bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of Low-Level Bacteremia in Children from Birth to Fifteen Years of Age
Authors: Kellogg James A. , Manzella John P. , Bankert David A. 
Published: March 2020

ABSTRACT
A single blood culture inoculated with a small volume of blood is still frequently being used for the diagnosis of bacteremia in children because of the continued belief by many that bacteria are usually found in high concentrations in the blood of pediatric patients with sepsis. To determine the importance of both blood volume cultured and the number of culture devices required for the reliable detection of pathogens in our pediatric population, blood from children from birth to 15 years of age and with suspected bacteremia at York Hospital (a 500-bed community hospital) was inoculated into at least a Pediatric Isolator (Wampole Laboratories; 1.5 ml of blood) or a standard Isolator (10 ml of blood) and a bottle of ESP anaerobic broth (Trek Diagnostic Systems; 0.5 to 10 ml of blood). The use of a second Isolator and additional aerobic and anaerobic bottles and the total blood volume recommended for cultures (2 to 60 ml) depended on the weight and total blood volume of each patient. One hundred forty-seven pathogens were recovered from the blood of 137 (3.6%) of 3,829 children for whom culturing was done. Of 121 septic episodes for which the concentration of pathogens in the blood could be determined using Isolators, 73 (60.3%) represented low-level bacteremia (≤10 CFU/ml of blood), including 28 pathogens (23.1%) which were detected at concentrations of only ≤1.0 CFU/ml. Of 144 septic episodes for which two or more culture devices (Isolators and/or bottles) were inoculated, 85 (59%) were associated with false-negative results from one or more of the culture devices. Of the 128 children for whom antibiotic therapy records were complete, therapy was either started or changed for 88 (68.8%) following notification of positive blood cultures. Low-level bacteremia was common in our pediatric population, requiring the culturing of up to 4 or 4.5% of a patient's total blood volume for the reliable detection of pathogens and appropriate, timely changes in empiric therapy.
Cloning and Sequencing of a Part of the Heat Shock Protein 65 Gene (
hsp65
) of “
Tropheryma whippelii
” and Its Use for Detection of “
T. whippelii
” in Clinical Specimens by PCR
Authors: Morgenegg Silvia , Dutly Fabrizio , Altwegg Martin 
Published: March 2020

ABSTRACT

Using broad-spectrum primers, we have amplified, cloned, and sequenced a 620-bp fragment of the “
Tropheryma whippelii
” heat shock protein 65 gene (
hsp65
) from the heart valve of a patient with Whipple's endocarditis. The deduced amino acid sequence shows high similarity to those from actinobacteria, confirming that “
T. whippelii
” is indeed a member of this phylum. Based on the nucleotide sequence, we have developed a “
T. whippelii
”-specific seminested PCR. Seventeen patients shown to be positive by 16S ribosomal DNA (rDNA) PCR and/or internal transcribed spacer (ITS) PCR were also positive by
hsp65
PCR. All 33 control specimens from patients without Whipple's disease and negative for “
T. whippelii
” by both seminested 16S rDNA and ITS PCR remained negative. All amplicons digested with
Xho
I revealed an identical restriction pattern. Eight of the 17
hsp65
amplicons representing all three previously described ITS types were sequenced. Three of the amplicons showed slight differences, but none of the mutations detected affected the amino acid sequence of the corresponding protein. We conclude that the
hsp65
gene is a suitable target for the specific detection of “
T. whippelii
.” Its product represents a putative antigen for a future serodiagnostic assay.
Comparative Evaluation of PASCO and National Committee for Clinical Laboratory Standards M27-A Broth Microdilution Methods for Antifungal Drug Susceptibility Testing of Yeasts
Authors: Arthington-Skaggs Beth A. , Motley Milwood , Warnock David W. , Morrison Christine J. 
Published: March 2020

ABSTRACT

The PASCO antifungal susceptibility test system, developed in collaboration with a commercial company, is a broth microdilution assay which is faster and easier to use than the reference broth microdilution test performed according to the National Committee for Clinical Laboratory Standards (NCCLS) document M27-A guidelines. Advantages of the PASCO system include the system's inclusion of quality-controlled, premade antifungal panels containing 10, twofold serial dilutions of drugs and a one-step inoculation system whereby all wells are simultaneously inoculated in a single step. For the prototype panel, we chose eight antifungal agents for in vitro testing (amphotericin B, flucytosine, fluconazole, ketoconazole, itraconazole, clotrimazole, miconazole, and terconazole) and compared the results with those of the NCCLS method for testing 74 yeast isolates (14
Candida albicans
, 10
Candida glabrata
, 10
Candida tropicalis
, 10
Candida krusei
, 10
Candida dubliniensis
, 10
Candida parapsilosis
, and 10
Cryptococcus neoformans
isolates). The overall agreements between the methods were 91% for fluconazole, 89% for amphotericin B and ketoconazole, 85% for itraconazole, 80% for flucytosine, 77% for terconazole, 66% for miconazole, and 53% for clotrimazole. In contrast to the M27-A reference method, the PASCO method classified as resistant seven itraconazole-susceptible isolates (9%), two fluconazole-susceptible isolates (3%), and three flucytosine-susceptible isolates (4%), representing 12 major errors. In addition, it classified two fluconazole-resistant isolates (3%) and one flucytosine-resistant isolate (1%) as susceptible, representing three very major errors. Overall, the agreement between the methods was greater than or equal to 80% for four of the seven species tested (
C. dubliniensis
,
C. glabrata
,
C. krusei
, and
C. neoformans
). The lowest agreement between methods was observed for miconazole and clotrimazole and for
C. krusei
isolates tested against terconazole. When the data for miconazole and clotrimazole were removed from the analysis, agreement was ≥80% for all seven species tested. Therefore, the PASCO method is a suitable alternative procedure for the testing of the antifungal susceptibilities of the medically important
Candida
spp. and
C. neoformans
against a range of antifungal agents with the exceptions only of miconazole and clotrimazole and of terconazole against
C. krusei
isolates.
Recovery of
Bordetella holmesii
from Patients with Pertussis-Like Symptoms: Use of Pulsed-Field Gel Electrophoresis To Characterize Circulating Strains
Authors: Mazengia Eyob , Silva Ellen A. , Peppe Joseph A. , Timperi Ralph , George Harvey 
Published: March 2020

ABSTRACT

A 4-year retrospective study showing that we isolated
Bordetella holmesii
, but not
Bordetella pertussis
, from patients with pertussis-like symptoms was performed. From 1995 through 1998, we isolated
B. holmesii
from 32 nasopharyngeal specimens that had been submitted from patients suspected of having pertussis. Previously,
B. holmesii
had been associated mainly with septicemia and was not thought to be associated with respiratory illness. A study was undertaken to describe the characteristics of the
B. holmesii
isolates recovered and why we were successful in detecting the organism in nasopharyngeal specimens.
B. holmesii
isolates were characterized for drug sensitivities and for genetic relatedness by pulsed-field gel electrophoresis (PFGE). These isolates, an additional strain of
B. holmesii
isolated from a blood culture and previously confirmed by the Centers for Disease Control and Prevention, Atlanta, Ga., and 14 other clinical isolates of
Bordetella
spp., including 4 of
B. bronchiseptica
, 5 of
B. parapertussis
, and 5 of
B. pertussis
, were studied. They were all separately inoculated on three Bordet Gengou (BG) selective media containing either 0.625 μg of oxacillin per ml, 40 μg of cephalexin per ml, or 2.5 μg of methicillin per ml, on BG agar with no antibiotic (control), and on charcoal agar (CA) with and without 40 μg of cephalexin per ml. We found that cephalexin, the antibiotic commonly incorporated in both CA and BG agar for the recovery of
Bordetella
spp., is inhibitory to the growth of
B. holmesii
. In addition, the genotypic analysis of the 32
B. holmesii
isolates by PFGE following restriction with
Xba
I and
Spe
I identified the dominant strains circulating during the study period.
Mass Spectrometric Identification of Mtb81, a Novel Serological Marker for Tuberculosis
Authors: Hendrickson Ronald C. , Douglass John F. , Reynolds Lisa D. , McNeill Patricia D. , Carter Darrick , Reed Steven G. , Houghton Raymond L. 
Published: March 2020

ABSTRACT

We have used serological proteome analysis in conjunction with tandem mass spectrometry to identify and sequence a novel protein, Mtb81, which may be useful for the diagnosis of tuberculosis (TB), especially for patients coinfected with human immunodeficiency virus (HIV). Recombinant Mtb81 was tested by an enzyme-linked immunosorbent assay to detect antibodies in 25 of 27 TB patients (92%) seropositive for HIV as well as in 38 of 67 individuals (57%) who were TB positive alone. No reactivity was observed in 11 of 11 individuals (100%) who were HIV seropositive alone. In addition, neither sera from purified protein derivative (PPD)-negative (0 of 29) nor sera from healthy (0 of 45) blood donors tested positive with Mtb81. Only 2 of 57 of PPD-positive individuals tested positive with Mtb81. Sera from individuals with smear-positive TB and seropositive for HIV but who had tested negative for TB in the 38-kDa antigen immunodiagnostic assay were also tested for reactivity against Mtb81, as were sera from individuals with lung cancer and pneumonia. Mtb81 reacted with 26 of 37 HIV
+
TB
+
sera (70%) in this group, compared to 2 of 37 (5%) that reacted with the 38-kDa antigen. Together, these results demonstrate that Mtb81 may be a promising complementary antigen for the serodiagnosis of TB.
Epidemiologic Subtyping of
Escherichia coli
Serogroup O157 Strains Isolated in Ontario by Phage Typing and Pulsed-Field Gel Electrophoresis
Authors: Preston Martin A. , Johnson Wendy , Khakhria Rasik , Borczyk Alexander 
Published: March 2020

ABSTRACT

Phage typing and DNA macrorestriction fragment analysis by pulsed-field gel electrophoresis (PFGE) were evaluated for use in the epidemiological subtyping of
Escherichia coli
serogroup O157 strains isolated in Ontario, Canada. Among 30 strains isolated from patients with sporadic cases of infection, 22 distinct
Xba
I macrorestriction patterns were identified and 17 strains exhibited unique PFGE patterns. In contrast, phage typing identified only seven different phage types and 17 strains belonged to the same phage type. A total of 25 phage type-macrorestriction pattern combinations were identified among the strains from patients with sporadic cases of infection. PFGE subtyping differentiated between unrelated strains that exhibited the same phage type, and in one group of strains, phage typing differentiated between strains of the same PFGE subtype. Both typing procedures correctly identified outbreak-related isolates as belonging to the same type in four separate outbreaks. Each outbreak strain was characterized by a distinct macrorestriction pattern, while phage typing subdivided the outbreak strains into only three different types. A small percentage of outbreak-related isolates had PFGE patterns that differed slightly (one or two DNA fragment differences) from that of the outbreak strain. On the other hand, each isolate from the same outbreak belonged to the same phage type as that of the outbreak strain. We conclude that phage typing and PFGE fingerprinting represent complementary procedures for the subtyping of
E. coli
serogroup O157 and that the combined use of these procedures provides optimal discrimination.
Correlation between In Vitro and In Vivo Antifungal Activities in Experimental Fluconazole-Resistant Oropharyngeal and Esophageal Candidiasis
Authors: Walsh Thomas J. , Gonzalez Corina E. , Piscitelli Steven , Bacher John D. , Peter Joanne , Torres Richard , Shetti Daiva , Katsov Victoria , Kligys Kristina , Lyman Caron A. 
Published: March 2020

ABSTRACT

Oropharyngeal and esophageal candidiasis (OPEC) is a frequent opportunistic mycosis in immunocompromised patients. Azole-resistant OPEC is a refractory form of this infection occurring particularly in human immunodeficiency virus (HIV)-infected patients. The procedures developed by the Antifungal Subcommittee of the National Committee for Clinical Laboratory Standards (NCCLS) are an important advance in standardization of in vitro antifungal susceptibility methodology. In order to further understand the relationship between NCCLS methodology and antifungal therapeutic response, we studied the potential correlation between in vitro susceptibility to fluconazole and in vivo response in a rabbit model of fluconazole-resistant OPEC. MICs of fluconazole were determined by NCCLS methods. Three fluconazole-susceptible (FS) (MIC, ≤0.125 μg/ml) and three fluconazole-resistant (FR) (MIC, ≥64 μg/ml) isolates of
Candida albicans
from prospectively monitored HIV-infected children with OPEC were studied. FR isolates were recovered from children with severe OPEC refractory to fluconazole, and FS isolates were recovered from those with mucosal candidiasis responsive to fluconazole. Fluconazole at 2 mg/kg of body weight/day was administered to infected animals for 7 days. The concentrations of fluconazole in plasma were maintained above the MICs for FS isolates throughout the dosing interval. Fluconazole concentrations in the esophagus were greater than or equal to those in plasma. Rabbits infected with FS isolates and treated with fluconazole had significant reductions in oral mucosal quantitative cultures (
P
< 0.001) and tissue burden of
C. albicans
in tongue, soft palate, and esophagus (
P
< 0.001). In comparison, rabbits infected with FR isolates were unresponsive to fluconazole and had no reduction in oral mucosal quantitative cultures or tissue burden of
C. albicans
versus untreated controls. We conclude that there is a strong correlation between in vitro fluconazole susceptibility by NCCLS methods and in vivo response to fluconazole therapy of OPEC due to
C. albicans
.
Phaeoisaria clematidis
as a Cause of Keratomycosis
Authors: Guarro Josep , Vieira Luiz A. , De Freitas Denise , Gené Josepa , Zaror Luis , Hofling-Lima Ana Luisa , Fischman Olga , Zorat-Yu Cecilia , Figueras M. José 
Published: March 2020

ABSTRACT

We report the first case of human infection by
Phaeoisaria clematidis
. This fungus caused a corneal ulcer in a Brazilian man who had previously suffered an eye injury. Diagnosis was established by positive direct examination and repeated cultures. The isolate was clearly resistant in vitro to the six antifungal agents tested.
Detrital zircon records of late Paleoproterozoic to early Neoproterozoic northern North China Craton drainage reorganization: Implications for supercontinent cycles
Authors: Liu Chaohui , Zhao Guochun , Liu Fulai , Shi Jianrong , Ji Lei 
Published: March 2020

Abstract
Statherian through Tonian strata of the Langshan–Zha’ertai–Bayan Obo–Huade rift zone (LZBH) at the northern margin of the North China Craton provide an excellent record of changes in sediment provenance related to the supercontinent dispersal and amalgamation. During the late Paleoproterozoic to early Neoproterozoic, the LZBH developed over the Yinshan Block and was flanked by the Khondalite Belt to the south, the Trans–North China Orogen and Yanliao rift zone to the east, ultimately preserving a &gt;7000-m-sequence of fluvial, marginal marine, and offshore marine sediments. In order to decipher the influence of these tectonic features on sediment delivery to the area, we evaluated 4955 U-Pb and 1616 Lu-Hf analyses from 66 samples across the entire LZBH, of which 1002 U-Pb and 271 Lu-Hf analyses from 12 samples are newly reported herein. The detrital zircon results indicate three stratigraphic intervals with internally consistent age peaks: (1) Changcheng to lower Jixian system (Statherian–lower Calymmian), (2) upper Jixian system (upper Calymmian), and (3) Qingbaikou system (Tonian). Statistical analysis of the detrital zircon results reveals two distinct changes in sediment provenance. The first transition, between the lower and upper Calymmian, reflects a provenance change from the basement of the Yinshan Block and the Khondalite Belt to a mixed signature, indicating derivation from both basement and Statherian rift-related magmatic products. Such a transition implies establishment of east–west drainage systems traversing the Paleoproterozoic Trans–North China Orogen caused by continued rifting since Statherian and pre-magmatic uplift during breakup of the North China Craton from the Columbia supercontinent. The second transition is indicated by the presence of Mesoproterozoic detrital zircons with juvenile Hf isotopic features since Tonian time and the up-section and northward increase of Mesoproterozoic detrital zircons. Their provenance is interpreted to be the Fennoscandian shield by a pancontinental drainage system related to aggregation of the Rodinia supercontinent. Thus, the detrital zircon spectra in the LZBH document the transition from initial unroofing of local uplifted basement of the Yinshan Block and Khondalite Belt to the distant Yanliao rift zone, then to the more distant Fennoscandian shield.
Serum cell-free DNA and progression of diabetic kidney disease: a prospective study
Authors: Li Xuan , Hu RenZhi , Luo Ting , Peng Chuan , Gong Lilin , Hu Jinbo , Yang Shumin , Li Qifu 
Published: March 2020

AimsCell-free DNA (cfDNA) is associated with diabetes and cardiovascular diseases. Our study was to evaluate whether serum cfDNA could predict the progression of diabetic kidney disease (DKD).MethodsIn this prospective study, a total of 160 patients with DKD were enrolled, and the kidney function was followed up by measurement of estimated glomerular filtration rate (eGFR) and urinary albumin–creatinine ratio (UACR) for three consecutive years. At baseline, concentrations of serum cfDNA were measured. DKD progression was defined as two-continuous decrease in eGFR and changes of UACR from less than 300 mg/g at baseline to higher than 300 mg/g at last follow-up. Regression models were used to analyze associations of serum cfDNA with the DKD progression.ResultsIn total, 131 patients finished all the follow-up visits. At the end of the study, 64 patients showed decreased eGFR and 29 patients had changes of UACR from less than 300 mg/g at baseline to higher than 300 mg/g at follow-up. At baseline, the progression group had higher serum cfDNA levels than the non-progression group (960.49 (816.53, 1073.65) ng/mL vs 824.51 (701.34, 987.06) ng/mL, p=0.014). Serum cfDNA levels were significantly negatively associated with the 1.5-year eGFR change (r=−0.219 p=0.009) and 3-year eGFR change (r=−0.181, p=0.043). Multivariate logistic analyses showed that after adjustment of age, gender, body mass index, fast plasma glucose, smoking, triglycerides, total cholesterol, duration of diabetes, systolic blood pressure, diabetic retinopathy, eGFR, high sensitivity C-reactive protein, angiotensin receptor blocker/ACE inhibitor usage, with the increase of one SD of serum cfDNA levels, the risk of DKD progression increased by 2.4 times (OR, 2.46; 95% CI 1.84 to 4.89).ConclusionSerum cfDNA is closely associated with DKD, and it might be a predictor of DKD progression in patients with type 2 diabetes.
Supporting antidepressant discontinuation: the development and optimisation of a digital intervention for patients in UK primary care using a theory, evidence and person-based approach
Authors: Bowers Hannah M , Kendrick Tony , Glowacka Marta , Williams Samantha , Leydon Geraldine , May Carl , Dowrick Chris , Moncrieff Joanna , Laine Rebecca , Nestoriuc Yvonne , Andersson Gerhard , Geraghty Adam W A 
Published: March 2020

ObjectivesWe aimed to develop a digital intervention to support antidepressant discontinuation in UK primary care that is scalable, accessible, safe and feasible. In this paper, we describe the development using a theory, evidence and person-based approach.DesignIntervention development using a theory, evidence and person-based approach.SettingPrimary Care in the South of England.ParticipantsFifteen participants with a range of antidepressant experience took part in ‘think aloud’ interviews for intervention optimisation.InterventionOur digital intervention prototype (called ‘ADvisor’) was developed on the basis of a planning phase consisting of qualitative and quantitative reviews, an in-depth qualitative study, the development of guiding principles and a theory-based behavioural analysis. Our optimisation phase consisted of ‘think aloud’ interviews where the intervention was iteratively refined.ResultsThe qualitative systematic review and in-depth qualitative study highlighted the centrality of fear of depression relapse as a key barrier to discontinuation. The quantitative systematic review showed that psychologically informed approaches such as cognitive–behavioural therapy were associated with greater rates of discontinuation than simple advice to reduce. Following a behavioural diagnosis based on the behaviour change wheel, social cognitive theory provided a theoretical basis for the intervention. The intervention was optimised on the basis of think aloud interviews, where participants suggested they like the flexibility of the system and found it reassuring. Changes were made to the tone of the material and the structure was adjusted based on this qualitative feedback.Conclusions‘ADvisor’ is a theory, evidence and person-based digital intervention designed to support antidepressant discontinuation. The intervention was perceived as helpful and reassuring in optimisation interviews. Trials are now needed to determine the feasibility, clinical and cost-effectiveness of this approach.
Analysis of team-sport wheelchair falls during the Rio 2016 Summer Paralympic Games: a video-based cross-sectional observational study
Authors: Sasadai Junpei , Maeda Noriaki , Shimizu Reia , Kobayashi Takumi , Sakai Shogo , Komiya Makoto , Urabe Yukio 
Published: March 2020

ObjectivesTo present the fall characteristics of athletes playing wheelchair rugby (WR) and wheelchair basketball (WB) using official videos from the Rio 2016 Paralympic Games and compare the key fall characteristics among the team wheelchair sports event.MethodsEighteen WR and 10 WB game videos for men (MWB) and women (WWB), including 8 teams per sport, were obtained from the official International Paralympic Committee of the Rio 2016 Paralympic Games. The videos were analysed to assess the number of falls, playing time of fall, playing phase, contact with other athletes, the direction of the fall and the body part first in contact with the floor during the fall.ResultsIn total, 359 falls (96 for WR, 172 for MWB and 91 for WWB) occurred with a mean of 5.3, 17.2 and 9.1 falls per match, respectively (p<0.05). Significant differences among the three sports were detected in the playing time (p=0.011), presence of contact (p=0.037), direction (p<0.001) and body part first in contact with the floor (p<0.001). For WR, the falls were primarily lateral and caused by contact, occurring in the second half of the match. WB falls tended to be in the first half for women and the second half for men. Most falls were contact falls in the forward direction.ConclusionBy observing the situational details, we described that a number of falls due to contact occurred during these team sports events, especially MWB. In addition, each sport exhibited characteristics attributable to differences in gender, degree of impairment and game rules. The directions of the falls and characteristics of the affected body parts indicate differences in impairments depending on the sport. A fall to the side or back may indicate a risk of injury.