bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventions for prudent antibiotic use in primary healthcare: An econometric analysis
Authors: Lampi Elina , Carlsson Fredrik , Sundvall Pär-Daniel , Torres Marcela Jaime , Ulleryd Peter , Åhrén Christina , Jacobsson Gunnar 
Published: February 2020

Abstract
Background

Rational antibiotic prescribing is crucial to combat antibiotic resistance. Optimal strategies to improve antibiotic use are not known. Strama, the Swedish strategic program against antibiotic resistance, has been successful in reducing antibiotic prescription rates. This study investigates whether two specific interventions directed toward healthcare centers, an informational visit and a self-evaluation meeting, played a role in observed reduction in rates of antibiotic prescriptions in primary healthcare.

Methods

The study was a retrospective, observational, empirical analysis exploiting the variation in the timing of the interventions and considering past prescriptions through use of estimations from dynamic panel data models. Primary healthcare data from 2011 to 2014 were examined. Data were from public and private primary healthcare centers in western Sweden. The key variables were prescription of antibiotics and indicator variables for the two interventions.

Results

The first intervention, an educational information intervention, decreased the number of prescriptions among public healthcare centers, but this effect was only temporary. We found no proof that the second intervention, a self-evaluation meeting at the healthcare center, had an impact on the reduction of prescriptions.

Conclusions

Single educational interventions aimed at influencing rates of antibiotic prescriptions have limited impact. A multifaceted approach is needed in efforts to reduce the use of antibiotics in primary health care.
Spatial variation in the frequency of knockdown resistance genotypes in Florida Aedes aegypti populations
Authors: Mundis Stephanie Jane , Estep Alden S. , Waits Christy M. , Ryan Sadie J. 
Published: February 2020

Abstract
Background
The development of insecticide resistance in disease-vectoring mosquito species can lead to vector control failure and disease resurgence. However, insecticide applications remain an essential public health intervention. In Florida, insecticide resistance in Aedes aegypti , an anthropophilic mosquito species capable of transmitting dengue, chikungunya, and Zika virus, is a major concern. Understanding the location, scale, and driving factors of insecticide resistance can enhance the ability of vector control organizations to target populations effectively.
Methods
We used previously collected data on frequencies of mutations that confer resistance to commonly used pyrethroid insecticides in Aedes aegypti specimens from 62 sites distributed across 18 counties in Florida. To determine the scale of clustering for the most resistant variant, we used a Ripley’s K function. We also used a spatial scanning statistic technique to identify the locations of clusters where higher than expected frequencies of susceptible or resistant mosquitoes occurred. We then tested for associations between landscape, demographic, and insecticide-use factors using a beta regression modelling approach and evaluated the effect of spatial lag and spatial error terms on overall explanatory power of these models.
Results
The scale at which maximum clustering of the most resistant variant occurs is approximately 20 kilometers. We identified statistically significant clusters of genotypes associated with resistancein several coastal cities, although some of these clusters were near significant clusters of susceptible mosquitoes, indicating selection pressures vary at the local scale. Vegetation density, distance from roads, and pyrethroid-use by vector control districts were consistently significant predictors of knockdown resistance genotype frequency in the top-performing beta regression models, although pyrethroid-use surprisingly had a negatively associated with resistance. The incorporation of spatial lags resulted in improvements to the fit and explanatory power of the models, indicating an underlying diffusion process likely explains some of the spatial patterns observed.
Conclusions
The genetic mutations that confer resistance to pyrethroids in Aedes aegpyti mosquitoes in Florida exhibit spatial autocorrelation and patterns that can be partially explained by landscape and insecticide-use factors. Further work at local scales should be able to identify the mechanisms by which these variables influence selection for alleles associated with resistance.
BRAF V600 mutation profiling in primary skin nodular melanoma in Indonesia: an analysis using high resolution pyrosequencing
Authors: Rinonce Hanggoro Tri , Aji Rovi Panji Mustiko , Hayati Ni’mah , Pudjohartono Maria Fransiska , Kameswari Bidari , Anwar Sumadi Lukman , Irianiwati - 
Published: February 2020

Abstract
Objective : We aimed to investigate the prevalence and type of BRAF V600 mutations and the associations with clinicopathological variables in primary skin nodular melanoma cases in Yogyakarta and Central Java, Indonesia using pyrosequencing.
Results : BRAF V600 mutations of the V600E type were found in 21 (53.85%) specimens. The variant allele frequencies (VAFs) ranged from 5.07% to 94.70%, averaging 29.05%. However, most cases had low VAFs, with 13 (61.9%) specimens below 20% and 4 (19.05%) below 10%.
Comparison of Bacterial Communities in Soil Samples with and without Tomato Bacterial Wilt Caused by Ralstonia solanacearum Species Complex
Authors: Zhang Ying , Hu Anna , Zhou Jianuan , Zhang Wenfei , Li Peng 
Published: February 2020

Abstract
Background: Ralstonia solanacearum is one of the most notorious soil-borne phytopathogens. It causes a severe wilt disease with deadly effects on many economically important crops. The microbita of disease-suppressive soils are thought that they can contribute to the disease resistance of crop plants, thus, to conduct the microbial community and their interaction characteristics between suppressive soil (SS) and conducive soil (CS) will help to understand resistance mechanism. Here, the bacterial community structure, correlation analysis with soil chemical properties, interaction network of SS (nearly no disease in three years), and CS (suffered heavy bacterial wilt disease) were analyzed.
Results: Compared with CS, a higher bacterial community diversity index was found in SS , and the relative abundance of main genera Bacillus , Gaiellales , Roseiflexus , Gemmatimonadaceae , Nocardioides , and Anaerolineacear reached significant levels. Redundancy analysis at the genus level indicated that the available phosphate played a key role in the bacterial community distribution, and its role was negatively correlated with soil pH, organic matter content, alkali-hydrolyzable nitrogen, and available potassium contents. Interaction network analysis further demonstrated that greater diversity at the genus level existed in the SS network and formed a stable network. Additionally, the species of Mycobacterium , Cyanobacteria , and Rhodobiaceae are the key components that sustain the network stability. Seven clusters of orthologous groups exhibited significant differences between SS and CS. Moreover, 55 bacterial strains with distinct antagonistic activities to R. solancearum were isolated and identified.
Conclusions: Our findings indicate that the bacterial diversity and interaction network differed between the CS and SS samples, providing a good foundation in the study of bacterial wilt.
Vertical pons hyperintensity and hot cross bun sign in cerebellar-type multiple system atrophy and spinocerebellar ataxia type 3
Authors: Sugiyama Atsuhiko , Yokota Hajime , Yamanaka Yoshitaka , Mukai Hiroki , Yamamoto Tatsuya , Hirano Shigeki , Koide Kyosuke , Ito Shoichi , Kuwabara Satoshi 
Published: February 2020

Abstract
Background The “hot cross bun” (HCB) sign, a cruciform hyperintensity in the pons on magnetic resonance imaging (MRI), has gradually been identified as a typical finding in multiple system atrophy, cerebellar-type (MSA-C). Few reports have evaluated the sensitivity of an HCB, including a cruciform hyperintensity and vertical line in the pons, which precedes a cruciform hyperintensity, in the early stages of MSA-C. Moreover, the difference in frequency and timing of appearance of an HCB between MSA-C and spinocerebellar ataxia type 3 (SCA3) has not been fully investigated.Methods This study investigated the time at which an HCB and orthostatic hypotension (OH) appeared in 41 patients with MSA-C, based on brain MRI and head-up tilt test. The MRI findings were compared with those of 26 patients with SCA3. The pontine signal findings on T2-weighted MRI were graded as 0 (no change), 1 (a vertical T2 high-intensity line), or 2 (a cruciform T2 high-intensity line), with grades 1 or 2 considered as an HCB. OH 30/15 was defined as a decrease in systolic blood pressure of > 30 mmHg or diastolic blood pressure of > 15 mmHg.Results Among the 24 patients with MSA-C within 2 years from the onset of motor symptoms, an HCB was detected in 91.7%, whereas OH 30/15 was present in 60.0%. Among the 36 patients with MSA-C within 3 years from the onset of motor symptoms, a grade 2 HCB was detected in 66.7% of those with MSA-C but in none of those with SCA-3.Conclusions HCB is a highly sensitive finding for MSA-C, even in the early stages of the disease. A grade 2 HCB in the early stage is an extremely specific finding for differentiating MSA-C from SCA-3.
The interrupted effect of autophagic flux and lysosomal function induced by graphene oxide in p62-dependent apoptosis of F98 cells
Authors: Zhang Chao , Feng Xiaoli , He Longwen , Zhang Yaqing , Shao Longquan 
Published: February 2020

Abstract
Abstract
Background : Graphene oxide (GO) nanoparticles (NPs) have been widely applied in various fields, especially in biomedical applications. Extensive studies have suggested that GO can pass through the blood-brain barrier (BBB) and induce abnormal autophagy and cytotoxicity in the central nervous system (CNS). However, the effect and specific mechanism of GO on astrocytes, the most abundant cells in the brain still has not been extensively investigated.
Results: In this study, we systematically explored the toxicity and mechanism of GO exposure in the rat astroglioma-derived F98 cell line using molecular biological techniques (immunofluorescence staining, flow cytometry and Western blot) at the subcellular level and the signaling pathway level. Cells exposed to GO exhibited decreased cell viability and increased lactate dehydrogenase (LDH) release in a concentration- and time-dependent manner. GO-induced autophagy was evidenced by transmission electron microscopy (TEM) and immunofluorescence staining. Western blots showed that LC3II/I and p62 were upregulated and PI3K/Akt/mTOR was downregulated. Detection of lysosomal acidity and cathepsin B activity assay indicated the impairment of lysosomal function. Annexin V-FITC-PI detection showed the occurrence of apoptosis after GO exposure. The decrease in mitochondrial membrane potential (MMP) with an accompanying upregulation of cleaved caspase-3 and Bax/Bcl-2 further suggested that endogenous signaling pathways were involved in GO-induced apoptosis.
Conclusion: The exposure of F98 cells to GO can elicit concentration- and time-dependent toxicological effects. Additionally, increased autophagic response can be triggered after GO treatment and that the blocking of autophagy flux plays a vital role in GO cytotoxicity, which was determined to be related to dysfunction of lysosomal degradation. Importantly, the abnormal accumulation of autophagic substrate p62 protein can induce capase-3-mediated apoptosis. Inhibition of abnormal accumulation of autophagic cargo could alleviate the occurrence of GO-induced apoptosis in F98 cells.
Keyword: Graphene oxide; Astrocyte; p62; Autophagy; Apoptosis
Survive and Thrive in Brazil: The Boa Vista Early Childhood Program: Study protocol of a stepped wedge randomized controlled trial
Authors: Brentani Alexandra , Ferrer Ana Paula Scolezze , Bessa Luana , Chang Susan , Walker Susan , Powell Christine , Hamadani Jena , Grisi Sandra , Fink Günther 
Published: February 2020

Abstract
Background: A growing body of evidence suggests that early life health and developmental outcomes can be improved through parental support programs. The objective of this project was to test the feasibility, impact, and relative cost-effectiveness of an adapted “Reach Up and Learn” program delivered through home visiting programs as well as through center-based parenting groups on child health and development in the municipality of Boa Vista, Brazil. Methods: A randomized stepped wedge design was used to roll out and evaluate the two parenting platforms in Boa Vista municipality. A total of 39 neighborhoods with high vulnerability index were selected for the study. For the first phase of the program, 9 neighborhoods were randomly selected for home visits, and 2 were randomly selected for the center-based parenting groups. In the second phase of the program, 10 neighborhoods were added to the home visiting program, and 8 were added to the center-based program. In the final phase of the program, the remaining 10 control areas will also be assigned to treatment. Study eligibility will be assessed through a baseline survey completed by all pregnant women in the 39 study areas. Pregnant women will be eligible to participate in the study if they are either classified as poor, were under age 20 when they became pregnant, or if they indicate to have been exposed to domestic or sexual violence. To assess program impact, an endline survey will be conducted when children reach age 2. The primary study outcome is child development at age 2 as measured by the PRIDI instrument. Secondary outcome will be infant mortality, which will be assessed linking municipal vital registration systems to the program rollout. Discussion: This trial will assess the feasibility and impact of parenting programs rolled out at medium scale. The results from trial should create evidence urgently needed for guiding Brazil’s national Criança Feliz program as well as similar efforts in other countries.
Prevalence and genotype distribution of HPV and cervical pathological results in Sichuan Province, China: a three years surveys prior to mass HPV vaccination
Authors: Luo Qing , Jiang Ni , Wu Qiaoyuan , Wang Jiaqiang , Zhong Jialing 
Published: February 2020

Abstract
Background HPV persistent infection is a strong carcinogenic factor to induce cervical cancer. Investigation of HPV epidemiology and genotype distribution is meaningful for the development cervical cancer prevention and control strategies. Methods By using PCR-based hybridization gene chip assay, HPV genotype was detected of 14185 women that came from HEC (Health Examination Center) or OGOC (Obstetrics and Gynecology Outpatient Clinics) between 2015 and 2017 in Sichuan area. The epidemiology and genotype distribution as well as the relationship to in histology and cytology abnormalities were analysed. Results The positivity of HPV was 23.84%. The HPV-positive rate of OGOC group (37.62%) is significantly higher than that of HEC group (15.29%), p <0.05. The prevalence of HPV reached peak at 41-50 age (5.86%) in HEC group, but at 21-30 age (14.74%) in OGOC group. Of the HPV positive women, single genotype infection was the most common form in both HEC and OGOC group, accounted for 62.06% in total screening population, 74.36% in HEC group and 54.01% in OGOC group. Three most prevalent HPV types were HPV-52 (5.02%), 58 (3.61%), 16 (3.24%) in total screening population. Of the HPV positive women, the top three were HPV-52 (20.93%), CP8304 (15.32%), 58 (14.42%) in HEC group, while were HPV-52 (21.14%), 16 (16.34%), 58 (15.61%) in OGOC group. HPV 52/16/58 accounted for the 41.84% of cytology and 56.52% of histological abnormalities. Conclusions Women in Sichuan area are facing with the great threat of HPV infection, especially the women of 21~30 or 41-50 years old. HPV 52, 58, 16 were the priority HPV type in OGOC group, while in in HEC group is HPV 52, CP8304, 58. HPV 52/16/58 accounted for the majority of cytology and histological abnormalities. These accurate data could provide a scientiﬁc basis for the prevention and control strategies of cervical cancer in Sichuan area.
Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest
Authors: Kim June-sung , Bae Hyun-Jin , Sohn Chang Hwan , Cho Sung-Eun , Hwang Jeongeun , Kim Won Young , Kim Namkug , Seo Dong-Woo 
Published: February 2020

Abstract
Background Emergency department overcrowding negatively impacts critically ill patients and could lead to the occurrence of cardiac arrest. However, associations between emergency department crowding and occurrence of both in-hospital cardiac arrest and out-of-hospital cardiac arrest have not been thoroughly investigated. This study aimed to evaluate the correlation between emergency department occupancy rates and incidence of in-hospital and out-of-hospital cardiac arrest. Methods A single-center, observational, registry-based cohort study was performed including all consecutive adult, non-traumatic cardiac arrest patients between January 2014 and June 2017. We used emergency department occupancy rates as a crowding index at time of presentation time of cardiac arrest and at the time of maximum crowding, and the average crowding rate for the duration of emergency department stay for each patient. To calculate incidence rate, we divided the number of arrest cases for each emergency department occupancy period by accumulated time. The primary outcome is association between the incidence of in-hospital cardiac arrest and out-of-hospital cardiac arrest and emergency department occupancy rates. Results During the study period, 629 adult, non-traumatic cardiac arrest patients were enrolled in our registry. Among these, 187 patients experienced in-hospital cardiac arrest and 442 patients had out-of-hospital cardiac arrest. In-hospital cardiac arrest patients compared to out-of-hospital cardiac arrest patients had a significantly higher return of spontaneous circulation rates (16.5% vs. 4.8%; P < .01) and better neurologic outcomes at discharge (cerebral performance category scales 4.7 vs. 4.0; P < .01). Emergency department occupancy rates were positively correlated with in-hospital cardiac arrest occurrence. Moreover, maximum emergency department occupancy in the critical zone had the strongest positive correlation with in-hospital cardiac arrest occurrence (Spearman rank correlation ρ = 1.0, P < .01). Out-of-hospital cardiac arrest incidence was negatively correlated with emergency department occupancy (ρ = -0.79, P = .04). Conclusion Maximum emergency department occupancy was strongly associated with in-hospital cardiac arrest occurrence, while occupancy rate was negatively correlated with out-of-hospital cardiac arrest incidence.
The epidemiology of acute kidney injury in critically ill patients in the Gansu Province: the EACG Study
Authors: Chen Yu , Feng Fang , Chang Xueni , Liu Dong , Yuan Yuan , Li Min , Yuan Jiaojiao , Mu Chenghua , Dong Chenming 
Published: February 2020

Abstract
Objective: To investigate the epidemiology of acute kidney injury and to clarify the risk factors associated with the prognosis of acute kidney injury in critically ill patients in the Gansu Province.Methods : This was a multicenter, retrospective study. The clinical data of all patients from January 1, 2017, to December 31, 2019, in the intensive care unit of the selected hospitals were screened. Descriptive statistical analysis was performed first, and then the patients were divided into a survival group and a nonsurvival group based on survival status at discharge. Logistic regression analyses were used to determine the risk factors for in-hospital mortality in patients with acute kidney injury. RESULTS : (1) Among the 8106 patients admitted, a total of 3019 patients were excluded according to the exclusion criteria. Among the included patients, 890 patients met the diagnostic criteria for AKI, with an incidence of 17.5% and mortality of 41.3%. The etiology of acute kidney injury was 64% prerenal, 33% renal, and 2.7% postrenal. Prerenal AKI was the most common, among which cases caused by sepsis and septic shock accounted for 44.7%. Among the selected AKI patients, AKI stage I accounted for 22.02%, AKI stage II accounted for 31.01%, AKI stage III accounted for 46.97%, and 35.8% of the AKI patients received renal replacement therapy. (2) Logistic regression analysis showed that sex , age, AKI stage, RRT, infection, cardio-pulmonary resuscitation, cardiac output, mechanical ventilation, diuretics, white blood cells, platelets, blood urea nitrogen, prothrombin time and activated partial thromboplastin time were significantly associated with the prognosis of acute kidney injury (P <0.05). Further analysis showed that male sex, old age, high AKI stage, RRT treatment, low cardiac output, mechanical ventilation, elevated leukocyte count, reduced platelet count and reduced serum albumin were independent risk factors for a poor prognosis of acute kidney injury.Conclusions : Large-scale epidemiological data from several representative general hospitals in the Gansu Province showed that the incidence and mortality of acute kidney injury in intensive care units were still very high. Sepsis and septic shock are the main causes of AKI.
Clinical Application and Observation of Single-Port Inflatable Mediastinoscopy Combined With Laparoscopy for Radical Esophagectomy in Esophageal Squamous Cell Carcinoma
Authors: Yin Qifan , Liu Huining , Song Yongbin , Zhou Shaohui , Yang Guang , Wang Wenhao , Qie Peng , Liu Lijun 
Published: February 2020

Abstract
Background Transthoracic esophagectomy is a crucial independent risk factor for the incidence of postoperative cardiopulmonary complications in elderly or comorbid patients. To reduce postoperative cardiopulmonary complications and promote postoperative recovery. We made a bold attempt to adopt the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer to observe the clinical application and effect. Method Data of patients with esophageal carcinoma were collected in the Hebei General Hospital from May 2018 to November 2019. The operation time、surgical blood loss、the number of dissected lymph nodes、duration of drainage tube、postoperative complications、the length of postoperative hospital stay were collected to assess the safety and feasibility of the single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal cancer. Results A total of 22 patients with esophageal cancer were analyzed in our research. There was no case of switching to thoracotomy、perioperative death or postoperative cardiopulmonary complications. The average operation time、surgical blood loss、amount of dissected lymph nodes、duration of drainage tube、postoperative hospital stay of all enrolled patients was 4.26±0.52 hours、142±36.50 ml、21.6±4.2、5.8±2.5 days、12.6±2.5 days, respectively. Among all the enrolled patients, one patient(4.5%) developed anastomotic fistula on the third day after surgery. 5 patients(22.7%) with anastomotic stricture. Pleural effusion was found in 4 cases (18.2%). Recurrent laryngeal nerve injury caused hoarseness or cough after drinking water in 3 cases (13.6%). one patients(4.5%) was switched from laparoscopy to open surgery as the patient had serious peritoneal adhesion. All of the patients were discharged successfully. Conclusion Our results showed that this surgery of single-port inflatable mediastinoscopy combined with laparoscopy for radical esophagectomy in esophageal squamous cell carcinoma is safe and feasible. The feasibility and safety could be further and better investigated with a RCT to achieve more conclusive results.