bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-world Use of Ceftolozane/tazobactam: a Systematic Literature Review
Authors: Puzniak Laura , Dillon Ryan , Palmer Thomas , Collings Hannah , Enstone Ashley 
Published: December 2020

Abstract
Background: Antibacterial-resistant gram-negative infections are a serious risk to global public health. Resistant Enterobacterales and Pseudomonas aeruginosa are highly prevalent, particularly in healthcare settings, and there are limited effective treatment options. Patients with infections caused by resistant pathogens have considerably worse outcomes, and significantly higher costs, relative to patients with susceptible infections. Ceftolozane/tazobactam (C/T) has established efficacy in clinical trials. This review aimed to collate data on C/T use in clinical practice.Methods: This systematic literature review searched online biomedical databases for real-world studies of C/T for gram-negative infections. Relevant study, patient, and treatment characteristics, microbiology, and efficacy outcomes were captured.Results: There were 83 studies comprising 3,701 patients were identified. The most common infections were respiratory infections (52.9% of reported infections), urinary tract infections (UTIs; 14.9%), and intra-abdominal infections (IAIs; 10.1%). Most patients included were seriously ill and had multiple comorbidities. The majority of patients had infections caused by P. aeruginosa (90.7%), of which 86.0% were antimicrobial-resistant. C/T was used as both a 1.5 g q8h and 3 g q8h dose, for a median duration of 7–56 days (varying between studies). Outcome rates were comparable between studies: clinical success rates ranged from 45.7–100.0%, with 27 studies (69%) reporting clinical success rates of >70%; microbiological success rates ranged from 31–100%, with 14 studies (74%) reporting microbiological success rates of >70%. Mortality rates ranged from 0–50%, with 31 studies (69%) reporting mortality rates of ≤20%. In comparative studies, C/T was as effective as aminoglycoside- or polymyxin-based regimens, and in some instances, significantly more effective.Conclusions: The studies identified in this review demonstrate that C/T is effective in clinical practice, despite the diverse group of seriously ill patients, different levels of resistance of the pathogens treated, and varying dosing regimens used. Furthermore, comparative studies suggest that C/T offers a successful alternative to standard of care (SoC).
Hospital Acquired Blood Stream Infection in an Adult Intensive Care Unit: a Retrospective Case Series
Authors: Harte Jeffrey , Soothill Germander , Samuel Jack , Sharifi Laurence , White Mary 
Published: December 2020

Abstract
Introduction: Hospital acquired blood stream infections are a common and serious complication in critically ill patients. Methods: A retrospective case series was undertaken investigating the incidence and causes of bacteraemia on an intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results: 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients, who developed bacteraemia was greater than those who did not (19.8 versus 16.8 respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures than in intensive care units reported in other studies.Conclusion: Critical care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive care setting particularly in patients who have undergone invasive procedures.
Identification and Validation of Three Core Genes in p53 Signaling Pathway in Hepatitis B Virus-Related Hepatocellular Carcinoma
Authors: Yu Mingxue , Xu Wenli , Jie Yusheng , Pang Jiahui , Huang Siqi , Cao Jing , Gong Jiao , Li Xinhua , Chong Yutian 
Published: December 2020

Abstract
Background：Hepatocellular carcinoma (HCC) is a common cancer and the leading cause is persistent hepatitis B virus infection. We aimed to identify some core genes and pathways for HBV-related HCC. Methods: Gene expression profiles of GSE62232, GSE121248, and GSE94660 were available from Gene Expression Omnibus. The GEO2R online tool and Venn diagram software were applied to analyze commonly differentially expressed genes. Then functional enrichment analysis using Gene Ontology (GO) and the Kyoto Encyclopedia of Gene and Genome (KEGG) as well as the protein-protein interaction (PPI) network was conducted. The overall survival rates and the expression levels were detected by Kaplan-Meier plotter and Gene Expression Profiling Interactive Analysis (GEPIA). Next, gene set enrichment analysis (GSEA) was performed to verify the KEGG pathway analysis. Furthermore, quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) was performed to validate the levels of gene expression in tumor tissues from HBV related HCC patients, HBV-related liver cell lines, and transfection si-p53 and knock-out p53 liver cancer cell lines. Finally, the prediction of the ceRNA network was constructed with R software. Results: Fifteen highly expressed genes associated with significantly worse prognoses were selected and CCNB1, CDK1, and RRM2 in the p53 signaling pathway were identified as core genes. GSEA results showed highly-expressed samples of three core genes were all enriched in the p53 signaling pathway in a validation dataset(P<0.0001). Expression of these three core genes were consistently higher in tumor tissue samples (P<0.0001) and liver cancer cell lines (P<0.05). However, transfection si-p53 and knock-out p53 liver cancer cell lines had lower expression (P<0.05). LncRNAs, including NEAT1, MALAT1, XIST, AC021078.1, and SNHG16, were identified by close interactions with core genes. Conclusions: CCNB1, CDK1, and RRM2 were enriched in the p53 signaling pathway and could be potential biomarkers and therapeutic targets for HBV-related HCC.
Patient with Multiple Rib Fractures Developed into Phrenic Hernia after Cardiopulmonary Resuscitation
Authors: Cheng Shaowen , Yang Jian , Peng Lei , Chen Yangping , Hu Zhihua 
Published: December 2020

Abstract
Phrenic hernia is a rare condition in patients with multiple rib fractures after cardiopulmonary resuscitation. We report a 28-year-old case of multiple injuries with multiple rib fractures who developed Phrenic hernia after cardiopulmonary resuscitation and underwent emergency surgery after sudden respiratory and cardiac arrest in ICU. This is the first report of Phrenic hernia after cardiopulmonary resuscitation after respiratory and cardiac arrest of multiple rib fractures in China.
‘Drinking and Dropping’: On Interacting with Plastic Pollution and Waste in South-Eastern Nigeria
Authors: Henderson Lesley , Dumbili Emeka W. 
Published: December 2020

Abstract
Nigeria is reported as having released up to 0.34 million tonnes of plastic debris into the ocean in 2010 and ranked ninth country in the world for pollution of the marine environment. It is a postcolonial, oil-rich country where plastic is cheap and widely available. Currently, there is no government policy regulating single-use plastic products. Previous studies have identified university student residential areas as ‘hot spots’ for plastic waste. We used qualitative methods (focus groups and semi-structured interviews) to explore how students made sense of their single use plastics consumption (including ‘pure water’ plastic sachets) and analysed how young Nigerians interact with plastic waste. Students perceived plastic waste as malodorous, causing harm to human health and blighting environmental aesthetics. Students saw themselves as the cause of plastic pollution (as consumers) whereas plastic industries were framed positively as producers bringing progress and prosperity. Participants were open about their indiscriminate littering practices subverting other study findings where responsibility tends to be deflected (to policy makers, producers). While we are relying on self-reported behaviour, we found no obvious link between awareness of environmental harm caused by plastic pollution and students’ actions. Within this peer group of young Nigerians, it was not considered ‘normal’ or ‘cool’ socially to use waste bins or recycle. We suggest that further research is needed into how plastic pollution is made sense of in terms of individual responsibility; lay understandings of miasmas; perceptions of public/private spaces and plastics as a signifier of modernity and enhanced social status.
A novel Chinese Medicine JY5 Formula Alleviates Hepatic Fibrosis Through Inhibiting Notch Signaling Pathway
Authors: Fu Yadong , Xiao Zhun , Tian Xiaoting , Liu Wei , Hu Yonghong , Fang Jing , Gao Siqi , Zhang Dingqi , Mu Yongping , Zhang Hua , Hu Yiyang , Huang Chenggang , Chen Jiamei , Liu Ping 
Published: December 2020

Abstract
Background: Advanced liver fibrosis can lead to cirrhosis, resulting in an accelerated risk of liver failure and hepatocellular carcinoma. It is necessary to develop an effective antifibrotic strategy. It has been reported that Fuzheng Huayu formula (FZHY) had a remarkable anti-hepatic fibrosis effect. Here, We obtain a new anti-fibrotic composition, which consists of the main active ingredients of FZHY formula and investigate its mechanism of pharmacological action.Methods: The main active ingredients of FZHY through the quantitative analysis in FZHY extracts and FZHY-treated plasma and liver in rats were investigated. The best anti-fibrotic composition of the main active ingredients was studied through the uniform design and validation experiments in vivo and its mechanism was evaluated in CCl4- and BDL-induced liver fibrosis models in rats and mice and TGF-β1-indued LX-2 cells activation model in vitro.Results：A novel composition, namely JY5 formula, which consisted of Salvianolic acid B, schisantherin A and amygdalin, the main active components of FZHY, could significantly alleviated hepatic hydroxyproline content and collagen deposition in CCl4- and BDL-induced fibrotic liver in rats and mice. Further studies showed that JY5 could inhibit the activation of hepatic stellate cells (HSCs) through inactivating Notch signaling in vivo and in vitro.Conclusions: We found a novel composition JY5 formula, which had an anti-hepatic fibrotic effect through inhibiting Notch signaling pathway, consequently suppressing HSCs activation. These results may provide some adequate scientific basis for the clinical research and application of JY5 formula, as a potential new therapeutic candidate for liver fibrosis.
Waist-to-Height Ratio, Waist Circumference, Body Mass Index and Risk of Cardiometabolic Multimorbidity: A National Longitudinal Cohort Study
Authors: Lu Yanqiang , Liu Siyuan , Qiao Yanan , Li Guochen , Wu Ying , Ke Chaofu 
Published: December 2020

Abstract
Background: Cardiometabolic multimorbidity is an increasing public health burden. This study aimed to evaluate the association of waist-to-height ratio (WHtR), waist circumference (WC) and body mass index (BMI) with risk of cardiometabolic multimorbidity.Methods: We used data from the China Health and Retirement Longitudinal Study (CHARLS). 10521 participants aged 45 and over were recruited, including 8807 individuals with 0 cardiometabolic disease at baseline (stage Ⅰ) and 1714 individuals with 1 cardiometabolic disease at baseline (stage Ⅱ). Logistic regression was conducted to estimate the odds ratios (ORs) and confidence intervals (CIs). Net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to evaluate the incremental predictive value beyond conventional factors.Results: In stage Ⅰ, increased risk of cardiometabolic multimorbidity was observed among participants with WHtR ≥ 0.5 (OR: 1.76, 95% CI: 1.05–2.97), WC ≥ 85 (men) + WC ≥ 75 (women) (OR: 1.77, 95% CI: 1.05–2.97) or BMI ≥ 24 (OR: 1.48, 95% CI: 0.98–2.24). Furthermore, both NRI and IDI of WHtR and WC were higher than those of BMI. In stage Ⅱ, the adjusted ORs (95% CIs) of WHtR ≥ 0.5, WC ≥ 85 (men) + WC ≥ 75 (women), and BMI ≥ 24 were 2.04 (1.24–3.35), 2.07 (1.28–3.34), and 1.47 (1.06–2.04), respectively. In addition, WC exhibited the highest NRI and IDI.Conclusions: WHtR, WC and BMI are independent predictors of cardiometabolic multimorbidity in middle-aged and elderly Chinese population. WHtR and WC show better abilities in predicting cardiometabolic multimorbidity than BMI.
A methodological review protocol of the use of Bayesian factor analysis in primary care research
Authors: Zhang Hao , Schuster Tibor 
Published: December 2020

Abstract
Background : The development of questionnaires for primary care practice and research is of increasing interest in the literature. In settings where valuable prior knowledge or preliminary data is available, Bayesian factor analysis can be used to incorporate such information when conducting questionnaire construct validation. This protocol outlines a methodological review that will summarize evidence on the current use of Bayesian factor analysis in the primary care literature.
Methods : A comprehensive search strategy has been developed and will be used to identify relevant literature (research studies in primary care) indexed in Medline, Scopus, EMBASE, CINAHL and Cochrane Library. The search strategy includes terms and synonyms for Bayesian factor analysis and primary care. The reference lists of relevant articles being identified will be screened to find further relevant studies. At least two reviewers will independently extract data and resolve discrepancies through consensus. Descriptive analyses will summarize the use and reporting of Bayesian factor analysis approaches for validating questionnaires applicable to primary care.
Discussion: This methodological review will provide a comprehensive overview of the current use and reporting of Bayesian factor analysis in primary care and will provide recommendations for its proper future use.
Risk Factors For Severity Of Thrombocytopenia In Full Term Infants: A Single Center Study
Authors: Saber Amira M , Aziz Shereen P , Almasry Al Zahraa E , Mahmoud Ramadan A 
Published: December 2020

Abstract
Background: Neonatal thrombocytopenia (NT) (platelet count <150 x 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, risk factors, and outcomes of severe NT in full term (FT) infants.Methods: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.Results: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P=0.001) and had higher rates of mortality (P=0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P=0.001).Conclusion: Severe NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with original disease of the babies.
Limited effects from professional identity formation-oriented intervention on self-regulated learning in a preclinical setting: a randomized-controlled study in Japan
Authors: Matsuyama Yasushi , Nakaya Motoyuki , Leppink Jimmie , Vleuten Cees van der , Asada Yoshikazu , Lebowitz Adam Jon , Sasahara Teppei , Yamamoto Yu , Matsumura Masami , Gomi Akira , Ishikawa Shizukiyo , Okazaki Hitoaki 
Published: December 2020

Abstract
Background: Developing self-regulated learning in preclinical settings is important for future lifelong learning. Previous studies indicate professional identity formation, i.e., formation of self-identity with internalized values and norms of professionalism, might promote self-regulated learning．We designed a professional identity formation-oriented reflection and learning plan format, then tested effectiveness on raising self-regulated learning in a preclinical year curriculum. Methods: A randomized controlled crossover trial was conducted using 112 students at Jichi Medical University. In six one-day problem-based learning sessions in a 7-month pre-clinical year curriculum, Groups A (n = 56, female 18, mean age 21.5y ± 0.7) and B (n = 56, female 11, mean age 21.7y ± 1.0) experienced professional identity formation-oriented format: Group A had three sessions with the intervention format in the first half, B in the second half. Between-group identity stages and self-regulated learning levels were compared using professional identity essays and the Motivated Strategies for Learning Questionnaire.Results: Two-level regression analyses showed no improvement in questionnaire categories but moderate improvement of professional identity stages over time (R2 = 0.069), regardless of timing of intervention. Conclusions: Professional identity moderately forms during the pre-clinical year curriculum. However, neither identity nor self-regulated learning is raised significantly by limited intervention.
Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for pelvic Day type II crescent fracture-dislocation: Case-control study
Authors: Xiang Guangheng , Dong Xiaoyu , Jiang Xingan , Cai Leyi , Wang Jianshun , Guo Xiaoshan , Xiao Jian , Feng Yongzeng 
Published: December 2020

Abstract
Objective: To investigate the clinical outcomes of percutaneous cross screws internal fixation for pelvic Day type II crescent fracture-dislocation.Methods: We reviewed 66 consecutive patients undergoing surgical treatment for Day type II crescent fracture-dislocation from June 2005 to December 2017. Percutaneous cross screws internal fixation was performed in 40 patients, and open reduction and internal fixation was performed in 26 patients. The patient characteristics, surgical complications, radiographic and clinical outcomes and were compared.Results: There was no statistically difference on the mean time from injury to surgery between the two groups. The time of operation, the amount of blood loss, the length of incision and the hospital stay were significantly shorter in the percutaneous cross screws internal fixation Group. No significant difference on Matta scores and Majeed scores between the two groups. The open reduction and internal fixation Group resulted in a higher rate of intraoperative hemorrhage, nerve injury, discomfort and pain.Conclusion: Percutaneous cross screws internal fixation for Day Ⅱ type pelvic crescent fracture-dislocation was safe and effective. Minimally invasive fixation had the advantages of short operation and hospitalization time, less intraoperative bleeding and surgical trauma.
Simulation-based mastery improved nursing skills in BSc Nursing Students: a quasi-experimental study
Authors: Mehdipour-Rabori Roghaye , Bagherian Behnaz , Nematollahi Monirsadat 
Published: December 2020

Abstract
Background: Clinical education is an essential part of nursing education. Selected clinical teaching methods influence the quality of education. Simulation-based mastery learning has been used to improve clinical skills among nursing students and may provide a novel way to enhance nursing skills. This study aimed to assess the effect of simulation-based mastery learning on the clinical skills of undergraduate nursing students from 2017 to 2019.Methods: This quasi-experimental study was conducted with two groups (the control and intervention). A hundred and five students were selected by random convenience sampling, and written consent was obtained. The intervention group participated in a simulation-based mastery learning intervention, and the control group received no intervention except for traditional training. The students of both groups completed the demographic information questionnaire and the checklist before and after the intervention. The results were analyzed by SPSS version 21 and descriptive and inferential statistics.Results: The results showed no significant differences between the two groups before the intervention (p> 0.05). In addition, students' performance in the intervention and control groups improved significantly at the post-test compared with the baseline (p<0.05). Furthermore, the Cohen test implied that the simulation-based mastery model used by the intervention group was significantly more effective than the traditional training used by the control.Conclusion: These findings showed that mastery learning was more effective in improving clinical skills in undergraduate nursing students. The results suggest that other nursing and health programs can be developed by implementing a mastery-based learning model.
Outcome of a single XEN microstent implant for glaucoma patients with different types of glaucoma
Authors: Schargus Marc , Teilig Therese , Rehak Matus , Busch Catharina , Bormann Caroline , Unterlauft Jan Darius 
Published: December 2020

Abstract
Background The aim of this retrospective study was to compare the efficacy and safety profile of a single XEN-microstent in different types of primary and secondary open angle glaucoma.Methods A single XEN microstent was implanted in patients with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), pseudoexfoliation glaucoma (PEX) and secondary glaucoma (Sec.Gl). The intraocular pressure (IOP), the active substances of the applied IOP-lowering drugs, the best corrected visual acuity (BCVA) and the mean deviation (MD) of the perimetry were measured at baseline and at regular follow-ups, scheduled at 2 days and 1, 3, 6 and 12 months after surgery.Results 153 eyes were included in this analysis. 113 eyes were affected by POAG (74%), 5 eyes by NTG (3%), 22 eyes by PEX (14%) and 13 eyes by Sec.Gl (9%). Mean IOP decreased in all treatment groups during the 12 months of follow-up (complete group: 23.9±7.4 to 15.4±5.1 mmHg (p<0.01); POAG: 22.8±6.5 to 15.1±4.6 mmHg (p<0.01); NTG: 16.6±3.4 to 11.6±2.2 mmHg (p<0.05); PEX: 28.0±7.9 to 17.1±6.6 mmHg (p<0.01); Sec.Gl: 28.9±13.9 to 15.5±6.9 mmHg (p<0.05)). In the 153 eyes the average number of IOP-lowering drugs applied decreased from 2.6±1.2 to 0.8±1.3 12 months after surgery (p<0.01). BCVA and mean deviation of automated standard perimetry remained stable in all groups during follow-up.Conclusion As in eyes suffering from POAG, IOP and number of IOP-lowering drugs applied can be effectively reduced by XEN implantation in eyes suffering from NTG, PEX and secondary glaucoma while leaving BCVA and visual field unchanged. Trial registration Trial was registered at DRKS (registration number: DRKS00020800, Registered 25.February 2020 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020800)