bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community-Onset Clostridioides Difficile Infection in Hospitalized Patients in The Netherlands
Authors: Crobach M J T , Notermans D W , Harmanus C , Sanders I M J G , De Greeff S C , Kuijper E J 
Published: November 2019

AbstractBackgroundClostridioides difficile infection (CDI) is increasingly reported in the community. The aim of this study was to analyze characteristics of hospitalized patients with community-onset CDI (CO-CDI).MethodsIn the Netherlands, 24 hospitals (university-affiliated and general hospitals) participate in the sentinel CDI surveillance program. Clinical characteristics and 30-day outcomes of hospitalized patients &gt;2 years old diagnosed with CDI are registered. Samples of these patients are sent to the national reference laboratory for polymerase chain reaction ribotyping. Data obtained for this surveillance from May 2012 to May 2018 were used to compare CO-CDI with hospital-onset (HO)-CDI episodes.ResultsOf 5405 registered cases, 2834 (52.4%) were reported as HO-CDI, 2174 (40.2%) were CO-CDI, and 339 (6.3%) had onset of symptoms in another healthcare facility (eg, nursing home). The proportion of CO-CDI increased over the years and was lower during winter months. Hospitalized patients with CO-CDI were younger (63.8 vs 68.0 years, P &lt; .001) and more often females (53.0% vs 49.6%, P = .02) than patients with HO-CDI. Median time between onset of symptoms and CDI testing was longer in CO-CDI (4 vs 1 day, P &lt; .001). Similar ribotypes were found in CO-CDI and HO-CDI, but ribotype 001 was more frequent among HO-CDI, whereas ribotype 023 was more frequent in CO-CDI. Six of 7 (85.7%) surgeries due to CDI, 27 of 50 (54%) ICU admissions due to CDI, and 48 of 107 (44.9%) of CDI-associated deaths were attributable to CO-CDI.ConclusionsOur study demonstrates that patients hospitalized with CO-CDI contribute substantially to the total number of CDI episodes and CDI-associated complications in hospitals, stressing the need for awareness and early testing for CDI in community and outpatient settings and also in patients admitted from community with diarrhoea. Surveillance programs that also target nonhospitalized CDI patients are needed to understand the true burden and dynamics of CDI.
Restabilization of the Occipitocervical Junction After a Complete Unilateral Condylectomy: A Biomechanical Comparison of Unilateral and Bilateral Fixation Techniques
Authors: Eli Ilyas M , Karsy Michael , Brodke Darrel S , Bachus Kent N , Couldwell William T , Dailey Andrew T , Mazur Marcus D 
Published: November 2019

Abstract

BACKGROUND
Occipitocervical instability may result from transcondylar resection of the occipital condyle. Initially, patients may be able to maintain a neutral alignment but severe occipitoatlantal subluxation may subsequently occur, with cranial settling, spinal cord kinking, and neurological injury.

OBJECTIVE
To evaluate the ability of posterior fixation constructs to prevent progression to severe deformity after radical unilateral condylectomy.

METHODS
Eight human cadaveric specimens (Oc-C2) underwent biomechanical testing to compare stiffness under physiological loads (1.5 N m). A complete unilateral condylectomy was performed to destabilize one Oc-C1 joint, and the contralateral joint was left intact. Unilateral Oc-C1 or Oc-C2 constructs on the resected side and bilateral Oc-C1 or Oc-C2 constructs were tested.

RESULTS
The bilateral Oc-C2 construct provided the greatest stiffness, but the difference was only statistically significant in certain planes of motion. The unilateral constructs had similar stiffness in lateral bending, but the unilateral Oc-C1 construct was less stiff in axial rotation and flexion-extension than the unilateral Oc-C2 construct. The bilateral Oc-C2 construct was stiffer than the unilateral Oc-C2 construct in axial rotation and lateral bending, but there was no difference between these constructs in flexion-extension.

CONCLUSION
Patients who undergo a complete unilateral condylectomy require close surveillance for occipitocervical instability. A bilateral Oc-C2 construct provides suitable biomechanical strength, which is superior to other constructs. A unilateral construct decreases abnormal motion but lacks the stiffness of a bilateral construct. However, given that most patients undergo a partial condylectomy and only a small proportion of patients develop instability, there may be scenarios in which a unilateral construct may be appropriate, such as for temporary internal stabilization.
Military Mobility, Authority and Negotiation in Early Colonial India*
Authors: Welsch Christina 
Published: November 2019

Abstract
This article focuses on the career of Muhammad Yusuf Khan, an officer in the British East India Company who sought to turn his military service into political and diplomatic authority, only to be executed as a rebel in 1764. His rise and fall occurred early in the so-called colonial transition, a period characterized in recent scholarship as one of relative fluidity in contrast to later, more rigid instantiations of colonial rule. Institutionally, the Company’s armies seem to contradict that pattern: their rapid growth in the eighteenth century produced new exclusions and restrictions, including some of the earliest formal articulations of a racial binary between Indian and European actors. Yusuf Khan, however, gained political capital by mobilizing elements of those intended restrictions in new contexts, imbuing the Company’s military hierarchies with alternate meanings outside of its formal infrastructure. His innovative reinterpretation of military prestige becomes clear when the Company’s records are read alongside Persian-language material from the Indian courts against which he fashioned his political identity. His career offers insight into how the inequitable, but dynamic relationship between the Company and its soldiers shaped the former’s approach to and understanding of India s political landscape
Calanoid copepod grazing affects plankton size structure and composition in a deep, large lake
Authors: Kunzmann Alessandra Janina , Ehret Harald , Yohannes Elizabeth , Straile Dietmar , Rothhaupt Karl-Otto 
Published: November 2019

Abstract
Cultural oligotrophication is expected to shift lake zooplankton to become dominated by calanoid copepods. Hence, understanding the influence of calanoids on the taxonomic and size structure of the lower plankton food web is crucial for predicting the effects of oligotrophication on energy fluxes in these systems. We studied the effect of an omnivorous calanoid, Eudiaptomus gracilis, on the lower planktonic food web using an in situ incubation approach in large and deep Lake Constance. We show that E. gracilis significantly reduced ciliate, phytoplankton, rotifer, but increased bacteria biovolume. Highest clearance rates were observed for ciliates whose biovolume declines may have caused a release of predation pressure on bacteria. E. gracilis grazing shifted the size structure of the phytoplankton community by reducing mean phytoplankton cell size (directional selection) and simultaneously increasing cell size variance (disruptive selection). Ciliate cell sizes experienced a similar selective regime in one of the experiments, whereas in the other two experiments, no change of size structure was detected. Results suggest strong influences of E. gracilis grazing on the lower plankton food web and a significant shift in phytoplankton size structure. For evaluating detailed effects of omnivorous consumers on plankton size structure, cascading interactions need to be considered.
A reverse translational study on the effect of rituximab, rituximab plus belimumab, or bortezomib on the humoral autoimmune response in SLE
Authors: van Dam Laura S , Osmani Zgjim , Kamerling Sylvia W A , Kraaij Tineke , Bakker Jaap A   , Scherer Hans U , Rabelink Ton J , Voll Reinhard E , Alexander Tobias , Isenberg David A , van Kooten Cees , Teng Y K Onno 
Published: November 2019

AbstractObjectivesSLE is a severe autoimmune disease characterized by autoreactive B cells and IC formation, which causes systemic inflammation. B cell–targeted therapy could be a promising treatment strategy in SLE patients; nevertheless, randomized clinical trials have not always been successful. However, some groups have demonstrated beneficial effects in severe SLE patients with off-label rituximab (RTX) with belimumab (BLM), or bortezomib (BTZ), which targeted different B cells subsets. This study assembled sera from SLE cohorts treated with RTX+BLM (n = 15), BTZ (n = 11) and RTX (n = 16) to get an in-depth insight into the immunological effects of these therapies on autoantibodies and IC formation.MethodsAutoantibodies relevant for IC formation and the avidity of anti-dsDNA were determined by ELISA. IC-mediated inflammation was studied by complement levels and ex vivo serum-induced neutrophil extracellular trap formation.ResultsReductions in autoantibodies were observed after all approaches, but the spectrum differed depending upon the treatment. Specifically, only RTX+BLM significantly decreased anti-C1q. Achieving seronegativity of ≥1 autoantibody, specifically anti-C1q, was associated with lower disease activity. In all SLE patients, the majority of anti-dsDNA autoantibodies had low avidity. RTX+BLM significantly reduced low-, medium- and high-avidity anti-dsDNA, while RTX and BTZ only significantly reduced medium avidity. IC-mediated inflammation, measured by C3 levels and neutrophil extracellular trap formation, improved after RTX+BLM and RTX but less after BTZ.ConclusionThis study demonstrated the impact of different B cell–targeted strategies on autoantibodies and IC formation and their potential clinical relevance in SLE.
Are environmental charities getting their feet wet when they lobby for marine protection around remote islands?
Authors: Farran Sue 
Published: November 2019

Abstract
Recent ‘Extinction’ protests in the UK and elsewhere highlight contemporary concerns about the environment and the shared responsibility of all to take meaningful steps to save it. Key players in this advocacy are environmental charities. One of the areas in which they have been most active – in the UK and elsewhere – is in persuading governments to establish large Marine Protected Areas, especially around island territories. These are often created as ‘no-take’ areas, meaning that fishing – other than subsistence fishing – and other marine activities are prohibited, often to the detriment of local fishers. Invariably this requires a change in the current law. This article queries whether, in advocating for marine-protected areas, environmental charities are overstepping the principles which determine charitable status.
Lamb performance in hardwood silvopastures, II: animal behavior in summer1
Authors: Pent Gabriel J , Greiner Scott P , Munsell John F , Tracy Benjamin F , Fike John H 
Published: November 2019

AbstractIntegrating trees into pastures, a practice known as silvopasture, may benefit livestock in the summertime through the provision of shade. The purpose of this project was to compare the behavioral patterns of sheep grazing in silvopastures and open pastures. Black walnut (Juglans nigra L.) and honeylocust (Gleditisia triacanothose L.) based silvopasture systems were compared with open pastures in a randomized complete block design with three blocks over two summers. Behavior measures were recorded within a replicate within a week, and these measures were taken sequentially within three experimental periods. Ewe lambs (n = 3) within each experimental unit were equipped with a wideband audio-recording device to detect prehension events. Time-lapse cameras documented sheep behavior every 60 s. In the silvopastures, the lambs spent over 90% of daylight hours within shade from trees. Lambs in silvopastures spent more time lying down than animals in the open pastures (P ≤ 0.01), while lambs in the open pastures spent more than 2 h longer each day standing (P &lt; 0.0001). Lambs in the black walnut silvopastures spent more time grazing (488 ± 14 min · d−1) than lambs in the honeylocust silvopastures (438 ± 14 min · d−1; P = 0.0493) and lambs in the open pastures (417 ± 14 min · d−1; P = 0.0026). There was no difference in grazing time for lambs in the latter two systems (P = 0.5597). Spectral analysis of the imagery revealed that the lambs in the black walnut silvopastures grazed more frequently than the lambs in the other systems for both years. The acoustic analysis, though limited by recorder durability to 47 complete recordings, revealed no difference in total bites taken per day (P ≥ 0.7222) or in the morning (P ≥ 0.2069), afternoon (P ≥ 0.5816), and evening periods (P ≥ 0.9337). Silvopastures provide an opportunity to improve lamb comfort in the summer.
Efficacy of Adjunctive Zinc in Improving the Treatment Outcomes in Hospitalized Children with Pneumonia: A Randomized Controlled Trial
Authors: Rerksuppaphol Lakkana , Rerksuppaphol Sanguansak 
Published: November 2019

Abstract

Background
The mortality rate of pneumonia is high, placing a huge burden on developing countries. Healthcare professionals use zinc as an adjunctive treatment for children with pneumonia; however, this contradicts with some published reports. Thus, this study aimed to assess the efficacy of zinc supplementation on the treatment outcomes of pneumonia.

Methods
A randomized, double-blind, placebo-controlled trial was conducted on hospitalized children with pneumonia. The children randomly received either zinc bis-glycinate (15 mg elemental zinc) or placebo, twice per day. The primary outcome was the resolution time of pneumonia, and the secondary outcomes were the duration of hospitalization and the recovery times of each clinical symptom.

Results
Out of the 91 children, 65 (71.4%) were males. The resolution period of clinical pneumonia was significantly shorter in the zinc group than the placebo group (48 and 72 h, respectively; hazard ratio = 0.585, 95% confidence interval 0.377–0.908). Similarly, the hospitalization period and the resolution period of fever were shorter in the zinc group [96 and 144 h (p = 0.008), and 24 and 42 h (p = 0.002), respectively]. Children receiving zinc needed a median of 28 h to reach the normal level of oxygen saturation compared to 48 h required by children under placebo (p = 0.014).

Conclusion
Zinc supplementation enhanced the treatment outcomes of pneumonia, by reducing the resolution period of pneumonia and normalizing oxygen levels and body temperature. The length of hospital stay for children receiving zinc was shorter than those receiving placebo.
Butyrate prevents valproate‐induced liver injury: In vitro and in vivo evidence
Authors: Pirozzi Claudio , Lama Adriano , Annunziata Chiara , Cavaliere Gina , De Caro Carmen , Citraro Rita , Russo Emilio , Tallarico Martina , Iannone Michelangelo , Ferrante Maria Carmela , Mollica Maria Pina , Mattace Raso Giuseppina , De Sarro Giovambattista , Calignano Antonio , Meli Rosaria 
Published: November 2019

AbstractSodium valproate (VPA), an antiepileptic drug, may cause dose‐ and time‐dependent hepatotoxicity. However, its iatrogenic molecular mechanism and the rescue therapy are disregarded. Recently, it has been demonstrated that sodium butyrate (NaB) reduces hepatic steatosis, improving respiratory capacity and mitochondrial dysfunction in obese mice. Here, we investigated the protective effect of NaB in counteracting VPA‐induced hepatotoxicity using in vitro and in vivo models. Human HepG2 cells and primary rat hepatocytes were exposed to high VPA concentration and treated with NaB. Mitochondrial function, lipid metabolism, and oxidative stress were evaluated, using Seahorse analyzer, spectrophotometric, and biochemical determinations. Liver protection by NaB was also evaluated in VPA‐treated epileptic WAG/Rij rats, receiving NaB for 6 months. NaB prevented VPA toxicity, limiting cell oxidative and mitochondrial damage (ROS, malondialdehyde, SOD activity, mitochondrial bioenergetics), and restoring fatty acid oxidation (peroxisome proliferator‐activated receptor α expression and carnitine palmitoyl‐transferase activity) in HepG2 cells, primary hepatocytes, and isolated mitochondria. In vivo, NaB confirmed its activity normalizing hepatic biomarkers, fatty acid metabolism, and reducing inflammation and fibrosis induced by VPA. These data support the protective potential of NaB on VPA‐induced liver injury, indicating it as valid therapeutic approach in counteracting this common side effect due to VPA chronic treatment.
Rapid actions of anti‐Müllerian hormone in regulating synaptic transmission and long‐term synaptic plasticity in the hippocampus
Authors: Wang Kang , Xu Fuhua , Campbell Shawn P. , Hart Kyle D. , Durham Tyler , Maylie James , Xu Jing 
Published: November 2019

AbstractAnti‐Müllerian hormone (Amh) is a peptide factor that is known to regulate sexual differentiation and gonadal function in mammals. Although Amh is also suggested to be associated with cognitive development and function in the postnatal brain, little is known about its expression or direct effects on neuronal activities in the hippocampus. Therefore, we assessed Amh and its receptor expression in the hippocampus of male and female mice using PCR, Western blot, and immunofluorescence staining. While Amh‐specific receptor expression was comparable between males and females, mRNA and protein levels of Amh were higher in females than those of males. Electrophysiological recordings on acute hippocampal slices showed that exogenous Amh protein addition increased synaptic transmission and long‐term synaptic plasticity at the Cornu Ammonis (CA) 3‐CA1 synapses. Amh exposure also increased the excitatory postsynaptic potential at CA1 synapses. Our findings support direct and rapid actions of Amh as a paracrine and/or autocrine factor in regulating hippocampal neuronal activities. Data provide functional evidence of Amh‐mediated postsynaptic modulation of synaptic transmission and Amh‐regulated long‐term synaptic plasticity in the hippocampus. These results suggest a potential role of Amh in learning and memory, and a possible cause of the sex differences in cognitive development and function.
Methemoglobinemia in a 14-year-old girl with new-onset dyspnea
Authors: Wallace Michelle , Tenbarge Caitlin , Harlow Sofia , Kasting Nathan , Gooden Justin 
Published: November 2019

ABSTRACT
Methemoglobinemia is a rare and potentially life-threatening medical emergency that can be overlooked when evaluating a patient in respiratory distress. Without early recognition, patients may develop respiratory failure and die. This article describes a teenager who presented to the ED for dyspnea and lightheadedness and failed to respond to supplemental oxygen. She was eventually diagnosed with methemoglobinemia.
Preventing kidney injury by avoiding fluid overload in patients with sepsis
Authors: Dodd Rebecca L. , Archambault Mark E. 
Published: November 2019

ABSTRACT
The global epidemiologic burden of sepsis is difficult to ascertain. Sepsis affects more than 31.5 million people worldwide every year, potentially resulting in 5 million deaths. Up to one-third of patients with sepsis also develop sepsis-associated acute kidney injury. This article describes the need for restraint in fluid resuscitation in patients with sepsis, in order to mitigate end-organ damage and ultimately to save lives.
Haematogenous Spondylodiscitis in Patients With Liver Cirrhosis
Authors: Abdelrahman Hemdan , Shousha Mootaz , Bahrami Reza , Boehm Heinrich 
Published: November 2019

Study Design.
A retrospective study of 36 liver cirrhosis patients presenting with spondylodiscitis.

Objectives.
The aim of this study was to analyze the characteristics of spondylodiscitis in the presence of liver cirrhosis and furthermore, to evaluate the outcome of surgery in this specific group of patients.

Summary of Background Data.
The incidence of haematogenous spondylodiscitis is increasing. The coexistence of liver cirrhosis makes the course of the disease more aggressive.

Methods.
A total of 36 liver cirrhosis patients presented with haematogenous spondylodiscitis. The onset of infection, clinical course and outcomes of management were reviewed retrospectively.

Results.
The associated comorbidities were cardiac in 17 patients, diabetes in 19, renal insufficiency in 16, and another focus for infection in nine cases. Neurological deficits were found in 24 patients (67%) and fever in 15 cases. Nine patients had septic manifestations. The lumbar spine was affected in 25 patients (69%). Noncontiguous spinal infection was found in nine patients (25%) and epidural abscess in 24 individuals. The preoperative C-reactive protein was elevated in all cases. The causative organism was most commonly Staphylococcus aureus (17 patients). A combined anteroposterior approach was necessary in 28 patients and a minimallly invasive surgery was performed in 30 cases. In-hospital mortality was 14% (5 patients). The neurological improvement rate was 82%. The postoperative antibiotic therapy was taken for more than 8 weeks in 22 patients. In 15 patients, a combination of antibiotics was necessary.

Conclusion.
Spinal infection in the presence of liver cirrhosis is challenging. The rate epidural abscess formation is relatively high. Early diagnosis remains the main cornerstone in the management and the indication for surgery should be carefully considered. Minimally invasive techniques should be used when possible to minimize complication rate, and higher amounts of intraoperative blood loss should be expected.

Level of Evidence: 4