bluuebunny/crossref_metadata_2025_split huggingface dataset:
Geographic mapping of Enterobacteriaceae with extended-spectrum β-lactamase (ESBL) phenotype in Pereira, Colombia
Authors: Arias Ramos Deving , Hoyos Pulgarín Julián Andrés , Moreno Gómez Germán Alberto , Alzate John Alexander , Olaya Gómez Juan Camilo , Cortés Bonilla Isabella , Vargas Mosquera Camila 
Published: July 2020

Abstract
Background
Antimicrobial resistance is an ecological and multicausal problem. Infections caused by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) can be acquired and transmitted in the community. Data on community-associated ESBL-E infections/colonizations in Colombia are scarce. Georeferencing tools can be used to study the dynamics of antimicrobial resistance at the community level.

Methods
We conducted a study of geographic mapping using modern tools based on geographic information systems (GIS). Two study centers from the city of Pereira, Colombia were involved. The records of patients who had ESBL-producing Enterobacteriaceae were reviewed. Antimicrobial susceptibility testing and phenotypic detection of ESBL was done according to CLSI standards.

Results
A population of 415 patients with community-acquired infections/colonizations and 77 hospital discharges were obtained. Geographic distribution was established and heat maps were created. Several hotspots were evidenced in some geographical areas of the south-west and north-east of the city. Many of the affected areas were near tertiary hospitals, rivers, and poultry industry areas.

Conclusions
There are foci of antimicrobial resistance at the community level. This was demonstrated in the case of antimicrobial resistance caused by ESBL in a city in Colombia. Causality with tertiary hospitals in the city, some rivers and the poultry industry is proposed as an explanation of the evidenced phenomenon. Geographic mapping tools are useful for monitoring antimicrobial resistance in the community.
Comparison of the therapeutic effects of surgery following prism adaptation test versus surgery alone in acute acquired comitant esotropia
Authors: Zhang Peng , Zhang Ying , Gao Lei , Yang Jun 
Published: July 2020

AbstractBackgroundTo compare the therapeutic effects of surgery following prism adaptation test versus surgery alone in acute acquired comitant esotropia (AACE).MethodsA total of 46 patients with AACE were enrolled in this retrospective study. Among them, 26 patients underwent surgery following prism adaptation test (combination group) and 20 patients underwent surgery alone (surgery group). The following parameters were evaluated including success rate, distant and near deviation angles, visual function, and near stereoacuity.ResultsThere were no significant differences in success rate between the combination group and surgery group at post-treatment 12 months (96.15% vs. 90.00%,p > 0.05). The postoperative distant and near deviation angles in two groups were significantly lower than that before surgery (p < 0.05). In addition, the numbers of patients with stereopsis postoperatively in two groups were significantly higher than that before surgery (allp < 0.05). Moreover, the numbers of patients with stereopsis and central stereopsis in the combination group were significantly higher than that in the surgery group postoperatively. At post-treatment 12 months, one (3.85%) case recurred in combination group and three (15.00%) cases in the surgery group. No complications were observed in the two groups.ConclusionsBoth approaches had therapeutic benefit in AACE. Surgery following prism adaptation test had better treatment benefits than surgery alone in improving binocular function and reducing recurrence rate.
Utilization of public health care by people with private health insurance: a systematic review and meta-analysis
Authors: Zhang Congcong , Fu Chenwei , Song Yimin , Feng Rong , Wu Xinjuan , Li Yongning 
Published: July 2020

Abstract
Background
The objective of this systematic review was to explore the association between private health insurance and health care utilization.

Methods
We searched the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases for relevant articles since 2010. Studies were eligible if they described original empirical research on the utilization of public health care by individuals with private health insurance, compared with individuals without private insurance. A pooled measure of association between insurance status with health care utilization was assessed through meta-analysis.

Results
Twenty-six articles were included in the final analysis. We found that patients with private insurance did not use more public health care than people without private insurance (P < 0.05). According to the subgroup analysis, people with private insurance were more likely to be hospitalized than people with no insurance (OR 1.67; 95% CI, 1.18 to 2.36).

Conclusions
People with private insurance did not increase their use of health care (outpatient services), compared to those without private insurance. Private health insurance coverage may ease the financial burden on patients and on the public health insurance system.
A systems approach for optimizing implementation to impact: meeting report and proceedings of the 2019 In the Trenches: Implementation to Impact International Summit
Authors: Hanney Stephen R. , Ovseiko Pavel V. , Graham Kathryn E. R. , Chorzempa Heidi , Miciak Maxi 
Published: July 2020

Abstract
Background
The In the Trenches series of cutting-edge knowledge sharing events on impact for front-line experts and practitioners provides an engagement platform for diverse stakeholders across government, research funding organizations, industry, and academia to share emerging knowledge and practical experiences. The second event of the series In the Trenches: Implementation to Impact International Summit was held in Banff, Alberta, Canada, on June 7–8, 2019. The overarching vision for the Summit was to create an engagement platform for addressing key challenges and finding practical solutions to move from implementation (i.e. putting findings into effect) to impact (i.e. creating benefits to society and the economy).

Processes and proceedings
The Summit used diverse approaches to facilitate active engagement and knowledge sharing between 80 delegates across sectors and jurisdictions. Summit sessions mostly consisted of short talks and moderated panels grouped into eight thematic sessions. Each presentation included a summary of Key Messages, along with a summary of the Actionable Insights which concluded each session. The presentations and discussions are analysed, synthesized and described in this proceedings paper using a systems approach. This demonstrates how the Summit focused on each of the necessary functions (and associated components) that should be undertaken, and combined, for effective research and innovation: stewardship and governance, securing finance, creating capacity, and producing and using research. The approach also identifies relevant challenges.

Conclusions
There is increased interest globally in the benefits that can accrue from adopting a systems approach to research and innovation. Various organizations in Canada and internationally have made considerable progress on Implementation to Impact, often as a result of well-planned initiatives. The Summit highlights the value of 1) collaboration between researchers and potential users, and 2) the adoption by funders of approaches involving an increasing range of responsibilities and activities. The Summit website (https://inthetrenchessummit.com/) will be periodically updated with new resources and information about future In the Trenches events.
The need for a holistic approach for SSc-ILD – achievements and ambiguity in a devastating disease
Authors: Hoffmann-Vold Anna-Maria , Allanore Yannick , Bendstrup Elisabeth , Bruni Cosimo , Distler Oliver , Maher Toby M. , Wijsenbeek Marlies , Kreuter Michael 
Published: July 2020

AbstractSystemic sclerosis (SSc) is a multi-organ autoimmune disease with complex interactions between immune-mediated inflammatory processes and vascular pathology leading to small vessel obliteration, promoting uncontrolled fibrosis of skin and internal organs. Interstitial lung disease (ILD) is a common but highly variable manifestation of SSc and is associated with high morbidity and mortality. Treatment approaches have focused on immunosuppressive therapies, which have shown some efficacy on lung function. Recently, a large phase 3 trial showed that treatment with nintedanib was associated with a reduction in lung function decline. None of the conducted randomized clinical trials have so far shown convincing efficacy on other outcome measures including quality of life determined by patient reported outcomes. Little evidence is available for non-pharmacological treatment and supportive care specifically for SSc-ILD patients, including pulmonary rehabilitation, supplemental oxygen, symptom relief and adequate information. Improved management of SSc-ILD patients based on a holistic approach is necessary to support patients in maintaining as much quality of life as possible throughout the disease course and to improve long-term outcomes.
A novel knock out strategy to enhance recombinant protein expression in Escherichia coli
Authors: Sharma Ashish K. , Shukla Esha , Janoti Deepak S. , Mukherjee Krishna J. , Shiloach Joseph 
Published: July 2020

Abstract
Background
The expression of recombinant proteins triggers a stress response which downregulates key metabolic pathway genes leading to a decline in cellular health and feedback inhibition of both growth and protein expression. Instead of individually upregulating these downregulated genes or improving transcription rates by better vector design, an innovative strategy would be to block this stress response thereby ensuring a sustained level of protein expression.

Results
We postulated that the genes which are commonly up-regulated post induction may play the role of signalling messengers in mounting the cellular stress response. We identified those genes which have no known downstream regulatees and created knock outs which were then tested for GFP expression. Many of these knock outs showed significantly higher expression levels which was also sustained for longer periods. The highest product yield (Yp/x) was observed in a BW25113ΔcysJ knock out (Yp/x 0.57) and BW25113ΔelaA (Yp/x 0.49), whereas the Yp/x of the control W3110 strain was 0.08 and BW25113 was 0.16. Double knock out combinations were then created from the ten best performing single knock outs leading to a further enhancement in expression levels. Out of 45 double knock outs created, BW25113ΔelaAΔyhbC (Yp/x 0.7) and BW25113ΔcysJΔyhbC (Yp/x 0.64) showed the highest increase in product yield compared to the single gene mutant strains. We confirmed the improved performance of these knock outs by testing and obtaining higher levels of recombinant asparaginase expression, a system better suited for analysing sustained expression since it gets exported to the extracellular medium.

Conclusion
Creating key knock outs to block the CSR and enhance expression is a radically different strategy that can be synergistically combined with traditional methods of improving protein yields thus helping in the design of superior host platforms for protein expression.
Long-term transmission patterns and public health policies leading to malaria elimination in Panamá
Authors: Hurtado Lisbeth , Cumbrera Alberto , Rigg Chystrie , Perea Milixa , Santamaría Ana María , Chaves Luis Fernando , Moreno Dianik , Romero Luis , Lasso Jose , Caceres Lorenzo , Saldaña Azael , Calzada Jose E. 
Published: July 2020

AbstractBackgroundThe present study provides a countrywide perspective of the malaria situation in Panamá over a long-term framework, with the purpose of identifying historical malaria resurgence events and their potential causes.MethodsA descriptive-ecological study was conducted by analysing demographic and epidemiological annual malaria time series data in Panamá (1884–2019) using several data sources. Malaria intensity indicators were calculated during the study period. The effects of El Niño Southern Oscillation on malaria transmission were also analysed using a retrospective analysis of malaria cases between 1957 and 2019.ResultsSeveral factors were identified responsible for malaria resurgence in Panamá, mostly related with Malaria Control Programme weakening. During the past 20 years (2000–2019) malaria has progressively increased in prevalence within indigenous settlements, with a predominance of male cases and a high proportion (15% of total cases) in children less than 5 years old. During this period, a significant and increasing proportion of thePlasmodium falciparumcases were imported. Retrospective analysis (1957–2019) evidenced that ENSO had a significant impact on malaria transmission dynamics in Panamá.ConclusionsData analysis confirmed that although authorities have been successful in focalizing malaria transmission in the country, there are still neglected issues to be solved and important intercultural barriers that need to be addressed in order to achieve elimination of the disease by 2022. This information will be useful for targeting strategies by the National Malaria Elimination Programme.
Lipoprotein (a) as a residual risk factor for atherosclerotic renal artery stenosis in hypertensive patients: a hospital-based cross-sectional study
Authors: Hu Xiangming , Yang Xing , Li Xida , Luo Demou , Zhou Yingling , Dong Haojian 
Published: July 2020

Abstract
Background
Low-density lipoprotein cholesterol (LDL-c) has been proven to be a risk factor for atherosclerotic cardiovascular disease (CVD), while lipoprotein (a) (Lp(a)) is a residual risk factor for CVD, even though LDL-c is well controlled by statin use. Importantly, the role of Lp(a) in atherosclerotic renal artery stenosis (ARAS) is still unknown.

Methods
For this hospital-based cross-sectional study, patients who simultaneously underwent coronary and renal angiography were examined. ARAS was defined as a 50% reduction in the cross-sectional (two-dimensional plane) area of the renal artery. Data were collected and compared between ARAS and non-ARAS groups, including clinical history and metabolite profiles. Univariate analysis, three tertile LDL-c-based stratified analysis, and multivariate-adjusted logistic analysis were conducted, revealing a correlation between Lp(a) and ARAS.

Results
A total of 170 hypertensive patients were included in this study, 85 with ARAS and 85 with non-RAS. Baseline information indicated comparability between the two groups. In the univariate and multivariate analysis, common risk factors for atherosclerosis were not significantly different. Stratified analysis of LDL-c revealed a significant increase in the incidence of ARAS in patients who had high Lp(a) concentrations at low LDL-c levels (odds ratio (OR): 4.77, 95% confidence interval (CI): 1.04–21.79, P = 0.044). Further logistic analysis with adjusted covariates also confirmed the result, indicating that high Lp(a) levels were independently associated with ARAS (adjusted OR (aOR): 6.14, 95%CI: 1.03–36.47, P = 0.046). This relationship increased with increasing Lp(a) concentration based on a curve fitting graph. These results were not present in the low and intermediate LDL-c-level groups.

Conclusion
In hypertensive patients who present low LDL-c, high Lp(a) was significantly associated with atherosclerotic renal artery stenosis and thus is a residual risk factor.
A cohort study evaluating the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment (OAT) across Ontario, Canada, using administrative health data
Authors: Morin Kristen A. , Eibl Joseph K. , Gauthier Graham , Rush Brian , Mushquash Christopher , Lightfoot Nancy E. , Marsh David C. 
Published: July 2020

AbstractBackgroundDue to the high prevalence of mental disorders among people with opioid use disorder, the objective of this study was to determine the association between concurrent mental disorders, mortality, morbidity, and continuous treatment retention for patients in opioid agonist treatment in Ontario, Canada.MethodsWe conducted a retrospective cohort study of patients enrolled in opioid agonist treatment between January 1, 2011, and December 31, 2015. Patients were stratified into two groups: those diagnosed with concurrent mental disorders and opioid use disorder and those with opioid use disorder only, using data from the Ontario Health Insurance Plan Database, Ontario Drug Benefit Plan Database. The primary outcome studied was all-cause mortality using data from the Registered Persons Database. Emergency department visits from the National Ambulatory Care Database, hospitalizations Discharge Abstract Database, and continuous retention in treatment, defined as 1 year of uninterrupted opioid agonist treatment using data from the Ontario Drug Benefit Plan Database were measured as secondary outcomes. Encrypted patient identifiers were used to link information across databases.ResultsWe identified 55,924 individuals enrolled in opioid agonist treatment, and 87% had a concurrent mental disorder diagnosis during this period. We observed that having a mental disorder was associated with an increased likelihood of all-cause mortality (odds ratio (OR) 1.4; 95% confidence interval (CI) 1.2–1.5). For patients diagnosed with mental disorders, the estimated rate of ED visits per year was 2.25 times higher and estimated rate of hospitalization per year was 1.67 times higher than for patients with no mental disorders. However, there was no association between having a diagnosis of a mental disorder and 1-year treatment retention in OAT-adjusted hazard ratio (HR) = 1.0; 95% CI 0.9 to 1.1.ConclusionOur findings highlight the consequences of the high prevalence of mental disorders for individuals with opioid use disorder in Ontario, Canada.
German version of the Chedoke McMaster arm and hand activity inventory (CAHAI-G): intra-rater reliability and responsiveness
Authors: Behrendt Frank , Rizza Julia Charlotte , Blum Fabian , Suica Zorica , Schuster-Amft Corina 
Published: July 2020

Abstract
Background
The English version of the Chedoke Arm and Hand Activity Inventory is a validated, upper-limb measure with the purpose of assessing functional recovery of the arm and hand after a stroke. A German translation and cross-cultural adaptation was recently produced and demonstrated high validity, inter-rater reliability and internal consistency. As a follow-up, the present study evaluated the intra-rater reliability and responsiveness of the CAHAI-G for the long and all shortened versions.

Methods
The CAHAI-G and the Action Research Arm Test were assessed on three different measurement events: upon entry (ME1), two to 3 days after entry (ME2), and after three to 4 weeks (ME3). For the intra-rater reliability analysis, the ME1 CAHAI assessments were recorded on video and rated by three therapists to obtain the intraclass coefficients (ICC). The data of all three MEs were analysed in a group of stroke inpatients for the evaluation of responsiveness. To test for responsiveness, the CAHAI-G change data were compared to concurrent instruments: The Global Rating of Change-questionnaire and the Global Rating of Concept-questionnaire. Both served as external criteria. For all CAHAI-G versions (7, 8, 9 or 13 items), the same analysis procedures for the evaluation of the responsiveness parameter were performed.

Results
In total, 27 patients (9 females, age 63 ± 13.7) were enrolled in the study. The ICCs for the intra-rater reliability were calculated to be between 0.988 and 0.998 for all CAHAI versions. Responsiveness parameters were as follows from CAHAI-G 7 to 13: Minimal Detectable Change (MDC90) 5.3, 6.0, 6.1, 8.2; Pearson’s correlation coefficients CAHAI-Gs with ARAT 0.365, 0.409*, 0.500**, 0.597**. The Area und Under the Curve and the Minimal Clinical Important Difference values for all CAHAI-G versions and the three external criteria ranged between 0.483 to 0.603 and 2.5 to 9.0, respectively.

Conclusion
In addition to the high validity, inter-rater reliability and internal consistency, the CAHAI-G revealed high intra-rater reliability. The data also suggest an adequate responsiveness of the CAHAI-G versions 9 and 13.
The importance of primary tumor origin in gastrointestinal malignancies undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Authors: Leigh Natasha , Solomon Daniel , Pletcher Eric , Labow Daniel M. , Magge Deepa R. , Sarpel Umut , Golas Benjamin J. 
Published: July 2020

Abstract
Background
Appendiceal and colorectal cancers with peritoneal carcinomatosis (PC) can derive benefit from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). However, its role in gastric and small bowel malignancies remains undefined.

Methods
We retrospectively analyzed 251 gastrointestinal adenocarcinomas with PC which underwent CRS/HIPEC at our institution from 2007 to 2017. We compared outcomes of gastric, small bowel, appendiceal, and colorectal cohorts.

Results
Thirty-one gastric, 8 small bowel, 91 appendiceal, and 121 colorectal cohorts were included. More gastric cancers (90%) received neoadjuvant chemotherapy than any other cohort, p = 0.002. Although colorectal had the lowest peritoneal cancer index (PCI) (9) and appendiceal the highest (16), all cohorts underwent similar rates of organ resection and complete cytoreduction. Length of stay (p = 0.005) and major perioperative morbidity (Clavien III/IV, p = 0.011) were significantly higher in gastric and small bowel. Median overall survival (OS, p < 0.001) was significantly shorter in gastric (13 months) and small bowel (9 months) than in appendiceal (33 months) and colorectal (42 months) cohorts. On multivariate analysis, complete cytoreduction and PCI score were significant predictors of OS, p < 0.05.

Conclusions
Primary tumor origin significantly affects outcomes after CRS/HIPEC for gastrointestinal malignancies. Though there was a survival benefit in appendiceal and colorectal, gastric and small bowel survival was comparable to systemic chemotherapy.
Talc pleurodesis versus indwelling pleural catheter among patients with malignant pleural effusion: a meta-analysis of randomized controlled trials
Authors: Wang Li , Deng Huan , Chen Xinling , Li Can , Yi Fengming , Wei Yiping , Zhang Wenxiong 
Published: July 2020

Abstract
Background
Talc pleurodesis (TP) and indwelling pleural catheter (IPC) are used for the management of malignant pleural effusion (MPE). Our meta-analysis was conducted to assess the efficacy and safety of both treatments among patients with MPE.

Methods
We acquired pertinent randomized controlled trials (RCTs) by searching PubMed, ScienceDirect, the Cochrane Library, Scopus, Ovid Medline, Embase, Web of Science, and Google Scholar. The endpoints included survival, pleurodesis rates, total drainage, further pleural interventions, hospital days, symptoms, quality of life (QoL), and complications.

Results
We included four high-quality RCTs. Both treatments were effective among patients with MPE and no previous pleurodesis, with comparable survival and equivalent relief of breathlessness. Additionally, the TP group had higher pleurodesis rates, less total drainage, and fewer all-grade complications (including catheter blockage and cellulitis). However, patients in the TP group had more pleural procedures and relatively longer hospital stays. Additionally, no apparent difference was detected in QoL.

Conclusions
TP has better pleurodesis rates, less total drainage, and fewer all-grade complications. However, TP has more pleural procedures and is not feasible for patients with trapped lungs. IPC has fewer further pleural interventions and shorter hospital stays. However, IPC has the nuisance of long-term in situ draining.