bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis
Authors: Wen Hongjie , Zhu Shouyan , Li Canzhang , Xu Yongqing 
Published: December 2019

Abstract
Background The treatment for infected tibial bone defects can be a great challenge for the orthopaedic surgeon. This meta-analysis was conducted to compare the efficacy and safety between bone transport (BT) and acute shortening technique (AST) in the treatment of infected tibial bone defects.Materials and Methods A literature survey was conducted by searching the PubMed, Web of Science, Cochrane Library, Embase together with China National Knowledge Infrastructure (CNKI), and Wanfang database for articles published as of August 9, 2019. NOS (Newcastle-Ottawa scale) and Cochrane's risk of bias tool were adapted to evaluated the bias and risk of each eligible study. The data of external fixation index (EFI), bone grafting, bone and functional results, complications, bone union time and characteristics of participants were extracted. RevMan V.5.3 was used to perform relevant statistical analyses. Relative risk (RR) were used for the binary variables and standard mean difference (SMD) for continuous variable. Each variable included its 95% confidence interval (CI).Results 5 studies, including a total of 199 patients, were included in the meta-analysis. Statistical significance was observed in EFI (SMD = 0.63,95% CI:0.25,1.01,P=0.001) and Bone grafting (RR = 0.26,95%CI:0.15,0.46,P<0.00001), however, no significance was observed in bone union time (SMD = -0.02, 95% CI: -0.39, 0.35, P=0.92), bone results (RR = 0.97,95%CI:0.91,1.04,P=0.41),functional results (RR = 0.96,95%CI:0.86,1.08,P=0.50) and complication (RR = 0.76,95%CI:0.41,1.39,P=0.37).Conclusions AST is preferred on the aspect of minimizing treatment period, while BT is superior to AST for reducing bone grafting. Due to the limited number of trials, The meaning of this conclusion should be taken with caution for infected tibial bone defects.
Capacity building of health professionals on omics sciences: evaluation of the effectiveness of a distance learning training course for Italian physicians.
Authors: Calabrò Giovanna Elisa , Tognetto Alessia , Mazzaccara Alfonso , Barbina Donatella , Carbone Pietro , Guerrera Debora , Pucchio Alessandra Di , Federici Antonio , Ricciardi Walter , Boccia Stefania 
Published: December 2019

Abstract
Background. The rapid adoption of personalized medicine approaches in healthcare requires professionals to be able to manage the “omics revolution”. In this context, the genetics/genomics literacy of healthcare professionals should be in line with the continuous advances in this field, in order to implement its potential implications for the diagnosis, control and treatment of diseases. The present study investigates the effectiveness of a distance learning course on genetics and genomics targeted at medical doctors.Methods. In the context of a project funded by the Italian Ministry of Health in 2017, we had set up a distance learning course, entitled Genetics and Genomics practice. The contents of the course were identified from a core curriculum in genetics directed mainly to general practitioners, for physicians and healthcare professionals, previously published. The course focused on genetic/genomic testing in clinical practice, pharmacogenomics and oncogenomic and it was developed according to the main models of andragogical training (Problem-based Learning and Case-based Learning). We used a pre-test versus post-test study design to assess knowledge improvement on a set of 10 Multiple Choice Questions (MCQs). We analysed the proportion of correct answers for each question pre and post-test, as well as the mean score difference stratified by gender, age, professional status and medical discipline. Moreover, the same test was submitted to the participants eight months after the conclusion of the course, in order to assess the retained knowledge.Results. An important number of Italian physicians (N= 1637) completed the course, most of which were primary care physicians (20.8%), public health professionals (11.5%) and specialist paediatricians (10.6%). We reported an improvement in the proportion of correct answers for all of the 10 MCQs set at the post-test. The overall mean score to the questions significantly increased in the post-test, from 59.46 in the pre-test to 71.42 in the post-test (p-value < 0.0001). Conclusions. Genomic literacy among healthcare professionals is essential to ensure optimal translation to healthcare delivery of research. The results of this course suggest that distance-learning training in genetic/genomic practices represents an effective method to improve physicians’ knowledge in the immediate and mid-term time scale.
Pass Rate Set by Borderline Regression Method but not by Modified Angoff is Independent on Difficulty of Content in Objective Structured Clinical Exams
Authors: Waldauf Petr , Cockings Jerome , Sitzwohl Christian , Maggiorini Marco , Elbers Paul , Lindner Marcus , Brass Konstantin , Núñez Alexandra , Ballnus Sven , Roy Anne Le , Duška František 
Published: December 2019

Abstract
Background Standard setting is a method of determining the cut-off point on the scoring scale that separates the competent from the non-competent. This is a crucial feature of each exam. Pass rate should ideally be independent on the difficulty of exam content. Methods We compared the modified Angoff method (MAM) with the borderline regression method (BRM) of standard setting in 185 candidates examined by 137 examiners in the oral part of the European Diploma in Intensive Care exam, June 2018. We then compared the effect of removal of the hardest questions on the performance of the two techniques. The exam comprised 299 items in total across 6 OSCE stations. OSCE stations were of two types; short computer based OSCE stations (3 x 12 minutes), and longer structured discussion stations based on a clinical case (3 x 25 minutes). Our focus was the effect of item difficulty on the performance of the two standard setting techniques in determining the pass mark. Results MAM and BRM both led to similar pass rates overall for the shorter computer based 12 min OSCE stations. In the longer structured discussion 25 min stations MAM set a pass mark much higher than BRM, failing more of the candidates whose performance during the examination was judged by examiners on their global assessment as above the standard required to pass. Further analysis showed the exam items most affecting this were the more difficult items with lower discrimination; Angoff judges over-estimated the borderline candidates ability for these items. Elimination of these items led to convergence of pass marks achieved by the two methods. Conclusion Pass mark setting by Modified Angoff Method, but not by Borderline Regression Method, is influenced by the difficulty of exam content. This has practical implication for evaluating the results of OSCE exams.
A European Field Assessment of the efficacy of fluralaner (Bravecto®) chewable and spot-on formulations for treatment of client-owned dogs with generalized demodicosis
Authors: Petersen Ivo , Chiummo Rafael , Zschiesche Eva , Karas-Tecza Joanna , Rapti Dhimiter , Roepke Rainer , thomas emmanuel 
Published: December 2019

Abstract
Background: Generalized canine demodicosis is unlikely to resolve without therapy and has been traditionally difficult to cure, however there are recent reports of isoxazoline compounds providing safe and effective treatment. This field study compared the efficacy of either oral or topically administered of fluralaner, an isoxazoline, with multiple topical treatments (as often as weekly) with imidacloprid-moxidectin for the treatment of naturally infested dogs with generalized demodicosis. Methods: This study in 5 European countries included 134 dogs randomized for treatment with either fluralaner chewable tablets, fluralaner spot-on, or topical imidacloprid-moxidectin. Both fluralaner formulations were administered once at the approved dose on day 0, while imidacloprid-moxidectin was administered at the approved dose once every 4 weeks or more frequently if necessary. Dogs were monitored for mites, using deep skin scrapings, and clinical signs prior to treatment on day 0, and then on approximately 28, 56 and 84 days after initial treatment. Treatment was considered efficacious if more than 90% of the dogs were free of live mites at days 56 and 84.Results: Treatment with topical or oral fluralaner was 98.0% effective while imidacloprid-moxidectin treatment was 87.5% effective. All groups showed a marked reduction in skin lesions by day 28, with continuing improvement at each subsequent visit through the final assessment on day 84. There were no treatment-related adverse events.Conclusion: Fluralaner chewable tablets and fluralaner spot-on are highly effective for treating dogs affected with generalized canine demodicosis following a single administration. Topical imidacloprid-moxidectin at weekly to monthly intervals did not achieve the mite-free levels required for adequate efficacy over the 12 weeks study period.
Ethylene glycol and glycolic acid production from xylonic acid by Enterobacter cloacae
Authors: Zhang Zhongxi , Yang Yang , Wang Yike , Gu Jinjie , Lu Xiyang , Liao Xianyan , Shi Jiping , Kim Chulho , Lye Gary , Baganz Frank , Hao Jian 
Published: December 2019

Abstract
Background Biological routes of ethylene glycol production have been developed in recent years by constructing of the synthesis pathways in microorganisms. However, no microorganisms have been reported to produce ethylene glycol naturally.Results Xylonic acid utilizing microorganisms were screened from natural environments, and an Enterobacter cloacae strain was isolated. The major metabolites of this strain were ethylene glycol and glycolic acid. However, the metabolites were switched to 2,3-butanediol, acetoin or acetic acid when this strain was cultured with other carbon sources. The metabolic pathway of ethylene glycol and glycolic acid synthesis from xylonic acid in this bacterium was identified. Xylonic acid was converted to 2-dehydro-3-deoxy-D-pentonate with the catalysis of D-xylonic acid dehydratase. 2-Dehydro-3-deoxy-D-pentonate was converted to form pyruvate and glycolaldehyde, and this reaction was catalyzed by an aldolase. D-xylonic acid dehydratase and 2-dehydro-3-deoxy-D-pentonate aldolase were encoded by yjhG and yjhH , respectively. The two genes are part of the same operon and are located adjacent on the chromosome. Besides yjhG and yjhH , this operon contains four other genes. However, individually inactivation of these four genes had no effect on either ethylene glycol or glycolic acid production; both formed from glycolaldehyde. YqhD exhibits ethylene glycol dehydrogenase activity in vitro . However, a low level of ethylene glycol was still synthesized by E. cloacae Δ yqhD . Parameters for ethylene glycol and glycolic acid production by the E. cloacae strain were optimized, and aerobic cultivation at neutral pH were found to be optimal. In fed batch culture, 34 g/L of ethylene glycol and 13 g/L of glycolic acid were produced in 46 hours, with a total conversion ratio of 0.99 mol/mol xylonic acid.Conclusions A novel route of xylose biorefinery via xylonic acid as an intermediate has been established.
Production and the characterization of avian crypt-villus enteroids and the effect of chemicals
Authors: Acharya Mohan , Arsi Komala , Donoghue Annie , Liyanage Rohana , Rath Narayan C 
Published: December 2019

Abstract
Background: Three-dimensional models of cell culture such as organoids and mini organs accord better advantage over regular cell culture because of their ability to simulate organ functions hence, used for disease modeling, metabolic research, and the development of therapeutics strategies. However, most advances in this area are limited to mammalian species with little progress in others such as poultry where it can be deployed to study problems of agricultural importance. In the course of enterocyte culture in chicken, we observed that intestinal mucosal villus-crypts self-repair and lead to the formation of enteroid-like structures which appeared to be useful as ex vivo models to study enteric physiology and diseases. Results: The villus-crypts harvested from chicken intestinal mucosa were cultured to generate enteroids, purified by filtration then re cultured with different chemicals and growth factors to assess their response based on their morphological dispositions. Histochemical analyses using marker antibodies and probes showed the enteroids consisting different cells such as epithelial, goblet, and enteroendocrine cells typical to villi and retain functional characteristics of intestinal mucosa. Conclusions: The villus enteroids can simulate villus functions with their absorptive cells functionally positioned and exposed to culture medium thus, can help understand the mechanisms of nutrient uptake and their regulation, interactions with alien organisms, and amenable to assays of the factors that may affect gut health.
MDR/XDR Acinetobacter baumannii hospital infection associated with high mortality: A retrospective study in the PICU
Authors: Shi Jingyi , Sun Ting , Cui Yun , Wang Chunxia , Wang Fei , Zhou Yiping , Miao Huijie , Shan Yijun , Zhang Yucai 
Published: December 2019

Abstract
Background Multiple drug-resistant (MDR) and extensively drug-resistant (XDR) Acinetobacter baumannii presents challenges for clinical treatment and causes high mortality in children. We aimed to assess the risk factors for MDR/XDR Acinetobacter baumannii (MDR/XDR-AB) infection and for 28-day mortality in this patient population.Methods This retrospective study included 102 pediatric patients who developed MDR/XDR-AB infection in the pediatric intensive care unit (PICU) of Shanghai Children’s Hospital in China from January 2015 to December 2017. Clinical presentations and outcome of the patients were analyzed.Results Of the 102 patients (63 males and 39 females; mean age: 51.79 months), There were 63 (61.77%) male in the case group. The 28-day mortality rate was 29.41%. 18(17.64%) had bloodstream infections;4(3.92%) for which cerebrospinal fluid (CSF) cultures were positive; 14(13.73%) of them got positive cultures in aseptic fluid; 10 (9.8%) had central line-associated bloodstream infections; lower respiratory isolates (56/102) accounted for 54.9% of all patients. Multivariate logistic analysis indicated that high serum level of BUN (RR, 1.216, 95%CI, 1.27-2.616; P = 0.001) and high serum level of Cr (RR, 1.823, 95%CI, 0.902-0.980), were associated with high risk of mortality in MDR/XDR-AB infected patients.Conclusion MDR/XDR-Ab infection is a serious concern in pediatric patients with high mortality (29.41%). Mortality rate is higher in blood stream infection and central nervous system infection. Acute kidney injury is associated with high risk of mortality. Early use of tigarecycline might be involved in improving MDR/XDR-AB bacteremia.
Classifying Breast Cancer Molecular Subtypes using Deep Clustering Approach
Authors: Rohani Narjes , Eslahchi Changiz 
Published: December 2019

Abstract
Background: Cancer is a complex disease with a high rate of mortality. The characteristics of tumor masses are very heterogeneous; thus, the appropriate classiﬁcation of tumors is a critical point in the correct treatment. A high level of heterogeneity has also been observed in breast cancer. Therefore, detecting the molecular subtypes of this disease is a worthwhile issue for medicine that could be facilitated using bioinformatics. Method: Numerous methods have already classiﬁed breast cancer based on gene expression data; however, they are not reliable due to the dynamic nature of these data. In contrast, gene mutation data are relatively stable and may lead to better classiﬁcation. The aim of this study is to introduce a novel method for detecting the molecular subtypes of breast cancer. In this study, somatic mutation proﬁles of tumors are used; nonetheless, the somatic mutation proﬁles are very sparse. To address this issue, we made use of the network propagation method on gene interaction network and made the mutation proﬁles dense. Afterward, we used deep embedded clustering (DEC) method to classify breast tumors into four subtypes. In the next step, gene signatures of each subtype obtained by Fisher exact test and Benjamini-Hochberg procedure. Results: Clinical and molecular analyses are executed, besides enrichment of results in numerous databases have shown that the proposed method, using mutation proﬁles can eﬃciently detect the molecular subtypes of breast cancer. Finally, a supervised classiﬁer is proposed based on discovered subtypes to predict the molecular subtype of a new patient.
Bacterial profile and drug resistance patterns in neonates admitted with sepsis to a tertiary teaching hospital in Ethiopia
Authors: Gashaw Mulatu , Ali Solomon , Tesfaw Getnet , Eshetu Beza , Workneh Netsanet , Berhane Melkamu , Bårnes Guro K. , Froeschl Guenter , Wieser Andreas , Gudina Esayas Kebede 
Published: December 2019

Abstract
Background : Tackling neonatal infections and antibiotic resistance remains a challenge in low-income countries where neonatal mortality is high and antibiotic resistance is growing. The aim of this study was to identify bacterial etiologies and their drug resistance patterns in neonates admitted with diagnosis of sepsis to neonatal intensive care unit at Jimma Medical Center in Ethiopia. Methods : A prospective longitudinal study was conducted from April to October 2018. A total of 313 clinical specimens (211 blood and 102 cerebrospinal fluid) were processed for 238 neonates suspected to have sepsis. Blood culture was done using BD BACTEC FX40 automated system. Bacterial identification and antibiotic susceptibility testing were done according to standard microbiological techniques. Results : Bacterial etiologies were isolated from 62.1% (131/211) and 3.9% (4/102) of blood and cerebrospinal fluid cultures respectively. The predominant bacteria isolated from blood were Coagulase negative Staphylococcus 27.5% (36/131), followed by S. aureus 20.6% (27/131), Klebsiella species 14.5% (19/131), and Acinetobacter species 10.7% (14/131). Nearly 85% of the isolates were multidrug resistant, predominantly observed in Gram-negative bacteria. Among locally available antibiotics, only meropenem for Gram-negatives and vancomycin for Gram-positives were found to be largely effective. Conclusion : Bacterial pathogens identified in the study were highly resistant to available antibiotics. Thus, an effort to reduce neonatal mortality in the setting should focus on improving diagnostics for neonatal infection and containment of antimicrobial resistance.
Primitive Reflexes in Very Low Birth Weight Infants Later Diagnosed with Autism Spectrum Disorder
Authors: Nagai Yukiyo , Nomura Kayo , Uemura Osamu 
Published: December 2019

Abstract
Background: As early screening and diagnosis is very important in treatment of Autism Spectrum Disorder, we investigated the relationship between primitive reflexes and Autism Spectrum Disorder (ASD). Methods: Of 88 very low birth weight infants born from April 2010 to March 2012, subjects comprised 38 examined for 18 primitive reflexes between age 38 and 45 wks corrected age and followed-up over 6 yrs. ASD was diagnosed using Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) and Autism Diagnostic Observation Schedule Second Edition (ADOS-2). We compared the number of abnormal primitive reflexes between two groups (11 children with and 19 without ASD) after excluding eight children with cerebral palsy in this case-control study. Results: The number of abnormal primitive reflexes differed significantly between groups, with hypoactive reflexes markedly higher in the ASD group (p=0.001). Conclusion: The result suggests primitive reflexes can be one of the key elements to identify ASD in low birth weight infants. Abnormal primitive reflexes of low birth weight infants with ASD in very early infancy may inform future research of the pathogenesis of ASD.
Level of physical activity and its correlates among health care workers in Ethiopia, 2019
Authors: Adane Tigist Demssew , Gebregiorgis Birhan Gebresillassie , Nigussie Elda Mekonnen , Wubetu Abate Dargie 
Published: December 2019

Abstract
Background These days, engaging at sufficient regular physical activity strongly recommended for good health and physical functioning. Physical activity can increase the self-confidence of the health professionals and they would become fit for daily activities with patients. Knowing the level of physical activity can help health care professionals to plan for physical activity programs. This study aimed to measure the level of physical activity and associated factors among adult health professionals at Tirunesh Beijing general hospital.Objective The aim of this study was to assess the level of physical activity and associated factors among health care workers in Ethiopia, 2019.Methods Institution based cross-sectional study conducted level of physical activity and associated factors among health care workers in Ethiopia, 2019. Two hundred nighty seven adult health professionals were participated, which was a 97.4% response rate. The global physical activity questionnaire used to measure the level of physical activity. Descriptive statistics and binary logistic regression analyses was done to affirm the variables characteristics. A predictor variable with a p-value of less than 0.2 exported to multivariate analysis. During multivariate analysis, statistical significance declared at a p-value of < 0.05.Results In general, the majority of the study participants, 89.2% (95% CI: 85.9-92.6) were achieved recommended levels of physical activity. Regarding the intensity of the physical activity, the overall mean time score was 518.4 mints per week or 2352.6 MET/week. For moderate-intensity physical activity, 83.5% of the study participants were physically active, (≥150 minutes/week). In the case of vigorous activity, about 32.7% of the study participants were physically active and engaged in vigorous physical activity (≥75 minutes /week). The study participants, who had self-motivation for physical activity, had a BMI of less than 25 kg/m2 and aged < 40 years were physically active.Conclusions Health care providers’ habit of physical activity improved as compared with the previous studies. However, the current level of physical activity of health professionals is not adequate. Health care providers’ age, body mass index and self-motivation attribute to physical activity. The level of physical activity can increase by enhancing staff motivation towards physical activity.