bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of gram negative bacteria causing community acquired pneumonia among adults in Mwanza City, Tanzania
Authors: Kishimbo Peter , Sogone Nyambura Moremi , Kalokola Fredrick , Mshana Stephen E. 
Published: August 2020

Abstract
Background
Community acquired pneumonia (CAP) in adults is still a common and serious illness in the sub-Saharan Africa. Identification of the pathogens is crucial in the management of CAP. This study was done to determine the common bacterial pathogens, treatment outcomes and associated factors for microbiological confirmed CAP among adults attending the Bugando Medical Centre and Sekou Toure hospital in the city of Mwanza, Tanzania.

Methods
This was a hospital based cross sectional study involving patients with community acquired pneumonia attending Bugando Medical Centre and Sekou Toure regional Hospital. Demographic and other data were collected using standardized data collection tool. Sputum culture was done followed by identification of the isolates and antibiotics susceptibility testing.

Results
A total of 353 patients were enrolled in the study. Out of 353 sputum samples, 265(75%) were of good quality. Of 353 non-repetitive sputum cultures, 72/353 (20.4, 95% CI: 16.2–24.6) were positive for the bacterial pathogens with five patients having more than one pathogen. Good quality sputa had significantly higher yield of pathogenic bacteria than poor quality sputa (26.1% vs.3.4%, P = 0.001). The majority 64 (83.1%) of the isolates were gram negative bacteria. Common bacteria isolated were Klebsiella pneumoniae 23/77(29.9%), Streptococcus pyogenes 10/77 (13.0%), Pseudomonas aeruginosa 9/77 (11.7%) and Escherichia coli 7/77 (9.1%). Of 23 K. pneumoniae isolates, 20/23 (87.0%) were resistant to ceftriaxone. Resistance to ceftriaxone was found to be associated with prolongation of CAP symptoms (p = 0.009).

Conclusion
Gram negative bacteria resistant to ampicillin, amoxicillin/clavulanic acid and ceftriaxone were most frequently isolated bacteria among adults’ patients with CAP attending BMC and Sekou Toure hospital. Routine sputum culture should be performed to guide appropriate treatment of CAP among adults in developing countries.
The role of VEGF and BMP-2 in stimulation of bone healing with using hybrid bio-composite scaffolds coated implants in animal model
Authors: Rady Asmaa A. M. , Hamdy Soha M. , Abdel-Hamid Mohamed A. , Hegazy Marwa G. A. , Fathy Shadia A. , Mostafa Amany A. 
Published: August 2020

Abstract
Background
Osteogenesis and angiogenesis are two closely correlated processes during bone growth, development, remodeling, and repair. Vascular endothelial growth factor (VEGF) is an essential mediator during the process of angiogenesis. The bone morphogenetic protein (BMP-2) family of growth factors plays critical roles in bone formation. VEGF has the potential to enhance BMPs-induced bone formation.

Purpose
This study attempted to assess VEGF and BMP-2 reflecting the effect of hybrid bio-composite scaffold on bone healing in dogs and evaluate the quality of the healing process radiologically.

Methods
This study was conducted on 12 adult mongrel dogs. All dogs were divided into four equal groups (n = 3 each): chitosan non-medicated (CH) (NM), chitosan medicated (CH) (M), chitosan bioglass non-medicated (CH.BG) (NM), and Chitosan Bioglass Medicated (CH.BG) (M). VEGF and BMP-2 were evaluated during fracture healing.

Results
Results have showed a non-significant decrease in serum VEGF activity in the (CH.BG) (M) group when compared to other groups during 2, 3 weeks, followed by gradual decrease, then increase at 12 weeks of interval period. There was highly significant increase from pre-surgery to 12 weeks in serum BMP-2 levels in the (CH.BG) (M) group when compared to other groups.

Conclusion
Biochemical parameters along with clinical and radiographical provide sound knowledge on the degree of bone healing with the use of chitosan bio-glass medicated by risedronate sodium drug. The statistical analysis will include the Fisher exact test and T test with significance level P < 0.05 (AU).

Graphical abstract
Molecular Classification of the PORTEC-3 Trial for High-Risk Endometrial Cancer: Impact on Prognosis and Benefit From Adjuvant Therapy
Authors: León-Castillo Alicia , de Boer Stephanie M. , Powell Melanie E. , Mileshkin Linda R. , Mackay Helen J. , Leary Alexandra , Nijman Hans W. , Singh Naveena , Pollock Pamela M. , Bessette Paul , Fyles Anthony , Haie-Meder Christine , Smit Vincent T. H. B. M. , Edmondson Richard J. , Putter Hein , Kitchener Henry C. , Crosbie Emma J. , de Bruyn Marco , Nout Remi A. , Horeweg Nanda , Creutzberg Carien L. , Bosse Tjalling ,   on behalf of the TransPORTEC consortium
Published: August 2020

PURPOSE The randomized Adjuvant Chemoradiotherapy Versus Radiotherapy Alone in Women With High-Risk Endometrial Cancer (PORTEC-3) trial investigated the benefit of combined adjuvant chemotherapy and radiotherapy (CTRT) versus radiotherapy alone (RT) for women with high-risk endometrial cancer (EC). Because The Cancer Genome Atlas defined an EC molecular classification with strong prognostic value, we investigated prognosis and impact of chemotherapy for each molecular subgroup using tissue samples from PORTEC-3 trial participants. METHODS Paraffin-embedded tissues of 423 consenting patients were collected. Immunohistochemistry for p53 and mismatch repair (MMR) proteins, and DNA sequencing for POLE exonuclease domain were done to classify tumors as p53 abnormal (p53abn), POLE-ultramutated ( POLEmut), MMR-deficient (MMRd), or no specific molecular profile (NSMP). The primary end point was recurrence-free survival (RFS). Kaplan-Meier method, log-rank test, and Cox model were used for analysis. RESULTS Molecular analysis was successful in 410 high-risk EC (97%), identifying the 4 subgroups: p53abn EC (n = 93; 23%), POLEmut (n = 51; 12%), MMRd (n = 137; 33%), and NSMP (n = 129; 32%). Five-year RFS was 48% for patients with p53abn EC, 98% for POLEmut EC, 72% for MMRd EC, and 74% for NSMP EC ( P < .001). The 5-year RFS with CTRT versus RT for p53abn EC was 59% versus 36% ( P = .019); 100% versus 97% for patients with POLEmut EC ( P = .637); 68% versus 76% ( P = .428) for MMRd EC; and 80% versus 68% ( P = .243) for NSMP EC. CONCLUSION Molecular classification has strong prognostic value in high-risk EC, with significantly improved RFS with adjuvant CTRT for p53abn tumors, regardless of histologic type. Patients with POLEmut EC had an excellent RFS in both trial arms. EC molecular classification should be incorporated in the risk stratification of these patients as well as in future trials to target specific subgroups of patients.
Conducting Goals-of-Care Discussions Takes Less Time Than Imagined
Authors: Pintova Sofya , Leibrandt Ryan , Smith Cardinale B. , Adelson Kerin B. , Gonsky Jason , Egorova Natalia , Franco Rebeca , Bickell Nina A. 
Published: August 2020

PURPOSE: To describe the length of encounter during visits where goals-of-care (GoC) discussions were expected to take place. METHODS: Oncologists from community, academic, municipal, and rural hospitals were randomly assigned to receive a coaching model of communication skills to facilitate GoC discussions with patients with newly diagnosed advanced solid-tumor cancer with a prognosis of < 2 years. Patients were surveyed after the first restaging visit regarding the quality of the GoC discussion on a scale of 0-10 (0 = worst; 10 = best), with ≥ 8 indicating a high-quality GoC discussion. Visits were audiotaped, and total encounter time was measured. RESULTS: The median face-to-face time oncologists spent during a GoC discussion was 15 minutes (range, 10-20 minutes). Among the different hospital types, there was no significant difference in encounter time. There was no difference in the length of the encounter whether a high-quality GoC discussion took place or not (15 v 14 minutes; P = .9). If there was imaging evidence of cancer progression, the median encounter time was 18 minutes compared with 13 minutes for no progression ( P = .03). In a multivariate model, oncologist productivity, patient age, and Medicare coverage affected duration of the encounter. CONCLUSION: Oncologists can complete high-quality GoC discussions in 15 minutes. These data refute the common misperception that discussing such matters with patients with advanced cancer requires significant time.
Changes in Adrenal Androgens and Steroidogenic Enzyme Activities From Ages 2, 4, to 6 Years: A Prospective Cohort Study
Authors: Kim Jae Hyun , Lee Young Ah , Lim Youn-Hee , Lee Kyunghoon , Kim Bung-Nyun , Kim Johanna Inhyang , Hong Yun-Chul , Yang Sei Won , Song Junghan , Shin Choong Ho 
Published: August 2020

Abstract

Context
The levels of adrenal androgens are increased through the action of steroidogenic enzymes with morphological changes in the adrenal zona reticularis.

Objective
We investigated longitudinal changes in androgen levels and steroidogenic enzyme activities during early childhood.

Design and Participants
From a prospective children’s cohort, the Environment and Development of Children cohort, 114 boys and 86 girls with available blood samples from ages 2, 4, and 6 years were included.

Outcome Measurements
Serum concentrations of adrenal androgens using liquid chromatography-tandem mass spectrometry and steroidogenic enzyme activity calculated by the precursor/product ratio.

Results
During ages 2 to 4 years, 17,20-lyase and dehydroepiandrosterone (DHEA) sulfotransferase activities increased (P &lt; 0.01 for both in boys). During ages 4 to 6 years, 17,20-lyase activity persistently increased, but 3β-hydroxysteroid dehydrogenase (HSD) and 17β-HSD activities decreased (P &lt; 0.01 for all). Serum DHEA sulfate (DHEA-S) levels persistently increased from 2, 4, to 6 years, and DHEA, 17-hydroxyprogesterone, and androstenedione levels increased during ages 4 to 6 years (P &lt; 0.01 for all). Serum DHEA-S levels during early childhood were associated with body mass index z-scores (P = 0.001 in only boys).

Conclusion
This study supports in vivo human evidence of increased 17,20-lyase and DHEA sulfotransferase activities and decreased 3β-HSD activity during early childhood.
Sino-European Differences in the Genetic Landscape and Clinical Presentation of Pheochromocytoma and Paraganglioma
Authors: Jiang Jingjing , Zhang Jing , Pang Yingxian , Bechmann Nicole , Li Minghao , Monteagudo Maria , Calsina Bruna , Gimenez-Roqueplo Anne-Paule , Nölting Svenja , Beuschlein Felix , Fassnacht Martin , Deutschbein Timo , Timmers Henri J L M , Åkerström Tobias , Crona Joakim , Quinkler Marcus , Fliedner Stephanie M J , Liu Yujun , Guo Jianming , Li Xiaomu , Guo Wei , Hou Yingyong , Wang Cikui , Zhang Liang , Xiao Qiao , Liu Longfei , Gao Xin , Burnichon Nelly , Robledo Mercedes , Eisenhofer Graeme 
Published: August 2020

Abstract

Context
Pheochromocytomas and paragangliomas (PPGLs) are characterized by distinct genotype-phenotype relationships according to studies largely restricted to Caucasian populations.

Objective
To assess for possible differences in genetic landscapes and genotype-phenotype relationships of PPGLs in Chinese versus European populations.

Design
Cross-sectional study.

Setting
2 tertiary-care centers in China and 9 in Europe.

Participants
Patients with pathologically confirmed diagnosis of PPGL, including 719 Chinese and 919 Europeans.

Main Outcome Measures
Next-generation sequencing performed in tumor specimens with mutations confirmed by Sanger sequencing and tested in peripheral blood if available. Frequencies of mutations were examined according to tumor location and catecholamine biochemical phenotypes.

Results
Among all patients, higher frequencies of HRAS, FGFR1, and EPAS1 mutations were observed in Chinese than Europeans, whereas the reverse was observed for NF1, VHL, RET, and SDHx. Among patients with apparently sporadic PPGLs, the most frequently mutated genes in Chinese were HRAS (16.5% [13.6-19.3] vs 9.8% [7.6-12.1]) and FGFR1 (9.8% [7.6-12.1] vs 2.2% [1.1-3.3]), whereas among Europeans the most frequently mutated genes were NF1 (15.9% [13.2-18.6] vs 6.6% [4.7-8.5]) and SDHx (10.7% [8.4–13.0] vs 4.2% [2.6–5.7]). Among Europeans, almost all paragangliomas lacked appreciable production of epinephrine and identified gene mutations were largely restricted to those leading to stabilization of hypoxia inducible factors. In contrast, among Chinese there was a larger proportion of epinephrine-producing paragangliomas, mostly due to HRAS and FGFR1 mutations.

Conclusions
This study establishes Sino-European differences in the genetic landscape and presentation of PPGLs, including ethnic differences in genotype-phenotype relationships indicating a paradigm shift in our understanding of the biology of these tumors.
Protocol for a mixed-methods exploratory investigation into the role of health information technology for the provision of cancer care in Indonesia
Authors: Espressivo Aufia , Puspitaningtyas Herindita , Hutajulu Susanna H. , Fuad Anis , Allsop Matthew J. 
Published: August 2020

Background: Cancer and its management can incur high costs, high risks and high demand. In Indonesia, there remains gap in the availability of national cancer data despite the establishment of a National Committee for Cancer Control. Multiple pilot projects have been developed by the Ministry of Health to improve the delivery of care, including interventions utilising digital health approaches and integrated referral information systems. However, it is not yet clear to what extent these approaches influence patient management or the experience of cancer patients themselves. This research aims to explore the current role of health information technology (HIT) in the provision of services and treatments for patients with cancer from primary to tertiary healthcare centres in Yogyakarta, Indonesia. Methods: The study will adopt an observational mixed-methods single case study design of health facilities involved in the delivery of cancer services in a sub-national health system. We will collect data through face-to-face interviews with a range of health professionals involved in the delivery of cancer care. Patients will be interviewed to share their views and experiences of the existing cancer referral system and communication with health facilities. Alongside interviews, we will undertake an analysis of routine data from participating health facilities to assess gaps in existing information systems. Data analysis will include framework analysis for qualitative data alongside descriptive analyses of quantitative data. Findings will be used to inform conceptual maps to be presented as part of Theory of Change workshops focused on understanding how the existing cancer referral system works, why and for whom, with a focus on future refinement and intervention development. Conclusion: Our findings will inform critical thinking around the design, implementation, adaptation, and evaluation of existing systems. Through early engagement and participation of key stakeholders and project partners, we intend that findings will have immediate utility.
Evaluation of patient satisfaction with the quality of maternal and child services of health facilities in Ile-Ife, Osun State
Authors: Oyeniran Yemisi Adebola , Adeyeye Olajumoke , Sowunmi Christiana Olanrewaju 
Published: August 2020

Background/AimsAn evaluation of patient satisfaction of the quality of healthcare facilities and services provides feedback to enhance improved service delivery. Patient satisfaction with care has been identified as one of the essential elements of quality care, which can be used to determine the quality of care being rendered in health centres. This study aimed to assess patient satisfaction with maternal and child services in health facilities in Ile-Ife, Osun State, Nigeria.MethodsA quantitative cross-sectional study was carried out in Ile-Ife, Osun State, in all seven secondary health facilities and 45 selected primary healthcare centres. A total of 330 nursing mothers with babies aged 0–1 years old were selected through simple random sampling. A self-developed, structured, pre-tested satisfaction survey based on Donabedian and Linder-Pelz satisfaction model was used to explore nursing mothers' satisfaction with maternal and child healthcare services and the determinants of satisfaction. Data were analysed using descriptive statistics and t-tests at a significance level of 0.05. Ordered logistic regression was used to establish the significance of association between sociodemographic characteristics and satisfaction.ResultsThe majority of clients were satisfied with maternal and child services in primary (76.7%) and secondary (55.1%) healthcare facilities, respectively. There was a significant difference between satisfaction at primary and secondary healthcare centres (P=0.012). The marital status and number of pregnancies of participants were significant determinants of clients' satisfaction with secondary healthcare facilities (P=0.035 and P=0.013, respectively).ConclusionsThere is high patient satisfaction with maternal and child healthcare services in both primary and secondary healthcare facilities in Ile-Ife. The majority of the health facilities have inadequate personnel for maternal and child healthcare services, which is one of the major factors contributing to high maternal and infant morbidity and mortality in Nigeria. However, many of the respondents may not have ever experienced high-quality services. Stakeholders in maternal and child services should improve on areas where poor satisfaction was reported.
<p><strong>A new species of the genus <em>Xylodromus</em> Heer, 1839 (Coleoptera: Staphylinidae: Omaliinae: Omaliini) from Jiangxi, China</strong></p>
Authors: SHAVRIN ALEXEY V. 
Published: August 2020

A new species, Xylodromus schweiki sp. nov. (Staphylinidae: Omaliinae: Omaliini), is described and illustrated based on a male collected in Jiangxi, China. Key words: Coleoptera, Staphylinidae: Omaliinae: Xylodromus, taxonomy, new species, China, Palaearctic Region
Initial angular deformity and its recovery of the proximal tibial metaphyseal fracture according to the cause: Trampoline-related injury versus other injuries
Authors: Bae Kunhyung , Jeon Ji Young , Park Soo-Sung , Park Jinhee , Kang Michael Seungcheol 
Published: August 2020

Purpose This study investigated the initial angular deformity of proximal tibial metaphyseal fracture in children and its recovery during follow-up according to the cause of injury. Methods Prospective data about the patients with a proximal tibial metaphyseal fracture at the age less than six years and available follow-up data at two years post-trauma were retrospectively reviewed. They were grouped into trampoline-related injuries (TRI) and non-TRI groups based on the cause of injury. Proximal tibial valgus and recurvatum angles were measured to assess angular deformity on the coronal and sagittal planes, respectively. Results A total of 47 patients (33 TRI and 14 non-TRI) were included. Initially, the valgus angles were -1.5° in TRI and 1.6° in non-TRI groups (p < 0.001) and the recurvatum angles were 7.8° in TRI and 4.1° in non-TRI groups (p = 0.048). After two-year follow-up, the valgus angles were 0.2° in TRI and 0.9° in non-TRI groups (p = 0.070), and the recurvatum angles were 6.5° in TRI and 2.3° in non-TRI groups (p = 0.001). Conclusion For children with a proximal tibial metaphyseal fracture, the initial coronal deformity was different according to the injury cause (varus in TRI whereas valgus in non-TRI). Although there was a near complete recovery after approximately two years of follow-up in the coronal deformities, the sagittal deformity (genu recurvatum) seems to recover incompletely or tardily, especially for those caused by TRI. Level of Evidence III
The Effect of Business Internships Model and Employment on Enhancing the Independence of Young Adults With Significant Impact From Autism
Authors: Schall Carol , Sima Adam P. , Avellone Lauren , Wehman Paul , McDonough Jennifer , Brown Alecia 
Published: August 2020

Abstract
This article presents findings from a multisite randomized clinical trial measuring the impact of employment on independence in 18 to 22 year old youth with significant impact from autism spectrum disorder (ASD). The treatment condition was Project SEARCH plus ASD Supports (PS+ASD) where 73.4% of participants gained competitive integrated employment (CIE) within 1 year of graduation compared to control participants who acquired CIE at 17%. Within group analysis revealed that PS+ASD participants demonstrated improvement in all domains whereas control group participants demonstrated improvement in one domain only. Between groups analysis indicated that participants in PS+ASD demonstrated nominally better rates of improvement than control group participants at graduation and 1-year follow-up. Results provide evidence that employment provides therapeutic benefits to individuals with ASD.
Asymmetric core-guided polarization-dependent plasmonic biosensor
Authors: Haider Firoz , Mashrafi Md. , Haider Rakib , Ahmmed Aoni Rifat , Ahmed Rajib 
Published: August 2020

A modified solid-core photonic crystal fiber (PCF)-based plasmonic
sensor is proposed where light propagation through the PCF is
controlled by scaling down of air holes. The modified core facilitates
the easy excitation of the plasmonic surface, resulting in improved
sensor performance. The chemically stable gold is externally coated on
the PCF surface, which helps to establish surface plasmon resonance
phenomena. The response of the sensor is analyzed based on the
numerical method, and the design parameters are optimized to enhance
the sensing performance. The asymmetric fiber-core structure provides
the polarization controllability and significantly suppresses the

y

-polarized response to achieve a
dominant

x

-polarized response and additional
functionalities. The sensor exhibits a maximum wavelength sensitivity
of 11,000 nm/RIU (refractive index unit) and sensing resolution of

9.09

×

10

−
6

RIU in the

x

-polarized mode. Also, the sensor
exhibits maximum amplitude sensitivity of

631

R
I
U

−
1

, and a good figure of merit is

157

R
I
U

−
1

. Furthermore, the sensor can detect
the unknown analytes’ refractive index (RI) in the sensing analyte RI
range of 1.33 to 1.40, which will lead to finding the potential
applications in biomolecules, organic chemicals, and environment
monitoring.
Third-order derivative matrix of a skew ray with respect to the source ray vector at a flat boundary
Authors: Lin Psang Dain 
Published: August 2020

Our group recently showed that the Seidel primary ray aberration coefficients of an axis-symmetrical system can be accurately determined using the third-order Taylor series expansion of a skew ray

R
¯

m

on an image plane. This finding inspires us to determine the third-order derivative matrix of

R
¯

m

with respect to the vector

X
¯

0

of the source ray, i.e.,

∂

R
¯

m

3

/

∂

X
¯

0
3

, under reflection/refraction at a flat boundary. Finite difference methods using the second-order derivative matrix,

∂

R
¯

m

2

/

∂

X
¯

0
2

, require multiple rays to compute

∂

R
¯

m

3

/

∂

X
¯

0
3

and suffer from cumulative rounding and truncation errors. By contrast, the present method is based on differential geometry. Thus, it provides a greater inherent accuracy and requires the tracing of just one ray. The proposed method facilitates the analytical investigation of the primary aberrations of an axis-symmetrical system and can be easily extended to determine the higher-order derivative matrices required to explore higher-order ray aberration coefficients.