bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With Single and Recurrent Bacteremia in Childhood Brucellosis
Authors: Ben-Shimol Shalom , Farahvar Salar , Fruchtman Yariv , Justman Naphtali 
Published: December 2019

Abstract

Background
Data regarding risk factors of bacteremic brucellosis, and specifically recurrent bacteremia, are scarce. We assessed patients with childhood brucellosis, differentiating between those having culture-negative, single-bacteremic, and recurrent-bacteremic episodes.

Methods
The medical files of pediatric brucellosis patients, from 2005 through 2014, were reviewed retrospectively. Univariate and multivariate analyses were performed to compare demographic and clinical characteristics of culture-negative, single-bacteremic, and recurrent-bacteremic (≥30 days between positive cultures) episodes.

Results
Of all 436 brucellosis cases, 22% were culture-negative, 72% were single-bacteremic, and 6% were recurrent-bacteremic. In a univariate analysis, single-bacteremic episodes were associated with fever (90% vs 65% and 40% in culture-negative and recurrent bacteremia, respectively) and elevated glutamic oxaloacetic transaminase (GOT) levels. Recurrent-bacteremic episodes were associated with anemia (26% vs 14% and 9% in single bacteremia and culture negative, respectively), elevated GOT, low immunoglobulin M (IgM) titers (56% vs 89% and 99%, respectively), and lower levels of adequate treatment (74% vs 94% and 86%, respectively). In multivariate analyses, single bacteremia was associated with fever (odds ratio [OR], 3.595, compared with culture negative), while recurrent bacteremia was inversely associated with IgM titers ≥1:160 (OR, 0.022 and 0.226 compared with culture negative and single bacteremia, respectively) and fever (OR, 0.108 compared with single bacteremia).

Conclusions
Brucellosis episodes are commonly complicated with bacteremia. Single-bacteremic episodes were associated with high-grade fever and elevated liver enzymes, possibly indicating high bacterial virulence. Recurrent-bacteremic episodes were associated with poor treatment at initial diagnosis, along with low rates of fever, low IgM titers, and high anemia rates, possibly indicating impaired host response. Physicians should consider treatment modifications for suspected recurrent-bacteremic brucellosis, including monitoring treatment adherence, and possibly administering prolonged treatment.
Human Genomic Diversity Where the Mediterranean Joins the Atlantic
Authors: Hernández Candela L , Pita Guillermo , Cavadas Bruno , López Saioa , Sánchez-Martínez Luis J , Dugoujon Jean-Michel , Novelletto Andrea , Cuesta Pedro , Pereira Luisa , Calderón Rosario 
Published: December 2019

Abstract
Throughout the past few years, a lively debate emerged about the timing and magnitude of the human migrations between the Iberian Peninsula and the Maghreb. Several pieces of evidence, including archaeological, anthropological, historical, and genetic data, have pointed to a complex and intermingled evolutionary history in the western Mediterranean area. To study to what extent connections across the Strait of Gibraltar and surrounding areas have shaped the present-day genomic diversity of its populations, we have performed a screening of 2.5 million single-nucleotide polymorphisms in 142 samples from southern Spain, southern Portugal, and Morocco. We built comprehensive data sets of the studied area and we implemented multistep bioinformatic approaches to assess population structure, demographic histories, and admixture dynamics. Both local and global ancestry inference showed an internal substructure in the Iberian Peninsula, mainly linked to a differential African ancestry. Western Iberia, from southern Portugal to Galicia, constituted an independent cluster within Iberia characterized by an enriched African genomic input. Migration time modeling showed recent historic dates for the admixture events occurring both in Iberia and in the North of Africa. However, an integrative vision of both paleogenomic and modern DNA data allowed us to detect chronological transitions and population turnovers that could be the result of transcontinental migrations dating back from Neolithic times. The present contribution aimed to fill the gaps in the modern human genomic record of a key geographic area, where the Mediterranean and the Atlantic come together.
Evolution of a Novel and Adaptive Floral Scent in Wild Tobacco
Authors: Guo Han , Lackus Nathalie D , Köllner Tobias G , Li Ran , Bing Julia , Wang Yangzi , Baldwin Ian T , Xu Shuqing 
Published: December 2019

Abstract
Many plants emit diverse floral scents that mediate plant–environment interactions and attain reproductive success. However, how plants evolve novel and adaptive biosynthetic pathways for floral volatiles remains unclear. Here, we show that in the wild tobacco, Nicotiana attenuata, a dominant species-specific floral volatile (benzyl acetone, BA) that attracts pollinators and deters florivore is synthesized by phenylalanine ammonia-lyase 4 (NaPAL4), isoflavone reductase 3 (NaIFR3), and chalcone synthase 3 (NaCHAL3). Transient expression of NaFIR3 alone in N. attenuata leaves is sufficient and necessary for ectopic foliar BA emissions, and coexpressing NaIFR3 with NaPAL4 and NaCHAL3 increased the BA emission levels. Independent changes in transcription of NaPAL4 and NaCHAL3 contributed to intraspecific variations of floral BA emission. However, among species, the gain of expression of NaIFR3 resulted in the biosynthesis of BA, which was only found in N. attenuata. This study suggests that novel metabolic pathways associated with adaptation can arise via reconfigurations of gene expression.
Staphylococcus aureus bloodstream infection in patients with prosthetic joint included in the prospective VIRSTA cohort study: frequency and time of occurrence of periprosthetic joint infection
Authors: Dufour Sébastien , Piroth Lionel , Chirouze Catherine , Tattevin Pierre , Becker Agathe , Braquet Pierre , Ferry Tristan , Duval Xavier , Le Moing Vincent ,   VIRSTA/AEPEI Study Group
Published: December 2019

Abstract
Among 143 patients of the VIRSTA cohort study having Staphylococcus aureus bacteremia and an arthroplasty implanted for more than a year, S. aureus periprosthetic joint infection was observed in 19%. Signs of infection (pain and swelling) were always present, in median 1 day (extremes: 0- 21) after onset of bacteremia.
Mandatory Police Training: The Epitome of Dissatisfaction and Demotivation?
Authors: Honess Richard 
Published: December 2019

Abstract
This article reports on a piece of survey research completed by 809 police officers of a Federated Rank in England and Wales. The survey examined the attitudes of the officers with regards to the provision of ongoing training within the police service and their motivation to undertake it, with a particular emphasis on training delivered by e-learning on the National Centre for Applied Learning Technologies platform. The results are discussed through the theoretical framework of andragogy (adult education theory) and self-determination theory with recommendations for improvement made based on these results.
Police Reform in a Post-Conflict Context: The Case of Solomon Islands
Authors: Dinnen Sinclair , Watson Danielle 
Published: December 2019

Abstract
Police reform in much of the developing world reflects a preoccupation with either shifts away from paramilitaristic policing models or restoration of law and order in post-conflict societies. For many Pacific Island Countries (PICs), dialogue on reform reflects the prioritization of internal organizational restructuring and capacity building, with minimal emphasis on responding to ever-changing stakeholder demands. What is also common is for police reform efforts to closely align with prioritized focal areas of donor countries or powerful neighbours in developed countries with different contextual realities. Here we discuss police reform efforts in a PIC that has been the recipient of a major regional post-conflict state-building intervention and highlight the complexities specific to piecing together the police reform architecture. We also make reference to Solomon Islands to support our argument that problematic police reform can be largely attributed to focal imbalances between internal and external transformation agendas. The article concludes with a summary of the constraints associated with police reform in post-conflict contexts and recommendations for navigating the reform process.
Is modelling complexity always needed? Insights from modelling PrEP introduction in South Africa
Authors: Grant Hannah , Foss Anna M , Watts Charlotte , Medley Graham F , Mukandavire Zindoga 
Published: December 2019

AbstractBackgroundMathematical models can be powerful policymaking tools. Simple, static models are user-friendly for policymakers. More complex, dynamic models account for time-dependent changes but are complicated to understand and produce. Under which conditions are static models adequate? We compare static and dynamic model predictions of whether behavioural disinhibition could undermine the impact of HIV pre-exposure prophylaxis (PrEP) provision to female sex workers in South Africa.MethodsA static model of HIV risk was developed and adapted into a dynamic model. Both models were used to estimate the possible reduction in condom use, following PrEP introduction, without increasing HIV risk. The results were compared over a 20-year time horizon, in two contexts: at epidemic equilibrium and during an increasing epidemic.ResultsOver time horizons of up to 5 years, the models are consistent. Over longer timeframes, the static model overstates the tolerated reduction in condom use where initial condom use is reasonably high ($\ge$50%) and/or PrEP effectiveness is low ($\le$45%), especially during an increasing epidemic.ConclusionsStatic models can provide useful deductions to guide policymaking around the introduction of a new HIV intervention over short–medium time horizons of up to 5 years. Over longer timeframes, static models may not sufficiently emphasise situations of programmatic importance, especially where underlying epidemics are still increasing.
The dilemmas and uncertainties in assessing the societal impact of research
Authors: Lauronen Juha-Pekka 
Published: December 2019

Abstract
In the 2000s, many European Union countries have established research impact assessment practices as part of the scrutiny of the third mission of universities. The Finnish research evaluation system has widely adopted a societal impact criterion. In this study, the question is what guiding principles does impact assessment rely on. This point of view is based on the experiences and opinions of experts interviewed for the study. Four implicit principles of impact assessment which guide assessment goals and practical implementations were found. The guiding principles have several social and methodological dilemmas due to liminal interpretations between social interests and academic endeavor. This study recommends that the evaluation scholars should consider the actual social purpose vis-à-vis consistent methodological approaches to assessment before applying ‘all-round’ solutions to scholarly fields.
Epigenetic silencing of microRNA‐874‐3p implicates in erectile dysfunction in diabetic rats by activating the Nupr1/Chop‐mediated pathway
Authors: Huo Wei , Li Hongyan , Zhang Yun , Li Hai 
Published: December 2019

AbstractDiabetes is a global medical problem that causes many deaths every year. Complications caused by diabetes are serious and affect patients’ quality of life. Diabetes mellitus erectile dysfunction (DMED) affects more than half of male diabetes patients. In this study, we determined the role of microRNA‐874‐3p (miR‐874‐3p) and nuclear protein‐1 (Nupr1) in streptozocin‐induced DMED rats. Control rats received equal amount of vehicle. These rats were also injected with lentiviral vector or agomir to silence or overexpress miR‐874‐3p or Nupr1. Apomorphine (100 μg/kg, s.c.) was used to induce erection and time of erection was recorded. Intracavernosal and mean arterial pressure ratio (ICP/MAP) were also recorded. O2− level and concentration of thiobarbituric acid reactive substances (TBARs) were detected using lucigenin‐derived chemiluminescence method and Colorimetry. Rat cavernosum tissues were collected for subsequent experiments. Cavernosum smooth muscle cells (CSMCs) were also used for in vitro experiments. Nupr1 was found highly expressed (by RT‐qPCR and Western blot analysis) in cavernosum tissues from DMED rats. Nupr1 silencing improved the ICP/MAP ratio and erection time. Nupr1 silencing also reduced CSMC apoptosis (by TUNEL assay) as well as decreased O2− level and TBAR concentration. Nupr1 was targeted and inhibited by miR‐874‐3p (by luciferase activity and RNA immunoprecipitation assays), which was downregulated in DMED. miR‐874‐3p downregulation was due to increased methylation at the promoter region (methylation‐specific PCR). miR‐874‐3p overexpression improved erection time and reduced apoptosis. In summary, miR‐874‐3p was downregulated which led to increased apoptosis and erectile dysfunction in DMED rats, through inhibition of Nupr1‐mediated pathway. This study may also provide a new therapeutic direction for the treatment of DMED.
Promoting Cultural Humility in Nursing Education Through the Use of Ground Rules
Authors: Smith Ariel , Foronda Cynthia 
Published: December 2019

Abstract
The National League for Nursing advocates for improved efforts related to diversity and inclusion in nursing education. By incorporating cultural humility into teaching and learning processes, faculty may be able to reduce bias and promote the inclusive learning environment necessary to retain diverse nursing students. This article emphasizes the importance of cultural humility in nursing education and presents novel ground rules, based on the literature, for implementation within the classroom to foster an academic environment suitable for students from all backgrounds.
Laparoscopic Compared With Open Resection for Colorectal Cancer and Long-term Incidence of Adhesional Intestinal Obstruction and Incisional Hernia: A Systematic Review and Meta-analysis
Authors: Udayasiri Dilshan K. , Skandarajah Anita , Hayes Ian P. 
Published: December 2019

BACKGROUND:
Incisional hernia and adhesional intestinal obstruction are important complications of laparoscopic and open resection for colorectal cancer. This is the largest systematic review of comparative studies on this topic.

OBJECTIVE:
This study aimed to investigate whether laparoscopic surgery decreases the incidence of incisional hernia and adhesional intestinal obstruction compared to open surgery for colorectal cancer.

DATA SOURCES:
Online databases PubMed, EMBASE, and the Cochrane Library were searched. Abstracts from the annual meetings of the American Society of Colon and Rectal Surgeons and the European Society of Coloproctology were performed to cover gray literature.

STUDY SELECTION:
We included both randomized and nonrandomized comparative studies.

INTERVENTIONS:
Laparoscopic resection was compared to open resection for patients with colorectal cancer.

MAIN OUTCOMES MEASURES:
The primary outcomes measured were incisional hernia and adhesional intestinal obstruction.

RESULTS:
Fifteen studies met inclusion criteria (6 randomized comparative studies/9 nonrandomized comparative studies); 84,172 patients. Meta-analysis showed decreased odds of developing incisional hernia in the laparoscopic cohort (OR, 0.79; 95% CI, 0.66–0.95; p = 0.01) but no difference in requirement for surgery (OR, 1.07; 95% CI, 0.64–1.79; p = 0.79). Similarly, there were decreased odds of developing adhesional intestinal obstruction in the laparoscopic cohort (OR, 0.81; 95% CI, 0.72–0.92, p = 0.001), but no difference in requirement for surgery (OR, 0.84; 95% CI, 0.53–1.35; p = 0.48).

LIMITATIONS:
Incisional hernia and adhesional intestinal obstruction were poorly defined in many studies.

CONCLUSION:
Laparoscopic surgery is associated with decreased odds of incisional hernias and adhesional intestinal obstructions compared with open surgery for colorectal cancer.
Combination therapy
Authors: Yuan-Dong Sun , Hao Zhang , Hui-Rong Xu , Jing-Zhou Liu , Hui-Yong Wu , Jian-Jun Han , Yu Jin-Ming 
Published: December 2019

AbstractBackground:This study systematically reviews the data for transcatheter arterial chemoembolization (TACE) alone or combined TACE and cryoablation therapy of hepatocellular carcinoma, aiming to provide clinical choice references for treatment of cancer.Methods:Electronic databases (PubMed, EMBASE, China National Knowledge Infrastructure, and Google Scholar) were systematically searched to include relevant studies published in English and Chinese between Jan 1, 2000, to July 31, 2017. The analysis was conducted in RevMan 5.3 based on random effects models.Results:Nineteen trials (n = 1427) were included. Combined TACE and cryoablation therapy had higher survival rate (1-year survival [RR 1.37; 95%-CI 1.26,1.49], 2-year survival [RR 1.50; 95%-CI 1.25,1.79], 3-year survival [RR 1.67; 95%-CI 1.16,2.40]), complete necrosis [RR 2.53; 95%-CI 2.07,3.10] and tumor control [RR 1.57; 95%-CI 1.40,1.75], which is more favorable for long-term efficacy of non-surgical hepatocellular carcinoma. Tumor recurrence of control group was above combination therapy [RR 0.27; 95%-CI 0.17, 0.43]. Compared with transcatheter arterial chemoembolization, effect of combination therapy occurred mainly in the survival, complete necrosis, tumor control, and recurrence. Taking combination therapy was generally more effective than taking TACE only.Conclusion:Compared with TACE only used to treat cancer, combination therapy had the best effect profile in general, and it had better survival in HCC when taking an integrated approach. The prognosis of treatments based on combination therapy is modulated by cryoablation.
Stiff limb syndrome with lower limb myoclonus
Authors: Zhang Chang-Guo , Li Lan-Lan , Feng Yao-Yao , Chen Jing 
Published: December 2019

Abstract

Rationale:
stiff limb syndrome (SLS) is a variant of stiff-man syndrome, primarily affecting a specific limb. Its diagnosis has always been challenging due to the lack of a specific confirmation test. We present a rare case of a patient with lower limb myoclonus and rigidity.

Patient concerns:
A 53-year-old male presented with a sudden onset of progressive left lower extremity myoclonus and muscle rigidity for 3 days. He rapidly showed signs of right lower limb involvement with severe joint stiffness and inability to walk.

Diagnosis:
The symptoms nature, physical examination, careful elimination of differential diagnosis suggested a diagnosis of stiff limb syndrome.

Interventions:
Intravenous infusion of gamma globulin 0.4 mg/kg coupled with baclofen and clonazepam were given after admission. He also received an injection of botulinum toxin A to relieve his muscle stiffness.

Outcomes:
The patients’ condition improved after the initial treatment with complete disappearance of muscle twitching. Further improvements were seen later on after the local administration of botulinum toxin A.

Lessons:
Stiff limb syndrome shares the same complex symptoms with many other conditions. Its diagnosis relies heavily on clinical presentations and on ruling out other conditions. However, unusual symptoms such as myoclonus can occur in few cases and together with the rarity of the condition, the prevalence of misdiagnosis is high. Therefore, being aware and recognizing the signs and symptoms is crucial for proper management. Additionally, EMG is a very important test if the present condition is suspected. However, a negative EMG result or a negative anti-glutamic acid decarboxylase antibody test should not exclude SLS diagnosis.
Renal actinomycosis with retroperitoneal abscess in a cirrhotic patient
Authors: Liao Wei-Kai , Huang Shih-Che , Hu Sung-Yuan , Tsai Che-An , Wang Ren-Ching 
Published: December 2019

Abstract

Rationale:
Renal actinomycosis is a rare clinical infection, subacute to chronic presentation caused by the Actinomyces bacteria. Actinomyces israelii is diagnosed in the overpowering majority of reported cases. Abdominopelvic manifestation forms 10% to 20% of all actinomycosis, and may be misdiagnosed as either a malignancy or chronic inflammation due to the lower correct preoperative diagnostic rate (<10%).

Patient concerns:
A 38-year-old man with alcoholic liver cirrhosis experienced right flank pain, abdominal pain, and fever for 3 days. Leukocytosis, acute kidney injury, and impaired liver function were found. A computed tomographic scan demonstrated multiple renal cystic lesions, along with fluid accumulation at the right subphrenic and retroperitoneal spaces.

Diagnoses:
Renal actinomycosis was confirmed via cultures of both the abscess and nephrectomy specimen which grew A israelii and the pathological findings of multiple renal abscesses of actinomycosis with the characteristics of sulfur granules.

Interventions:
A nephrectomy was performed for an inadequate percutaneous drainage of renal abscess.

Outcomes:
A full course of antibiotics with intravenous penicillin G (3 million units every 4 hours) was prescribed for 2 weeks, followed by oral penicillin V given at a dose of 2 grams per day for 6 months at our out-patient facility.

Lessons:
A precise diagnosis of primary renal actinomycosis depends on any histopathological findings and/or cultures of specimens. A high dose of intravenous penicillin G is the first choice, followed by oral penicillin V, with the duration of each being dependent upon the individual condition.
Prognostic value of site-specific metastases for patients with advanced intrahepatic cholangiocarcinoma
Authors: Cheng Rui , Du Qiang , Ye Jingmin , Wang Bi , Chen Yanling 
Published: December 2019

Abstract
Intrahepatic cholangiocarcinoma (ICC) is an aggressive malignancy with poor prognosis and increasing incidence. Due to its asymptomatic manifestation, ICC often progresses to a metastatic stage on diagnosis. The current study attempted to evaluate the prognostic value of site-specific metastases in patients with metastatic ICC.
Surveillance, Epidemiology, and End Results (SEER) database (2010–2015) was queried and metastatic ICC patients were classified according to the metastatic sites. Kaplan–Meier analysis was used for survival comparisons and multivariate analysis was performed to elicit characteristics independently associated with survival.
A total of 1567 patients were identified and included in the analysis. Compared with those with multiple-site metastases, patients with single-site metastases had better prognostic outcomes. Among the single-site metastases, regional lymph nodes metastases had the best prognosis; liver metastases had better prognostic outcomes than bone metastases; no significant difference was found between lung and bone or liver metastasis. Local treatment of primary tumor might benefit patients with isolated lymph nodes metastases and few exceptional cases of patients with liver metastases.
Different metastatic sites have distinct impact on the survival outcomes of patients with advanced ICC and highly selected subset of them might benefit from the local treatment of the primary tumor.