bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between subthreshold depression and self-care behaviours in people with type 2 diabetes: a systematic review of observational studies
Authors: Shrestha Monika , Ng Ashley , Al-Ghareeb Amal , Alenazi Fatimah , Gray Richard 
Published: December 2019

Abstract
Background Self-care behaviours in people living with type 2 diabetes are important to achieving optimal glycemic control. Major depression in type 2 diabetes is associated with decreased adherence to self-care behaviours. The association between subthreshold depression and self-care behaviours, however, has not previously been systematically reviewed. Methods Five electronic databases were searched to identify observational studies in adults with type 2 diabetes investigating the association between subthreshold depression and self-care behaviours. Two reviewers independently completed title and abstract and full-text screening, appraised study quality, and extracted the data. Included articles were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results A total of 6,408 articles were identified through the database searching. After the abstract and full-text review, two articles met the inclusion criteria. Due to a limited number of studies, a meta-analysis could not be done. The two studies showed inconsistent findings on the association between subthreshold depression and self-care behaviours. Important risks of bias were identified in both the included studies. Conclusions There is no clear evidence that subthreshold depression is associated with self-care behaviours in adults with type 2 diabetes. Our review established a gap in knowledge and suggests that further high-quality studies are needed to examine the association between subthreshold depression and self-care behaviours in people with type 2 diabetes. Systematic review registration: PROSPERO CRD42018116373
Antibiotic susceptibility Patterns against Upper Respiratory Tract Pathogens in Tertiary Care Hospitals of Lahore, Pakistan
Authors: Ullah Kalim , Baloch Marvi , Iqbal Javeid , Khan Ayaz Ali , Saeed Hamid , Islam Muhammad 
Published: December 2019

Abstract
Backgrounds In Pakistan, despite the surge in antibiotic consumption scanty of literature evidences exist regarding antibiotic susceptibility patterns in URTIs. Thus, we conducted the study to evaluate the antibiotic susceptibility patterns in URTIs.Methods A cross-sectional study was conducted by collecting 259 culture samples from tertiary care hospitals of Lahore, Pakistan. Using simple random sampling, culture reports of even numbered patient were included as per study inclusion criteria.Results Two hundred sixty samples were processed out of which only 144 (55.4%) samples yielded growth, i-e., 42.7% males and 49% females. In males, the resistance was high against ceftazidime (19.3%), ampicillin (13.1%), ciprofloxacin (11.6%) and gentamicin (10.8%), while in female samples it was significant against cefuroxime (6.9%), ampicillin (5.4%), tobramycin (4.6%) and ciprofloxacin (6.5%). Besides, males were sensitive against imepenem (25.8%), amikacin (22%), ceftazidime (19.3%), ciprofloxacin (19.3%) and piptaz (16.2%), while females were sensitive against amikacin (9.2%), imepenem (9.2%) and ciprofloxacin (6.9%). Overall, carbepenems, imipenem (35%) and meropenem (30.8%), were found highly sensitive followed by aminoglycosides (amikacin; 31.9%), quinolones (ciprofloxacin; 26.3%), piptaz (19.2%) among penicillin and cephalosporin, while resistant was maximum against cephalosporin (ceftazidime; 25.4%) followed by penicillin (ampicillin, 18.5%) and quinolones.Conclusion These data suggested that P. aeruginosa and Klebsiella , were the most frequent bacterial isolates in URTIs of Lahore, Pakistan. These isolates were resistant to ampicillin, cefuroxime and ceftazidime, but were sensitive to carbapenem and aminoglycoside class of antibiotics. Thus, health care professionals, policy makers and drug regulators must devise policies to overcome the menace of growing antimicrobial resistance.
Molecular epidemiology of Clostridioides difficile in patients with inflammatory bowel disease in China
Authors: Lv Tao , Chen Yunbo , Zheng Lisi , Wu Tao , Shen Ping , Li Lanjuan 
Published: December 2019

Abstract
Background: Clostridioides difficile (C. difficle) infection (CDI) in inflammatory bowel disease (IBD) patients can be recurrent, resulting in poor outcomes, but the molecular characterization of C. difficle in IBD patients remains to be well-established in China. This study aimed to investigate the molecular epidemiology of C. difficile in adult and pediatric IBD patients in China. Methods: C. difficile strains were isolated and identified from the fecal samples of adult and pediatric IBD patients. Toxigenic strains were typed using multilocus sequence typing (MLST), and susceptibility to 10 antimicrobials was evaluated using E-test.Results: Among the 838 IBD patients, 96 (11.5%) patients were positive for CDI, which comprised of 53 adult (9.6%) and 43 children (14.9%) cases. Isolates positive for both toxin A and toxin B genes (A+B+) accounted for 90.2% (74/82), while the remaining 9.8% were negative for toxin A, but positive for toxin B (A–B+). These toxigenic strains were susceptible to metronidazole and vancomycin, but highly resistant to clindamycin, levofloxacin, erythromycin and ciprofloxacin. Furthermore, the isolates obtained from pediatric patients had a significantly higher resistance rate to clindamycin, when compared to isolates obtained from adult CDI (p=0.009). In addition, these toxigenic strains were categorized as 18 sequence types (STs). The dominant types consisted of ST-35 (20.7%), ST-2 (17.1%), ST-54 (13.4%) and ST-3 (13.4%) in all patients, ST-2 (19.6%), ST-35 (15.2%) and ST-54 (13.0%) in adult patients, and ST-35 (27.8%), ST-3 (19.4%), ST-2 (13.9%), ST-54 (13.9%) and ST-37(8.3%) in pediatric patients, respectively. All isolates formed three distinct clusters in the phylogenetic analysis. Conclusions: The incidence and molecular epidemiology of C. difficile infection in adult IBD patients resembled CDI in the general inpatient population. A higher antibiotic resistance rate was identified among the C. difficile isolates obtained from pediatric IBD patients, and few STs accounted for most multidrug-resistant strains. However, the molecular genetic features of the same ST-type between these two groups remained highly correlated.
Persuasive antimicrobial stewardship intervention in the context of a KPC outbreak: a controlled interrupted time series analysis
Authors: Pereira Nuno Rocha , Dias Paulo Figueiredo , Correia Sofia , Shahriari Shirin , Neves João , Teixeira José , Paiva José Artur , Alves Carlos Lima , Azevedo Ana 
Published: December 2019

Abstract
Introduction: Antimicrobial resistance is a major public health threat. Antimicrobial stewardship (AMS) is one of the key strategies to overcome resistance, but robust evidence on the effect of specific interventions is lacking. We report an interrupted time series (ITS) analysis of a persuasive AMS intervention implemented during a KPC producing Klebsiella pneumoniae outbreak. Methods: A controlled ITS for carbapenem consumption, total antibiotic consumption and antibiotic-free days, between January 2012 and May 2018 was performed, using segmented regression analysis. The AMS intervention was implemented in the Vascular Surgery ward starting on April 2016 in the context of a KPC outbreak. The General Surgery ward was taken as a control group. Data were aggregated by month for both wards, including 51 pre-intervention and 26 intervention points. Results: The AMS intervention produced a level change in carbapenem consumption of -9.92 DDDs/100 patient-days accompanied by a reduction of total antibiotic consumption and an increase of 4% in antibiotic-free days in Vascular Surgery ward. These differences were not apparent in the control group. No differences in mortality or readmission rates between pre-intervention and intervention periods were noticed in any of the groups. Conclusion: Persuasive AMS interventions on top of previously implemented restrictive interventions can reduce carbapenem consumption and increase antibiotic-free days. Starting persuasive AMS interventions in an outbreak setting does not compromise the sustainability of the intervention.
Utilization of all components in biomass through high reducing sugar production and lignin nanoparticles preparation
Authors: Liu Wei , Zhuo Shengnan , Su Xianfa , Si Mengying , Zhang Kejing , Tong Aizi , Shi Yan 
Published: December 2019

Abstract
BackgroundLignocellulosic biomass for biofuel production was considered as an effective way to develop new energy. However, the efficient sugar conversion of cellulose and practical utilization of lignin are great challenges for sustainable biorefinery. In addition, sugar conversion and lignin utilization are generally performed separately. In this study, high reducing sugar production and multiple lignin nanoparticles preparation were realized in a pattern based on tetrahydrofuran-water (THF-H2O) pretreatment of corn straw (CS). ResultsThe maximum production of the reducing sugar was 26.79 g/l, which was significantly higher than the theoretical yield of 20.65 g/l. Lignin nanoparticles with different sizes ranged from 239 to 798 nm were prepared using dissolved lignin in the supernatant fluid from different THF-H2O pretreatment conditions through self-assembly with introducing water. The formation of lignin particles with different sizes were influenced by soluble lignin characteristics in the pretreatment liquid. The lignin molecular, functional groups, and structure were explored to elucidate the effects on the variation of lignin particles sizes by GPC, FTIR, and 2D-HSQC-NMR. The guaiacyl (G)-type lignin was easier to be dissolved in the mild pretreatment liquid, contributing to form smaller lignin nanoparticles with a good dispersibility. Comparatively, a small content of syringyl- and G-type lignin which caused by the lignin depolymerization retained in the severe pretreatment liquid to form the larger sphere particles. ConclusionsThe optimal pretreatment under TH22 (THF-H2O pretreatment at 120 °C for 2 h) simultaneously realized the utilization of all components in biomass through high reducing sugar production and the smaller lignin particles preparation. This new pattern of CS pretreatment plays a novel perspective for the technical design of lignocellulosic biomass conversion.
Recovery and resiliency of skin microbial communities on the southern leopard frog (Lithobates sphenocephalus) following two biotic disturbances
Authors: Weeks Denita Mychele , Parris Matthew James , Brown Shawn Paul 
Published: December 2019

Abstract
Background: Microorganisms have intimate functional relationships with invertebrate and vertebrate taxa, with the potential to drastically impact health outcomes. Perturbations that affect microbial communities residing on animals can lead to dysbiosis, a change in the functional relationship, often associated with disease. Batrachocytrium dendrobatidis (Bd), a fungal pathogen of amphibians, has been responsible for catastrophic amphibian population declines around the globe. Amphibians harbor a diverse cutaneous microbiome, including some members which are known to be antagonistic to Bd. Anti-Bd microorganisms have allowed some frog populations to persist in the presence of Bd, where other populations that lack anti-Bd microorganisms have perished. Research suggests disease-antagonistic properties of the microbiome may be a function of microbial community interactions, rather than individual bacterial species. Further, dysbiosis of microbial communities has been associated with Bd disease epidemics. Conservation efforts have identified amphibian-associated bacteria that exhibit anti-fungal properties for use as ‘probiotics’ on susceptible amphibian populations. Probiotic application, usually with a single bacterial species, may benefit from a greater understanding of amphibian species-specific microbiome responses to disturbances (e.g. dysbiosis vs. recovery). We assessed microbiome responses to two microbial disturbance events over multiple time points. Results: Exposing Lithobates sphenocephalus (southern leopard frog) adults to the biopesticidal bacteria, Bacillus thuringiensis, followed by exposure to the fungal pathogen Bd, did not have long term impacts on the microbiome. After initial shifts, microbial communities returned to a state that resembled pre-disturbance. Conclusions: Our results indicate microbial communities on L. sphenocephalus are robust and resistant to permanent shifts from some disturbances. This resiliency of microbial communities may explain why L. sphenocephalus is not experiencing the population declines from Bd that impacts many other species. Conservation efforts may benefit from studies outlining amphibian species-specific microbiome responses to disturbances (e.g. dysbiosis vs. recovery). If microbial communities on a threatened amphibian species are unlikely to recover following a disturbance, additional measures may be implemented to ameliorate the impacts of physical and chemical stressors on host-associated microbial communities.
Radiotherapy related skin toxicity (RAREST-02): A reminder app developed to reduce radiation dermatitis in patients with head-and-neck cancer
Authors: Rades Dirk , Narvaez Carlos , Dömer Claudia , Janssen Stefan , Olbrich Denise , Tvilsted Soeren , Conde-Moreno Antonio J , Cacicedo Jon 
Published: December 2019

Abstract
Background: Radiotherapy of head-and-neck cancer can be associated with significant toxicities including dermatitis and oral mucositis. Severe toxicities may require interruptions of the radiation treatment associated with impairment of the patients’ prognoses. This study will investigate whether the addition of a reminder app to standard care can reduce dermatitis and oral mucositis rates during radiotherapy in these patients. Methods: This randomized trial compares standard care supported by a reminder app (Arm A) to standard care alone (Arm B) with respect to grade ≥2 radiation dermatitis and oral mucositis at 60Gy of radiotherapy, the minimum planned dose for patients receiving definitive or adjuvant radiotherapy for locally advanced head-and-neck cancer. Moreover, radiation-induced dermatitis and oral mucositis grade ≥3 at 60Gy and both grade ≥2 and grade ≥3 at the end of radiation treatment (EOT) will be evaluated, as well as quality of life and pain. According to sample size calculations, 80 patients are required per arm within the full analysis set. Taking into account that 5% of patients will not qualify for full analysis set, 168 patients should be randomized. The impact of the reminder app will be considered clinically relevant, if the rates of grade ≥2 radiation dermatitis (primary endpoint) and oral mucositis (secondary endpoint) can be reduced by 20%. Discussion: If the addition of a reminder app to standard care will lead to a significant reduction of radiation dermatitis and oral mucositis, it could become a helpful tool for head-and-neck cancer patients during radiotherapy. Trial registration: clinicaltrials.gov (NCT04110977; URL: https://clinicaltrials.gov/show/NCT04110977). Registered on 27th of September, 2019. First patient is planned to be included in December 2019.
Structure and Function of the Arctic and Antarctic Marine Microbiota as Revealed by Metagenomics
Authors: Zhang Weipeng , Cao Shunan , Ding Wei , Chen Xiu-Lan , Mcminn Andrew , Wang Min , He Jianfeng , Zhang Yu-Zhong 
Published: December 2019

Abstract
Background: The Arctic and Antarctic are the two most geographically distant bioregions on earth. Recent sampling efforts and following metagenomics have shed light on the global ocean microbial diversity and function, yet the microbiota of polar regions has not been included in such global analyses.Results: Here a metagenomic study of seawater samples (n = 60) collected from different depths at 28 locations in the Arctic and Antarctic zones was performed, together with metagenomes from with the Tara Oceans datasets. More than 7,500 (19%) polar seawater-derived operational taxonomic units could not be identified in the Tara Oceans datasets, and more than 3,900,000 protein-coding gene orthologs had no hits in the Ocean Microbial Reference Gene Catalog. Analysis of 214 genome bins, recovered from the polar seawater microbiomes, revealed strains that are prevalent in the polar regions while nearly undetectable in temperate seawater. Metabolic pathway reconstruction for these microbes suggested versatility for saccharide and lipids biosynthesis, nitrate and sulfate reduction, and CO2 fixation. Comparison between the Arctic and Antarctic microbiomes revealed that antibiotic resistance genes were enriched in the Arctic while functions like DNA recombination were enriched in the Antarctic.Conclusions: Our data highlight the occurrence of dominant and endemic microbes in the Arctic and Antarctic seawater with unique functional traits for environmental adaption, and provide a foundation for analyzing the global ocean microbiome in a more complete perspective.
Acute myeloid leukemia with inv(16)(p13.1q22) and deletion of the 5’MYH11/3’CBFB gene fusion: a report of two cases and literature review.
Authors: Lv Lili , Yu Jingwei , Qi Zhongxia 
Published: December 2019

Abstract
Background Acute myeloid leukemia (AML) with inv(16)(p13.1q22) or t(16;16)(p13.1;q22) is associated with a high rate of complete remission (CR) and favorable overall survival (OS) when treated with high-dose Cytarabine. At the inversion breakpoints, deletion of 3’CBFB has been reported, but most of them were studied by chromosome and fluorescence in situ hybridization (FISH) analyses. The genomic characteristics of such deletions remain largely undefined, hindering further understanding of the clinical significance of the deletions. Case presentation We report here two AML cases with inv(16) and deletion of the 5’MYH11/3’CBFB gene fusion, which were characterized by chromosome, FISH, and single nucleotide polymorphism (SNP) microarray analyses. Both cases have achieved CR for more than three years.Conclusions Deletion of 3’CBFB in AML with inv(16) is also accompanied with deletion of 5’MYH11 in all the cases studied by SNP microarray, suggesting that 3’CBFB and 5’MYH11 were most likely deleted together as a fusion product of inv(16) instead of occurring separately. In concert with the findings of other published studies of similar patients, our study suggests that deletion of 5’MYH11/3’CBFB in AML with inv(16) may not have negative impact on the prognosis of the disease.
Nitrogen status assessment for multiple cultivars of strawberries using portable NIR spectrometers combined with cultivar recognition and multivariate analysis
Authors: Wu Gangshan , Jiang Qiyou , Bai Yuhao , Tian Chongfeng , Pan Wei , Zhang Baohua 
Published: December 2019

Abstract
Background The assessment of nitrogen status non-destructively in strawberry was performed to indicate its growth and provide guidance for precise management of N fertilizer using near-infrared reflectance (NIR) spectroscopy with leaf spectral reflectance. The Leaf soil plant analysis development (SPAD) value was thought as an indicator data that indirectly reflects nitrogen status in strawberry. However, the variation of cultivars would lead to differences in the cell structure and light scattering and/or reflection effects of strawberry leaves when assessed strawberry N status, which caused that no single leaf SPAD threshold value or same N demand can be applied for all strawberry cultivars. As a result, accurate detection of SPAD values and N status in strawberries with multiple cultivars is still challenging.Results In this study, Individual-cultivar model, hybrid-cultivar model and multi-cultivar model were developed for the determination of SPAD values, and the performance of the models in lessening the impact of cultivar variation were studied and compared. Individual-cultivar model was constructed on the basis of the single cultivar of strawberry leaf; hybrid-cultivar model was developed by merging the spectrum reflectance data and SPAD values of all studied leaf samples, and multi-cultivar model was built in combination with cultivar identification, individual-cultivar models, and model search strategy.Conclusion The results indicated that multi-cultivar model was more superior to the other two models for SPAD values estimation of strawberry leaves from different cultivars, with the overall Rp and RMSEP value respectively being 0.966 and 0.468. We demonstrate that the leaf N content per strawberry is profoundly affected by cultivar variation, and establishing a multi-cultivar model might be more useful in monitoring nitrogen status and guiding N fertilization recommendations for different strawberry cultivars.
Critical clinical situations in adult patients with Mucopolysaccharidosis (MPS)
Authors: Stepien Karolina M , Gevorkyan A. K. , Hendriksz Christian J , Lobzhanidze T V , Pérez-López J , Tol Govind , Riera Mireia delToro , Vashakmadze N D , Lampe Christina 
Published: December 2019

Abstract
Background: Mucopolysaccharidoses (MPS) are rare, inherited disorders associated with enzyme deficiencies that result in glycosaminoglycan (GAG) accumulation in multiple organ systems. Management of MPS is evolving as patients increasingly survive to adulthood and undergo multiple surgeries throughout their lives. As surgeries in these patients are considered to be high risk, this can result in a range of critical clinical situations in adult patients. Results: We discuss strategies to prepare for and manage critical clinical situations in adult patients with MPS, including supporting the multidisciplinary team, preoperative and airway assessments, surgical preparations, and postoperative care. We also present eight critical clinical cases (age range: 21–38 years) from four leading inherited metabolic disease centres in Europe to highlight challenges and practical solutions to optimise the care of adult patients with MPS. Critical clinical situations included surgical procedures, pregnancy and a thrombus in a port-a-cath. Conclusions: Individualised strategies to manage critical clinical situations need to be developed for each patient to compensate for the heterogeneous symptoms that may be present and the potential complications that may occur. These strategies should include input from the wider MDT, and be coordinated by metabolic specialists with expertise in the management of MPS disorders and surgery in adult patients with MPS.