bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hand hygiene compliance among caregivers of inpatients with multidrug-resistant organism infection in China: a cross-sectional study
Authors: Chang Wenyan , Chen Xiaobing , He Wenying , Lin Taoyu 
Published: September 2020

Abstract
Background

Caregivers are an important provider of daily living care for multidrug-resistant organism (MDRO) inpatients in China, they are at risk for contracting and spreading MDRO from frequent interactions with patients. Improving the hand hygiene (HH) compliance of caregivers has important significance in reducing the incidence of infection. However, we have little information about HH compliance among caregivers of MDRO inpatients in most medical institutions. Therefore, we decide to examine HH compliance among caregivers of MDRO inpatients in China.
Methods

Using direct observations, we investigated HH compliance among caregivers of MDRO inpatients between March and August 2019 in a large university-affiliated hospital in China. Using the WHO’s Hand Hygiene Observation Tool, we surveyed a total of 440 HH opportunities.
Results

Out of the total participants, 16.2% were elderly. Overall HH compliance was 46.8%. The most frequent moment for HH was “after a touching patient” (69.2%) and the lowest compliance was “before clean/aseptic procedures” (25.6%). Compliance during “visiting” was highest (66.7%), with hands being less frequently washed during “resting” (29.0%).
Conclusions

Overall compliance with HH when caring for MDRO inpatients is less than optimal. Elderly caregivers should be valued by society and the public. These results may be used to identify issues and interventions to address HH practices and achieve a reduction in MDRO infections.
Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai — A retrospective of 11-year clinical analysis in a shanghai tertiary hospital
Authors: ZHENG Yan-Jun , XIE Ting , WU Lin , LIU Xiao-Ying , ZHU Ling , CHEN Ying , MAO En-Qiang , HAN Li-Zhong , CHEN Er-Zhen , YANG Zhi-Tao 
Published: September 2020

Abstract
Background:

Candida spp. are important opportunist pathogens causing bloodstream infections (BSIs). The present study aims to describe the current epidemiology of Candida BSI in a large Shanghai Tertiary-care Hospital from 2008 to 2018 and to identify the risk factors and the impact of antifungal therapy on clinical outcomes.
Methods:

From January 2008 to December 2018, all consecutive patients who developed Candida BSI at Ruijin Hospital were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and its impact on the outcome were analyzed.
Results:

The incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients, and the overall 28-day mortality rate was 28.5%. Among the 393 cases of Candida BSI, 299 cases (76.1%) received antifungal therapy. 247 received early appropriate antifungal therapy (an appropriate drug with adequate dosage was started before the subsequent in vitro susceptibility results), and 52 received target antifungal therapy (appropriate target treatment started after susceptibility results, regardless of whether the inappropriate antifungal treatment has been initialed or not). The 28-day mortality rate was significantly lower in those who received early appropriate antifungal therapy or target antifungal therapy compared with those who did not receive antifungal therapy (25.5% and 23.1% vs. 39.4%,P = 0.012 and P = 0.046). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, neutropenia were independent risk factors for the 28-day mortality rate, while antifungal therapy was a protective factor for short-term survival rate.
Conclusions:

The epidemiology of Candida BSI in Shanghai differed from that observed in Western countries. Antifungal therapy did influence the short-term survival, while there was no significant difference between the mortality for those who received early appropriate antifungal therapy and for those who received target antifungal therapy.
Cauda Equina Syndrome-Induced Acute Urinary Retention in Patients with Acute Lumbar Disc Herniation: Report of Two Clinical Cases.
Authors: Dinh Hoai Thi Phuong , Nguyen Hai Minh , Le Duyen Nha , Le Anh Thi Quy , Nguyen Minh Thanh , Nguyen Hung Khoa 
Published: September 2020

Abstract
Objective: to discuss two cases with CES-induced acute urinary retention, knowledge of which is essential for early diagnosis, treatment and prevention of neurological dysfunctions. Case presentation: Two patients were hospitalized with symptoms lower back pain with weakness and progressive loss of feeling of lower limbs accompanied by acute urinary retention, urinary system tests were within normal limits. Magnetic resonance imaging results in lumbar disc herniation causing spinal stenosis. Both patients underwent posterior lumbar interbody fusion (PLIF) procedure and showed improvements in symptoms after surgery and re-examination.Conclusion: The diagnosis should be based on magnetic resonance imaging. Lumbar disc herniation is the most common cause of acute urinary retention from cauda equina compression. Laminectomy, with early decompression within 24 to 48 hours, reduces the risk of long-term neurological dysfunction and increases the chances of recovery for the patient.
Adductor Canal Block in the Outpatient Clinic for Pain Control Following Knee Surgery
Authors: rhatomy sholahuddin , rasyid faiz alam , setyawan riky 
Published: September 2020

Abstract
Background: The outcome of knee surgery is influenced by the surgery itself and the rehabilitation program. Post-operative pain management is the most important factor for a successful rehabilitation program. We hypothesized that an adductor canal block (ACB) in the outpatient clinic is safe, effective for pain relief, and decreases analgesic consumption.Methods: We included patients who underwent knee surgery. Patients were scheduled to an ACB on post-operative day (POD) 14 at the outpatient clinic with 0.1% ropivacaine. We evaluated pain with the use of a visual analogue scale (VAS) and analgesic consumption on PODs 5, 7, 9, 15, 17, 19, 21, 23, 25, 27, and 29.Results: We enrolled 115 patients. The mean VAS pain scores before ACB on PODs 5, 7, and 9 were 7.4, 7.2, and 6.2, respectively. After the patients received the ACB on POD 14, the mean VAS pain score significantly decreased to 1.6, then gradually increased at PODs 17, 19, 21, and 23. After POD 23, the VAS pain score flattened. Patients’ mean analgesic (etoricoxib) consumption before receiving the ACB on PODs 5, 7, and 9 were 102 mg, 98 mg, and 98 mg, respectively. After receiving ACB, analgesic consumption significantly decreased (16 mg) on POD 15, then gradually increased on PODs 17, 19, and 21. After POD 21, analgesic consumption stabilized.Conclusions: Single-shot ACB in the outpatient clinic is safe and significantly decreases pain and analgesic consumption and may enhance rehabilitation programs.
Association Between Renal Function and Platelet Reactivity During Aspirin Therapy in Elderly Patients With Atherosclerotic Cardiovascular Disease
Authors: Liang Wenyi , Zhang Peng , Liu Meilin 
Published: September 2020

Abstract
Background: Aspirin is the key treatment in the secondary prevention of atherosclerotic cardiovascular disease. High on-treatment platelet reactivity (HTPR) to aspirin has been reported to partially account for the enhanced risk of thrombotic events. In particular, HTPR has been described more frequently among elderly patients. The aim of this study was to identify the clinical and biological factors associated with HTPR in a real-life elderly population.Methods: In this retrospective study, elderly patients with atherosclerotic cardiovascular disease on regular aspirin treatment were enrolled. Cardiovascular risk factors, routine biological parameters, comorbidities, and concomitant medications were recorded. The upper quartile of the platelet aggregation rate, determined by light transmission aggregometry with arachidonic acid, was defined as the HTPR group.Results: A total of 304 patients were included (mean age 77 ± 8 years, 76% men). Patients in the HTPR group were older than the patients in the non-HTPR group (mean age: 79 ± 7 vs. 76 ± 8 years, p = 0.008). Patients with moderately decreased estimated glomerular filtration rate (eGFR) had a higher frequency of HTPR than patients with slightly decreased eGFR or normal eGFR (35.8%, 22.5%, 12.2%, respectively, p < 0.05). In multivariate analysis, an independent risk factor for HTPR was the eGFR (OR: 0.984, 95% CI: 0.980-0.988, p < 0.001).Conclusions: Advanced age and decreased eGFR are correlated with poor pharmacodynamic response to aspirin. Antiplatelet strategy in elderly patients with atherosclerotic cardiovascular disease should be driven by an individualized approach, especially in patients with impaired renal function.
Effect of Dynamic Circuit Pressures Monitoring on the Lifespan of Extracorporeal Circuit and the Efficiency of Solute Removal During Continuous Renal Replacement Therapy
Authors: Li Peiyun , Zhang Ling , Lin Li , Tang Xin , Guan Mingjing , Wei Tiantian , Chen Lixin 
Published: September 2020

Abstract
Objective: To observe the effects of dynamic pressure monitoring on the lifespan of the extracorporeal circuit and the efficiency of solute removal during continuous renal replacement therapy (CRRT).Materials and Methods: A prospective observational study was performed at the West China Hospital of Sichuan University in the intensive care unit. Analyses of the downloaded pressure data recorded by CRRT machines and the solute removal efficiencies, calculated by 2*Ce/(Cpre+Cpost), where Ce, Cpre and Cpost are the concentrations of the effluent, pre-filter blood, and post-filter blood, respectively, were performed. Samples were collected at 0, 2, 6, 12, 24 h after the initiation of CRRT. We measured the concentrations of creatinine, blood urea nitrogen (BUN) and β2-microglobulin in the plasma and effluent.Results: Extracorporeal circuits characterized by moderate-severe (M-S) access outflow dysfunction (AOD) events, defined as access outflow pressure less than or equal to -200 mm Hg more than 5mins, had shorter lifespans with no anticoagulation (17.6±11.2 h vs. 35.1±17.1 h, P=0.001) or with regional citrate anticoagulation (RCA) (40.3±22.2 h vs. 55.9±21.7 h, P=0.016). Moreover, Cox regression analysis revealed that the lack of moderate-severe AOD events, RCA, or continuous veno-venous hemodiafiltration (CVVHDF) independently prolonged the circuit lifespan. All tested solutes removal efficiencies started to decline at 12h. Furthermore, efficiencies of all solutes removal dropped obviously at 24h when TMP≥ 150mmHg.Conclusion: RCA and CVVHDF predicted a longer circuit lifespan. Moderate-severe AOD events were associated with a shorter circuit lifespan when RCA or no anticoagulation was used. Replacement of extracorporeal circuit might be considered if TMP≥ 150mmHg at 24h.
Mice With A Cleavage-Resistant N-Cadherin Exhibit Synapse Anomaly in the Hippocampus and Outperformance in Spatial Memory Tasks
Authors: Asada-Utsugi Megumi , Uemura Kengo , Kubota Masakazu , Noda Yasuha , Tashiro Yasutaka , Uemura Maiko T , Yamakado Hodaka , Urushitani Makoto , Takahashi Ryosuke , Hattori Satoko , Miyakawa Tsuyoshi , Ageta-Ishihara Natsumi , Kobayashi Katsunori , Kinoshita Makoto , Kinoshita Ayae 
Published: September 2020

Abstract
N-cadherin is a homophilic cell adhesion molecule that stabilizes excitatory synapses, by connecting pre- and post-synaptic termini. Upon NMDA receptor (NMDAR) activation by glutamate, membrane-proximal domains of N-cadherin are cleaved serially by a-disintegrin-and-metalloprotease 10 (ADAM10) and then presenilin 1(PS1, catalytic subunit of the γ-secretase complex). To assess the physiological significance of the initial N-cadherin cleavage, we engineer the mouse genome to create a knock-in allele with tandem missense mutations in the mouse N-cadherin/Cadherin-2 gene (Cdh2 R714G, I715D, or GD) that confers resistance to proteolysis by ADAM10 (GD mice). GD mice showed a better performance in the radial maze test, with significantly less revisiting errors after intervals of 30 and 300 sec than WT and a tendency for enhanced freezing in fear conditioning. Interestingly, GD mice reveal higher complexity in the tufts of thorny excrescence in the CA3 region of the hippocampus. Fine morphometry with serial section transmission electron microscopy (ssTEM) and three-dimensional (3D) reconstruction reveals significantly higher synaptic density, significantly smaller PSD area, and normal dendritic spine volume in GD mice. This knock-in mouse has provided in vivo evidence that ADAM10-mediated cleavage is a critical step in N-cadherin shedding and degradation and involved in the structure and function of glutamatergic synapses, which affect the memory function.
The Effects of Normal Aging, Subjective Cognitive Decline, Mild Cognitive Impairment, or Alzheimer's Disease on Visual Search
Authors: Xue Chaunwei , Tang Yi , Wang Changming , Yang Haibo , Li Liang 
Published: September 2020

Abstract
Background：To examine the progressively developed visual-search deficiency associated with Alzheimer's disease (AD).Methods: Healthy-younger adults, healthy-older adults (normal-aging control, NC), adults with subjective cognitive decline (SCD), amnestic mild cognitive impairment (aMCI), or mild AD participated in this study. To determine whether 1 of 4 letters presented at 4 symmetrically-located positions differed from the other 3, when the 4 letters were masked by either other randomly positioned and oriented letters or random-pixel noise. Meanwhile, eye movements were trackedResults: In all the participants, with the stimulus-presentation time being longer, the visual-search performance improved, and both the eye interest-area first fixation duration (IFFD) and the interest-area-fixation count (IFC) increased. Particularly under the noise-masking condition, the AD group performed the worst at stimulus-presentation times between 300 and 900 ms. The aMCI group, but not the SCD group, performed worse than the NC group at the stimulus-presentation time of either 300 or 500 ms. The IFC was higher in all the patient groups than that in the NC group, and distinguishable between participants with AD and those with SCD or aMCI. Conclusions: The visual-search performance combined with eye-moment tracking under the noise-masking condition can be used for distinguishing AD from normal aging, SCD, and aMCI.
A Colorimetric Test for the Evaluation of the Insecticide Content of LLINs Used on Bioko Island, Equatorial Guinea
Authors: Kaur Harparkash , Allan Elizabeth Louise , Eggelte Teunis A , Garcia Guillermo A , Monti Feliciano 
Published: September 2020

Abstract
BackgroundInsecticide-treated nets and indoor residual spraying of insecticides are used as the major vector control interventions in the fight against malaria. Measuring the actual amount of deposits of insecticides on bed nets and walls is essential for evaluating the quality and effectiveness of the intervention. A colorimetric “Test Kit” designed for use as a screening tool, able to detect the type II pyrethroids on fabrics and sprayed walls, was used for the first time to detect deltamethrin on long-lasting insecticidal nets (LLINs) deployed on Bioko Island, Equatorial Guinea.MethodsLLINs were analysed using the colorimetric Test Kit performed in situ, which leads to the formation of an orange-red solution whose depth of colour indicates the amount of type II pyrethroid on the net. The kit results were validated by measuring the amount of extracted insecticide using high-performance liquid chromatography (HPLC) with diode array detection (DAD).ResultsDeltamethrin concentration was determined for 130 LLINs by HPLC-DAD. The deltamethrin concentration of these nets exhibited a significant decrease with the age from 65 mg/m2 (<12 months of use) to 31 mg/m2 (>48 months; p<0.001). Overall, 18% of the nets being used in households had <15 mg/m2 of deltamethrin, thus falling into the failed category as assessed by the colorimetric Test Kit. This was supported by the bioassay determined bio-efficacy of the nets with ≥80% mortality following the World Health Organization (WHO) minimal effectiveness criteria. The Test Kit was field evaluated in situ and found to be rapid, accurate, and easy to use by people without laboratory training. The Test Kit was shown to have a reliable linear relationship between depth of colour produced and deltamethrin concentration (R2 = 0.9135).ConclusionResults of this study show that this colorimetric test was a reliable method to assess the insecticidal content of LLINs under operational conditions. The Test Kit provides immediate results and offers a rapid, inexpensive, field-friendly alternative to the complicated and costly methods as HPLC and WHO cone bioassays which also need specialist staff. Thus, enabling National Malaria Programs to gain access to effective and affordable monitoring tools for use in situ.
A botanical product containing cistanche and ginkgo extracts improves chronic fatigue syndrome: a randomized, double-blind, placebo-controlled study
Authors: Kan Juntao , Hu Chun , Chen Liang , Liu Siyu , Venzon Dawna , Murray Mary , Wang Chaojih , Yeh Ailing , Liu Bryan , Li Shuguang , Du Jun 
Published: September 2020

Abstract
BackgroundDietary therapy may be beneficial in alleviating symptoms of chronic fatigue syndrome (CFS), a disorder characterized by extreme fatigue with no underlying medical condition. The aim of this study is to evaluate the protective effect of a botanical product containing cistanche (Cistanche tubulosa (Schenk) Wight) and ginkgo (Ginkgo biloba L.) extracts on adults with CFS in a randomized, double-blind, placebo-controlled clinical trial.MethodsA total of 190 subjects with CFS were randomized to receive low dose, high dose of product or placebo (tablets) once daily for 60 days. Blood samples and questionnaires of Chalder fatigue, quality of life (QOL), and sexual life quality (SLQ) were collected at baseline and post-intervention.ResultsOur product significantly relieved the symptoms of CFS, among which impaired memory or concentration, muscle pain, unrefreshing sleep, and post-exertional malaise were significantly improved. The intervention of product significantly decreased both physical and mental fatigue scores of the Chalder fatigue questionnaire, and improved QOL and SLQ of the subjects. Levels of blood ammonia and lactic acid in the subjects of product group were significantly lower than those of placebo group. In addition, the change in lactic acid concentration was significantly associated with the effectiveness for CFS symptoms, and correlated to the change in total physical fatigue score of the Chalder fatigue questionnaire.ConclusionsOur botanical product relieves the CFS symptoms and improves the scores of Chalder fatigue, QOL and SLQ questionnaires. These findings suggest a nutritional supplementation approach with botanical extracts as an alternative strategy in mitigating CFS.Trial registrationThis trial has been registered on https://clinicaltrials.gov/ under the identification code: NCT02807649. Registered 21 June 2016 - Retrospectively registered.
miRNA-486-5p Promotes COPD Progression by Targeting HAT1 to Regulate the TLR4-Triggered Inflammatory Response of Alveolar Macrophages
Authors: Zhang Jie , Xu Zhongneng , Kong Lianhua , Gao Hong , Zhang Yueming , Zheng Yulong , Wan Yufeng 
Published: September 2020

Abstract
Background: The aim of this study is to investigate the key regulatory miRNA-486-5p and underlying molecular mechanisms in chronic obstructive pulmonary disease (COPD) progression.Methods: Aberrant miRNA expression in smokers compared to non-smokers and COPD compared to normal was analyzed using microarray datasets and reverse-transcriptase quantitative polymerase chain reaction (qPCR). ELISA assay was used to determine the secretion of inflammatory cytokines in cell supernatants. Inflammatory cytokine expression, including HAT1, TLR4, and miR-486-5p, was determined using qPCR or western blotting. Luciferase reporter assays and fluorescence in situ hybridization were used to confirm the target regulation between miR-486-6p and HAT1. Results: Our results showed that miR-486-5p was significantly up-regulated in the COPD and smoker groups compared to the control group based on bioinformatics analysis and qPCR validation of alveolar macrophages and peripheral monocytes. miR-218-5p expression significantly correlated with IL-6, IL-8, TNF-α, and IFN-γ expression. Luciferase reporter assays confirmed that miR-486-5p directly targets HAT1, and cellular localization showed that miR-486-5p and HAT1 were highly expressed in the cytoplasm. miR-486-5p overexpression led to significant TLR4 up-regulation and significant HAT1 down-regulation. Inversely, miR-486-5p inhibition led to significant TLR4 down-regulation and significant HAT1 up-regulation. HAT1 knockdown using siRNA significantly increased TLR4, IL-6, IL-8, TNF-α, and IFN-γ expression. Conclusions: miR-486-5p was differentially expressed in alveolar macrophages of COPD patients. miR-486-5p overexpression might increase the TLR4-triggered inflammatory response in COPD patients by targeting HAT1.
Institutional Delivery Services Utilization and Associated Factors Among Mothers Who Gave Birth in The Last Year in Mandura District, North West Ethiopia, 2019.
Authors: Mitikie Kassahun Asres , Wassie Gizachew Tadesse , Beyene Melkamu Bedemo 
Published: September 2020

Abstract
Background: The risk of death from complications relating to pregnancy and childbirth for women’s lifetime is higher in developing countries. Improving maternal and child health through a well-organized institutional delivery service is central to achieve reduced maternal and child mortality. Despite the efforts that have been made to improve maternal health outcomes in Ethiopia, institutional delivery is still unacceptably low. This study was aimed to assess institutional delivery service utilization and associated factors in the study area. Methods: Community-based cross-sectional study was conducted. A multi-stage sampling technique was used to employ a total of 546 women. Data were collected using an interviewer-administered questionnaire. Logistic regression models were used to determine factors associated with the outcome variable. Adjusted Odds ratios with 95% CI were computed to measure the strength of association and statistical significance was declared at p-value <0.05.Results: The Prevalence of institutional delivery in the study area was 38% (34%-42%). Factors significantly associated with institutional delivery were ANC visit 1.80(1.12-2.91), knowledge on danger sign 3.60(2.25-5.76), urban residency 2.09(1.15-3.81), Parity 0.49(0.25-0.95) accessibility of health facility 4.60(2.01-10.89), husbands educational level: primary 2.50(1.27-4.91), secondary and above 2.36(1.24-4.48), mothers occupation: governmental employee 2.05(1.00-4.18), and Private employee 2.42 (1.09-5.35). Conclusions: The prevalence of institutional delivery in the District was low. Antenatal visits, residency, knowledge on pregnancy danger signs, parity, accessibility of health facilities, maternal occupation, and husband education were significantly associated with institutional delivery. Strengthen the community-based awareness creation program regarding the danger signs of pregnancy and benefits of institutional delivery through the health developmental army, health extension workers, and local health care service providers; empowering women to get a job access, advocating education in the community, and improving antenatal care utilization would be among important measures to improve institutional delivery utilization.