bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Surgical Site Infection in Spinal Surgery and Interventions: A Retrospective Study
Authors: Saruwatari Rikiya , Yamada Kei , Sato Kimiaki , Yokosuka Kimiaki , Yoshida Tatsuhiro , Nakae Ichiro , Shimazaki Takahiro , Morito Shinji , Shiba Naoto 
Published: October 2020

Abstract
Background: Surgical site infection following spinal surgery causes prolonged delay in recovery after surgery, increases cost, and sometimes leads to additional surgical procedures. We investigated risk factors for the occurrence of surgical site infection events in terms of patient-related, surgery-related, and postoperative factors.Methods: This retrospective study included 1000 patients who underwent spinal surgery in our hospital between April 2016 and March 2019. Before September 2015, we observed multiple occurrences of spinal surgical site infections caused by methicillin-resistant Staphylococcus aureus, and we have since been culturing swabs taken from inside and outside the wound before postoperative wound closure as a form of surgical site infection surveillance.Results: The patient-related factors of dementia, length of preoperative hospital stay (≥14 days), diagnosis at the time of surgery (traumatic injury or deformity), surgery-related factor of multilevel surgery (≥9 intervertebral levels), and postoperative factor of time to ambulation (≥7 days) were statistically significant risk factors for spinal surgical site infection. A retrospective study of 392 patients who underwent spinal surgery between June 2009 and August 2011, before surgical site infection surveillance was implemented, showed that the incidence of surgical site infection was 4.59%, although in this study, it had dropped to 2.0%.Conclusion: The introduction of surgical site infection surveillance thus helps reduce the incidence of surgical site infection through measures taken by medical staff to prevent them and to improve associated problems. One risk factor identified in this study that is amenable to intervention is the time to ambulation. As delayed ambulation is a risk factor for postoperative surgical site infection, how medical staff can intervene in postoperative ambulation to further reduce the incidence of surgical site infection is a topic for future research.
Intralymphatic Immunotherapy: A 3-year Randomized, Double-blind Study in 72 Patients With Allergic Rhinitis Due to Birch and Grass
Authors: Ahlbeck Lars , Ahlberg Emelie , Björkander Janne , Aldén Caroline , Papapavlou Georgia , Palmberg Laura , Nyström Ulla , Retsas Pavlos , Nordenfelt Patrik , Togö Totte , Johansen Pål , Rolander Bo , Jenmalm Maria , Nilsson Lennart 
Published: October 2020

Abstract
Background: There is need for a fast, efficient, and safe way to induce tolerance in patients with severe allergic rhinitis.Methods: Patients with severe birch and timothy allergy were randomized and received three doses of 0.1 ml of birch and 5-grass allergen extracts (10,000 SQ units/ml, ALK-Abelló), or birch and placebo or 5-grass and placebo by ultrasound-guided injections into inguinal lymph nodes at monthly intervals. We have no clean placebo group but the pollen seasons are mostly divided by time. Rhinoconjunctivitis Total Symptom Score, Medication Score and Rhinoconjunctivitis Quality of Life Questionnaire were evaluated before treatment and after each birch and grass pollen season during three subsequent years. Circulating proportions of T helper subsets and allergen-induced cytokine and chemokine production were analyzed by flow cytometry and Luminex.Results: The three groups reported fewer symptoms, lower use of medication and improved quality of life during the birch and grass pollen seasons each year after treatment at an almost similar rate independently of treatment. Mild local pain was the most common adverse event. IgE levels to birch decreased, whereas birch-induced IL-10 secretion increased in all three groups. IgG4 levels to birch and timothy and skin prick test reactivity remained mainly unchanged. Conjunctival challenge tests with timothy extract showed a higher threshold for allergen. In all three groups, regulatory T cell frequencies were increased three years after treatment.Conclusion: Intralymphatic immunotherapy against grass and birch pollen allergy was safe, seemed to be effective, and to be associated with bystander immune modulatory responses.Trial registration: EudraCT (2013-004726-28). Registered 14 January 2014https://www.clinicaltrialsregister.eu/ctr-search/search?query=2013-004726-28
Fine Particulate Matter Constituents Associated With Emergency Room Visits for Pediatric Asthma: A Time-Stratified Case–Crossover Study in an Urban Area
Authors: Ho Yu-Ni , Cheng Fu-Jen , Tsai Ming-Ta , Tsai Chih-Min , Chuang Po-Chun , Cheng Chi-Yung 
Published: October 2020

Abstract
Background: Global asthma-related mortality tallies at around 2.5 million annually. Although asthma may be triggered or exacerbated by particulate matter (PM) exposure, studies investigating the relationship of PM and its components with emergency department (ED) visits for pediatric asthma are limited. This study aimed to estimate the impact of short-term exposure to PM constituents on ED visits for pediatric asthma. Methods: We retrospectively evaluated non-trauma patients aged younger than 17 years who visited the ED with a primary diagnosis of asthma. Further, measurements of PM10, PM2.5, and four PM2.5 components (i.e., nitrate (NO3−), sulfate (SO42−), organic carbon (OC), and elemental carbon (EC)) were collected between 2007 and 2010 from southern particulate matter supersites. These included one core station and two satellite stations in Kaohsiung City, Taiwan. A time‐stratified case‐crossover study was conducted to analyze the hazard effect of PM. Results: Overall, 1597 patients were enrolled in our study. In the single-pollutant model, the estimated risk increase for pediatric asthma incidence on lag 3 were 14.7% [95% confidence interval (CI), 3.2–27.4%], 13.5% (95% CI, 3.3–24.6%), 14.8% (95% CI, 2.5–28.6%), and 19.8% (95% CI, 7.6–33.3%) per interquartile range increments in PM2.5, PM10, nitrate, and OC, respectively. In the two-pollutant models, OC remained significant after adjusting for PM2.5, PM10, and nitrate. During subgroup analysis, children were more vulnerable to PM2.5 and OC during cold days (<26°C, interaction p=0.008 and 0.012, respectively). Conclusions: Both PM2.5 concentrations and its chemical constituents OC and nitrate are associated with ED visits for pediatric asthma. Among PM2.5 constituents, OC was most closely related to ED visits for pediatric asthma, and children are more vulnerable to PM2.5 and OC during cold days.
Diagnostic Pitfalls: Intramyocardial Lymphoma Metastasis Mimics Acute Coronary Syndrome in A Diffuse Large B Cell Lymphoma Patient – Case Report
Authors: Prenek Lilla , Csupor Klára , Besztercán Péter , Boros Krisztina , Kardos Erika , Vorobcsuk András , Egyed Miklós , Kellner Ádám , Rajnics Péter , Varga Csaba 
Published: October 2020

Abstract
Background: Cardiac tumors are very uncommon compared to other cardiac diseases. Their clinical symptoms can vary from absent to nonspecific. The most common symptoms are arrhythmias, blood flow obstruction due to valvular dysfunction, shortness of breath, systemic embolization, accumulation of pericardial fluid. Hereby, we describe a very rare case of a diffuse large B cell lymphoma patient who presented with the symptoms and signs of acute coronary syndrome (ACS) but the patient’s complaints were caused by his intramyocardial lymphoma metastasis.Case presentation: 48-year-old diffuse large B cell lymphoma patient was admitted to our emergency department with chest pain, effort dyspnea and fever. The patient had normal blood pressure, blood oxygen saturation, sinus tachycardia, fever, crackles over the left lower lobe, novum incomplete right bundle branch block with Q waves and minor ST alterations, elevated C-reactive protein, high-sensitivity troponin-T and d-dimer levels. Chest X-ray revealed consolidation on the left side and enlarged heart. Bed side transthoracic echocardiography showed inferior akinesis with pericardial fluid. Coronary angiography showed no occlusion or significant stenosis. Chest computed tomography demonstrated the progression of his lymphoma in the myocardium. He was admitted to the Department of Hematology for immediate chemotherapy and he reached complete metabolic remission, followed by allogeneic hematopoietic stem cell transplantation. Unfortunately, about 9 months later, he developed bone marrow deficiency consequently severe sepsis, septic shock and multiple organ failure what he did not survive.Conclusions: Our case demonstrates a very rare manifestation of a heart metastasis. ACS is an unusual symptom of cardiac tumors. But our patient’s intramyocardial lymphoma in the right atrium and ventricle externally compressed the right coronary artery, causing the patient’s symptoms which imitated ACS. Fortunately, the quick diagnostics and immediate aggressive chemotherapy provided the patient’s remission and suitability to further treatment.
Genetic Spectrum and Clinical Early Natural History of Glucose-6-Phosphate Dehydrogenase Deficiency in Mexican Children Detected Through Newborn Screening.
Authors: Vela-Amieva Marcela , Alcántara-Ortigoza Miguel Ángel , Angel Ariadna González del , Martínez-Belmont Leticia , López-Candiani Carlos , Ibarra-Gonzalez Isabel 
Published: October 2020

Abstract
Background: Glucose-6-phosphate dehydrogenase deficiency (G6PDd) newborn screening is still a matter of debate due to its highly heterogeneous birth prevalence and clinical expression as well as the lack of enough knowledge on its natural history. Herein, we describe the early natural clinical course and the underlying GDPD genotypes in infants with G6PDd detected by newborn screening and later studied in a single follow-up center. G6PDd newborns were categorized into three groups: group 1: hospitalized with or without neonatal jaundice (NNJ); group 2: nonhospitalized with NNJ; and group 3: asymptomatic. Results: A total of 81 newborns (80 males, one female) were included. Most individuals (46.9%) had NNJ without other symptoms, followed by asymptomatic (42.0%) and hospitalized (11.1%) patients, although the hospitalization of only 3 of these patients was related to G6PDd, including NNJ or acute hemolytic anemia (AHA). Nine different G6PDd genotypes were found; the G6PD A− 202A/376G genotype was the most frequent (60.5%), followed by the G6PD 376G/542T (Santamaria, 22.2%) and the Union-Maewo (rs398123546, 7.4%) genotypes. These genotypes produce a wide range of clinical and biochemical phenotypes with significant overlapping residual enzymatic activity values among class I, II or III variants. Some G6PD A− 202A/376G individuals had enzymatic values that were close to the cutoff value (5.3 U/g Hb, 4.6 and 4.8 U/g Hb in the groups with and without NNJ, respectively), while others showed extremely low enzymatic values (1.1 U/g Hb and 1.4 U/g Hb in the groups with and without NNJ, respectively). Conclusion: Wide variability in residual enzymatic activity was noted in G6PDd individuals with the same G6PD genotype. This feature, along with a documented heterogeneous mutational spectrum, makes it difficult to categorize G6PD variants according to current WHO classification and precludes the prediction of complications such as AHA, which can occur even with residual enzymatic activity (>10%) and/or be associated with the common and mild G6PD A− 376G/968C and G6PD A− 202A/376G haplotypes.
Neuropsychiatric, Cognitive and Sexual Impairment in Mastocytosis Patients
Authors: JENDOUBI Fatma , SEVERINO-FREIRE Maella , NEGRETTO Mathilde , ARBUS Christophe , PAUL Carle , Livideanu Cristina Bulai 
Published: October 2020

Abstract
Background: Mastocytosis is a rare disease characterised by the accumulation and/or proliferation of abnormal mast cells (MCs) in one or several organs. It may present with a number of different symptoms that involve various organ systems. The current study aims to assess the prevalence of MC mediator-related symptoms in a cohort of mastocytosis patients with a specific focus on neurological, psychiatric, cognitive and sexual symptoms. We also assessed the impact of the disease on patients’ professional lives.Patients were administered a validated multidimensional questionnaire to collect information on patients’ perception of the severity of their symptoms. From the questionnaires we extracted the neurological, cognitive, psychiatric and sexual symptoms and the impact of the disease on patients’ professional lives as well as their grading. The affective status was assessed using the 17-item version of the Hamilton Depression Rating Scale. Results: We included 139 patients. Mastocytosis was classified as systemic in 113 patients and cutaneous in 26 patients. The prevalence of MC mediator-related systemic symptoms was as follows: cutaneous (71%), gastro-intestinal (48%), cardio-vascular (36%), musculoskeletal (26.6%), fatigue (24%), urinary (14.4%) and respiratory (10%). Headaches and vertigo were noted in respectively 55% and 32% of patients. Irritability, episodes of memory loss and difficulty concentrating were reported in 54%, 52% and 40% of cases, respectively. Sexual impairment was noted in 24% of patients. No associations were found between neuropsychiatric/cognitive impairment and age, gender, diagnostic delay, disease form, the presence of cutaneous lesions, the level of serum and bone marrow tryptase and the presence of KIT mutation in bone marrow and/or skin. Depression was noted in 49% of patients. One in four patients reported a negative impact of the disease on their professional lives.Conclusions: This current study provides some insights regarding symptoms related to mastocytosis and their impact on patients’ professional lives.
Faculty Retention in Regional Medical Schools in Iran: A Qualitative Content Analysis
Authors: Shaterjalali Maria , Gholampoor Yousef , Jeihooni Ali Khani , karimi shahnaz , Mansoori Yaser , Homayounfar Reza , Ehrampoush Elham 
Published: October 2020

Abstract
Background and Purpose: Recruitment and retention of competent faculty members are important in maintaining and improving the quality of education and research performance of universities. The aim of the present study was to find out the faculty members’ views, experiences, and attitudes to identify the reasons for faculty attrition and retention in regional medical schools in Iran.Methods: In this qualitative study, we used a content analysis method. The participants included 12 faculty members who had been transferred to type I universities, four faculty members applying for transfer, four with more than ten years of experience and working in the universities of small cities without any application for transfer. Data were collected using semi-structured interviews, which were conducted either face-to-face or via phone calls. To measure the trustworthiness of the data, we evaluated four components of credibility, transferability, dependability, and confirmability, proposed by Lincoln and Guba.Results: The findings were classified into three categories and 14 subcategories. The first category was “retention facilitators” including four subcategories of facilitated communication, proximity to major universities, gaining experience, and support by authorities. The second category was “retention threats” including six subcategories of social infrastructure, individual dimension, occupation dimension, economic dimension, sense of respect, and executive management. The third category was “retention strategies” which included four subcategories of employment and promotion processes, inter-university collaboration with type I universities, facilitation of the scientific growth, and fulfilment of the safety needs.Conclusion: Several factors play a role in the faculty members’ retention in regional medical schools. Authorities can create a more positive environment by devising a suitable reward system, supporting academic activities, and increasing the level of practical faculty autonomy to develop a sense of belonging among them and reduce the intention to transfer among their human resources.
A New OXA-66-harboring Acinetobacter Baumannii Sub-Clonal Complex 195 is Spreading Widely in Guangzhou, China, A Multicenter Study
Authors: Li Yujun , Huang Xiaomei , Wang Yuyao , Pan Chuzhi , Mo Zexun , Huang Muchao , Fang Changquan , Guo Penghao , Chen Huiling , Zhao Ziwen , Wei Shuquan 
Published: October 2020

Abstract
Objectives The clonal spread of Acinetobacter baumannii (A. baumannii) is an emerging problem. We analyzed the molecular epidemiology of A. baumannii isolated from 5 teaching hospitals in Guangzhou, China. Methods 138 A. baumannii isolates were collected. Multilocus sequence typing (MLST) was used to assess the genetic relationships among the isolates. The blaOXA-51-like gene was amplified and then sequenced. Results Most of the isolates (55.8%, 77/138) were obtained from intensive care units (ICUs). The respiratory system was the most common site where A. baumannii was found (72.5%, 100/138). A. baumannii remained susceptible to polymyxin and tigecycline, but the susceptibility to other antimicrobial agents was below 30%. We used MLST to group the A. baumannii isolates into 8 existing sequence types (STs) and 17 new STs. With the predicted founder ST195 (accounted for 35.5% of all isolates, 49/138), Clonal complex (CC) 195 was the most prevalent and widely spread STs in the hospital environment. All ST195 isolates harbored OXA-66 according to the blaOXA-51-like gene sequencing. But each hospital had its unique epidemiological feature. Conclusions OXA-66 gene harboring CC195 was the most epidemic STs in Guangzhou, China. Health care facilities should develop their own management strategy.
Biofilm Formation and Antibiotic resistance of Enterobacteriaceae isolates from Surgical Site infections in Hôpital de Référence Saint Joseph, Kinshasa, Democratic Republic of Congo
Authors: Iyamba Jean-Marie Liesse , Mabankama Rodriguez Musomoni , Lukukula Cyprien Mbundu , Unya Joseph Welo , Okombe Daniel Tassa , Ngbandani Benjamin Kodondi , Vihembo Grégoire Mbusa , Ngoma Nelson Nsiata , Kajinga Thierry Mukendi , Mapipi Odette Mboma , Kasongo Jacques Onokodi , Takaisi-Kikuni NB 
Published: October 2020

Abstract
Background: Enterobacteriaceae are one of the most predominant pathogen in surgical site infections. In recent years we oberved increase in resistance among bacteria from surgical site infections. The aim of this study was to evaluate antimicrobial suceptibility pattern of Enterobacteriaceae isolates from surgical site infections, the biofilm formation and the production of OXA-48 carbapenemase.Methods: A total of 41 Enterobacteriaceae (19 Escherchia coli, 8 Enterobacter sp., 9 Citrobacter sp., and 5 Serratia sp. ) clinical isolates were collected from patients with SSI in Hôpital Saint Joseph (Kinshasa) for diagnostic purposes. The pus samples were cultured and the antibiotic susceptibility profile of the isolates were determined by disk-diffusion method following Clinical and Laboratory Standards Institute 2012 recommendations. OXA-48-producing Enterobacteriaceae were detected using ChromaticTM OXA-48 chromogenic medium. Crystal Violet Staining Method was used to assess the ability of bacteria strains to form a biofilm. Results: All Enterobacteriacea isolates studied were biofilm producers and highly resistant to the majority of antibiotics tested. E. coli, Enterobacter sp., Citrobacter sp., and Serratia sp. were 100 % resistant cefotaxime, imipenem, and amoxicillin-clavulanic acid, and ampicillin. Serratia sp. isolates were 100% and 80% sensitive to norfloxacine and amikacine respectively. There was relationship between antibiotic resistance and biofilm production. E. coli, Enterobacter sp., and Citrobacter sp. strains were all OXA-48 producers.Conclusion: The results of the present study demonstrate the emergence of multidrug resistant organisms, the correlation between antibiotic resistance- biofilm formation and OXA-48 production. These results suggest the implementation of antimicrobial resistance survey programm in order to prevent and combat the spread of multidrug resistant organisms in hospital and community in Democratic Republic of Congo.
Global Absence and Targeting of Protective Immune States in Severe COVID-19.
Authors: Krummel Matthew , Combes Alexis , Courau Tristan , Kuhn Nicholas , Hu kenneth , Ray Arja , Chen William , Cleary Simon , Chew Nayvin , Kushnoor Divyashree , Reeder Gabriella , Shen Alan , Tsui Jessica , Hiam Kamir , Sandoval Priscila Munoz , Zhu Wandi , Lee David , Sun Yang , You Ran , Magnen Melia , Rodriguez Lauren , Leligdowicz Aleksandra , Zamecnik Colin , Loudermilk Rita , Wilson Michael , Ye Chun , Fragiadakis Gabriela , Looney Mark , Chan Vincent , Ward Alyssa , Carrillo Sidney , Matthay Michael , Erle David , Woodruff Prescott , Langelier Charles , Kangelaris Kristen , Hendrickson Carolyn , Calfee Carolyn , Rao Arjun 
Published: October 2020

Abstract
While SARS-CoV-2 infection has pleiotropic and systemic effects in some patients, many
others experience milder symptoms. We sought a holistic understanding of the
severe/mild distinction in COVID-19 pathology, and its origins. We performed a wholeblood
preserving single-cell analysis protocol to integrate contributions from all major cell
types including neutrophils, monocytes, platelets, lymphocytes and the contents of
serum. Patients with mild COVID-19 disease display a coordinated pattern of interferonstimulated
gene (ISG) expression across every cell population and these cells are
systemically absent in patients with severe disease. Severe COVID-19 patients also
paradoxically produce very high anti-SARS-CoV-2 antibody titers and have lower viral load
as compared to mild disease. Examination of the serum from severe patients
demonstrates that they uniquely produce antibodies with multiple patterns of specificity
against interferon-stimulated cells and that those antibodies functionally block the
production of the mild disease-associated ISG-expressing cells. Overzealous and autodirected
antibody responses pit the immune system against itself in many COVID-19
patients and this defines targets for immunotherapies to allow immune systems to
provide viral defense.
Early Postoperative Clinical Outcomes of Robotic Arm-Assisted Vs. Image-Based Navigated Total Hip Arthroplasty
Authors: Shibanuma Nao , Ishida Kazunari , Matsumoto Tomoyuki , Takayama Koji , Sanada Yutaro , Kurosaka Masahiro , Kuroda Ryosuke , Hayashi Shinya 
Published: October 2020

Abstract
Background The purpose of this study was to compare the clinical outcomes of total hip arthroplasty (THA) using computer navigation systems (nTHA) and those of robotic arm-assisted THA (rTHA).Methods Thirty prospective subjects who underwent rTHA were clinically compared with 30 subjects who underwent nTHA. Clinical data (the surgical time, intraoperative blood loss, length of hospital stay, pain severity, number of days to independent walking, and Harris Hip Score (HHS) at discharge) and radiographic parameters (the inclination and anteversion angles) were statistically compared between the two groups. Results The surgical time, number of days to independent walking, and postoperative pain were significantly reduced in the rTHA group than in the nTHA group. The rTHA group showed a significantly higher postoperative HHS than did the nTHA group. No statistically significant difference was observed in radiographic parameters between the groups.Conclusion The surgical time, postoperative pain, and number of days to independent walking were significantly shorter, and the HHS at discharge was significantly higher in the rTHA group than in the nTHA group. Thus, as compared to nTHA, rTHA improved early clinical outcomes.