bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antimicrobial point prevalence surveys in two Ghanaian hospitals: opportunities for antimicrobial stewardship
Authors: Afriyie Daniel Kwame , Sefah Israel A , Sneddon Jacqueline , Malcolm William , McKinney Rachel , Cooper Lesley , Kurdi Amanj , Godman Brian , Seaton R Andrew 
Published: January 2020

Abstract

Background
Improved knowledge regarding antimicrobial use in Ghana is needed to reduce antimicrobial resistance (AMR). This includes point prevalence studies (PPSs) in hospitals. Objectives were to: (i) provide baseline data in two hospitals [Keta Municipal Hospital (KMH) and Ghana Police Hospital (GPH)] and identify priorities for improvement; (ii) assess the feasibility of conducting PPSs; and (iii) compare results with other studies.

Methods
Standard PPS design using the Global PPS paper forms, subsequently transferred to their template. Training undertaken by the Scottish team. Quality indicators included: rationale for use; stop/review dates; and guideline compliance.

Results
Prevalence of antibiotic use was 65.0% in GPH and 82.0% in KMH. Penicillins and other β-lactam antibiotics were the most frequently prescribed in both hospitals, with third-generation cephalosporins mainly used in GPH. Antibiotic treatment was mainly empirical and commonly administered intravenously, duration was generally short with timely oral switching and infections were mainly community acquired. Encouragingly, there was good documentation of the indications for antibiotic use in both hospitals and 50.0%–66.7% guideline compliance (although for many indications no guideline existed). In addition, almost all prescribed antibiotics had stop dates and there were no missed doses. The duration of use for surgical prophylaxis was generally more than 1 day (69.0% in GPH and 77.0% in KMH).

Conclusions
These two hospitals were the first in Ghana to use the Global PPS system. We found the PPS was feasible, relatively rapid and achieved with limited training. Targets for improvement identified included reduction of broad-spectrum antibiotics and duration of treatment.
Sudden and steady orbital period changes across six classical Nova Eruptions: the end of hibernation and two serious challenges for the magnetic braking model of cataclysmic variable evolution
Authors: Schaefer Bradley E 
Published: January 2020

ABSTRACT
I report on two new measures of the sudden change in the orbital period (P) across the nova eruption (ΔP) and the steady period change in quiescence ($\dot{P}$) for classical novae (CNe) RR Pic and HR Del, bringing a total of six such measures for CNe, all in a final report of my large and long observing program. The fractional changes (ΔP/P) in parts-per-million (ppm) are −290.71 ± 0.28 (QZ Aur), −472.1 ± 4.8 (HR Del), −4.46 ± 0.03 (DQ Her), +39.6 ± 0.5 (BT Mon), −2003.7 ± 0.9 (RR Pic), and −273 ± 61 (V1017 Sgr). These results are in stark opposition to the Hibernation Model for the evolution of cataclysmic variables (CVs), which requires ΔP/P&gt; + 1000 ppm to get the required drop in the accretion rate to produce hibernation. The hibernation model cannot be salvaged in any way. My program has also measured the first long-term $\dot{P}$ for CNe, with −2.84 ± 0.22 (QZ Aur), +4.0 ± 0.9 (HR Del), +0.00 ± 0.02 (DQ Her), −2.3 ± 0.1 (BT Mon), and +1.25 ± 0.01 (RR Pic) in units of 10−11 d per cycle. These can be directly compared to the predictions of the magnetic braking model, where the long-term average $\dot{P}$ is a single universal function of P. The measured values are +5.3, −94, 0.00, +6.9, and −190 times that predicted by the model, so the predictions are always greatly wrong. Further, the effects of the ΔP averaged over the eruption cycle are usually much larger than the magnetic braking effects. To get a realistic model of CV evolution, we must add the physics of the ΔP and $\dot{P}$ variations.
Impact of Pseudomonas aeruginosa Isolation on Mortality and Outcomes in an Outpatient Chronic Obstructive Pulmonary Disease Cohort
Authors: Jacobs David M , Ochs-Balcom Heather M , Noyes Katia , Zhao Jiwei , Leung Wai Yin , Pu Chan Yeu , Murphy Timothy F , Sethi Sanjay 
Published: January 2020

Abstract

Background
Tracheobronchial colonization by Pseudomonas aeruginosa (PA) has been shown to negatively impact outcomes in cystic fibrosis and bronchiectasis. There is uncertainty whether the same association is prevalent in chronic obstructive pulmonary disease (COPD), especially in the outpatient setting. Our objective was to determine (1) whether PA isolation is associated with mortality and (2) changes in exacerbation and hospitalization rates within a longitudinal cohort of COPD outpatients.

Methods
Pseudomonas aeruginosa colonization was ascertained in monthly sputum cultures in a prospective cohort of COPD patients from 1994 to 2014. All-cause mortality was compared between patients who were colonized during their follow-up period (PA+) and those who remained free of colonization (PA−); Cox proportional hazards models were used. Exacerbation and hospitalization rates were evaluated by 2-rate χ 2 and segmented regression analysis for 12 months before and 24 months after PA isolation.

Results
Pseudomonas aeruginosa was isolated from sputum in 73 of 181 (40%) patients. Increased mortality was seen with PA isolation: 56 of 73 (77%) PA+ patients died compared with 73 of 108 (68%) PA− patients (P = .004). In adjusted models, PA+ patients had a 47% higher risk of mortality (adjusted hazard ratio = 1.47; 95% confidence interval, 1.03–2.11; P = .04). Exacerbation rates were higher for the PA+ group during preisolation (15.4 vs 9.0 per 100 person-months, P &lt; .001) and postisolation periods (15.7 vs 7.5, P &lt; .001). Hospitalization rates were higher during the postisolation period among PA+ patients (6.25 vs 2.44, P &lt; .001).

Conclusions
Tracheobronchial colonization by PA in COPD outpatients was associated with higher morbidity and mortality. This suggests that PA likely contributes to adverse clinical outcomes rather than just a marker of worsening disease.
The Complex Interplay of Pain, Depression, and Anxiety Symptoms in Patients With Chronic Pain
Authors: Gómez Penedo Juan M. , Rubel Julian A. , Blättler Larissa , Schmidt Stefanie J. , Stewart Julian , Egloff Niklaus , grosse Holtforth Martin 
Published: January 2020

Objective:
This study aimed to analyze the associations among depressive and anxiety and pain symptoms in patients diagnosed with chronic pain.

Materials and Methods:
Four hundred fifty-four inpatients who were consecutively admitted in a multimodal 3-week treatment in a tertiary, psychosomatic university clinic completed 25 items from the Brief Pain Inventory and the Hospital Anxiety and Depression Scale at baseline and after treatment termination. Associations among symptoms were explored by network analyses using the graphical least absolute shrinkage and selection operator to estimate their partial correlations, whereas Extended Bayesian Information Criterion was used to select the best network solution for the data. We explored symptoms’ centrality and expected influence within the network and the minimum spanning tree for the network.

Results:
Besides expected associations within depressive and anxiety and pain symptoms, the estimated network showed several local associations between depressive and pain interference symptoms. The lacks of being cheerful and of laughing are 2 of the depressive symptoms that showed the greatest associations with pain interference and a strong centrality within the network. Sleep problems were associated with both anxiety and depressive symptoms and pain intensity symptoms. Although at posttreatment most of the symptoms showed a significant decrease, the strength of the associations between the symptoms within the network was significantly higher than at baseline.

Discussion:
The results support focusing psychosocial interventions in chronic pain treatment not only on reducing pain, anxiety, and sleep symptoms but also on enhancing positive affect. Future research is needed to replicate these findings using repeated within-person measures designs.
Impact of β-Blockers on Heart Rate and Oxygen Uptake During Exercise and Recovery in Older Patients With Heart Failure With Preserved Ejection Fraction
Authors: Maldonado-Martín Sara , Brubaker Peter H. , Ozemek Cemal , Jayo-Montoya Jon A. , Becton J. Thomas , Kitzman Dalane W. 
Published: January 2020

Purpose:
The study aimed to investigate the differences in oxygen uptake (

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2) and heart rate (HR) (at rest, submaximal exercise, peak exercise, and recovery) in patients with heart failure with preserved ejection fraction (HFpEF) with β-blockers (BB) or without BB treatment (NBB) and to analyze the relationship between HR reserve (HRresv) and peak

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2 (

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2peak) in BB and NBB.

Methods:
A total of 174 HFpEF patients (>65 yr; BB, n = 59; NBB, n = 115) were assessed with a cardiopulmonary exercise test to peak exertion using an incremental protocol. After 5 min of supine rest, HR and

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2 (HRrest,

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2rest) at submaximal exercise (HRsubmax,

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2submax), at peak exercise (HRpeak,

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2peak), at 1 min of passive recovery (HRrec1), HRresv (HRpeak− HRrest), and HR recovery (HRrecov = HRpeak− HRrec1) were evaluated.

Results:
Analysis showed that HRrest (66.0 ± 12.2 vs 69.7 ± 10.6 bpm), HRsubmax (91.7 ± 16.2 vs 98.6 ± 15.2 bpm), and HRrec1 (102.9 ± 18.9 vs 109.4 ± 16.9 bpm) were significantly lower (P ≤ .05) in BB than in NBB, respectively. However, there were no significant differences (P > .05) between the BB and the NBB for HRpeak, HRresv, HRrecov,

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2rest,

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2submax, and

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2peak. A significant relationship was found between HRresv and

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2peak values in both groups (BB, r = 0.52; NBB, r = 0.49, P < .001).

Conclusions:
The nonsignificant differences in HRpeak, HRresv, HRrecov, or

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2 values between BB and NBB HFpEF patients, along with significant correlation between HRresv and

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2peak, suggest that these measures may have equal utility in prognostic and functional assessment as well as clinical applications, including the prescription of exercise, in elderly HFpEF patients.
Intracranial Pressure Monitoring via External Ventricular Drain: Are We Waiting Long Enough Before Recording the Real Value?
Authors: Liu Xiuyun , Griffith Margaret , Jang Hannah J. , Ko Nerissa , Pelter Michele M. , Abba Jacob , Vuong Maximilian , Tran Nate , Bushman Kelly , Hu Xiao 
Published: January 2020

ABSTRACT

BACKGROUND
External ventricular drain (EVD) is a standard approach for both monitoring intracranial pressure (ICP) and draining cerebrospinal fluid (CSF) for patients with subarachnoid hemorrhage. Documenting an accurate ICP value is important to assess the status of the brain, which would require the EVD system to be leveled properly and closed to CSF drainage for an adequate period. It is suggested that a minimum period of 5-minute EVD closure is needed before documenting a true ICP; however, there is no commonly agreed upon standard for documenting ICP. To obtain an insight into how well the intermittent EVD clamping procedure is performed for ICP documentation, we conducted a retrospective analysis of ICP recordings obtained through EVD from 107 patients with subarachnoid hemorrhage.

METHODS
The EVD was kept open for continuous CSF drainage and then intermittently closed for ICP documentation. For each EVD closure, mean ICP, standard deviation of ICP, duration of EVD closure, and time interval between 2 adjacent EVD closures were studied. The total number of EVD closures was calculated for each patient. We developed an algorithm to evaluate whether ICP reached a new equilibrium before the EVD was reopened to drainage. The percentage of EVD closures that reach the equilibrium was calculated.

RESULTS
The 107 patients had 32 755 EVD closures in total, among which 65.9% instances lasted less than 1 minute and only 16.3% of all the EVD closure episodes lasted longer than 5 minutes. The median duration of each EVD closure was 25 seconds (interquartile range, 10.2 seconds to 2.33 minutes). Only 22.9% of the EVD closures reached ICP equilibrium before EVD reopening.

CONCLUSION
A standard guideline and proper training are needed for bedside nurses, and a potential tool that can render ICP trend at a proper scale at bedside would help clinicians correctly document ICP.
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Evaluation and Management for Patients With Very Early‐onset Inflammatory Bowel Disease
Authors: Kelsen Judith R. , Sullivan Kathleen E. , Rabizadeh Shervin , Singh Namita , Snapper Scott , Elkadri Abdul , Grossman Andrew B. 
Published: January 2020

ABSTRACTThe rate of pediatric inflammatory bowel disease (IBD) has been increasing over the last decade and this increase has occurred most rapidly in the youngest children diagnosed <6 years, known as very early‐onset inflammatory bowel disease (VEO‐IBD). These children can present with more extensive and severe disease than older children and adults. The contribution of host genetics in this population is underscored by the young age of onset and the distinct, aggressive phenotype. In fact, monogenic defects, often involving primary immunodeficiency genes, have been identified in children with VEO‐IBD and have led to targeted and life‐saving therapy. This position paper will discuss the phenotype of VEO‐IBD and outline the approach and evaluation for these children and what factors should trigger concern for an underlying immunodeficiency. We will then review the immunological assays and genetic studies that can facilitate the identification of the underlying diagnosis in patients with VEO‐IBD and how this evaluation may lead to directed therapies. The position paper will also aid the pediatric gastroenterologist in recognizing when a patient should be referred to a center specializing in the care of these patients. These guidelines are intended for pediatricians, allied health professionals caring for children, pediatric gastroenterologists, pediatric pathologists, and immunologists.
Systematic Review With Meta‐analysis of the Health‐related Quality of Life in Children With Celiac Disease
Authors: Nikniaz Zeinab , Abbasalizad Farhangi Mahdieh , Nikniaz Leila 
Published: January 2020

ABSTRACTObjectives:The aim of this article is to systematically review and meta‐analyze the published data on the comparison of the health‐related quality of life (HRQOL) in children and adolescents with celiac disease (CD) and healthy children. Moreover, the meta‐analysis was performed to compare the parent proxy‐report and child self‐report of HRQOL.Methods:The databases of PubMed, Embase, Scopus, and Cochrane library were searched from inception to April 2019 to identify observational studies that evaluated the HRQOL in children with CD. Studies comparing the HRQOL in celiac patients and healthy children, and also comparing the parent's proxy‐report and child self‐report of HRQOL were included. Comprehensive meta‐analysis software was used for statistical analysis.Results:Through our systematic search, 26 articles met our predefined inclusion criteria. The result of our meta‐analysis on studies using the PedsQL questionnaire showed that the total score of HRQOL was not significantly different between celiac patients and healthy controls (SMD (95% confidence interval; CI]: −0.11[−0.45 to 0.23], P = 0.52). The result of our meta‐analysis showed that the parents reported the child‘s diet and communication scores lower than that of children. Only 4 out of 11 studies showed a significant correlation between HRQOL and gluten‐free diet (GFD) compliance and 2 of 4 studies showed a significant negative association between HRQOL and age at diagnosis.Conclusions:The results of the present study showed that there was no significant difference between children with CD and healthy controls regarding HRQOL. Moreover, the parental perception of their children's HRQOL was lower than the children's perception.
Longitudinal Changes in Crude Protein and Amino Acids in Human Milk in Chinese Population
Authors: Ren Qiqi , Sun Han , Zhao Mengya , Xu Yingwei , Xie Qinggang , Jiang Shilong , Zhao Xuejun , Zhang Wei 
Published: January 2020

ABSTRACTObjective:More than 20% of the world population live in China, which has made significant achievement in human milk research. Part of the data that were published in Chinese were, however, unavailable to non‐Chinese speakers. There was also no comprehensive overview of crude protein and amino acid levels in human milk in Chinese population. This systematic review aimed to compile the data on human milk crude protein and amino acid levels in Chinese population.Methods:After searching for and screening original research articles in both English and Chinese, 23 published from 1987 to 2019 were identified (18 in Chinese and 5 in English). The data were pooled into 9 defined lactation stages.Results:Crude protein and amino acids (protein bound plus nonprotein bound) concentrations gradually decreased during the first 60 postpartum days and remained relatively static thereafter. The concentrations and dynamic change of crude protein and amino acids were similar to those in other populations. By contrast, the longitudinal changes in free amino acids (nonprotein bound) were less clear due to the limited data available. Several common weaknesses were identified in these studies.Conclusions:Our study represented the most comprehensive overview on crude protein and amino acid concentrations in human milk in Chinese population, and enhanced the knowledge of protein and amino acid intakes and requirements by Chinese infants.
The role of Body Mass Index in high and low velocity trauma causing knee injury associated to popliteal artery lesions
Authors: Marchetti A Ascoli , Naldi V , Potenza V , Oddi F.M. , Maio F. Di , Citoni G. , Farsetti P , Ippoliti A. 
Published: January 2020

AbstractBackgroundOsteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of BMI on arterial trauma damage and outcome.MethodsData were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years.ResultsThe lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%) revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities.ConclusionsRevascularization success is not associated with high- or low-velocity traumas. Furthermore, unlike high-velocity traumas, low-velocity traumas are associated with a body mass index >35kg/m2.
Multiplex generation, tracking, and functional screening of substitution mutants using a CRISPR/retron system
Authors: Lim Hyeonseob , Jun Soyeong , Park Minjeong , Lim Junghak , Jeong Jaehwan , Lee Ji Hyun , Bang Duhee 
Published: January 2020

ABSTRACTWe developed a clustered regularly interspaced short palindromic repeats (CRISPR)/retron system for multiplexed generation of substitution mutations by co-utilization of a retron system that continuously expresses donor DNA and a CRISPR/Cas9 cassette that induces cleavage at target genomic loci. Our system efficiently introduces substitution mutation in theEscherichia coligenome in a high-throughput manner. These substitution mutations can be tracked by analysis of retron plasmid sequences without laborious amplification of individual edited loci. We demonstrated that our CRISPR/retron system can introduce thousands of mutations in a single experiment and be used for screening phenotypes related to chemical responses or fitness changes. We expect that our system could facilitate genome-scale substitution screenings.
Reduction of Elevated Proton Leak Rejuvenates Mitochondria in the Aged Cardiomyocyte
Authors: Zhang Huiliang , Alder Nathan N. , Wang Wang , Szeto Hazel , Marcinek David J. , Rabinovitch Peter S. 
Published: January 2020

AbstractAging-associated diseases, including cardiac dysfunction, are increasingly common in the population. However, the mechanisms of physiologic aging in general, and cardiac aging in particular, remain poorly understood. Age-related heart impairment, especially diastolic dysfunction in HFpEF is lacking a clinically effective treatment. Using the model of naturally aging mice and rats, we show direct evidence of increased proton leak in the aged heart mitochondria. Moreover, we identified ANT1 as mediating the increased proton permeability of old cardiomyocytes. Most importantly, the tetra-peptide drug SS-31 prevents age-related excess proton entry, decreases the mitochondrial flash activity and mitochondrial permeability transition pore opening, rejuvenates mitochondrial function by direct association with ANT1 and the mitochondrial ATP synthasome, and leads to substantial reversal of diastolic dysfunction. Our results uncover the excessive proton leak as a novel mechanism of age-related cardiac dysfunction and elucidate how SS-31 is able to reverse this clinically important complication of cardiac aging.