bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular epidemiology and antimicrobial resistance of group A streptococcus recovered from patients in Children
Authors: Li Hongxin , Zhou Lin , Zhao Yong , Ma Lijuan , Liu Xiaoyan , Hu Jin 
Published: January 2020

Abstract
Background: Group A streptococcus (GAS) is an important human pathogen responsible for a broad range of infections. Epidemiological surveillance has been crucial to detect changes in the geographical and temporal variation of the disease pattern. The objective of this study was to investigate the molecular epidemiological characteristics and antimicrobial resistance of GAS isolates from patients in Children’s Hospital in Beijing.Methods: From 2016 to 2017, pharyngeal swab samples were collected from the outpatients in Children’s Hospital, Capital Institute of Pediatrics, who were diagnosed as scarlet fever. Antimicrobial susceptibility test was performed according to the distribution of common antibiotics and Clinical and Laboratory Standards Institute (CLSI) recommendations. The distribution of the macrolide-resistance genes ( ermB, ermA, mefA ), emm (M protein-coding gene) typing, and superantigens (SAg) gene profiling were examined by polymerase chain reaction (PCR).Results: A total of 297 GAS strains were collected. The sensitivity of the strains to penicillin, ceftriaxone, and levofloxacin was 100%. The rate of antimicrobial resistance to erythromycin and clindamycin were 98.3% and 96.6%, respectively. The dominant emm types were emm12 (65.32%), emm1 (27.61%), emm75 (2.69%), and emm89 (1.35%). Of the 297 isolates, 290 (97.64%) carried the ermB gene, and 5 (1.68%) carried the mefA gene, while none carried the ermA gene. The most common superantigen genes identified from GAS isolates were smeZ (96.97%) , speC (92.59%), speG (91.58%), and ssa (85.52%), speI (54.55%), speH (52.19%), and speA (34.34%). Isolates with the genotype emm 1 possessed speA, speC, speG, speJ, speM, ssa, and smeZ, while emm 12 possessed speC, speG, speH, speI, speM, ssa, and smeZ superantigens. Conclusions: The prevalent strain of GAS isolates in Beijing has a high antimicrobial resistance rate to macrolides, while penicillin can still be used as the preferred treatment choice. The primary mechanism of resistance to erythromycin is related to the expression of ermB . The common emm types were e mm 12 and emm 1. A correlation was established between emm and the superantigen gene. Thus, long-term monitoring and investigation of the emm types and superantigen genes of GAS prevalence is imperative.
Quality Of Post-Abortion Care In Java, Indonesia: An Essential Services Analysis ﻿
Authors: Philbin Jesse , Soeharno Nugroho , Giorgio Margaret , Kurniawan Rico , Ingerick Meghan , Utomo Budi 
Published: January 2020

Abstract
Background High maternal mortality in Indonesia persists despite economic growth and a reform that extended health insurance to all Indonesians. Quality of obstetric health services, in general, has been identified as a factor for this; in addition, the country’s restrictive abortion laws merit special attention to the quality of post-abortion care (PAC) services. Methods Using data from a survey of 657 hospitals and emergency obstetric-registered public health centers in Java, Indonesia’s most populous island, we used the essential services framework to measure the health system’s capacity to offer PAC. We then used this framework to explore how Java’s capacity to offer PAC could change given two hypothetical reforms. Finally, we calculated the proportion of PAC patients treated using each of four different procedures. Results No emergency obstetric health centers (PONEDs) are adequately staffed or authorized to offer basic PAC services, while 46% of all hospitals in Java have the full set of services needed. These proportions increase in hypothetical scenarios in which PAC authorization is expanded to midwives, general physicians, and PONED facilities. Eighty-eight percent of PAC patients were treated using dilation and curettage (D&C). Conclusions Allowing clinicians other than Ob/Gyns to perform uterine evacuation and offering first-trimester PAC service in PONEDs would greatly improve the capacity of Java’s health system to serve PAC patients. Increasing the use of vacuum aspiration and misoprostol would lower the burden of treatment for patients, reduce costs to the health system, and facilitate the task-shifting efforts needed to expand access to this life-saving service.
The intention on Modern Contraceptive Use and Associated Factors among Postpartum Women in Public health institutions of Sodo Town, Southern Ethiopia 2019: Institutional Based Cross-Sectional Study.
Authors: Gebeyehu Natnael Atnafu , Abebe Kelemu 
Published: January 2020

Abstract
Background: The postpartum period is an important transitional time for couples to put the decision on family planning utilization. However, women in Ethiopia are usually uncertain about the use of family planning during this period. This study was aimed to assess the intention of modern contraceptive use and associated factors among postpartum women attending the immunization clinic in Sodo Town.Method: Institutional based cross-sectional study design with a sample size of 416 was conducted from May 25 to June 20, 2019. The data were collected by using a systematic random sampling technique of interviewer-administered questionnaires. Those candidate variables at Bivariate analysis with a p-value<0.2 were moved to the Multivariate logistic regression model to control potential confounding variables and P-value<0.05 at multivariate analysis was considered as a cutoff pointResults: A total of 416 postpartum women participated in the study yielding a response rate of 98.1 % and 291 (70%) of them had an intention on modern contraceptive use. The odds of intention on modern contraceptive use was higher among respondents who had secondary school education (AOR=2.052, 95%CI: 1.064-3.958) than participants with no formal education. It was also higher among antenatal care visit attendees (AOR=1.736,95%CI:1.021-2.951) than those did not attend antenatal care visit. Knowledgeable participants on modern contraceptive use were more likely intend to use (AOR=2.535, 95%CI: 1.499-4.282) than their counterparts. Besides, the odds of the intention of modern contraceptive use among postpartum women who had menses resumption were higher (AOR=2.047,95%CI:1.141-3.675)than those whose menses not resumed.Participants who had husband approval were more likely to intend to use contraceptives (AOR=2.395,95%CI:1.501-5.458) than their counterparts.Conclusion: The intention of modern contraceptives among postpartum women was low. Family planning providers should emphasize reducing barriers of intention like lack of education, knowledge, male partner approval, antenatal care visit and advise the impact of menses on fertility.
Predictors of the use of analgesic drugs 1 year after joint replacement: a single-center analysis of 13,000 hip and knee replacements
Authors: Rajamäki Tuomas , Puolakka Pia A. , Hietaharju Aki , Moilanen Teemu , Jämsen Esa 
Published: January 2020

Abstract
Background: Pain persists in a moderate number of patients following hip or knee replacement surgery. Persistent pain may subsequently lead to the prolonged consumption of analgesics after surgery and expose patients to the adverse drug events of opioids and NSAIDs, especially in older patients and patients with comorbidities. This study aimed to identify risk factors for the increased use of opioids and other analgesics one year after surgery and focused on comorbidities and surgery-related factors.Methods: All patients who underwent a primary hip or knee replacement for osteoarthritis from 2002 to 2013 were identified. Redeemed prescriptions for acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids (mild and strong) were collected from a nationwide Drug Prescription Register. The user rates of analgesics and the adjusted odds ratios for analgesic use one year after joint replacement were calculated.Results: Of the 6,238 hip replacement and 7,501 knee replacement recipients, 3,591 (26.1%) were still using analgesics one year after surgery. Significant predictors of overall analgesic use (acetaminophen, NSAID, or opioid) were (odds ratio (95% CI)) age 65-74.9 years (reference <65), 1.2 (1.04-1.3), age > 75 years, 1.3 (1.2-1.5), female gender, 1.3 (1.2-1.4), BMI 30-34.9 kg/m2 (reference <25kg/m2), 1.2 (1.03-1.5), BMI >35 kg/m2, 1.7 (1.4-2.2), a higher number of comorbidities (according to modified Charlson Comorbidity Index score), 1.4 (1.2-1.6), and hypertension, 1.1 [1.00–1.2]. Diabetes and other comorbidities were not significant independent predictors. Of the other clinical factors, the preoperative use of analgesics, 4.0 (3.6-4.3) and knee surgery, 1.3 (1.2-1.4), predicted the use of analgesics, whereas simultaneous bilateral knee replacement (compared to unilateral procedure) was a protective factor, 0.80 (0.70-0.92). Opioid use was associated with obesity, higher CCI score, epilepsy, knee vs hip surgery, unilateral vs bilateral knee operation, total vs unicompartmental knee replacement, and the preoperative use of analgesics/opioids.Conclusions: Obesity (especially BMI >35 kg/m2) and the preoperative use of analgesics were the strongest predictors of an increased postoperative use of analgesics. It is remarkable that also older age and higher number of comorbidities predicted analgesic use despite these patients being the most vulnerable to adverse drug events.
Drug retention of 7 biologics and tofacitinib in biologics-naïve and biologics-switched patients with rheumatoid arthritis -The ANSWER cohort study-
Authors: Ebina Kosuke , Hirano Toru , Maeda Yuichi , Yamamoto Wataru , Hashimoto Motomu , Murata Koichi , Takeuchi Tohru , Shiba Hideyuki , Son Yonsu , Amuro Hideki , Onishi Akira , Akashi Kengo , Hara Ryota , Katayama Masaki , Yamamoto Keiichi , Kumanogoh Atsushi , Hirao Makoto 
Published: January 2020

Abstract
Background: This multi-center, retrospective study aimed to clarify retention rates and reasons for discontinuation of 7 biological disease-modifying antirheumatic drugs (bDMARDs) and tofacitinib (TOF), one of the janus kinase inhibitors, in bDMARDs-naïve and bDMARDs-switched patients with rheumatoid arthritis (RA).Methods: This study assessed 3,897 patients and 4,415 treatment courses with bDMARDs and TOF from 2001 to 2019 (2,737 bDMARDs-naïve patients and 1,678 bDMARDs-switched patients [59.5% switched to their second agent], female 82.3%, baseline age 57.4 years, disease duration 8.5 years; rheumatoid factor positivity 78.4%; Disease Activity Score in 28 joints using erythrocyte sedimentation rate 4.3; concomitant prednisolone [PSL] dose 6.1 mg/day [42.4%], and methotrexate [MTX] dose 8.5 mg/week [60.9%]). Treatment courses included abatacept (ABT; n=663), adalimumab (ADA; n=536), certolizumab pegol (CZP; n=226), etanercept (ETN; n=856), golimumab (GLM; n=458), infliximab (IFX; n=724), tocilizumab (TCZ; n=851), and TOF (n=101/only bDMARDs-switched cases). Drug retention rates and discontinuation reasons were estimated at 36 months using the Kaplan-Meier method and adjusted for potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX, starting date, and number of switched bDMARDs) using Cox proportional hazards modeling.Results: Adjusted drug retention rates for each discontinuation reason were as follows: lack of effectiveness in the bDMARDs-naïve group (from 70.8% [CZP] to 85.1% [ABT]; P=0.001 between agents) and the bDMARDs-switched group (from 52.8% [CZP] to 78.7% [TCZ]; P<0.001 between agents). Toxic adverse events in the bDMARDs-naïve group (from 86.9% [IFX] to 96.3% [ABT]; P<0.001 between agents) and the bDMARDs-switched group (from 81.1% [ADA] to 95.4% [ETN]; P=0.01 between agents). Finally, overall retention rates excluding discontinuation for non-toxic reasons or remission ranged from 64.2% (IFX) to 82.0% (ABT) (P<0.001 between agents) in the bDMARDs-naïve group and from 44.2% (ADA) to 66.8% (TCZ) (P<0.001 between agents) in the bDMARDs-switched group. Conclusions: Remarkable differences were observed in drug retention of 7 bDMARDs and TOF between bDMARDs-naïve and bDMARDs-switched cases.
Barriers to patient, provider, and caregiver adoption and use of electronic personal health records in chronic care: a systematic review
Authors: Niazkhani Zahra , Toni Esmaeel , Cheshmekaboodi Mojgan , Georgiou Andrew , Pirnejad Habibollah 
Published: January 2020

Abstract
Background Existing evidence shows benefits of electronic personal health records (PHRs) in improving outcomes for chronic disease patients. However, its use has not been as widespread as expected. We aimed to review barriers to patient, provider, and caregiver adoption/use of PHRs in chronic disease care. Methods A systematic search in Medline, PubMed, Science Direct, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, and the Institute of Electrical and Electronics Engineers (IEEE) dtabase was performed to find original studies assessing barriers to PHR adoption/use in chronic care till the end of 2018. Two researchers independently screened and extracted data. We used the PHR adoption model and the Unified Theory of Acceptance and Use of Technology to analyze the results. The mixed methods appraisal tool (MMAT) version 2018 was used to assess the quality of evidence in included studies. Results Sixty publications met our inclusion criteria. Issues found hindering PHR adoption/use in chronic disease care were associated with demographic factors (e.g., patient age and gender) along with key variables related to health status, computer literacy, preferences for direct communication, and patient’s strategy for coping with a chronic condition; as well as factors related to medical practice/environment (e.g., providers’ lack of interest or resistance to adopting PHRs due to workload, lack of reimbursement, and lack of user training); technological (e.g., concerns over privacy and security, interoperability with electronic health record systems, and lack of customized features for chronic conditions); and chronic disease characteristics (e.g., multiplicities of co-morbid conditions, settings and providers involved in chronic care). Conclusions PHRs can be meaningfully used in chronic disease care if they are implemented as a component of comprehensive care models specifically developed for this care. Our results provide insight into hurdles and barriers mitigating PHR adoption/use in chronic disease care. Deeper understating of the interplay between these barriers will provide opportunities that can lead to an enhanced PHR adoption/use in chronic disease care.
Performance of the CKD-EPI and MDRD equations to estimate the glomerular filtration rate: a systematic review of Latin American studies
Authors: Brañez-Condorena Ana , Goicochea-Lugo Sergio , Zafra-Tanaka Jessica Hanae , Becerra-Chauca Naysha , Failoc-Rojas Virgilio E , Herrera-Añazco Percy , Taype-Rondan Alvaro 
Published: January 2020

Abstract
BackgroundMost commonly used equations to estimate the glomerular filtration rate (GFR) are the CKD-Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD). However, it is not clear which one shows a better performance in Latin America. Objective To assess the performance of both estimated GFR (eGFR) equations in Latin American countries. Methods In January 2019, we performed a systematic search in PubMed, Scopus, and “Biblioteca Regional de Medicina” (BIREME) to identify studies that reported eGFR using CKD-EPI and MDRD equations and compared them with a measured GFR (mGFR) using exogenous filtration markers, among adults from Latin American countries. Study selection, data extraction, and risk of bias evaluation were performed by two reviewers independently. We performed meta-analyses of P30, bias (using mean difference [MD] and its 95% confidence intervals [95% CI]), sensitivity, and specificity; and evaluated certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Results We included 12 papers, six of them were meta-analyzed (5 from Brazil and 1 from Mexico). Meta-analyses that compared CKD-EPI using creatinine measured with calibration traceable to isotope dilution mass spectrometry (CKD-EPI-Cr IDMS) and MDRD-4 IDMS did not show statistically significant differences in bias (5 studies, MD: 0.55 mL/min/1.73m 2 , 95% CI: -3.34 to 4.44), P30 (2 studies, MD: 4%, 95% CI: -4% to 13%), sensitivity (2 studies, 76% and 75%), and specificity (2 studies, 91% and 89%), with very low certainty of evidence for bias and P30, and low certainty of evidence for sensitivity and specificity. Conclusions We found that the performance of CKD-EPI-Cr IDMS and MDRD-4 IDMS do not differ significantly, although CKD-EPI-Cr IDMS tends to have a non-significant better performance in terms of P30. However, since most of the meta-analyzed studies were from Brazil, results may not be extrapolated to other Latin American countries. Trial registration CRD42019123434, PROSPERO. Registered 18 February 2019.
Persistent fontanelles in Chihuahuas and inter- and intra-rater reliability of fontanelle area measurement in computed tomography images
Authors: Kiviranta Anna-Mariam , Rusbridge Clare , Lappalainen Anu K. , Junnila Jouni J.T. , Jokinen Tarja S. 
Published: January 2020

Abstract
Background: The Chihuahua dog breed is known for frequent occurrence of a bregmatic fontanelle on the dorsal skull. A common conception is that this skull defect is clinically irrelevant in Chihuahuas. No studies, however, describe the prevalence of this malformation, whether it is accompanied by fontanelles at other locations on the skull or how to assess the severity of these lesions. Our primary aim was, by using computed tomography imaging, to describe the presence, number, and location of persistent fontanelles (PF) at cranial sutures on dorsal, lateral and caudal cranial surfaces in Chihuahuas. The secondary aim was to develop a method to measure the fontanelle area in computed tomography images by using the closed polygon tool of Osirix Medical Imaging Software. Results: Of the 50 dogs evaluated, 46 (92%) had either one or several PFs. The mean ± SD number of affected cranial sutures per dog was 2.4 ± 2.3 (range 0-10), and mean ± SD number of PFs was 2.8 ± 3.0 (range 0-13). Of the 46 dogs with affected sutures, 7 (15%) had no PF at a location typical for a bregmatic fontanelle. The inter-rater reliability of the fontanelle area measurement was almost “perfect”, and intra-rater reliability reached “excellent” agreement. Conclusions: PFs are almost ubiquitous in the examined group of Chihuahuas. They are located at dorsal, lateral, and caudal surfaces of the cranium, and hence are not all recognized reliably by palpation in adult dogs. Though the pathogenesis of the PFs described here is unknown, bone-deficient lesions may occur due to congenital defects in cranial bone ossification, delayed closure of cranial sutures, or bone resorption, as is observable in children with craniosynostosis (premature cranial suture closure). Because the imaging findings described in the Chihuahuas of this study are similar to findings among children with craniosynostosis/premature cranial base synchondrosis closure, this growth disorder may be a predisposing factor for the PFs described here. Further studies are necessary to evaluate the pathogenesis and clinical relevance of these lesions. Due to high inter- and intra-rater reliability of the method of fontanelle area measurement it may be useful in future studies.
Glycan Shedding in both the Blood and CSF: Initial Predictor of Immune Attack in Autoimmune Encephalomyelitis?
Authors: Pei Shanshan , Zhu Jiajia , Zhou Zheyi , Ding Yuewen , Peng Yu , Wang Zhanhang , Chen Jinyu , wang honghao 
Published: January 2020

Abstract
Background Neuromyelitis optica (NMO), multiple sclerosis (MS) and autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy belong to autoimmune diseases incentral nervous system mainly manifestate encephalomyelitis. The glycocalyx (GLX), consists of several membrane-bound macromolecules, is located on the luminal side of the endothelium and mediates the blood and the vessel interaction. Until now, there is still lacking a holistic understanding of the GLX degradation in autoimmune encephalomyelitis. Aim This study aimed to detect the shedding levels of GLX components, heparan sulfate (HS) and hyaluronic acid (HA) in serum and cerebrospinal fluid (CSF), correlate them with the severity and assess the diagnostic value of them, and evaluate their correlations with pro-inflammatory cytokines. Methods Serum and CSF samples were obtained from 24 NMO patients, 15 MS patients, 10 autoimmune GFAP astrocytopathy patients, and 18 controls without non-inflammatory neurological diseases. Soluble HS, HA and IFN-γ, IL-17A, matrix metalloproteinase (MMP)-1 were detected by enzyme linked immunosorbent assay ELISA. Results Besides levels of serum and CSF levels of HS, HA and related cytokines were significantly elevated in these diseases. Notably, HS, HA in NMO, MS patients, and autoimmune GFAP astrocytopathy diseases were widely correlated with EDSS scores. Importantly, the ROC curve analysis suggested a potential diagnostic role of HS or HA . Conclusions The results here suggested the GLX degradation and inflammation in NMO, MS and autoimmune GFAP astrocytopathy. Moreover, increased shedding of HS or HA may indicate worse clinical situation. Importantly, CSF HS and HA may be informative diagnostic biomarkers for telling autoimmune encephalomyelitis from the non-inflammatory neurological controls. Furthermore, therapeutic strategy for protecting GLX may be effective to these diseases.