bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic resistant gene of Pseudomonas aeruginosa from non-clinical environment: public health implications in Mthatha, Eastern Cape Province, South Africa
Authors: Hosu Mojisola C. , Vasaikar Sandeep , Okuthe Grace. E. , Apalata Teke 
Published: June 2020

Abstract
Background

Pseudomonas aeruginosa (P. aeruginosa) are Gram-negative bacilli that are ubiquitous in nature particularly plentiful in soils and in aquatic milieu because they thrive well in humid or wet environments. It has extensive metabolic versatility, ability to thrive well and colonize diverse ecological habitats such as soil, rhizosphere, wastewaters that, enhances its potential threat to public health. Abattoirs, aquatic ecosystem including generated wastewaters are latent sources of pathogenic bacteria, serve as reservoirs and contribute to the spread of antibiotic resistant genes. Several studies have focused on clinical environment while scarce data exist from non-clinical environments, which sometimes are hotspots of antibiotic resistance. Thus, the present investigation aimed to identify antibiotic resistant gene of P. aeruginosa from non-clinical sources in Mthatha, Eastern Cape and evaluate its public health implications.
Results

Fifty-five (55) Pseudomonas species and other organisms recovered from effluent and surface water samples included P. aeruginosa (65.4%), P. fluorescens (27.3%), Burkholderia gladioli (5.5%) and Burkholderia cepacia (1.8%). The P. aeruginosa isolates showed high resistance to aztreonam (86.1%), ceftazidime (63.9%), piperacillin (58.3%) and cefepime (55.6%); with moderate resistance displayed to imipenem (50%), piperacillin/tazobactam (47.2%), meropenem (41.7%) and levofloxacin (30.6%). Twenty out of thirty-six (36) P. aeruginosa displayed multidrug resistance profiles and were classified as multidrug resistant (MDR) (55.6%). Most of the bacterial isolates exhibited a high Multiple Antibiotic Resistance (MAR) Index of > 0.2 ranging from 0.08–0.69 with a mean MAR Index of 0.38. PCR analysis of fifteen (15) P. aeruginosa isolates detected 14 (93.3%) harbored blaSHV, 6 (40%) harbored blaTEM with the least occurring ESBL as blaCTX−M at 3 (20%).
Conclusions

Results of the current study indicating resistance of environmental P. aeruginosa isolates to front-line clinically relevant antipseudomonal drugs is concerning and poses risk to the environment and receiving water bodies. Given the public health relevance, the results of this study highlight the importance and urgent need of monitoring multidrug-resistant pathogens in effluent environments. These non-clinical environments are potential reservoirs of resistance genes that would further serve as avenues for the dissemination of multidrug resistant bacteria in the community.
Cost-Effectiveness of Emergency Obstetric Care in rural Kenya: Comparing Ambulance transfer and Self-referral
Authors: Kalisa Richard , Muriithi Moses Kinyanjui , Bijlmakers Leon , Akker Thomas van den , Roosmalen Jos van 
Published: June 2020

Abstract
Background

Obstetric complications are difficult to predict and may require referral, expedited by ambulance use. We conducted a cost-effectiveness analysis comparing ambulance transfers and self-referrals in obstetric emergencies in a predominantly rural setting in Kenya.
Methods

A retrospective cross-sectional cost-effectiveness analysis using a healthcare system perspective was conducted of parturient women transferred by ambulance to a higher level hospital compared with self-referrals between January to June 2019. Direct costs needed for ambulance, self-referral and clinical care were calculated. Every woman admitted with a pregnancy-related complication was assessed using the adapted sub-Saharan African Maternal Near Miss (MNM) criteria. Each referred woman was categorized as: ‘necessary referral’ meaning that they were managed for either MNM or potentially life-threatening complications (PLTC) and ‘unnecessary referral’ meaning those with no obstetric complications. Incremental cost effectiveness ratio (ICER) for referral was considered attractive or very attractive interventions when costs per life years gained (LYG) were below $150 and $30, respectively.
Results

Overall, 2804 women (96.3%) were self-referrals, while 108 ambulance transfers occurred (3.7%). Main indications for ambulance transfer were prolonged labor (n = 21; 19.4%), pre-eclampsia/eclampsia (n = 19; 17.6%) and sepsis/peritonitis following cesarean section (n = 15; 13.9%). Necessary referrals were considered to have occurred in 81/108 (75%) for ambulance transfers versus 239/2804 (9.3%) self-referrals. If all necessary referral cases had exclusively used ambulance services (ambulance + self-referrals), then the total intervention costs would be $90,112 and LYG 6095, equivalent to ICER of $14.8 per LYG. Women with unnecessary referrals by ambulance were 27/108 (25%) versus self-referrals in 2565/2804 (91.5%) indicating that these women could have been managed in sub-county hospitals or health centers.
Conclusions

Cost-effectiveness of reasonably well-targeted ambulance services on women with MNM or PLTC in our setting was very attractive.
Minimally Invasive Repair of a Delayed Recurrent Traumatic Cerebrospinal Fluid Rhinorrhea: A Case Report of Dislocation of the Bony and Dural Defects
Authors: Liu Xiaofei , Chen Ping , Wang Bing 
Published: June 2020

Abstract
Background：Dural and bony defects mostly occur in the same position in the cerebrospinal fluid（CSF）rhinorrhea of anterior cranial base fractures,and a few cases of delayed CSF leakage after repair are also reported.Case presentation：We report a case in which a pedicled temporoparietal fascial flap was used to repair the comminuted fracture of the anterior skull base with CSF leakage. Delayed CSF leakage occurred 45 days after the operation.A minimally invasive approach through an eyebrow incision was performed for reoperation,it was found that the bony defect was located in the right frontal sinus and the dural defect was located in the right ethmoid plate. Conclusions:This case suggests that delayed traumatic CSF rhinorrhea after reconstructive surgery is more complex than usual,and appropriate approach should be adopted to repair the dural and bony defects , the transeyebrow approach is a good choice.
Knowledge, attitudes, anxiety, and preventive behaviors towards COVID-19 among health care providers in Yemen: an online cross-sectional survey
Authors: Alrubaiee Gamil Ghaleb , Al-Qalah Talal Ali Hussein , Al-Aawar Mohammed Sadeg A. 
Published: June 2020

Abstract
Background: The current rapid prevalence of the novel coronavirus (COVID-19) pandemic over the world is associated with a considerable level of scared, anxiety and panic among the public, in particular, healthcare providers (HCPs) as the most vulnerable group at risk for SARS-CoV-2 infection. To protect and enhance HCPs' capacity to carry out their duties in responding to COVID-19, healthcare authorities should keep them away from stress and anxiety and improve their knowledge, attitude, and practice towards COVID-19 to ensure their compliance to infection control precautions. Therefore, this study aimed to explore knowledge, attitudes, anxiety, and preventive behaviours among Yemeni HCPs towards COVID-19.Methods: A descriptive, web-based-cross-sectional study was used. It was conducted among a number of 1244 Yemeni HCPs. The COVID-19 related questionnaire was designed using Google forms. The link of the survey was sent to the respondents via emails, WhatsApp messages and WhatsApp groups as well as Telegram and other social media. The data collection started on 22nd April 2020, at 6 PM and closed on 26th April 2020 at 11 AM.Results: The results indicated that out of 1244 of the Yemeni HCPs participating in this study, 61.3% were male and more than (67%) were in the age group of 20 to 30 years old with a mean of 29.25±6.75. Most of them (85.9%) had a bachelor degree or above and had 10 years of working experience or less (88.2%). Besides, although 57.1% of the respondents obtained their information via social and news media and 60.3% had never attended lectures/discussions about COVID-19, the results revealed that the majority of respondents had an adequate level of knowledge, an optimistic attitude, moderate anxiety and high performance in preventive behaviors (60.3%, 85.00%, 50.80 & 87.60%, respectively) toward the COVID-19 pandemic.Conclusion: Although the Yemeni HCPs exhibited an adequate level of knowledge, an optimistic attitude, moderate anxiety and high performance in preventive behaviours toward the COVID-19 pandemic, the results showed gaps in some themes, particularly in their knowledge and attitude on COVID-19 pandemic which need to be updated or refreshed.
Patterns and Correlates of Mis-implementation in State Public Health Practice in the United States
Authors: Padek Margaret , Mazzucca Stephanie , Allen Peg , Weno Emily Rodriguez , Tsai Edward , Luke Douglas A. , Brownson Ross C. 
Published: June 2020

Abstract
Background: Much of the disease burden in the United States is preventable through application of existing knowledge. State-level public health practitioners are in ideal positions to affect programs and policies related to chronic disease, but the extent to which mis-implementation occurring with these programs is largely unknown. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones.Methods: A 2018 comprehensive survey assessing the extent of mis-implementation and multi-level influences on mis-implementation was reported by state health departments (SHDs). Questions were developed from previous literature. Surveys were emailed to randomly selected SHD employees across the Unites States. Spearman’s correlation and multinomial logistic regression were used to assess factors in mis-implementation.Results: Half (50.7%) of respondents were program managers or unit directors. Forty nine percent reported that programs their SHD oversees sometimes, often or always continued ineffective programs. Over 50% also reported that their SHD sometimes or often ended effective programs. The data suggest the strongest correlates and predictors of mis-implementation were at the organizational level. For example, the number of organizational layers impeded decision-making was significant for both continuing ineffective programs (OR=4.70; 95% CI=2.20, 10.04) and ending effective programs (OR=3.23; 95% CI=1.61, 7.40).Conclusion: The data suggest that changing certain agency practices may help in minimizing the occurrence of mis-implementation. Further research should focus on adding context to these issues and helping agencies engage in appropriate decision-making. Greater attention to mis-implementation should lead to greater use of effective interventions and more efficient expenditure of resources, ultimately to improve health outcomes.
Effect of socioeconomic and ethnic characteristics on COVID-19 infection: The case of the Ultra-Orthodox and the Arab communities in Israel.
Authors: Saban Mor , Shachar T , O-MA Miron , Wilf-Miron Racel 
Published: June 2020

Abstract
BackgroundDuring infectious disease outbreaks the weakest communities are more vulnerable to the infection and its deleterious effects. In Israel, the Arab and Ultra-Orthodox Jewish communities have unique demographic and cultural characteristics that place them at risk for infection.ObjectiveTo examine the socioeconomic and ethnic differences in relation to COVID-19 testing, cases and deaths, and to analyze infection spread patterns in ethnically diverse communities. MethodsConsecutive data on COVID-19 diagnostic testing, confirmed cases and deaths collected from March 31st through May 1st, 2020 in 174 localities across Israel (84% of the population) were analyzed by socioeconomic ranking and ethnicity. ResultsTests were performed on 331,594 individuals (4·29% of the total population). Of those, 14,865 individuals (4·48%) were positive and 203 died (1·37% of confirmed cases).The percentage of the population tested was 26% and the risk of testing positive was 2·16 times higher in the lowest, compared with the highest socioeconomic category. The proportion of confirmed cases was 4·96 times higher in the Jewish compared with the Arab population.The rate of confirmed cases in 2 Ultra-Orthodox localities increased relatively early and quickly. Other Jewish and Arab localities showed consistently low rates of confirmed COVID-19 cases, regardless of socioeconomic ranking.ConclusionsCulturally different communities reacted differently to the COVID-19 outbreak and to government measures, resulting in different outcomes. Therefore, socioeconomic and ethnic variables cannot fully explain communities' reaction to the pandemic. Our findings stress the need for designing a culturally adapted approach for dealing with health crises.
Effect of Seed Extraction Methods of Tomato on Physiological Quality of Seeds and Seedlings
Authors: Degwale Alemu , Tesfa Tiru , Meseret Belete 
Published: June 2020

Abstract
Tomato (Solanum lycopersicum L.) belongs to the family Solanaceae is one of the most popular and most processed vegetable crops worldwide with a great nutritional contribution to the human diet. Even though its demand is increasing with increasing profitability, the production constricted by lack of quality seeds due mainly to lack of proper seed extraction method particularly for large scale seed production. Extensive disease epidemics might also be due to unsatisfactory seed extraction method. Empirical evidences are scanty on instant and latent effects of seed extraction methods of tomato seeds. Thus, this study was initiated to investigate the effect of seed extraction methods on physiological quality of seeds and seedlings of tomato. The experiment was carried under laboratory and field conditions in a completely randomized design. Results revealed that the highest germination percent (99.33 and 89.76% under laboratory and field conditions respectively) was obtained at 2% HCl for 60 minutes. Whereas, maximum weight of 1000 seeds (4.277g) was found at 1% of HCl for 30 minutes whereas maximum mycoflora load (36%) was observed from 72 hours fermentation. Yet, no mycoflora was detected from higher concentration (2% and more HCl) and time length (60 minutes and longer time). Seed quality parameters like seedling length, seedling fresh weight, seedling dry weight, and vigour indices were significantly higher at extraction method of 2% HCl for 60 minutes. Thus it can be concluded that maximum physiological seed quality and best performance of seedlings of tomato can be obtained from 2% HCl for 60 minutes.
Effect of gamma sterilization on filtering efficiency of various respiratory face-masks
Authors: Kumar Amit , Sangeetha D.N. , Yuvaraj Ramani , Menaka M. , Subramanian V. , Venkatraman B. 
Published: June 2020

Abstract
Three types of respiratory masks viz N95, non-woven fabric and double layer cotton cloth are being used as an essential inhalation protective measure against COVID-19 by suppressing the entry of respiratory droplets. The filtering efficiency of these masks were tested before and after sterilization using gamma radiation for the two flow rate conditions corresponding normal breath rate (20 lpm) and during sneezing/coughing (90 lpm). Sterilization is carried out using a gamma irradiator containing Co-60 source for the two dose exposures viz. 15kGy and 25kGy. The filtering efficiency for surgical (non-woven fabric) and double layer cotton cloth mask is found to vary from 18% to 22% for the cumulative particle of size ≥ 0.3µm in both un-irradiated and irradiated condition.The filtration efficiency of N95 mask is found to be reduced to 70% for the most penetrating particle size (0.3 µm) with the flow rate of 20 lpm and further reduced for particles in the range of 0.1 and 0.2µm with flow rate of 90 lpm. The reduction in efficiency after gamma sterilization is associated with reduction of electrostatic interaction of filter medium with particles laden in the air stream.Even with reduced filtering efficiency due to gamma sterilization, the N95 masks are much superior than the surgical and cloth masks.Instead of disposing N95 mask after single use, they can be reused a few times as N70 mask during this pandemic crisis after sterilization using gamma radiation.
YTHDF2, a protein repressed by miR-145, regulates proliferation, apoptosis and migration in ovarian cancer cells
Authors: Li Jie , Wu Lei , Pei Meili , Zhang Yun 
Published: June 2020

Abstract
RNA methylation can reverse the methylation modification at RNA level, which is a kind of extremely important epigenetic modification. YTHDF2, as a reader of m6A modification, the function and mechanisms of in epithelial ovarian cancer(EOC) have not been elucidated so far. In this study, we demonstrated that YTHDF2 was significantly upregulated in EOC tissues compared with normal ovarian tissues, further function studies confirmed that YTHDF2 significantly promoted the proliferation and migration of EOC cell lines, and reduced the global mRNA m6A levels. Next, we found that the expression levels of miR-145 and YTHDF2 were inversely correlated in ovarian cancer tissues and cells, and YTHDF2 is the direct target gene of miR-145. Interestingly, there was a crucial crosstalk between miR-145 and YTHDF2 via a double-negative feedback loop. Overexpression of YTHDF2 rescues miR-145-induced reduction of proliferation and migration in EOC cells. To conclude, YTHDF2 and miR-145, as two crucial m6A regulators, are involved in the progression of EOC by indirectly modulating m6A levels. In view of these promising results, YTHDF2 and miR-145 may provide new insights into the carcinogenesis and new potential therapeutic targets for EOC.
Pyruvate enhances M1 microglial polarization via NF-κB/MCT1/iNOS signaling axis under low glucose condition
Authors: Zhou Peng , Du Juan-juan , Zhou Tao , Sun Chen-you , Cui Huai-rui , Ding Mao-chao , Yang Chao-xian , Liao Min 
Published: June 2020

Abstract
Background

Proinflammatory microglia rely predominantly on glycolysis to maintain cytokine production during an inflammatory response. However, during ischemia, where glucose supply is low, inducible nitric oxide synthase (iNOS) production remains high accompanied by an increase in monocarboxylate transporter 1 (MCT1) expression. In this study, we explored whether there is a link between iNOS and MCT1 expressions, and whether pyruvate can act as an energy source to sustain the M1 phenotype.
Methods

Using a mouse model with laser-induced brain ischemia and cell culture with low-glucose treatment, we examined responses from microglia.
Results

The expressions of iNOS and MCT1, as well as arginase-1 (ARG1), were increased in the brain of the ischemic mouse model. In the BV2 microglial cell line and primary microglia treated under low glucose condition, iNOS and MCT1 also increased, while ARG1 decreased. The addition of pyruvate under low-glucose or lipopolysaccharide (LPS) treatment enhanced iNOS and MCT1 expressions compared with groups without pyruvate. MCT1 knockdown resulted in decreased iNOS while MCT1 overexpression increased iNOS. Furthermore, inhibitor of nuclear factor-kappaB (NF-κB) reduced both iNOS and MCT1.
Conclusion

Our data suggested that after proinflammatory microglial polarization, MCT1 is upregulated through the NF-κB signaling pathway, which leads to iNOS production. We speculate that microglia may continuously pick up monocarboxylates such as pyruvate through MCT1 to sustain the M1 phenotype.
ECOG-ACRIN 2399: Analysis of Patient Related Outcomes After Chemoradiation for Locally Advanced Head and Neck Cancer
Authors: Cmelak Anthony J. , Dietrich Mary S. , Li Shuli , Ridner Sheila , Forastiere Arlene A , Burtness Barbara A. , Cella David , Murphy Barbara A. 
Published: June 2020

Abstract
Background: We conducted a correlative study for E2399, a function preservation trial for resectablelocally advanced oropharynx and larynx cancer, to prospectively assess effects of chemoradiation (CCR) on quality of life (QOL), swallowing and voice. We correlated the results of swallow assessments done via questionnaires and objective assessments.Methods: The Functional Assessment of Cancer-HN (FACT-HN), the Performance Status Scale – Head and Neck (PSS-HN), swallow assessments (including modified barium swallow studies), and voice assessments: Voice Handicap Index (VHI), the Voice Disability Assessment (VDA), and American Speech-Language Hearing Association’s Functional Communication Measure (FCM) were conducted at baseline and periodically post-treatment for 2 years.Results: Baseline QOL and swallowing function predicted overall survival. Patients experienced a marked decrease in QOL, swallowing, and speech post CCR although the decrease in vocal function was modest. Function and QOL returned towards baseline in the majority of patients by 12 months post treatment. Less than 10% of patients had severe dysphagia and were PEG dependent at 12 months post treatment. There was a high degree of correlation between the FACT-HN and PSS-HN swallow items. Statistically significant correlations were found between subjective and objective measures of swallow function.Conclusions: Patients experience marked loss in swallowing function post CCR which returned to baseline in the majority of patients. The correlations between the FCM and self-report swallow items on the PSS and FACT-HN appear to be sufficiently strong to justify their use as a surrogate marker for swallowing disability in large therapeutic trials.
The Local Concentration of Ca2+ Correlates with BMP7 Expression and Osseointegration in Patients with Total Hip Arthroplasty
Authors: Fu Xiaodong , Wang Weili , Li Xiaomiao , Gao Yingjian , Li Hao , Shen Yi 
Published: June 2020

Abstract
Background

A successful osseointegration of total hip arthroplasty (THA) relies on the interplay of implant surface and bone marrow microenvironment. This study was undertaken to investigate the impact of perioperative biochemical molecules (Ca 2+ , Mg 2+ , Zn 2+ , VD, PTH) on the bone marrow osteogenetic factors (BMP2, BMP7, Stro-1 + cells) in the metaphyseal region of the femoral head, and further on the bone mineral density (BMD) of Gruen R3.

Methods

Bone marrow aspirates were obtained from the discarded metaphysis region of the femoral head in 51 patients with THA. Flow cytometry was used to measure the Stro-1 + expressing cells. ELISA was used to measure the concentrations of bone morphologic proteins (BMP2 and BMP7). The perioperative concentrations of the biochemical molecules above were measured by radioimmunoassay. The BMD of Gruen zone R3 was examined at 6 months after THA, using dual-energy X-ray absorptiometry (DEXA).

Results

Our data demonstrated that the concentration of Ca 2+ was positively correlated with BMP7 expression, and with the postoperative BMD of Gruen zone R3. However, the concentration of Mg 2+ had little impact on the R3 BMD, although it was negatively correlated with the expression of BMP7. The data also suggested that the other biochemical molecules, such as Zn 2+ , VD, and PTH, were not significantly correlated with any bone marrow osteogenetic factors (BMP2, BMP7, Stro-1 + cells). The postoperative R3 BMD of patients of different gender and age had no significant difference.

Conclusions

These results indicate the local concentration of Ca 2+ may be an indicator for the prognosis of THA patients.