bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urinary Tract Infections Caused by Fluconazole-Resistant Trichosporon japonicum in 2 Kidney Transplant Patients and Analysis of Their Homology
Authors: Li Tingting , Huang Ying , Chen Xianguo , Wang Zhongxin , Xu Yuanhong 
Published: August 2020

AbstractTrichosporon spp. are emerging opportunistic agents that cause systemic diseases and life-threatening disseminated disease in immunocompromised hosts. Trichosporon japonicum is a highly rare cause of invasive trichosporonosis. In this study, we describe 2 cases of urinary tract infection caused by Trichosporon japonicum in kidney transplant patients. Culturing of urine samples yielded bluish-green colonies of T. japonicum on Candida chromogenic fungal medium. The isolates were identified as T. japonicum by matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI TOF-MS; Autof MS 1000). The identification of T. japonicum was further confirmed by 18S rRNA gene sequencing. In vitro drug susceptibility testing showed that the 2 strains of T. japonicum were resistant to 5-flucytosine, fluconazole, and caspofungin, with dose-dependent sensitivity to itraconazole and voriconazole but sensitivity to amphotericin B. The homology of the 2 T. japonicum strains, as determined by cluster analysis and principal component analysis of MALDI-TOF MS, was ~85%, suggesting a common nosocomial origin. The first 2 case reports of fluconazole-resistant T. japonicum urinary infection in kidney transplant recipients are presented.
Intrathecal Morphine in Postoperative Analgesia for Colorectal Cancer Surgery: A Retrospective Study
Authors: Young Jamie , Macpherson Alistair , Thakerar Arti , Alexander Marliese 
Published: August 2020

Abstract

Background
Colorectal cancer surgery is commonly performed with adequate analgesia essential for patient recovery. This study assessed the effectiveness of intrathecal morphine and patient-controlled analgesia (ITM + PCA) vs patient-controlled analgesia alone (PCA) for postoperative pain management in colorectal cancer surgery.

Methods
This retrospective study extracted and analyzed data covering a 4-year period (2014–2018) from a clinical database with 24- and 48-hour postsurgery follow-up. Primary outcomes included pain scores, median opioid consumption (oral morphine equivalence dose), sedation, nausea and vomiting, and length of admission. Outcomes were analyzed for ITM + PCA vs PCA alone, overall and stratified by laparotomy or laparoscopy procedures.

Results
In total, 283 patients were included: ITM + PCA (163) and PCA alone (120). Median opioid consumption in the first 24 hours for ITM + PCA vs PCA alone was lower for laparotomy (–32.7 mg, P&lt;0.001) and laparoscopy (–14.3 mg, P&lt;0.001). Median pain score (worst pain) within the first 24 hours for ITM + PCA vs PCA alone was similar for laparotomy (P&gt;0.05) and lower for laparoscopy (–1 unit, P=0.031). Sedation occurred less frequently for ITM + PCA vs PCA at 24 hours (3.5% vs 11.4%, P=0.031), with nonsignificant reduction at 48 hours (4.8% vs 18.8%, P=0.090) for laparotomy, but with no difference for laparoscopy (P&gt;0.05). Incidence of nausea and vomiting and length of admission were similar for ITM + PCA vs PCA alone for laparotomy or laparoscopy (P&gt;0.05).

Conclusion
This retrospective study demonstrated that ITM + PCA can achieve similar analgesic effects after laparotomy and laparoscopy colorectal cancer surgery compared with PCA alone while resulting in a reduction of oral opioid consumption and lower incidence of sedation.
Undermining Governors: Argentina’s Double-Punishment Federal Spending Strategy
Authors: Fenwick Tracy Beck , González Lucas 
Published: August 2020

AbstractThroughout Latin American federations, programmatic welfare spending is increasingly nationally oriented and bureaucratically delivered. By explaining the logic and the effects of combining two types of federal spending, discretionary and non-discretionary, this article uncovers an additional driver that contributes to understanding policymaking and its implementation not only in Argentina, but potentially in other robust federal systems such as Brazil, Canada, and the United States. Using original data on federal infrastructure and programmatic social welfare spending for the twenty-four provinces of Argentina between 2003 and 2015, we provide empirical evidence that both forms of spending penalize opposition districts and more populated urban provinces (regardless of partisan affinity), and thus undercut the ability of key governors to become future presidential challengers. This research suggests that presidents of territorially diverse federations with strong governors can utilize the dual-punishment spending strategy to alter the balance of power, reinforcing the dominance of the center.
Medical breakthroughs: chance and opportunity
Authors: Hughes J M B 
Published: August 2020

AbstractMedical advances of great importance in improving diagnosis, treatment or prevention of disease are often called ‘breakthroughs’. The processes by which breakthroughs are achieved are multiple, but may include necessity (a problem which must be solved), opportunity (the time must be right), chance (the unexpected), curiosity (a desire to understand mechanisms) and ingenuity (ability to find a solution). Discovery can be the start of a chain reaction, so that the breakthrough at the end of the chain becomes “inevitable”. Two examples are given in which these attributes played a part (i) the development of a vaccine against the poliomyelitis virus and (ii) the harnessing of penicillin as a therapeutic agent to treat serious bacterial infections.
Collagen scaffolds functionalized with triple-helical peptides support 3D HUVEC culture
Authors: Malcor Jean-Daniel , Hunter Emma J , Davidenko Natalia , Bax Daniel V , Cameron Ruth , Best Serena , Sinha Sanjay , Farndale Richard W 
Published: August 2020

Abstract
Porous biomaterials which provide a structural and biological support for cells have immense potential in tissue engineering and cell-based therapies for tissue repair. Collagen biomaterials that can host endothelial cells represent promising tools for the vascularization of engineered tissues. Three-dimensional collagen scaffolds possessing controlled architecture and mechanical stiffness are obtained through freeze–drying of collagen suspensions, followed by chemical cross-linking which maintains their stability. However, cross-linking scaffolds renders their biological activity suboptimal for many cell types, including human umbilical vein endothelial cells (HUVECs), by inhibiting cell–collagen interactions. Here, we have improved crucial HUVEC interactions with such cross-linked collagen biomaterials by covalently coupling combinations of triple-helical peptides (THPs). These are ligands for collagen-binding cell-surface receptors (integrins or discoidin domain receptors) or secreted proteins (SPARC and von Willebrand factor). THPs enhanced HUVEC adhesion, spreading and proliferation on 2D collagen films. THPs grafted to 3D-cross-linked collagen scaffolds promoted cell survival over seven days. This study demonstrates that THP-functionalized collagen scaffolds are promising candidates for hosting endothelial cells with potential for the production of vascularized engineered tissues in regenerative medicine applications.
Expression of mitochondrial TSPO and FAM173B is associated with inflammation and symptoms in patients with painful knee osteoarthritis
Authors: Palada Vinko , Siddiqah Ahmed Aisha , Hugo Anders , Radojčić Maja R , Svensson Camilla I , Kosek Eva 
Published: August 2020

Abstract

Objectives
To characterize the expression profiles of two nuclear-encoded mitochondrial genes previously associated with chronic pain, the translocator protein (TSPO) and family with sequence similarity 173B (FAM173B), in different knee compartments from patients with painful knee OA. Also, to examine their association with the joint expression of inflammatory cytokines/chemokines and clinical symptoms.

Methods
The study was performed on 40 knee OA patients and 19 postmortem (PM) controls from which we collected the knee tissues: articular cartilage (AC), synovial membrane (SM) and subchondral bone (SB). Quantitative real-time polymerase chain reaction was used to determine the relative mRNA levels of TSPO, FAM173B, and inflammatory mediators IL6, IL8, IL10, IL12, MCP1, CCL11 and CCL17. OA patients rated their pain intensity (visual analogue scale), severity of knee-related outcomes (KOOS) and pain sensitivity assessed by pressure algometry.

Results
The gene expression of TSPO in SM was elevated in OA patients compared with control subjects while there were no group differences in AC and SB. Expression of FAM173B was reduced in SM but elevated in SB in OA patients compared with controls. The expression of TSPO and FAM173B in SM and SB was associated with the expression of inflammatory substances, but not in AC. Synovial expression of TSPO correlated with lower pain intensity and FAM173B with increased pressure pain sensitivity in OA.

Conclusion
Our results suggest that altered expression of TSPO and FAM173B is associated with joint expression of inflammatory mediators and with clinical symptoms indicating the relevance for the pathophysiology of knee OA.
The Latent Structure of Negative Symptoms in Individuals With Attenuated Psychosis Syndrome and Early Psychosis: Support for the 5 Consensus Domains
Authors: Chang Wing Chung , Strauss Gregory P , Ahmed Anthony O , Wong Sandra C Y , Chan Joe K N , Lee Edwin H M , Chan Sherry K W , Hui Christy L M , James Sydney H , Chapman Hannah C , Chen Eric Y H 
Published: August 2020

Abstract
Negative symptoms are prevalent in the prodromal and first-episode phases of psychosis and highly predictive of poor clinical outcomes (eg, liability for conversion and functioning). However, the latent structure of negative symptoms is unclear in the early phases of illness. Determining the latent structure of negative symptoms in early psychosis (EP) is of critical importance for early identification, prevention, and treatment efforts. In the current study, confirmatory factor analysis was used to evaluate latent structure in relation to 4 theoretically derived models: 1. a 1-factor model, 2. a 2-factor model with expression (EXP) and motivation and pleasure (MAP) factors, 3. a 5-factor model with separate factors for the 5 National Institute of Mental Health (NIMH) consensus development conference domains (blunted affect, alogia, anhedonia, avolition, and asociality), and 4. a hierarchical model with 2 second-order factors reflecting EXP and MAP, as well as 5 first-order factors reflecting the 5 consensus domains. Participants included 164 individuals at clinical high risk (CHR) who met the criteria for a prodromal syndrome and 377 EP patients who were rated on the Brief Negative Symptom Scale. Results indicated that the 1- and 2-factor models provided poor fit for the data. The 5-factor and hierarchical models provided excellent fit, with the 5-factor model outperforming the hierarchical model. These findings suggest that similar to the chronic phase of schizophrenia, the latent structure of negative symptom is best conceptualized in relation to the 5 consensus domains in the CHR and EP populations. Implications for early identification, prevention, and treatment are discussed.
Green synthesis of silver nanoparticles using Indian male fern (Dryopteris Cochleata), operational parameters, characterization and bioactivity on Naja naja venom neutralization
Authors: Singh Pushpendra , Yasir Mohammad , Khare Ruchi , Shrivastava Rahul 
Published: August 2020

Abstract
Snakebite is considered as one of the acute severe medical problems across the world. Snake venoms composed of various group of toxins, enzymes and non-toxic enzymes. Phospholipases A2 present in Naja naja snake venom plays a significant role in lipid signalling and contributes to different inflammation in the human body. Dryopteris cochleata rhizomes have antioxidant, antimicrobial property and used to treat lesions, gonorrhoea, sores, muscular pain, rheumatic and also useful in dog and snake bites. In this study, Indian male fern D. cochleata rhizomes have been used for green synthesis of silver nanoparticles with the aim to increase the bioactivity of plant extract and to evaluate N. naja snake venom inhibition activity of prepared nanoparticles. Green synthesized nanoparticles were characterized with the help of ultraviolet–visible spectroscopy, Fourier-transform infrared spectroscopy, X-ray powder diffraction and atomic force microscopy. Naja naja venom inhibition activity of nanoparticles was performed using in vitro phospholipases A2 assay and tissue damage activity. The results showed that surface plasmon resonance maxima peaks of nanoparticles were observed at 424 nm. Average particle size was around 35 nm, with a spherical shape. Neutralization results exhibited that synthesized silver nanoparticles from D. cochleata decreased percentage of tissue damage, resulting in significant inhibition of phospholipase A2 and N. naja snake venom. Results concluded that green synthesized silver nanoparticles from D. cochleata rhizome neutralize N. naja snake venom activity.
Reducing Barriers for RN-BSN Education: The Assessment Competency Evaluation
Authors: Goliat Laura , Gravens Kathleen A. , Bonnett Pamela L. , Schrull Patricia L. , Bowler Connie , Prosser Regina , Vitantonio Deborah A. , Batch-Wilson Wendy , Szweda Christine , Kavanagh Joan M. , Mau Kathleen A. , Sharpnack Patricia A. , Dillon-Bleich Kimberly , Drennen Carol 
Published: August 2020

Abstract
The Northeast Team of the Ohio Action Coalition, composed of regional clinical and academic educators, identified a potential barrier for nurses pursuing a baccalaureate degree. Duplication of health assessment content was identified for some associate degree graduates enrolled in RN-BSN programs, thereby adding extra time and cost for attaining the baccalaureate degree. In response, the Northeast Team of the Ohio Action Coalition developed an assessment competency evaluation that, if successfully passed, would grant credit for the health assessment course. The assessment competency evaluation provided the opportunity for students to demonstrate competency in both health assessment and clinical judgment skills.
Blood pressure and cardiovascular risk factors in women treated for climacteric symptoms with acupuncture, phytoestrogens, or hormones
Authors: Palma Federica , Fontanesi Francesca , Neri Isabella , Xholli Anjeza , Facchinetti Fabio , Cagnacci Angelo 
Published: August 2020

Abstract

Objective:
To evaluate the response of cardiovascular risk factors to the treatment of climacteric symptoms.

Methods:
In this prospective study, women reporting climacteric symptoms were randomized to 3 months of treatment with either acupuncture (n = 19), phytoestrogens (75 mg soy isoflavones, BID; n = 22), or low-dose hormone therapy (HT; 0.3 mg conjugated equine oestrogens plus 1.5 mg medroxyprogesterone acetate; n = 20). Greene's climacteric scale, blood pressure (BP), lipids, glucose, insulin, and homeostatic model assessment of insulin resistance were assessed before and after treatment. Observed changes were compared by analysis of variance.

Results:
HT and acupuncture reduced Greene climacteric score to a similar extent, but the effect of phytoestrogens was significantly lower (P < 0.05). With acupuncture, systolic (−7.4 ± 15.3 mm Hg; P < 0.05) and diastolic BP (−8.3 ± 7.7mm Hg; P < 0.01) decreased, and the same occurred with phytoestrogens (−8.4 ± 9.0 mm Hg [P < 0.01] and −6.6 ± 7.9 mm Hg [P < 0.01]). Neither BP systolic (1.9 ± 17.5 mm Hg) nor BP diastolic (−1.4 ± 9.6 mm Hg) changed during HT. Low-density lipoprotein cholesterol decreased with phytoestrogens (−9.9 ± 19.6 mg/dL; P < 0.05), and triglycerides increased with both HT (34.5 ± 12.2 mg/dL; P < 0.01) and phytoestrogens (17.41 ± 24.4 mg/dL; P < 0.01). A slight but significant increase in homeostatic model assessment of insulin resistance (0.14 ± 0.5; P < 0.05) was observed after HT.

Conclusions:
Treatment of climacteric symptoms with acupuncture and phytoestrogens, but not HT, is associated with a clear BP reduction, and phytoestrogens with potentially positive alterations in low-density lipoprotein cholesterol level.

Trial Registration:
EudractCT Number 2008-006053-41.

Video Summary:
http://links.lww.com/MENO/A637.
Assessment of menopausal symptoms and quality of life in women with premature ovarian failure after hematopoietic stem-cell transplantation for hematologic diseases
Authors: Su Huina , Li Huiling , Yang Xin , Wang Chaohua , Zhao Yang 
Published: August 2020

Abstract

Objective:
This study aimed to evaluate and compare menopausal symptoms and quality of life between women with premature ovarian failure who underwent hematopoietic stem-cell transplantation (HSCT) for hematologic diseases and naturally menopausal women.

Methods:
This observational study enrolled 415 women (215 HSCT women and 200 naturally menopausal women as control group) from June 2017 to November 2019 in the menopause clinic of Peking University People's Hospital. Menopausal symptoms and quality of life were evaluated using the modified Kupperman index (KI), menopause rating scale (MRS), and menopause quality of life questionnaire.

Results:
The total KI and MRS scores were 12.53 ± 8.27 and 7.69 ± 6.50 in the HSCT group and 21.57 ± 9.23 and 12.05 ± 6.70 in the control group, respectively (P < 0.05). The scores related to sexual problems and vaginal dryness were 1.20 ± 1.24 and 1.07 ± 1.24 in the HSCT group and 1.15 ± 1.01 and 1.01 ± 1.01 in the control group, respectively (P > 0.05). Age was a risk factor for menopausal symptoms (odds ratio 1.70, 95% confidence interval 1.01-1.12). The main reasons for consultations in the HSCT group were amenorrhea and infertility (76.74%).

Conclusions:
Compared with naturally menopausal women with the same number of years since menopause, the MRS and KI scores of women with premature ovarian failure who underwent HSCT showed milder symptoms. The MRS may be a better alternative to reflect the severity of menopausal symptoms. Age was a risk factor for menopausal symptoms. Oncofertility counseling should be initiated as early as possible before the start of treatment.
Transgender adults, gender-affirming hormone therapy and blood pressure: a systematic review
Authors: Connelly Paul J. , Clark Anna , Touyz Rhian M. , Delles Christian 
Published: August 2020

Objectives:
Gender-affirming hormone therapy (GHT) is utilized by people who are transgender to align their secondary sex characteristics with their gender identity. Data relating to cardiovascular outcomes in this population are limited. We aimed to review the impact of GHT on the blood pressure (BP) of transgender individuals.

Methods:
We searched PubMed/MEDLINE, SCOPUS and Cochrane Library databases for articles published relating to the BP of transgender adults commencing GHT. Methodological quality was assessed via the ‘Quality Assessment Tool for Before–After (Pre–Post) Studies with No Control Group’.

Results:
Six hundred articles were screened, of which 14 studies were included in this systematic review encompassing 1309 individuals (∼50% transgender men and women) treated with GHT between 1989 and 2019. These articles were all pre–post observational studies without control groups. Mean ages ranged between 23.0–36.7 years (transgender men) and 25.2–34.8 years (transgender women). Interventions were diverse and included oral, transdermal and injectable hormonal preparations with 4 months to 5 years follow-up. Most studies in transgender men did not demonstrate a change in BP, whereas transgender women on GHT demonstrated both increases and decreases in SBP. These studies were heterogenous with significant methodological limitations and only two were determined to have a good quality rating.

Conclusion:
There is currently insufficient data to advise the impact of GHT on BP in transgender individuals. Better quality research is essential to elucidate whether exogenous sex hormones modulate BP in transgender people and whether this putative alteration infers poorer cardiovascular outcomes.
Effects of Teaching Evidence-Based Medicine on Physician Assistant Students′ Critical Appraisal, Self-Efficacy, and Clinical Application: A Randomized Controlled Trial
Authors: Stack Matthew A. , DeLellis Nailya O. , Boeve Wallace , Satonik Robert C. 
Published: August 2020

Purpose
To use a randomized controlled design to explore the effects of evidence-based medicine (EBM) education on physician assistant (PA) students' EBM knowledge, self-efficacy, and evidence-seeking behavior in a simulated clinical situation and to present a model of EBM competence.

Methods
Sixty-one didactic-year PA students from one Midwestern University (2 sequential cohorts) were randomized to receive the standard PA curriculum plus EBM training (intervention) or the standard PA curriculum only (control). Evidence-based medicine knowledge was measured with a validated Fresno test. Self-efficacy was measured with a validated Likert scale. Clinical application of EBM skills was measured with an objective structured clinical examination (OSCE).

Results
Evidence-based medicine education led to significant improvements on the Fresno and self-efficacy tests, both within and between groups. On the OSCE, the intervention group performed no better than the control group. Higher Fresno pretest scores were significantly related to decreasing improvements in the posttest scores: R = −0.634.

Conclusion
Teaching EBM to PA students improved their EBM knowledge and self-efficacy but not their clinical application. Future research should focus on enhancing EBM evaluation and application in the clinical setting.
Reduced Gritty Perseverance Partially Explains the Relationship Between Overinvolved Parenting and Stress in Physician Assistant Graduate Students
Authors: Francis Andrea P. , Drake Nicole , Chen Matthew , Young Lauren 
Published: August 2020

Purpose
The purpose of this research was to assess the role of noncognitive factors (socioeconomic status [SES], overinvolved parenting, and grit) in predicting perceived stress and grade point average (GPA) among graduate students enrolled in a physician assistant (PA) program.

Methods
In this cross-sectional survey study, 98 PA students completed surveys measuring SES, overinvolved parenting, grit (passion), grit (perseverance), self-reported GPA, and perceived stress.

Results
More overinvolved parenting was reported by PA students under the age of 25 years compared to those over the age of 25. Lower SES predicted higher perceived stress. After controlling for SES, grit (perseverance) partially mediated the relationship between overinvolved parenting and perceived stress. Neither parenting style nor grit was associated with GPA.

Conclusions
Younger PA students reported higher levels of overinvolved parenting. The relationship between experiences with overinvolved parenting and current levels of stress in PA school is partially explained by reduced gritty resilience.