure was a change in their help-seeking intention if either sign was observed.ResultsOf the 518 women enrolled, 382 (73.7%) completed the post-test survey. At follow-up, women who received the intervention were more likely to report a higher level of concern if they observed leukocoria (OR 1.711 [CI: 1.176-2.497] p=0.005]) and were less likely to have a delayed help-seeking intention. (OR 0.560 [CI 0.382-0.817] p =0.003) No change in the level of concern for strabismus was identified between the groups; however, at follow-up, women who received the intervention were less likely to delay help-seeking (OR 0.318 [CI 0.125-0.806] p=0.016).ConclusionProviding parents with relevant, evidence-based information can significantly improve their knowledge and positively influence help-seeking intentions if leukocoria or strabismus are observed.Trial registrationANZCTR.org.auidentifier: ACTRN12617001431314p;World Health Organization Universal Trial Number: U1111-1203-0485Table of Contents SummaryThis study reports the results of a randomised controlled trial evaluating a novel, evidence-based, theory-informed pediatric eye-health information pamphlet for parents.What is known on this subjectLack of parental awareness of signs of pediatric eye disease (leukocoria and strabismus) delays consultation with healthcare professionals (help-seeking), contributing to late diagnosis and poor outcomes. Providing parents with relevant health information can improve their child’s health outcomes.What this study addsUsing an RCT to evaluate a novel health intervention, this study demonstrates that providing parents with evidence-based, theory informed pediatric eye-health information can improve their knowledge and help-seeking intentions if leukocoria or strabismus are observed in their child.
Female genital schistosomiasis and reproductive tract infections. A cross-sectional study in rural adolescents in South Africa
Authors: Shukla Jilna Dilip , Kleppa Elisabeth , Holmen Sigve , Ndhlovu Patricia D. , Mtshali Andile , Sebitloane Motshedisi , Vennervald Birgitte Jyding , Gundersen Svein Gunnar , Taylor Myra , Kjetland Eyrun Floerecke 
Published: October 2019

ABSTRACTBackground and objectivesThe aim of the current study was to establish the relative prevalences of Female Genital Schistosomiasis (FGS) and sexually transmitted infections (STIs). We hypothesised that due to the use of syndromic management for STIs it is possible that FGS is being misdiagnosed and mismanaged as an STI. We therefore wanted to examine the relationship between FGS and the individual STIs in schistosomiasis endemic areas.MethodsBetween 2011 and 2013, a cross-sectional study was performed in 32 randomly selected secondary schools in rural KwaZulu-Natal, South Africa, where each school had at least 300 pupils. In a research clinic, FGS diagnosis, STI testing, and face-to-face interviews were performed in sexually active, young women aged 16 – 22 years.ResultsFGS was the second most prevalent current genital infection (23%). There were significantly more women who had presented FGS among those who had detectable urinary schistosomiasis (35%), compared to those without (19%, p< 0.001). In the FGS positive group 35% were positive for HPV infection, compared to 24 % in the FGS negative group (p=0.010). In the FGS positive group 37% were sero-positive for HSV infection, compared to 30% in the FGS negative group (p=0.079). There were significantly fewer chlamydia infections amongst women with FGS (20%, p=0.018) compared with those who did not have FGS (28%).ConclusionsFGS was the second most common genital infection after HSV but the two were not significantly associated. HPV infection was significantly associated with FGS. Surprisingly Chlamydia infection were negatively associated with FGS. The results show the importance of the inclusion of FGS in the management protocols for genital infections in areas endemic for urinary schistosomiasis, and highlight the importance for more research on suitable differential diagnostic tools and disease management.Key messages boxFGS was the second most common genital infection in this rural population after HSV.FGS was positively associated with HPV.FGS was negatively associated with genital chlamydia infections.FGS should be included in the syndromic management of genital infections.
A Network Analysis Framework to Improve the Delivery of Mosquito Abatement Services in Machala, Ecuador
Authors: Lippi Catherine A. , Mao Liang , Stewart-Ibarra Anna M. , Heydari Naveed , Ayala Efraín Beltrán , Burkett-Cadena Nathan D. , Blackburn Jason K. , Ryan Sadie J. 
Published: October 2019

AbstractBackgroundVector-borne disease places a high health and economic burden in the American tropics. Comprehensive vector control programs remain the primary method of containing local outbreaks. With limited resources, many vector control operations struggle to serve all affected communities within their districts. In the coastal city of Machala, Ecuador, vector control services, such as application of larvicides and truck-mounted fogging, are delivered through two deployment facilities managed by the Ecuadorian Ministry of Health. Public health professionals in Machala face several logistical issues when delivering mosquito abatement services, namely applying limited resources in ways that will most effectively suppress vectors of malaria, dengue, and encephalitis viruses.MethodsUsing a transportation network analysis framework, we built models of service areas and optimized delivery routes based on distance costs associated with accessing neighborhoods throughout the city. Optimized routes were used to estimate the relative cost of accessing neighborhoods for mosquito control services in Machala, creating a visual tool to guide decision makers and maximize mosquito control program efficiency. Location-allocation analyses were performed to evaluate efficiency gains of moving service deployment to other available locations with respect to distance to service hub, neighborhood population, dengue incidence, and housing condition.ResultsUsing this framework, we identified different locations for targeting mosquito control efforts, dependent upon management goals and specified risk factors of interest, including human population, housing condition, and reported dengue incidence. Our models indicate that neighborhoods on the periphery of Machala with the poorest housing conditions are the most costly to access. Optimal locations of facilities for deployment of control services change depending on pre-determined management priorities, increasing the population served via inexpensive routes up to 34.9%, and reducing overall cost of accessing neighborhoods up to 12.7%.ConclusionsOur transportation network models indicate that current locations of mosquito control facilities in Machala are not ideal for minimizing driving distances or maximizing populations served. Services may be optimized by moving vector control operations to other existing public health facilities in Machala. This work represents a first step in creating a spatial tool for planning and critically evaluating the systematic delivery of mosquito control services in Machala and elsewhere.
Hepatitis B virus resistance to tenofovir: fact or fiction? A synthesis of the evidence to date
Authors: Mokaya Jolynne , McNaughton Anna L , Bester Phillip A , Goedhals Dominique , Barnes Eleanor , Marsden Brian D , Matthews Philippa C 
Published: October 2019

ABSTRACTBackgroundTenofovir (TFV) is a widely used antiviral treatment for chronic hepatitis B virus (HBV) infection. There is a high genetic barrier to the selection of TFV resistance-associated mutations (RAMs), but the distribution and clinical significance of TFV RAMs are not well understood, and the topic remains contentious. We here present assimilated evidence for putative TFV RAMs with the aims of cataloguing and characterising mutations that have been reported, and starting to develop insights into the mechanisms of resistance and potential clinical significance.MethodsWe carried out a systematic literature search in PubMed to identify clinical,in vitroandin silicoevidence of TFV resistance. The structure of HBV reverse transcriptase (RT) has not been solved; we therefore compared HBV RT to the crystal structure for HIV RT to map the likely sites of RAMs.ResultsWe identified a ‘long-list’ of 37 putative TFV RAMs in HBV RT, occurring within and outside sites of enzyme activity, some of which can be mapped onto a homologous HIV RT structure. Based on quality and quantity of supporting data, we generated a ‘short-list’ of nine sites that are supported by the most robust evidence. Most resistance arises as a result of suites of multiple RAMs. Other factors including adherence, viral load, HBeAg status, HIV coinfection and NA dosage may also influence viraemic suppression.ConclusionThere is emerging evidence for polymorphisms that may reduce susceptibility to TVF. A better understanding of HBV drug resistance is imperative to optimise approaches to public health elimination targets.
Dengue importation into Europe: a network connectivity-based approach
Authors: Salami Donald , Capinha César , Martins Maria do Rosário Oliveira , Sousa Carla Alexandra 
Published: October 2019

AbstractThe spread of dengue through global human mobility is a major public health concern. A key challenge is understanding the transmission pathways and mediating factors that characterized the patterns of dengue importation into non-endemic areas. Utilizing a network connectivity-based approach, we analyze the importation patterns of dengue fever into European countries.Seven connectivity indices were developed to characterize the role of the air passenger traffic, seasonality, incidence rate, geographical proximity, epidemic vulnerability, and wealth of a source country, in facilitating the transport and importation of dengue fever. We used generalized linear mixed models (GLMMs) to examine the relationship between dengue importation and the connectivity indices while accounting for the air transport network structure. We also incorporated network autocorrelation within a GLMM framework to investigate the propensity of a European country to receive an imported case, by virtue of its position within the air transport network.The connectivity indices and dynamical processes of the air transport network were strong predictors of dengue importation in Europe. With more than 70% of the variation in dengue importation patterns explained. We found that transportation potential was higher for source countries with seasonal dengue activity, high passenger traffic, high incidence rates, lower economic status, and geographical proximity to a destination country in Europe. We also found that position of a European country within the air transport network was a strong predictor of the country’s propensity to receive an imported case.Our findings provide evidence that the importation patterns of dengue into Europe can be largely explained by appropriately characterizing the heterogeneities of the source, and topology of the air transport network. This contributes to the foundational framework for building integrated predictive models for bio-surveillance of dengue importation.
Exploring and mitigating potential bias when genetic instrumental variables are associated with multiple non-exposure traits in Mendelian randomization
Authors: Yang Qian , Sanderson Eleanor , Tilling Kate , Borges M Carolina , Lawlor Deborah A 
Published: October 2019

AbstractBackgroundOur aim is to produce guidance on exploring and mitigating possible bias when genetic instrumental variables (IVs) associate with traits other than the exposure of interest in Mendelian randomization (MR) studies.MethodsWe use causal diagrams to illustrate scenarios that could result in IVs being related to (non-exposure) traits. We recommend that MR studies explore possible IV-non-exposure associations across a much wider range of traits than is usually the case. Where associations are found, confounding by population stratification should be assessed through adjusting for relevant population structure variables. To distinguish vertical from horizontal pleiotropy we suggest using bidirectional MR between the exposure and non-exposure traits and MR of the effect of the non-exposure traits on the outcome of interest. If vertical pleiotropy is plausible, standard MR methods should be unbiased. If horizontal pleiotropy is plausible, we recommend using multivariable MR to control for observed pleiotropic traits and conducting sensitivity analyses which do not require prior knowledge of specific invalid IVs or pleiotropic paths.ResultsWe applied our recommendations to an illustrative example of the effect of maternal insomnia on offspring birthweight in the UK Biobank. We found little evidence that unexpected IV-non-exposure associations were driven by population stratification. Three out of six observed non-exposure traits plausibly reflected horizontal pleiotropy. Multivariable MR and sensitivity analyses suggested an inverse association of insomnia with birthweight, but effects were imprecisely estimated in some of these analyses.ConclusionsWe provide guidance for MR studies where genetic IVs associate with non-exposure traits.Key messagesGenetic variants are increasingly found to associate with more than one social, behavioural or biological trait at genome-wide significance, which is a challenge in Mendelian randomization (MR) studies.Four broad scenarios (i.e. population stratification, vertical pleiotropy, horizontal pleiotropy and reverse causality) could result in an IV-non-exposure trait association.Population stratification can be assessed through adjusting for population structure with individual data, while two-sample MR studies should check whether the original genome-wide association studies have used robust methods to properly account for it.We apply currently available MR methods for discriminating between vertical and horizontal pleiotropy and mitigating against horizontal pleiotropy to an example exploring the effect of maternal insomnia on offspring birthweight.Our study highlights the pros and cons of relying more on sensitivity analyses without considering particular pleiotropic paths versus systematically exploring and controlling for potential pleiotropic paths via known characteristics.
Unmasking selective path integration deficits in Alzheimer’s disease risk carriers
Authors: Bierbrauer Anne , Kunz Lukas , Gomes Carlos A. , Luhmann Maike , Deuker Lorena , Getzmann Stephan , Wascher Edmund , Gajewski Patrick D. , Hengstler Jan G. , Fernandez-Alvarez Marina , Atienza Mercedes , Cammisuli Davide M. , Bonatti Francesco , Pruneti Carlo , Percesepe Antonio , Bellaali Youssef , Hanseeuw Bernard , Strange Bryan A. , Cantero Jose L. , Axmacher Nikolai 
Published: October 2019

SummaryAlzheimer’s disease (AD) manifests with progressive memory loss and spatial disorientation. Neuropathological studies suggest early AD pathology in the entorhinal cortex (EC) of young adults at genetic risk for AD (APOEε4-carriers). Because the EC harbors grid cells, a likely neural substrate of path integration (PI), we examined PI performance inAPOEε4-carriers during a virtual navigation task. We report a selective impairment inAPOEε4-carriers specifically when recruitment of compensatory navigational strategies via supportive spatial cues was disabled. A separate fMRI study revealed that PI performance was associated with the strength of entorhinal grid-like representations, suggesting grid cell dysfunction as a mechanistic explanation for PI deficits inAPOEε4-carriers. Furthermore, retrosplenial cortex was involved in the recruitment of compensatory navigational strategies via supportive spatial cues. Our results provide evidence for selective PI deficits in AD risk carriers, decades before potential disease onset.
Multi-level analysis of reproduction in the Antarctic midge,Belgica antarctica, identifies female and male accessory gland products that are altered by larval stress and impact progeny viability
Authors: Finch Geoffrey , Nandyal Sonya , Perrieta Carlie , Davies Benjamin , Rosendale Andrew J. , Holmes Christopher J. , Gantz Josiah D. , Spacht Drew , Bailey Samuel T. , Chen Xiaoting , Oyen Kennan , Didion Elise M. , Chakraborty Souvik , Lee Richard E. , Denlinger David L. , Matter Stephen F. , Attardo Geoffrey M. , Weirauch Matthew T. , Benoit Joshua B. 
Published: October 2019

AbstractThe Antarctic midge,Belgica antarctica, is a wingless, non-biting midge endemic to Antarctica. Larval development requires at least two years, but adult life lasts only two weeks. The nonfeeding adults mate in swarms and females die shortly after oviposition. Eggs are suspended in a gel of unknown composition that is expressed from the female accessory gland. This project characterizes molecular mechanisms underlying reproduction in this midge by examining differential gene expression in whole males, females, and larvae, as well as in male and female accessory glands. Functional studies were used to assess the role of the gel encasing the eggs, as well as the impact of stress on reproductive biology. RNA-seq analyses revealed sex- and development-specific gene sets along with those associated with the accessory glands. Proteomic analyses were used to define the composition of the egg-containing gel, which is generated during multiple developmental stages and derived from both the accessory gland and other female organs. Functional studies indicate the gel provides a larval food source and thermal and dehydration buffer, all of which are critical for viability. Larval dehydration stress directly reduces production of storage proteins and key accessory gland components, a feature that impacts adult reproductive success. Modeling reveals that bouts of dehydration may significantly impact population growth. This work lays a foundation for further examination of reproduction in midges and provides new information related to general reproduction in dipterans. A key aspect is that reproduction and stress dynamics, currently understudied in polar organisms, are likely to prove critical for determining how climate change will alter survivability.
Reader Engagement with Wikipedia’s Medical Content
Authors: Maggio Lauren A. , Steinberg Ryan M. , Piccardi Tiziano , Willinsky John M. 
Published: October 2019

AbstractWikipedia’s extensive health and medical entries, maintained by WikiProject Medicine (WPM), are well supported by external links that provide readers with both a means of verifying the sources drawn upon and visiting those sources to learn more about a topic. In analysing how readers approach these links, data was collected on reader engagement with these links on WPM pages and on the rest of Wikipedia over a 32-day period. Readers of WPM pages were found to engage with external links more frequently than readers of the rest of Wikipedia, with WPM readers favoring hovering over a link and footnote clicking, compared to W readers who tended to click more external links per page viewed. Compared to readers of the rest of Wikipedia, WPM readers appear more attentive to the external link’s function in verifying and authorizing Wikipedia content, than to the educational potential of examining the sources themselves.
Evaluating the granularity and statistical structure of lesions and behaviour in post-stroke aphasia
Authors: Zhao Ying , Halai Ajay D. , Ralph Matthew A. Lambon 
Published: October 2019

AbstractThe pursuit of relating the location of neural damage to the pattern of acquired language and general cognitive deficits post-stroke stems back to 19th century behavioural neurology. Whilst spatial specificity has improved dramatically over time, from the large areas of damage specified by post-mortem investigation to the millimetre precision of modern MRI, there is an underlying issue that is rarely addressed, which relates to the fact that damage to a given area of the brain is not random but constrained by the brain’s vasculature. Accordingly, the aim of this study was to uncover the statistical structure underlying the lesion profile in chronic aphasia post-stroke. By applying varimax-rotated principal component analysis to the lesions of 70 patients with chronic post-stroke aphasia, we identified 17 interpretable clusters, largely reflecting the vascular supply of middle cerebral artery sub-branches and other sources of individual variation in vascular supply as shown in classical angiography studies. This vascular parcellation produced smaller displacement error in simulated lesion-symptom analysis compared with individual voxels and Brodmann regions. A second principal component analysis of the patients’ detailed neuropsychological data revealed a four factor solution reflecting phonological, semantic, executive-demand and speech fluency abilities. As a preliminary exploration, stepwise regression was used to relate behavioural factor scores to the lesion principal components. Phonological ability was related to two components, which covered the posterior temporal region including the posterior segment of the arcuate fasciculus, and the inferior frontal gyrus. Three components were linked to semantic ability and were located in the white matter underlying the anterior temporal lobe, the supramarginal gyrus and angular gyrus. Executive-demand related to two components covering the dorsal edge of the middle cerebral artery territory, while speech fluency was linked to two components that were located in the middle frontal gyrus, precentral gyrus, and subcortical regions (putamen and thalamus). Future studies can explore in formal terms the utility of these PCA-derived lesion components for relating post-stroke lesions and symptoms.