bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Epidemiology of Acute Kidney Injury in a Pediatric Malawian Trauma Cohort: a Prospective Observational Study
Authors: Bjornstad Erica C. , Muronya William , Smith Zachary H. , Gibson Keisha , Mottl Amy K , Charles Anthony , Marshall Stephen W. , Golightly Yvonne M. , Munthali Charles K. , Gower Emily W. 
Published: January 2020

Abstract
Introduction: Acute kidney injury (AKI) is highly associated with mortality risk in children worldwide. Trauma can lead to AKI and is a leading cause of pediatric death in Africa. However, there is no information regarding the epidemiology of pediatric, trauma-associated AKI in Africa.Methods: Prospective cohort study of pediatric trauma patients admitted to a tertiary referral hospital in Malawi. Participants enrolled at admission were followed prospectively throughout their hospitalization. AKI was defined by sequential serum creatinine measurements and Kidney Disease Improving Global Outcomes criteria. We calculated descriptive statistics and univariate relative risks (RR) for hypothesis-generation of potential risk factors associated with AKI.Results: We analyzed data from 114 participants. Depending on baseline creatinine definition, AKI incidence ranged from 4-10%. The new Schwartz equation estimated baseline creatinine values best and yielded an AKI incidence of 9.7%. Almost one in ten children died during hospitalization, but those with AKI (n=4) were at significantly higher risk of death compared to those without AKI (40.0% vs 6.2%; RR 6.5, 95% CI 2.2-19.1). Burn injuries were most commonly associated with AKI (63.6%). Other potential AKI risk factors included multiple injuries, trunk or facial injuries, and recent consumption of herbal remedies.Conclusions: AKI occurs in 10% of admitted pediatric trauma patients in Malawi and increases the risk of death 7-fold compared to those without AKI. This large unrecognized burden in trauma requires further investment by researchers, clinicians and policymakers to develop evidenced-based triage, recognition, and management approaches to prevent the associated sequelae and potential mortality from AKI.
Human adipose tissue-derived mesenchymal stem cells in Parkinson's disease：Inhibit T helper 17 cell differentiation and regulate immune balance towards a regulatory T cell phenotype
Authors: Bi Yong , Liang Huazheng , Lin Xiaobin , Yang Dehao , Zhang Xiaowei , Ke Jianming , Xiao Jingjing , Chen Zhilin , Chen Weian , Zhang Xu , Wang Shaoshi , Liu Chun-Feng 
Published: January 2020

Abstract
Parkinson's disease (PD), known as a neurodegenerative disorder, shows typical pathology of neuroinflammation, which might be the result of the imbalance between regulatory T cells (Treg) and T helper 17 (Th17) cells. The present study aimed to investigate the modulating effect of Ad-MSCs on peripheral blood mononuclear cells (PBMCs) derived from PD patients. CD4 + peripheral blood T cells were isolated and co-cultured with Ad-MSCs at a ratio of 4:1 under Th17 or Treg polarizing conditions, respectively, for 4 days. Our results showed that Ad-MSCs specifically inhibited the differentiation of IL-17-producing CD4 + T cells collected from PBMCs of PD patients evidenced by the decreased expression of RORγt- the key transcription factor for Th17 cells, IL-6R, and IL-23R. In the meantime, Ad-MSCs and induced a functional CD4 + CD25 + Foxp3 + T regulatory cell phenotype evidenced by the secretion of IL-10. Furthermore, levels of LIF protein and its receptor mRNA were significantly increased under both polarizing conditions. These findings suggest that the regulation of the Th17/Treg balance by Ad-MSCs was correlated with the increase in LIF secretion. Therefore, Ad-MSCs are an important player in ­modulating inflammatory responses and a potential therapeutics for PD patients.
Prevalence and molecular characterization of methicillin-resistant Staphylococcus aureus with mupirocin, fusidic acid and/or retapamulin resistance
Authors: Chen Wenjing , He Chunyan , Yang Han , Shu Wen , Cui Zelin , Tang Rong , Zhang Chuanling , Liu Qingzhong 
Published: January 2020

Abstract
Data on the prevalence of resistance to mupirocin (MUP), fusidic acid (FA) and retapamulin (RET) in methicillin-resistant Staphylococcus aureus (MRSA) from China are still limited. In this study we examined these three antibiotics resistance pheno and geno-typically in 1206 MRSA clinical isolates. Phenotypic MUP, FA and RET resistance was determined by MICs, and genotypically by PCR and DNA sequencing examining genes mupA / B , fusB - D , cfr and vgaA / Av , and mutations in ileS , fusA / E , rplC , and 23S RNA V domain. The genetic characteristics of resistance isolates were conducted by PFGE and MLST. Overall MRSA MUP, FA and RET resistance was low (5.1%, 1.0% and 0.3%, respectively). The mupA was the mechanism of high-level MUP resistance. All low-level MUP resistance isolates possessed an equivocal mutation N213D in IleS, and 2 of them additionally had the reported V588F mutation impacting the Rossman fold. FusA mutations, such as L461K, H457Q, H457Y and V90I, were the primary FA resistance mechanisms among high-level resistance isolates, most of which contained fusC ; however, all low-level resistance strains carried fusB . No resistance mechanisms detected were found among RET resistance isolates. Genetic analysis demonstrated clone spread for MUP resistance isolates. In conclusion, MUP, FA and RET exhibited highly activity against MRSA isolates. Acquired genes and chromosome-borne genes mutations were responsible for MUP and FA resistance, and further investigation is needed to uncover the RET resistance mechanisms. Moreover, the surveillance to MUP in MRSA should be strengthened to prevent resistance increase due to the expansion of clones.
Characterization of chemotaxis and motility response towards fructose in Escherichia coli
Authors: Liu Fanghai , Wang Fangbin , Liu Jian 
Published: January 2020

Abstract
BackgroundPeritrichously flagellated bacteria such as Escherichia coli perform chemotaxis by a biased random walk toward various chemicals, which was driven by the bacterial flagellar motor. The chemotaxis system is a perfect robust system which can adapt to its pre-stimulus level after the stimulus. Fructose, a typical monosaccharide that can attract Escherichia coli. Previous studies have shown Escherichia coli to be chemotactic to both amino acids and simple sugars. However, little is known about the chemotaxis and motility response of Escherichia coli towards fructose.ResultsIn this study, we characterized the chemotaxis behavior of Escherichia coli to different concentrations of fructose from 0mM to 50mM by using microfluidics and bead assay. We observed the wild-type cells responded to the stimulus of fructose, which suggested fructose is an attractant to Escherichia coli, while the cells defective in chemotaxis could not sense the stimulus of fructose. Fructose affects the motor behavior of wild-type cells and reduces the CCW motor speeds significantly compared to CW motor speeds, contrast to that fructose cannot affect the motor speeds of cells defective in chemotaxis. The CW biases of wild-type cells increased with the addition of fructose. And the fructose promotes bacterial aggregation on surface by lowering the bacteria motor speed.ConclusionsWe found that fructose is an attractant to Escherichia coli, with the wild-type cells showed stronger response to higher concentration of fructose, while cells lacking chemoreceptors and CheY cannot sense or respond to fructose. The motility of wild-type cells was reduced in various concentrations of fructose, which helped the aggregation of cells near the surface, in contrast with the result that the fructose showed no effect on the motility of the cells defective in chemotaxis. Similar phenomena are expected to be found in the effect of other monosaccharides to Escherichia coli.
Heterologous prime-boost: an important candidate immunization strategy against tembusu virus
Authors: Pan Yuting , Jia Renyong , Li Juping , Wang Mingshu , Chen Shun , Liu Mafeng , Zhu Dekang , Zhao Xinxin , Wu Ying , Yang Qiao , Yin Zhongqiong , Jing Bo , Huang Juan , Zhang Shaqiu , Zhang Lin , Liu Yunya , Yu Yanlin , Tian Bin , Pan Leichang , Rehman Mujeeb Ur , Cheng Anchun 
Published: January 2020

Abstract
Background Tembusu virus (TMUV), a newly emerging pathogenic flavivirus, is acute and spreads rapidly which causes massive economic losses in the Chinese duck industry. Vaccination is the most effective method to prevent TMUV. So, it’s urgent to look for an effective vaccine strategy against TMUV. Heterologous prime-boost regimen priming with DNA vaccine and boosting with recombinant adenovirus vaccine have been proven to be the successful strategy in protecting against virus in experimental animal models. Methods In this study, heterologous and homologous prime-boost strategies using DNA vaccine and recombinant adenovirus vaccine expressing prM-E or E protein of TMUV were evaluated to protect ducks against the infection of TMUV for the first time, including priming and boosting with DNA vaccine, priming and boosting with recombinant adenovirus vaccine, and priming with DNA vaccine and boosting with recombinant adenovirus vaccine. Humoral and cellular immune responses were detected and evaluated. We then challenged the ducks with TMUV at 12 days after boosting to assay for the clinical symptoms, mortality, viral loads and histopathological lesions of these different strategies. Results Comparing with homologous prime-boost strategies, higher levels of specific antibodies against E protein and the neutralizing antibodies against TMUV were detected in heterologous prime-boost regimen. And also, it could induce higher levels of IFN-γ than homologous prime-boost strategies in the later stage. Interestingly, heterologous prime-boost strategy induced higher level of IL-4 in the early stage, but gradually decreased and was even lower than homologous prime-boost strategy in the later stage. Moreover, the heterologous prime-boost strategy could efficiently protect ducks with low viral tiers, no clinical symptoms and histopathological lesions in this experiment after challenging with TMUV while slight clinical symptoms and histopathological lesions were observed in homologous prime-boost strategies. Conclusions Our results indicated that the heterologous prime-boost strategy induced higher levels of humoral and cellular immune responses and better protection against the TMUV infection in ducks than the homologous prime-boost strategies, suggesting that heterologous prime-boost strategy is an important candidate for the design of a novel vaccine strategy against TMUV.
Yiqi Fumai Injection for patients with Septic Shock: study protocol for a randomized controlled trial1
Authors: zeng jing , Cai Hai-rong , Liu Shu-ling , Zhao Shuai , Li Zhi-shang , Luo Si-cong , Cai Xin-gui , Zhang Wei-zhang , Zhang Lie-yuan , Chen Bo-jun 
Published: January 2020

Abstract
Background Septic shock is an important problem in critical care medicine and one of the leading causes of death in intensive care units (ICU). In China, Traditional Chinese medicine ( TCM) has been widely used as the adjuvant treatment to improve the symptoms and prognosis in patients with septic shock. Yiqi Fumai Injection (YFI) is one of the most important proprietary TCM for septic shock, previous studies have demonstrated its efficacy and safety. However, these conclusions were limited due to the small sample size and low quality of methodologies of these studies. Therefore, we designed this study to evaluate the efficacy and safety of using YFI as an adjunct treatment for septic shock.Methods This is a double-blind, randomized, parallel, placebo-controlled clinical trial. A total of 800 participants will be randomly assigned to receive either treatment or placebo in a 1:1 ratio. The treatment group will receive YFI combined with conventional treatment, and the control group will receive 0.9% sodium chloride injection combined with conventional treatment for 2 weeks. The primary outcome is the 28- days mortality. Secondary outcomes are blood lactate levels, hemodynamics , blood gas analysis, immune function indicators, inflammatory indicators, acute physiology improvement and chronic health assessment (APACHE) II scores, and sepsis-related organ failure score (SOFA). Adverse events will be observed and recorded at the same time for safety assessment.Discussion This randomized controlled trial will help evaluate the efficacy and safety of YFI for the treatment of septic shock. The results of this trial will provide recommendations for the management of septic shock.
Increasing access to CBT for psychosis patients: a feasibility, randomized controlled trial evaluating brief, targeted CBT for distressing voices delivered by Assistant Psychologists (GiVE2)
Authors: Hayward Mark , Berry Clio , Cameron Ben , Arnold Kate , Berry Katherine , Bremner Stephen , Cavanagh Kate , Fowler David , Gage Heather , Greenwood Kathryn , Hazell Cassie , Jones Anna-Marie , Robertson Sam , Strauss Clara 
Published: January 2020

Abstract
Background The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp. One response to this problem has been the development of CBTp in brief formats that are targeted at a single symptom and the mechanisms that maintain distress. We have developed a brief form of CBTp for distressing voices and reported preliminary evidence for its effectiveness when delivered by highly trained therapists (Clinical Psychologists). This study will investigate the delivery of this intervention by a cost-effective workforce of Assistant Psychologists following a brief training and evaluate the acceptability and feasibility of conducting a future, definitive, randomised control trial (RCT).Methods This is a feasibility study for a pragmatic three-arm parallel group superiority 1:1:1 RCT comparing a Guided self-help CBT intervention for voices and treatment as usual (GiVE) to Supportive Counselling and treatment as usual (SC) to Treatment as usual alone (TAU), recruiting across two sites, with blinded post-treatment and follow-up assessments. A process evaluation will quantitatively and qualitatively explore stakeholder experience.Discussion Expected outcomes will include an assessment of the feasibility of conducting a definitive RCT and data to inform the calculation of its sample size. If evidence from a subsequent fully powered RCT suggests that GiVE is clinically and cost effective when delivered by briefly trained Assistant Psychologists, CBTp offered in these less resource-intensive forms has the potential to generate benefits for individual patients (reduced distress, enhanced recovery and enhanced quality of life), service-level patient benefit (increased access to evidence-based psychological therapies) and economic benefits to the NHS (in terms of the reduced use of mental health inpatient services).
Changes in NSE and S-100β during the perioperative period and effects on brain injury in infants with biliary atresia undergoing parent liver transplantation
Authors: Yu Hongli , Yu Wenli , Zhu Min , Zhang Guicheng , Shi Yiwei , Sun Ying 
Published: January 2020

Abstract
Background: The S100 calcium-binding protein β (S-100β) and the neuron-specific enolase (NSE) can reflect brain injury, the value of the perioperative changes in S-100β and NSE levels in children with end-stage liver disease (ESLD) undergoing parent liver transplantation is unknown. This was to investigate the effects of parent liver transplantation on the changes of serum NSE and S-100β during the perioperative period, on brain injury, and on postoperative cognitive function. Methods: This was a prospective observational study of infants with congenital biliary atresia who had to undergo selective liver transplantation in 2017 at Tianjin First Central Hospital. Blood samples were drawn before skin incision (T1), 30 min after anhepatic phase (T2), 1 h of neohepatic phase (T3), and 24 h after hepato-reperfusion (T4). S-100β and NSE were measured by ELISA. Children were assessed using the Bayley Scale of Infant Development (BSID) 1 day before and 3 months after surgery. The pediatric anesthesia emergence delirium (PAED) was used at 0.5, 2, and 4 h after extubation. Results: Compared with T1, serum NSE and S100β were increased at T2, T3, and T4. Compared with T1, serum S-100β and NSE increased at T2 and peaked at T3 (all P<0.05). S-100β and NSE decreased at T4 (both P<0.05). Compared with 1 day before surgery, MDI and PDI were decreased at 3 months after surgery (MDI: from 87.7±8.4 to 84.5±8.5, P=0.015; PDI: from 82.9±8.7 to 79.6±8.8, P=0.016). Conclusion: Liver transplantation causes a certain degree of brain injury in children, as revealed by serum NSE and S100β levels.
Mutation spectrum and biochemical features in infants with neonatal Dubin-Johnson syndrome
Authors: Kim Kwang Yeon , Kim Tae Hyeong , Seong Moon-Woo , Park Sung Sup , Moon Jin Soo , Ko Jae Sung 
Published: January 2020

Abstract
Background : Dubin-Johnson syndrome (DJS) is an autosomal recessive disorder presenting as isolated direct hyperbilirubinemia.DJS is rarely diagnosed in the neonatal period. The purpose of this study was to clarify the clinical features of neonatal DJS and to analyze the genetic mutation of adenosine triphosphate-binding cassette subfamily C member 2 ( ABCC2 ). Methods: From 2013 to 2018, 135 infants with neonatal cholestasis at Seoul National University Hospital were enrolled. To clarify the characteristics of neonatal DJS, the clinical and laboratory results of 6 DJS infants and 129 infants with neonatal cholestasis from other causes were compared. Results: A total of 8 different ABCC2 variants were identified among the 12 alleles of DJS. The most common variant was p.Arg768Trp (33.4%), followed by p.Arg100Ter (16.8%). Three novel variants were identified (p.Gly693Glu, p.Thr394Arg, and p.Asn718Ser). Aspartate transaminase (AST) and alanine transaminase (ALT) levels were significantly lower in infants with DJS than in infants with neonatal cholestasis from other causes. Direct bilirubin and total bilirubin were significantly higher in the infants with DJS. Conclusions : We found three novel variants in 6 Korean infants with DJS. When AST and ALT levels are normal in infants with neonatal cholestasis, genetic analysis of ABCC2 permits an accurate diagnosis.
Delays in diagnosis and treatment of vaccine preventable community acquired bacterial meningitis (CABM): a retrospective analysis at three tertiary care centers
Authors: Torres Sarah D , Das Mitashee , Kim Carla Y , Ankam Jyoti V , Luche Nicole , Harmon Michael , Schorr Emily C , Glassberg Brittany , Morse Stephen S , Weiss Don , Gofshteyn Jacqueline S , Yeshokumar Anusha K , Thakur Kiran T 
Published: January 2020

Abstract
Background Outcomes in community-acquired bacterial meningitis (CABM) are significantly impacted by delays in diagnosis and treatment. This retrospective case series aims to describe the sociodemographic, epidemiological, and clinical variables including time to diagnosis and treatment of vaccine preventable CABM in three tertiary care settings in New York City (NYC). Methods A retrospective chart review was conducted of patients at Columbia University Irving Medical Center (CUIMC), Children’s Hospital of New York (CHONY), Mount Sinai Health System, and Weill Cornell Medical Center with CABM due to Haemophilus influenzae type B, Streptococcus pneumoniae, and Neisseria meningitidis between January 1, 2012 and December 31, 2017. A descriptive statistical analysis was performed. Results Our case series consisted of 36 patients, 24 (66.7%) females, and 12 (33.33%) males with a median age of 42 years (IQR 55 years). Median time from presentation to lumbar puncture (LP) was eight hours (IQR 7). The median time from hospital presentation to diagnosis was 12 hours (IQR 9), and the median time from LP to diagnosis was three hours (IQR 5). Delay in diagnosis which is defined by more than 8 hours from hospital presentation, occurred in 13 patients (36.1%) due to initial misdiagnosis, most commonly systemic febrile and/or viral infections and otitis media. Conclusions Despite evidence of the importance of early diagnosis and treatment for CABM, this case series shows the ongoing challenges with early clinical diagnosis. Misdiagnoses were an underlying reason for delays from presentation to LP and to antibiotic treatment in the majority of our patients. This study in NYC identifies ongoing major delays in diagnosis and antimicrobial treatment in CABM, and future studies are needed to identify mechanisms to improve time to antibiotic treatment and LP in CABM.
Inapropriate Use of Antibiotics Effective Against Gram Positive Microorganism in Under Restrictive Antibiotic Policies in ICU; A Prospective Observational Study
Authors: Özger Hasan Selçuk , Fakıoğlu Dolunay Merve , Erbay Kübra , ALBAYRAK ASLINUR , Hızel Kenan 
Published: January 2020

Abstract
Background Gram-positive spectrum antibiotics such as vancomycin, teicoplanin, daptomycin ,and linezolid are frequently used in empirical treatment combinations in critically ill patients Although they are included in the national antibiotic restriction program, thought to be inappropriate, unnecessary and suboptimal use is high due to their widespread use. In our study, in addition to their widespread use, gram-positive spectrum antibiotics were evaluated due to their use in more limited and clear clinical indications. This study aims to determine the frequency of inappropriate uses of gram-positive spectrum antibiotics and risk factors for inappropriate use according to different quality parameters. Methods This clinical study was conducted prospectively between 01.10.2018 and 01.10.2019 in the medical and surgical ICUs of Gazi University Faculty of Medicine Hospital with a total bed capacity of 55. Patients older than 18 years of age onset of gram-positive spectrum antibiotics (vancomycin, teicoplanin, linezolid ,and daptomycin) were included. Patients under the age of eighteen or immunosuppressed (neutropenic, HIV-infected patients with hematologic or solid organ malignancies) were not included in the study. The demographic and clinical features of the patients were recorded. The treatment was also evaluated and recorded by 2 infectious diseases specialists and 2 clinical pharmacists except for the clinical staff at 24-hour intervals from the first day to the last day of treatment. SPSS software for Windows, version 17 (IBM, Armonk, NY) was used to analyze the data. Categorical variables are presented as number and percentage, and non-categorical variables are presented as mean ± standard deviation. Results In the use of antibiotics, the incidence of non-compliance with at least one of the determined quality parameters was 83%. Multivariate analysis was performed to evaluate risk factors for inappropriate antibiotic use, and creatine values ​​were found to increase the risk of inappropriate antibiotic use. Conclusions In spite of the restricted antibiotic program, inappropriate antibiotic use in ICUs is quite common. In particular, it is necessary to establish local guidelines in collaboration with different disciplines for the determination and follow-up of de-escalation and optimal treatment doses Keywords:Antibiotic stewardship, rational antibiotic use, antibiotic resistance, gram positive microorganism, inapropriate use of antibiotics