bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enterococcal periprosthetic joint infection: clinical and microbiological findings from a 8-year retrospective cohort study
Authors: Renz Nora , Trebse Rihard , Akgün Doruk , Perka Carsten , Trampuz Andrej 
Published: November 2019

Abstract
Background : Treatment of enterococcal periprosthetic joint infections (PJI) is challenging due to non-standardized management strategies and lack of biofilm-active antibiotics. The optimal surgical and antimicrobial therapy are unknown. Therefore, we evaluated characteristics and outcome of enterococcal PJI. Methods : Consecutive patients with enterococcal PJI from two specialized orthopedic institutions were retrospectively analyzed. Both institutions are following the same diagnostic and treatment concepts. The probability of relapse-free survival was estimated using Kaplan-Meier survival curves and compared by log-rank test. Treatment success was defined by absence of relapse or persistence of PJI due to enterococci or death related to enterococcal PJI. Clinical success was defined by the infection-free status, no subsequent surgical intervention for persistent or perioperative infection after re-implantation and no PJI-related death within 3 months. Results : Included were 75 enterococcal PJI episodes, involving 41 hip, 30 knee, 2 elbow and 2 shoulder prostheses. PJI occurred postoperatively in 61 episodes (81%), hematogenously in 13 (17%) and by contiguous spread in one. E. faecalis grew in 64 episodes, E. faecium in 10 and E. casseliflavus in one. Additional microorganism(s) were isolated in 38 patients (51%). Enterococci were susceptible to vancomycin in 73 of 75 isolates (97%), daptomycin in all 75 isolates, and fosfomycin in 21 of 22 isolates (96%). The outcome data was available for 66 patients (88%). The treatment success after 3 years was 83.7% (95% confidence interval [CI]; 76.1-96.7%) and the clinical success was 67.5% (95% CI; 57.3-80.8%). In 11 patients (17%), a new PJI episode caused by a different pathogen occurred. All failures occurred within the three years of surgery. Conclusion : About half of enterococcal PJI were polymicrobial infections. The treatment success was high (84%). All treatment failures occurred within the first three years after revision surgery. Interestingly, 17% of patients experienced a new PJI caused by another pathogen at a later stage.
Self-reported confidence in patient safety competencies among Chinese nursing students: a multi-site cross-sectional survey
Authors: huang fei fei , shen xiaoying , Chen Xue Lei , he liping , Huang Sufen , li jingxiu 
Published: November 2019

Abstract
Background Nursing interns are an important backup force for nursing professionals, so efforts to strengthen their patient safety (PS) competencies are a major priority. To do so requires assessing the strengths and weaknesses of Chinese nursing students’ PS competence and identifying the influencing factors.
Methods This was a multi-site, cross-sectional, web-based study that was carried out between September 2018 and January 2019. A national online survey was completed by 732 Chinese undergraduate nursing students. Our primary outcome factor was the Health Professional Education in Patient Safety Survey score. We also collected socio-demographic and clinical practice-related characteristics as independent variables.
Multiple stepwise linear regression was performed to identify predictors of PS competence.
Results Chinese undergraduate nursing students were fairly confident in their clinical safety skills but less confident in what they learned about sociocultural or context-dependent aspects of PS and speaking up about PS, including effective communication and understanding human and environmental factors. Less than half of the students felt that they could approach someone engaging in unsafe practice and were reluctant to voice concern about adverse events. We observed significant differences in PS competence between students from different regions, across different PS learning styles (self-study and classroom theoretical study), with different self-assessed PS competence levels, and with experiences of adverse events(p<0.05). These factors accounted for almost 15% of the total variance in PS competence scores (adjusted R2=0.15，p=0.00).
Conclusions The results of this study provide a better understanding of PS competence among final-year nursing students in China. Our findings may help nursing educators or healthcare organizations to cultivate and improve PS competence by establishing documented policies or by improving the efficacy of intervention.
Genome-wide association study (GWAS) for morphological and yield-related traits in an oil palm hybrid (Elaeis oleifera x Elaeis guineensis) population
Authors: Osorio Jaime , Garzón Gina , Delgadillo Paola , Bastidas Silvio , Moreno Leidy , Enciso Felix , Cornejo Omar , Barrero Luz Stella 
Published: November 2019

Abstract
Background The genus Elaeis has two species of economic importance for the oil palm agroindustry: Elaeis oleifera (O), native to the Americas, and Elaeis guineensis (G), native to Africa. This work provides to our knowledge, the first association mapping study in an interspecific OxG oil palm population, which shows tolerance to pests and diseases, high oil quality, and acceptable fruit bunch production. Results Using genotyping-by-sequencing (GBS), we identified a total of 3,776 single nucleotide polymorphisms (SNPs) that were used to perform a genome-wide association analysis (GWAS) in 378 OxG hybrid population for 10 agronomic traits. Twelve genomic regions (SNPs) were located near candidate genes implicated in multiple functional categories, such as tissue growth, cellular trafficking, and physiological processes. Conclusions We provide new insights on genomic regions that mapped on candidate genes involved in plant architecture and yield. These potential candidate genes need to be confirmed for future targeted functional analyses. Associated markers to the traits of interest may be valuable resources for the development of marker-assisted selection in oil palm breeding. Keywords: Association mapping, Elaeis guineensis , Elaeis oleifera , genotyping-by-sequencing, plant architecture, yield.
A self-aggregating peptide: Implications for the development of thermostable vaccine candidates
Authors: Cruz-Resendiz Adolfo , Zepeda Jesus , Sampieri Alicia , Bastian Carlos , Acero Gonzalo , Sánchez-Betancourt Jose Ivan , Gevorkian Goar , Vaca Luis 
Published: November 2019

Abstract
Background: The use of biomaterials has been expanded to improve the characteristics of vaccines. Recently we have identified that the peptide PH(1-110) from polyhedrin self-aggregates and incorporates foreign proteins to form particles. We have proposed that this peptide can be used as an antigen carrying system for vaccines. However, the immune response generated by the antigen fused to the peptide has not been fully characterized. In addition, the adjuvant effect and thermostability of the particles has not been evaluated. Results: In the present study we demonstrate the use of a system developed to generate nano and microparticles carrying as a fusion protein peptides or proteins of interest to be used as vaccines. These particles are purified easily by centrifugation. Immunization of animals with the particles in the absence of adjuvant result in a robust and long-lasting immune response. Proteins contained inside the particles are maintained for over one year at ambient temperature, preserving their immunological properties. Conclusion: The rapid and efficient production of the particles in addition to the robust immune response they generate position this system as an excellent method for the rapid response against emerging diseases. The thermostability conferred by the particle system facilitates the distribution of the vaccines in developing countries or areas with no electricity.Keywords: vaccines, particles, self-assembling, thermostable, immunology
CRISPR-cas system in the acquisition of virulence genes in dental-root canal and hospital-acquired isolates of Enterococcus faecalis
Authors: Gholizadeh Pourya , Aghazadeh Mohammad , Ghotaslou Reza , Rezaee Mohammad Ahangarzadeh , Pirzadeh Tahereh , Lanotte Philippe , Ganbarov Khudaverdi , Bastami Milad , Yousefi Mehdi , Kafil Hossein Samadi 
Published: November 2019

Abstract
Introduction

Enterococcus faecalis is one of the important causative agents of nosocomial and life-threatening infections in human. Several studies have demonstrated that the presence of CRISPR- cas is associated with antibiotic susceptibility and lack of virulence traits. In this study, we aimed to assess the phenotypic and genotypic virulence determinants in relation to CRISPR elements from the dental-root canals and hospital-acquired isolates of E. faecalis .Methods and materials

Eighty-eight hospital-acquired and 73 dental-root canal isolates of E. faecalis were assessed in this study. Phenotypic screening of the isolates included biofilm formation, and gelatinase and hemolysis activities. Genotypical screening using PCR was further used to evaluate the presence of CRISPR elements and different virulence-associated genes such as efaA , esp , cylA , hyl , gelE , ace , ebpR , and asa1 .Results

Biofilm formation, and gelatinase and hemolysis activity were detected in 93.8%, 29.2% and 19.2% of the isolates, respectively. The most prevalent virulence-associated gene was ace , which was followed by efaA , whereas cylA was the least identified. The presence of CRISPR1- cas , orphan CRISPR2 and CRISPR3- cas was determined in 13%, 55.3% and 17.4% of the isolates, respectively. CRISPR elements were significantly more prevalent in the dental-root canals isolates. An inverse significant correlation was found between CRISPR- cas loci, esp and gelE , while direct correlations were observed in the case of cylA , hyl , gelE (among CRISPR-loci 1 and 3), asa1 , ace , biofilm formation, and hemolysis activity.Conclusion

Findings, therefore, indicate that CRISPR- cas might prevent the acquisition of some respective pathogenicity factors in some isolates, though not all; so selective forces could not influence pathogenic traits.
Second-line treatment strategy for urothelial cancer patients who progress or are unfit for cisplatin therapy: a network meta-analysis
Authors: Wang Huitao , Liu Jianhe , Fang Kewei , Ke Changxing , Jiang Yongming , Wang Guang , Yang Tongxin , Chen Tao , Shi Xin 
Published: November 2019

Abstract
Background Second-line treatment for urothelial carcinoma (UC) patients is used if progression or failure after platinum-based chemotherapy occurs or if patients are cisplatin-unfit. However, there is still no widely accepted treatment strategy. We aimed to analyze the effectiveness and safety of second-line treatment strategies for UC patients. Methods The PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) that included UC patients who were cisplatin-ineligible or unfit up to April 19, 2019. The primary outcomes were progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Results Thirteen trials that assessed 3502 UC patients were included. This study divided the network comparisons into three parts. The first part contained studies comparing taxanes and other interventions; the second part assessed investigator’s choice chemotherapy (ICC)-related comparisons; and the third part assessed best support care (BSC). In the OS results of the first part, pembrolizumab (87.5%), ramucirumab plus docetaxel (74.6%), and atezolizumab (71.1%) had a relative advantage. Pembrolizumab also had advantages in ORR and severe adverse effect (SAE) results. Vinflunine and ramucirumab plus docetaxel had a relatively high surface under the cumulative ranking curve (SUCRA) rank by exploratory cluster analysis. Conclusions This study concluded that atezolizumab and pembrolizumab are superior to other treatments, mainly in OS results, but no treatment confers a significant advantage in PFS. Pembrolizumab still has relative advantages in ORR and SAE results compared to ICC. Due to limitations, more studies are necessary to confirm the conclusions.
Myocardial Characterization in Pre-Dialysis Chronic Kidney Disease: A Study of Prevalence, Patterns and Outcomes
Authors: Price Anna M , Hayer Manvir K , Vijapurapu Ravi , Fyyaz Saad A , Moody William E , Ferro Charles J , Townend Jonathan N , Steeds Richard P , Edwards Nicola C 
Published: November 2019

Abstract
Background Late gadolinium enhancement (LGE) using cardiac magnetic resonance (CMR) characterizes myocardial disease and predicts an adverse cardiovascular (CV) prognosis. Myocardial abnormalities, are present in early chronic kidney disease (CKD). To date there are no data defining prevalence, pattern and clinical implications of LGE-CMR in CKD.Methods Patients with pre-dialysis CKD (stage 2-5) attending specialist renal clinics at University Hospital Birmingham (UK) who underwent gadolinium enhanced CMR (1.5T) between 2005 and 2017 were included. The patterns and presence (LGEpos) / absence (LGEneg) of LGE were assessed by two blinded observers. Association between LGE and CV outcomes were assessed.Results In total, 159 patients received gadolinium (male 61%, mean age 55 years, mean left ventricular ejection fraction 69%, left ventricular hypertrophy 5%) with a median follow up period of 3.8 years [1.04-11.59]. LGEpos was present in 55 (34%) subjects; the patterns were: right ventricular insertion point n=28 (51%), mid wall n=18 (33%), sub-endocardial n=5 (9%) and sub-epicardial n=4 (7%). There were no differences in left ventricular structural or functional parameters with LGEpos. There were 12 adverse CV outcomes over follow up; 7 of 55 with LGEpos and 5 of 104 LGEneg. LGEpos was not predicted by age, gender, glomerular filtration rate or electrocardiographic abnormalities.Conclusions In a selected cohort of subjects with moderate CKD but low CV risk, LGE was present in approximately a third of patients. LGE was not associated with adverse CV outcomes. Further studies in high risk CKD cohorts are required to assess the role of LGE with multiplicative risk factors.
Uses of Quick Response Codes in Healthcare Education: A Scoping Review
Authors: Karia Chiraag Thakrar , Hughes Andrew , Carr Sue 
Published: November 2019

Abstract
Background

To review published literature on the use of quick response (QR) codes within healthcare education. In addition, the authors aimed to gain information on user perceptions and the challenges faced when implementing QR codes in an educational context.

Methods

Medline, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), HMIC (Healthcare Management Information Consortium) and HBE (Health Business Elite) were searched using specified search terms that included ‘quick response code’ and ‘education’. Title and abstract review of 217 publications was performed. Papers which discussed the application of QR codes relevant to healthcare education were included. A total of 24 articles were reviewed and thematic analysis conducted to generate themes.

Results

Use of QR codes in healthcare education were broadly aligned to four common themes. These included: to increase participant engagement, for simulation training, for just-in-time (JIT) learning and to facilitate with administrative tasks in training. Perceptions towards the use of QR codes was generally positive. Challenges identified, included: problems with technical infrastructure, unavailability of smartphones and resistance to use in certain environments.

Conclusions

The use of QR codes for healthcare education is increasing, and whilst they offer some advantages there are also some important considerations including: provision of the necessary technological infrastructure, patient and staff safety and governance and adherence to guidelines on safe and appropriate use of this technology in sensitive settings.
CHARACTERISTICS AND OUTCOME OF INFLUENZA-ASSOCIATED ENCEPHALOPATHY/ENCEPHALITIS AMONG CHILDREN IN A TERTIARY PEDIATRIC HOSPITAL IN ITALY, 2017-2019
Authors: Mastrolia Maria Vincenza , Rubino Chiara , Resti Massimo , Trapani Sandra , Galli Luisa 
Published: November 2019

Abstract
BACKGROUND: Influenza is the most frequent cause of acute upper respiratory tract infections during winter season. Although rare, neurological manifestations are known to occur during influenza infection and approximatively three-quarters of cases are in children. In this study, we aimed to characterize the burden and clinical spectrum of influenza-associated encephalopathy and encephalitis in children admitted at a tertiary pediatric hospital in Italy over two influenza seasons (2017-2019). METHODS: We retrospectively analyzed clinical, laboratory, instrumental data and outcome of patients discharged with ICD9-CM 487.0 code RESULTS: Fifteen children (13.1% of those discharged with a diagnosis of influenza infection in the study period), had influenza-associated central nervous system (CNS) manifestations. Eight patients (53.3%) were diagnosed as influenza encephalitis, 7 (46.7%) as influenza encephalopathy. Median age was 27 months. In children under 2 years of age (40% of all cases) altered consciousness was the most frequent neurological manifestation while respiratory symptoms were present at admission in all cases. Younger children also required intensive care support more frequently. Five subjects (33.3%) presented comorbidity. None of the patients had received seasonal influenza vaccination. The median time from onset of respiratory signs to onset of neurological manifestations was 24 hours. Cerebrospinal fluid (CSF) analysis was normal in most patients and polymerase chain reaction for influenza virus RNA on CSF, when performed, was negative in all samples. Neuroradiological investigations, performed in 5 children, reported cortical and subcortical white matter signal alterations. Oseltamivir was administered only in 2 cases. Fourteen patients recovered without sequelae, and only a 2-year-old girl had minimal impairment in fine motor skills at discharge. CONCLUSIONS: All children presenting acute neurological features during influenza season should be evaluated for influenza-associated CNS complications even if the respiratory involvement is mild. Absence of underlying diseases or other risk factors are not protective factors against CNS influenza-associated complications. The lack of CSF pleocytosis does not exclude CNS involvement. Children under 2 years of age are at higher risk of requiring intensive care support.
Profile and Outcome of Patients with Upper Gastrointestinal Bleeding Presenting to Urban Emergency Departments of Tertiary Hospitals in Tanzania
Authors: Rajan Shaffin S. , Sawe Hendry Robert , Iyullu Asha J. , Kaale Dereck A. , Olambo Nancy A. , Mfinanga Juma A. , Weber Ellen J. 
Published: November 2019

Abstract
Background Upper Gastrointestinal Bleeding (UGIB) is a common Emergency Department (ED) presentation with high morbidity and mortality. There is a paucity of data on the profile and outcome of patients who present with UGIB to EDs, especially within limited resource settings where emergency medicine is a new specialty. We aim to describe the patient profile, clinical severity and outcomes of the patients who present with UGIB to the ED of tertiary referral hospitals in Tanzania.Methodology This was a prospective cohort study of consecutive adult (≥18 years) patients presenting to the EDs of Muhimbili National Hospital (ED-MNH) and MUHAS Academic Medical Centre (ED-MAMC), in Tanzania with non-traumatic upper gastrointestinal bleeding (UGIB) from July 2018 to December 2018. Patient demographic data, clinical presentation, and ED and hospital management provided were recorded. We used the clinical Rockall score to assess disease severity. The primary outcome was 7- day mortality and regression analysis was performed to identify predictors of mortality.Results During the study period, 123 patients presented to one of the two EDs with an UGIB. The median age was 42 years (Interquartile range (IQR) 32-64 years), and 87 (70.7%) were male. Hematemesis with melena was the most frequently encountered ED complaint 39 (31.7%). Within 7 days, 23 (18.7%) patients died and one-third 8 (34.8%) of these died within 24 hours. There were no ED deaths. Upper GI endoscopy, was performed on 46 (37.4%) patients, of whom only 8 (17.4%) received endoscopy within 24 hours (early UGI endoscopy). All patients who received early UGI endoscopy had a low or moderate clinical Rockall score i.e. <3 and 3-4. No patient with scores of >4 received early UGI endoscopy. Age >40 years was a significant independent predictor of mortality (OR=7.00 (95% CI 1.7-29.2). Having a high clinical Rockall score of ≥4 was a significant independent predictor of mortality (OR=6.4 (95% CI 1.8-22.8)Conclusion In this urban ED in Sub-Saharan Africa, UGIB carried a high mortality rate. Age > 40 years and clinical Rockall score ≥4 were independent predictors of higher mortality. Future studies should focus on evaluating how to improve access to UGI endoscopy.
Borrelia miyamotoi DNA in a patient suspected of Lyme borreliosis
Authors: Fiecek Beata , Lewandowska Grazyna , Roguska Urszula , Rozej-Bielicka Wioletta , Tylewska-Wierzbanowska Stanislawa , Chmielewski Tomasz 
Published: November 2019

Abstract
Background

Clinical manifestations in infection caused by B. miyamotoi can mimick highly variable symptoms of Lyme disease. The aim of our studies was to detect DNA of B. miyamotoi spirochetes in clinical materials from patients suspected of neuroborreliosis(retrospectively).Methods

Samples of blood serum and cerebrospinal fluid were collected from 133 patients with clinical manifestations of neuroborreliosis. Diagnosis was established by detection of IgM and / or IgG specific antibodies to B. burgdorferi with ELISA in both sera and CSF. Specificity of positive ELISA results in sera were confirmed with Western-blot test. Bacterial DNA from the collected material was extracted, amplified and sequenced.Results

Among 133 patients with clinical manifestations of neuroborreliosis recognized in the years 2010-2018., DNA of B. miyamotoi was detected in CSF from 1 (0.8%) patient with extraocular optic neuritis of the left eye (GenBank accession No. MK674170 and MK674171).Conclusion

Detection of B. miyamotoi in patients with central nervous system infections, will allow a better understanding of the epidemiology of infections caused by Borrelia sp. spirochetes. Patients with neurological symptoms and questionable serological findings are a serious diagnostic problem, due to failure to meet the criteria for neuroboreliosis. This indicates the need for further studies of patients with signs of CNS infection.