bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Environmental Factors and Oral Epstein-Barr Virus DNA Loads: A Multicenter Cross-sectional Study in China
Authors: He Yong-Qiao , Liao Xiao-Yu , Xue Wen-Qiong , Xu Ya-Fei , Xu Feng-Hua , Li Fang-Fang , Li Xi-Zhao , Zhang Jiang-Bo , Wang Tong-Min , Wang Fang , Yu Huan-Lin , Feng Qi-Sheng , Chen Li-Zhen , Cao Su-Mei , Liu Qing , Mu Jianbing , Jia Wei-Hua 
Published: October 2018

Abstract

Background
Oral Epstein-Barr virus (EBV) status reflects host EBV activity and potentially links to EBV-associated diseases, however, factors influencing oral EBV loads or reactivation, such as environmental exposures or host factors, are not fully understood.

Methods
A 2-stage, multicenter, cross-sectional study of 6558 subjects from 21 administrative cities of southern China and 3 populations from representative geographical areas in China (referred to as the south, north, and northeastern populations) was performed. The relationships between demographical factors and environmental exposures to EBV loads were analyzed by logistic regression models.

Results
Current smoking, with a dose-response effect, was found to be strongly associated with higher oral EBV loads in the pooled data, with an odds ratio of 1.58 (95% confidence interval, 1.39–1.79), as well as in each of the separate populations. The odds ratio increased to 3.06 when current smokers in southern China were compared to never smokers in northern China. Additionally, higher oral EBV loads tended to be detected in older participants, male participants, and participants in southern China.

Conclusions
This study provided evidence linking the effect of host-environmental factors, particularly smoking, to oral EBV activity. It could strengthen our understanding of the possible causal roles of EBV-related diseases, which may help to prevent or mitigate EBV-associated diseases.
Adverse Drug Reactions in Paediatric In-Patients in a South African Tertiary Hospital
Authors: Makiwane Memela , Decloedt Eric , Chirehwa Maxwell , Rosenkranz Bernd , Kruger Mariana 
Published: October 2018

Abstract

Background
The prevalence of adverse drug reaction (ADR) rates in children in sub-Saharan Africa is unknown.

Objectives
To describe the prevalence of ADRs in paediatric in-patients at a tertiary hospital in South Africa.

Methods
This is a prospective study during a 3-month study period. Data collected included age, sex, diagnosis, medicines received and ADRs experienced. Causality were assessed, using the 10-question Naranjo probability scale and classified according to the Hartwig severity scale.

Results
There were 61 ADRs in 18.4% (52 of 282) of patients. Median age of patients was 1.4 years (interquartile range: 0.5–5.3 years). ADR was the primary admission reason in 31%. The majority of the ADRs were moderate 45.9% (28 of 61), and only 11.5% severe (7 of 61). Paediatric oncology patients suffered significantly more ADRs (56.5%; 13 of 23) [odds ratio 7.3 (3.0–17.9), p &lt; 0.01], followed by HIV-infected patients (42.9%; 9 of 21).

Conclusion
The prevalence of ADRs was 18.4%, while 31% was the reason for admission.
Secondary antibody deficiency in neurology
Authors: Tallantyre Emma C. , Robertson Neil P. , Jolles Stephen 
Published: October 2018

Purpose of review
Induction of lymphocyte depletion is increasingly used as a therapeutic strategy for central and peripheral neuroinflammatory disease. However, there is also a growing recognition of the treatment-related complication of secondary antibody deficiency (SAD). Although the occurrence of hypogammaglobulinaemia is a recognized phenomenon during immunomodulation, robust data on the coexistence of impaired responses to immunization, and significant and/or atypical infections is scarce. Here we review the literature on SAD in anti-CD20 therapy.

Recent findings
Several factors that may increase the incidence of SAD have now been identified, including low levels of immunoglobulins prior to the commencement of B-cell ablation therapy, duration of maintenance therapy, and concurrent or prior use of other immunosuppressing agents such as cyclophosphamide and steroids. Measurement of disease-specific antibodies and vaccine response are likely to be helpful adjuncts to measurement of serum immunoglobulin levels during B-cell depleting therapy. Supportive treatment may include amending the treatment schedule to limit cumulative dose.

Summary
B-cell depleting agents offer considerable therapeutic benefit in neurology. We propose modifications in current practice that include risk stratification and early identification of SAD, with the aim of minimising morbidity and mortality related to this underappreciated condition.
Intraoperative Cone Beam Tomography and Navigation for Displaced Acetabular Fractures: A Comparative Study
Authors: Sebaaly Amer , Jouffroy Pomme , Emmanuel Moreau Pierre , Rodaix Camille , Riouallon Guillaume 
Published: October 2018

Objectives:
To evaluate the accuracy of reduction of the acetabular articular surface using an intraoperative computed tomography scanner (O-Arm) and screw navigation compared with a classical open technique.

Design:
Prospective matched cohort study.

Setting:
Tertiary referral center.

Patients/Participants:
Adult patients with acute acetabular fractures were included in the study. All patients were treated by 2 senior surgeons using intraoperative imaging and screw navigation.

Main Outcome Measurements:
The primary outcome measure was articular reduction. Secondary outcomes were radiation dosage, operative variables [operative time, time for image acquisition, intraoperative bleeding (cell saver), number of surgical plates, and number of screws], and postoperative variables (first postoperative day pain on the visual analog scale, postoperative transfusion, and hemoglobin change). P < 0.05 was considered statistically significant.

Results:
Thirty-five patients were treated in the inclusion period (2016–2017) and were matched to 35 cases in our database (2013–2016). Mean age was 43 years, and the most common fracture type was a both-column fracture (OTA/AO type C). Postoperative image analysis showed that reduction was achieved in 87.1% of the cases in the O-Arm group versus 64.7% in the control group (P < 0.05). Mean gap of the articular fragments was 3.6 mm in the O-Arm group compared with 5.6 mm (P = 0.01) in the control group. There was no significant difference between the 2 groups in regards to all other studied variables except a decrease in intraoperative blood loss and transfusions and an increase in surgical time with the O-Arm group. Finally, the total radiation dose was decreased using the intraoperative O-Arm compared with a routine postoperative computed tomography scan (dose length product in O-Arm: 498 mGy.cm; dose length product in historical group: 715 mGy.cm).

Conclusions:
Using intraoperative imaging and screw navigation for displaced acetabular fractures allow screw navigation with increasing articular surface reduction accuracy. Operative and anesthesia times were not increased, whereas radiation exposure to the patient was significantly decreased. We recommend the use of intraoperative imaging for the treatment of displaced acetabular fractures.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Clinical significance of cerebroplacental ratio
Authors: Kalafat Erkan , Khalil Asma 
Published: October 2018

Purpose of review
Two-thirds of the pregnancies complicated by stillbirth demonstrate growth restriction. Identification of the foetus at risk of growth restriction is essential to reduce the risk of stillbirth. The aim of this review is to critically appraise the current evidence regarding clinical utility of cerebroplacental ratio (CPR) in antenatal surveillance.

Recent findings
The CPR has emerged as an assessment tool for foetuses at increased risk of growth disorders. CPR is a better predictor of adverse events compared with middle-cerebral artery or umbilical artery Doppler alone. The predictive value of CPR for adverse perinatal outcomes is better for suspected small-for-gestational age foetuses compared with appropriate-for-gestational age (AGA) foetuses. CPR could be useful for the risk stratification of small-for-gestational age foetuses to determine the timing of delivery and also to calculate the risk of intrapartum compromise or prolonged admission to the neonatal care unit. Although there are many proposed cut-offs for an abnormal CPR value, evidence is currently lacking to suggest the use of one cut-off over another. CPR appears to be associated with increased risk of intrapartum foetal compromise, abnormal growth velocity, and lower birthweight in AGA foetuses as well. Moreover, birthweight differences are better explained with CPR compared to other factors such as ethnicity. However, the role of CPR in predicting adverse perinatal outcomes such as acidosis or low Apgar scores in AGA foetuses is yet to be determined.

Summary
CPR appears to be a useful surrogate of suboptimal foetal growth and intrauterine hypoxia and it is associated with a variety of perinatal adverse events.
The patient perspective: perceptions of the quality of the abortion experience
Authors: Altshuler Anna L. , Whaley Natalie S. 
Published: October 2018

Purpose of review
Abortion services are essential in sexual and reproductive health and should be held to the same standards as other health services. Patient (or person)-centeredness is a key dimension of healthcare quality that incorporates the perspectives of patients in care provision. The purpose of this review is to summarize studies published in the last year examining women's experiences with abortion care and to describe facilitators and barriers to person-centered care.

Recent findings
Considering person-centeredness in abortion care using dimensions of dignity, autonomy, privacy, communication, social support, supportive care and health facility environment allows for critical evaluation of data describing women's experiences with abortion and postabortion services. Review of the available literature shed light on the impact of social stigma, health policy and abortion restrictions on women's abortion experiences.

Summary
Considering multiple domains and varied settings, current data suggest abortion services worldwide generally fail to provide person-centered care. Institutions and providers may be limited in their ability to provide patient-centered abortion care because of deeply embedded social stigma, institutional regulations and legal restrictions.
Expanding adolescent access to hormonal contraception: an update on over-the-counter, pharmacist prescribing, and web-based telehealth approaches
Authors: Williams Rebekah L. , Meredith Ashley H. , Ott Mary A. 
Published: October 2018

Purpose of review
Hormonal contraceptives are largely responsible for recent declines in unintended adolescent pregnancies, with oral contraceptives being the most commonly used. Young people face multiple barriers to accessing effective contraception in clinical settings. This article reviews innovations in contraceptive access.

Recent findings
The three biggest innovations are over-the-counter oral contraceptives (OTC-OCs), pharmacist-prescribing, and web-based telehealth platforms. In many countries, oral contraceptives are available OTC, and FDA trials for OTC-OCs are underway in the United States. Many states have passed legislation allowing pharmacists to prescribe contraceptives after a brief health screening. Web-based telehealth platforms also provide prescription contraceptive access. There is a small but growing body of literature that demonstrates young people's interest in, and capacity to consent to, hormonal contraceptives in nontraditional settings. State-to-state variability in minor consent, pharmacist prescribing, and telehealth laws act as barriers to young people's access to these newer options.

Summary
Access to hormonal contraception is expanding outside of clinical settings, reducing barriers. Adolescents’ unique needs should be considered in the design, implementation, and evaluation of these new approaches. More data is needed to ensure that adolescents are not excluded from expanded contraceptive access options, as they are disproportionately affected by unintended pregnancy.
Antithrombotic Therapy and Outcomes of Patients With New-Onset Transient Atrial Fibrillation After ST-Segment Elevation Myocardial Infarction
Authors: Kayapinar Osman , Kaya Adnan , Keskin Muhammed , Tatlisu Mustafa Adem 
Published: October 2018

Background:
Atrial fibrillation (AF) is a common complication of ST-segment elevation myocardial infarction (STEMI), and AF might require anticoagulant treatment in some conditions.

Study Question:
There are no clear recommendations about vitamin K antagonist (VKA) use in patients with STEMI who complicated with new-onset transient AF. In this study, we examined the association of concomitant use of VKA and dual antiplatelet therapy (DAPT) with clinical outcomes of this patient population.

Study Design:
A total of 4086 patients with STEMI who underwent primary percutaneous coronary intervention retrospectively investigated. Among these patients, a total of 286 patients who developed new-onset transient AF during hospitalization were enrolled. VKA group consisted of 116 patients treated with warfarin, aspirin, and clopidogrel, and DAPT group consisted of 170 patients treated with aspirin and clopidogrel.

Measures and Outcomes:
One-year mortality, ischemic stroke, major, and minor bleeding were determined as clinical outcomes.

Results:
Although VKA group had proportionally lower mortality (17.2% vs. 20.0%) and ischemic stroke (7.8% vs. 11.8%) compared with DAPT group, the differences did not reach to statistical significance, whereas the 1-year major bleeding had higher rates at VKA group and that had 3.5-times higher major bleeding than DAPT group. This relationship was persisted after multivariable analysis (hazard ratio = 3.37, 95% CI, 1.76–10.04, P = 0.012).

Conclusions:
There is not a widely accepted treatment algorithm in patients with STEMI who complicated with new-onset AF in clinical guidelines. The current study indicated that transient form of new-onset AF might not require long-term VKA. Besides, addition of VKA to DAPT therapy may increase the rates of major and minor bleeding.
The Relationship Between Daytime Salivary Melatonin and Gastrointestinal Symptoms in Young Adults Seeking Psychiatric Care
Authors: Söderquist Fanny , Sundberg Isak , Ramklint Mia , Widerström Rebecka , Hellström Per M. , Cunningham Janet L. 
Published: October 2018

ABSTRACT

Objective
The pathophysiology of irritable bowel syndrome (IBS) is not completely understood, although we do know that patients with IBS have a high prevalence of psychiatric comorbidity (mainly depression and anxiety disorders). Melatonin, produced in the gastrointestinal tract, influences gut motility. Psychiatric conditions are associated with circadian disturbances in peripheral melatonin levels. This study aimed to investigate associations between daytime salivary melatonin and gastrointestinal symptoms in young adult psychiatric patients.

Methods
Ninety-six patients (86% women), aged 18–25 years (M (SD) = 21 (2)), seeking psychiatric care with primarily anxiety disorders, affective disorders, or both were included in the study. Total scores from the Gastrointestinal Symptoms Rating Scale - IBS were compared with salivary melatonin measured at three time points (30 minutes after waking up, at 11:00 hours and 30 minutes after lunch) during the waking hours of 1 day.

Results
After adjustment for potential confounders, melatonin levels in saliva 30 minutes after lunch remained significantly correlated to the total Gastrointestinal Symptoms Rating Scale - IBS score after correction for multiple testing (B = 0.016, SE = 0.006, p = .015, q = 0.045). In a post hoc analysis, symptoms of gastrointestinal pain and bloating contributed most to this association.

Conclusions
In young adult psychiatric patients, salivary melatonin levels after lunch are associated with gastrointestinal symptoms, which is consistent with the proposed effect of elevated levels of gastrointestinal melatonin on gut motility. This result suggests a link between IBS symptoms and regulation of melatonin in patients with psychiatric disorders.
Changes in surface hydrology, soil moisture and gross primary production in the Amazon during the 2015/2016 El Niño
Authors: van Schaik Erik , Killaars Lars , Smith Naomi E. , Koren Gerbrand , van Beek L. P. H. , Peters Wouter , van der Laan-Luijkx Ingrid T. 
Published: October 2018

The 2015/2016 El Niño event caused severe changes in precipitation across the tropics. This impacted surface hydrology, such as river run-off and soil moisture availability, thereby triggering reductions in gross primary production (GPP). Many biosphere models lack the detailed hydrological component required to accurately quantify anomalies in surface hydrology and GPP during droughts in tropical regions. Here, we take the novel approach of coupling the biosphere model SiBCASA with the advanced hydrological model PCR-GLOBWB to attempt such a quantification across the Amazon basin during the drought in 2015/2016. We calculate 30–40% reduced river discharge in the Amazon starting in October 2015, lagging behind the precipitation anomaly by approximately one month and in good agreement with river gauge observations. Soil moisture shows distinctly asymmetrical spatial anomalies with large reductions across the north-eastern part of the basin, which persisted into the following dry season. This added to drought stress in vegetation, already present owing to vapour pressure deficits at the leaf, resulting in a loss of GPP of 0.95 (0.69 to 1.20) PgC between October 2015 and March 2016 compared with the 2007–2014 average. Only 11% (10–12%) of the reduction in GPP was found in the (wetter) north-western part of the basin, whereas the north-eastern and southern regions were affected more strongly, with 56% (54–56%) and 33% (31–33%) of the total, respectively. Uncertainty on this anomaly mostly reflects the unknown rooting depths of vegetation.
This article is part of a discussion meeting issue ‘The impact of the 2015/2016 El Niño on the terrestrial tropical carbon cycle: patterns, mechanisms and implications’.
Interactive effects of tree size, crown exposure and logging on drought-induced mortality
Authors: Shenkin Alexander , Bolker Benjamin , Peña-Claros Marielos , Licona Juan Carlos , Ascarrunz Nataly , Putz Francis E. 
Published: October 2018

Large trees in the tropics are reportedly more vulnerable to droughts than their smaller neighbours. This pattern is of interest due to what it portends for forest structure, timber production, carbon sequestration and multiple other values given that intensified El Niño Southern Oscillation (ENSO) events are expected to increase the frequency and intensity of droughts in the Amazon region. What remains unclear is what characteristics of large trees render them especially vulnerable to drought-induced mortality and how this vulnerability changes with forest degradation. Using a large-scale, long-term silvicultural experiment in a transitional Amazonian forest in Bolivia, we disentangle the effects of stem diameter, tree height, crown exposure and logging-induced degradation on risks of drought-induced mortality during the 2004/2005 ENSO event. Overall, tree mortality increased in response to drought in both logged and unlogged plots. Tree height was a much stronger predictor of mortality than stem diameter. In unlogged plots, tree height but not crown exposure was positively associated with drought-induced mortality, whereas in logged plots, neither tree height nor crown exposure was associated with drought-induced mortality. Our results suggest that, at the scale of a site, hydraulic factors related to tree height, not air humidity, are a cause of elevated drought-induced mortality of large trees in unlogged plots.
This article is part of a discussion meeting issue ‘The impact of the 2015/2016 El Niño on the terrestrial tropical carbon cycle: patterns, mechanisms and implications'.
Extracellular matrix components are required to protectBacillus subtilisfrom T6SS-dependentPseudomonasinvasion and modulate co-colonization of plants
Authors: Molina-Santiago Carlos , Pearson John R. , Navarro-García Yurena , Berlanga-Clavero María Victoria , Caraballo-Rodriguez Andrés Mauricio , Petras Daniel , Cazorla Francisco M. , de Vicente Antonio , Dorrestein Pieter C. , Romero Diego 
Published: October 2018

AbstractBacteria adapt to environmental changes and interact with other microorganisms using a wide array of molecules, metabolic plasticity, secretion systems and the formation of biofilms. Some research has looked at changes in the expression of biofilm related genes during interactions between different bacterial species, however no studies have directly demonstrated the functional significance of biofilms in modulating such interactions. In this study, we have explored this fundamental question by studying the interaction betweenBacillus subtilis3610 andPseudomonas chlororaphisPCL1606. We demonstrate the important role of the extracellular matrix in protectingB. subtiliscolonies from infiltration byPseudomonas. Surprisingly, we find that thePseudomonastype VI secretion system (T6SS) is required in the cell-to-cell contact with matrix-impairedB. subtiliscells, revealing a novel role for T6SS against Gram-positive bacteria. In response toP. chlororaphisinfiltration, we find thatB. subtilisactivates sporulation and expresses motility-related genes. Experiments using plant organs demonstrate the functional importance of these different bacterial strategies in their coexistence as stable bacterial communities. The findings described here further our understanding of the functional role played by biofilms in mediating bacterial social interactions.
Blended Bioinformatics Training in Resource-Limited Settings: A case study of challenges and Opportunities for Implementation
Authors: Ahmed Azza , Awadallah Ayah A. , Elmahdi Mawada T. , Suliman Maram A. , Khalil Atheer E. , Elsafi Hassan , Hamdelnile Basil D. , Abdullateif Mohamed , Fadlelmola Faisal M. 
Published: October 2018

AbstractMotivationDelivering high quality distance-based courses in resource limited settings is a challenging task. Besides the needed infrastructure and expertise, effective delivery of a bioinformatics course could benefit from hands-on sessions, interactivity, and problem-based learning approaches.ResultsIn this article, we discuss the challenges and best practices in delivering bioinformatics training in limited resource settings taking the example of hosting and running a multiple-delivery online course, Introduction to Bioinformatics (IBT), that was developed by the H3ABioNet Education and Training Working Group and delivered in 27 remote classrooms across Africa in 2017. We take the case of the University of Khartoum classroom. Believing that our local setting is similar to others in less developed countries, so we also reflect upon aspects like classroom environment and recruitment of students to maximize outcomes.Supplementary informationSupplementary data are available