bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antimicrobial practices among small animal veterinarians in Greece: a survey
Authors: Valiakos George , Pavlidou Eleni , Zafeiridis Christos , Tsokana Constantina N , Vilas Victor J Del Rio 
Published: May 2020

Abstract
Background The inappropriate use of antibiotics is a major issue in clinical practice in Greece with serious implications for public health and animal health. The purpose of the present study was to provide a first insight into the use of antibiotics by small animal practitioners in Greece and assess their compliance with general rules for the rational use of antibiotics. This is the first survey of its kind in Greece.Methods A questionnaire was designed to collect basic information on the use of antibiotics by pet veterinarians. The questionnaire was sent to a total of 70 veterinarians mainly operating in the region of Attica, a region that comprises almost 50% of the Greek population and where veterinarians are engaged solely in small animal practice. The questionnaire consisted of 37 closed questions dealing with various aspects on the use of antibiotics.Results The majority of respondents’ report cases where the pet owner initiated antibiotic treatment without veterinary prescription. Almost every clinician reported owner-compliance challenges. Regarding microbiological analysis, 73% of respondents prefer to adopt the empirical treatment while waiting the laboratory results or use antibiogram only when the treatment is unsuccessful. Eighty-eight per cent declared to use antimicrobials postoperatively in clean surgical procedures. Different types of antimicrobials and treatment durations than the ones proposed by guidelines on rational use of antibiotics are preferred for various organ systems e.g. in urinary and gastrointestinal infections. Conclusions Our findings suggest the need for guidelines on antibiotic use in small animal practice in Greece, and the deployment of systematic surveillance on antimicrobials use and resistance to inform the initial choice of antibiotics upon local antimicrobial resistance profiles. Targeting the other end of the problem, pet owners, our findings indicate the need to educate them on the rational use of antibiotics and, critically, stop antibiotic availability without prescription.
Serum amyloid A 1 protein isoforms induce Rheumatoid Arthritis
Authors: Leung Elaine Lai-Han , Lai Huan-Ling , Li Run-Ze , Pan Hu-Dan , Jiang Ze-Bo , Li Ying , Duan Fu-Gang , Xu Jia-Hui , Zhang Yi-Zhong , Shi A-Xi , Wei Chun-Li , Zhang Fang-Yuan , Yao Xiao-Jun , Liu Liang 
Published: May 2020

Abstract
The authors have withdrawn this preprint due to author disagreement.
A review of multi-dimensional diagnosis of Alport syndrome in 22 children in Northeast China
Authors: Zhang Li , Sun Bai-chao , Zhao Bing-gang , Ma Qing-shan 
Published: May 2020

Abstract
Background Alport syndrome (AS) is progressive hereditary nephritis due to different gene mutations. Affected individuals usually develop hematuria during childhood with gradual deterioration of renal functions. We adopted multi-dimensional methods to diagnose Alport syndrome in order to decrease the misdiagnosis.Methods Twenty-two children were diagnosed and managed by the Department of Pediatric Nephrology of Jilin University First Hospital between January 2017 and January 2020 through multi-dimensional methods. Information collected included age of onset, age at diagnosis, clinical manifestations, family history (FH), renal pathology and their genotype. Results All patients presented with hematuria with various degrees of proteinuria in some patients. While three children suffered from hearing loss, none of the children in the cohort had any visual problem or renal failure. Besides five patients estimated as Stage 2, the remain seventeen cases were at Stage 0. Renal biopsy were obtained in eighteen patients and fourteen of them showed glomerular basement membranes (GBM)-specific abnormalities. Thirteen children had mutations of the collagen IV genes. Conclusion Combined with the importance of early diagnosis and economic factors, we adopted multi-dimensional methods to improve the diagnosis of Alport syndrome and estimate the risk of progression. We also reviewed the therapy progress.
Fabry disease screening in high-risk populations in Japan: A nationwide study
Authors: Yoshida Shinichiro , Kido Jun , Sawada Takaaki , Momosaki Ken , Sugawara Keishin , Matsumoto Shirou , Endo Fumio , Nakamura Kimitoshi 
Published: May 2020

Abstract
Background: Fabry disease (FD) is a X-linked inherited disorder caused by mutations in the GLA gene, which results in deficiency of α-galactosidase A (α-Gal A). This leads to the progressive accumulation of metabolites, which can cause malfunctions in systemic organs. A recent screening study in newborns showed that the incidence of FD was more frequent than previously estimated and that there are still many undiagnosed or misdiagnosed patients with FD. Therefore, the purpose of this study was to identify patients with FD by performing high-risk screening in 18,135 individuals, enrolled from October 2006 to March 2019, with renal, cardiac, or neurological manifestations from all of the prefectures in Japan. A total of 601 hospitals participated in this study.Results: Low α-Gal A activity was detected in 846 individuals, with 224 of them diagnosed with FD by GLA sequencing. Cases with a family history of FD (n = 64) were also subjected to sequencing, without α-Gal A assay, as per individual request, and 12 of them were diagnosed with a variant of FD. A total of 236 patients with FD (97 males and 139 females) were detected from the 18,199 participants. A total of 101 GLA variants, including 26 novel variants, were detected in the 236 patients with FD from 143 families, with 39 amenable variants (39%) and 79 of the 236 patients (33%) suitable for migalastat treatment.Conclusions: From the 18,199 participants, 101 GLA variants, including 26 novel variants, were identified in the 236 patients with FD from 143 families. Migalastat was identified as a suitable treatment option in 33% of the patients with FD and 39% of the GLA variants were detected as amenable. Therefore, the simple screening protocol using dried blood spots that was performed in this study could be useful for early diagnosis and selection of appropriate treatments for FD in high-risk and underdiagnosed patients with various renal, cardiac, or neurological manifestations.
The human arthritic hip joint is a source of mesenchymal stromal cells (MSCs) with extensive multipotent differentiation potential
Authors: Wagenbrenner Mike , Heinz Tizian , Horas Konstantin , Jakuscheit Axel , Arnholdt Joerg , Herrmann Marietta , Rudert Maximilian , Holzapfel Boris , Steinert Andre , Weißenberger Manuel 
Published: May 2020

Abstract
Background: While multiple in vitro studies examined mesenchymal stromal cells (MSCs) derived from bone marrow or hyaline cartilage, there is little to no data about the presence of MSCs in the joint capsule or the ligamentum capitis femoris (LCF) of the hip joint. Therefore, this in vitro study examined the presence and differentiation potential of MSCs isolated from the bone marrow, arthritic hyaline cartilage, the LCF and full-thickness samples of the anterior joint capsule of the hip joint. Methods: MSCs were isolated and multiplied in adherent monolayer cell cultures. Osteogenesis and adipogenesis were induced in monolayer cell cultures for 21 days using a differentiation medium containing specific growth factors, while chondrogenesis in the presence of TGF-ß1 was performed using pellet-culture for 27 days. Control cultures were maintained for comparison over the same duration of time. The differentiation process was analyzed using histological and immunohistochemical stainings as well as semiquantitative RT-PCR for measuring the mean expression levels of tissue-specific genes. Results: This in vitro research showed that the isolated cells from all four donor tissues grew plastic-adherent and showed similar adipogenic and osteogenic differentiation capacity as proven by the histological detection of lipid droplets or deposits of extracellular calcium and collagen type I. After 27 days of chondrogenesis proteoglycans accumulated in the differentiated MSC-pellets from all donor tissues. Immunohistochemical staining revealed vast amounts of collagen type II in all differentiated MSC-pellets, except for those from the LCF. Interestingly all differentiated MSCs still showed a clear increase in mean expression of adipogenic, osteogenic and chondrogenic marker genes. In addition, the examination of an exemplary selected donor sample revealed that cells from all four donor tissues were clearly positive for the surface markers CD44, CD73, CD90 and CD105 by flow cytometric analysis. Conclusions: This study proved the presence of MSC-like cells in all four examined donor tissues of the hip joint. No significant differences were observed during osteogenic or adipogenic differentiation depending on the source of MSCs used. Further research is necessary to fully determine the tripotent differentiation potential of cells isolated from the LCF and capsule tissue of the hip joint.
Evaluation of the association between presenteeism and perceived availability of social support among hospital doctors in Zhejiang, China
Authors: Xi Xiaoyu , Lu Qianni , Lu Mengqing , Xu Ailin , Hu Hao , Ung Carolina Oi Lam 
Published: May 2020

Abstract
Objective:
This study investigated the association between presenteeism and the perceived availability of social support among hospital doctors in China.

Method:
A questionnaire was administered by doctors randomly selected from 13 hospital in Hangzhou China using stratified sampling. Logit model was used for data analysis.

Results:
The overall response rate was 88.16%. Among hospital doctors, for each unit increase of the perceived availability of social support, the prevalence of presenteeism was decreased by 8.3% (OR=0.91, P=0.000). In particular, if the doctors perceived availability of appraisal support, belonging support and tangible support as sufficient, the act of presenteeism was reduced by 20.2% (OR=0.806, P=0.000) 20.4% (OR=0.803, P=0.000) and 21.0% (OR=0.799, P=0.000) respectively with statistical differences.

Conclusion:
In China, appraisal support, belonging support and tangible support, compared to other social support, had a stronger negative correlation with presenteeism among hospital doctors. The benefits of social support in alleviating doctors’ presenteeism warrant further investigation.
Fascin-1 expression in colorectal cancer identifies patients at high risk for early disease recurrence and associated mortality.
Authors: Tampakis Athanasios , Tampaki Ekaterini Christina , Nonni Afrodite , Kostakis Ioannis D. , Posabella Alberto , Kontzoglou Konstantinos , von Flüe Markus , Felekouras Evangelos , Kouraklis Gregory , Nikiteas Nikolaos 
Published: May 2020

Abstract
Background; Fascin is the main actin cross-linker protein that regulates adhesion dynamics and stabilizes cell protrusion, such as filopodia. In human cancer, fascin expression correlates with aggressive clinical features. This study aimed to determine the expression patterns of fascin-1 and assess its prognostic significance in colorectal cancer. Methods; One hundred eleven specimens of patients with primary resectable colorectal cancer were examined via immunohistochemistry for the expression of fascin-1, and the results were correlated with clinicopathological characteristics and survival data. Results; Fascin-1 staining displayed strong intensity in the cytoplasm of the colorectal cancer cells and endothelial cells of tumor blood vessels. Moderate and high fascin-1 expression was associated with progressive anatomic disease extent (p < 0.001), higher T classification (p = 0.007), the presence of lymph node (p < 0.001) and distant metastasis (p = 0.002), high grade tumors (p = 0.002) and vascular invasion (p < 0.001). Patients displaying moderate and high fascin-1 expression demonstrated a significantly worse 5-year overall survival [HR; 3.906, (95%CI) = 1.250-12.195] and significantly worse 3-year progression-free survival [HR; 3.448, (95%CI) = 1.401–8.475] independent of other clinicopathological characteristics. Besides, high fascin-1 expression in early-stage cancer only was associated with a dismal prognosis. Conclusions; High fascin-1 expression in colorectal cancer is an independent negative prognostic factor for survival, increasing the risk for disease recurrence or death almost by sevenfold. Fascin-1 expression could be potentially utilized to identify high-risk patients prone to metastasis already in early-stage disease.
Optimal Regimens and Cutoff Evaluation of Ceftiofur Against Actinobacillus pleuropneumoniae in Swine
Authors: Sun Da , Mi Kun , Hao Haihong , Xie Shuyu , Chen Dongmei , Huang Lingli 
Published: May 2020

Abstract
BackgroundActinobacillus pleuropneumoniae, formerly known as Haemophilus pleuropneumoniae, can cause pleuropneumoniae in pigs of different ages, leading to significant mortality. Ceftiofur was the first cephalosporin antibiotic used in animals that was effective against gram-negative and gram-positive bacteria. This study aimed to determine the breakpoint of ceftiofur against Actinobacillus pleuropneumoniae based on the investigation of the epidemiologic cutoff value (ECV), and pharmacodynamic-pharmacokinetic breakpoint.ResultsThe epidemiologic cutoff value was 0.125 µg/mL. The results of the pharmacodynamic study showed that the MICs of BW39 were 0.5 µg/mL and 1 µg/mL under in vitro and ex-vivo conditions, respectively, and the minimal bactericidal concentrations (MBCs) under in vitro and ex vivo conditions were both 1 µg/mL. The time-killing profiles of ceftiofur against BW39 were time-dependent. According to the inhibitory sigmoid Emax model, the AUC24 h/MIC values for the bacteriostatic, bactericidal, and elimination effects in serum were 45.73, 63.83, and 69.04 h for healthy pigs, respectively. Based on the Monte Carlo simulation, the COPD was calculated as 2 µg/mL, and the optimized dosage regimen of ceftiofur against Actinobacillus pleuropneumoniae to achieve bacteriostatic, bactericidal, and elimination effects over 24 h was 2.13, 2.97, and 3.42 mg/kg for the 50% target attainment rate (TAR) and 2.47, 3.21, and 3.70 mg/kg for the 90% TAR, respectively.ConclusionsIn this study, the epidemiologic cutoff value was 0.125 µg/mL, as calculated by ECOFFinder software. According to the PK/PD evaluation in vitro and ex vivo, the value of the pharmacodynamics cutoff was 2 µg/mL, as obtained by Monte Carlo simulation. The COPD suggested that the breakpoint could be better than the COWT value because COPD derived from PL/PD data was obtained in vitro and ex vivo, which was more significant. According to the PK/PD parameters, the single bactericidal dose was 3.21 mg/kg for the 90% target, which would be more available to cure Actinobacillus pleuropneumoniae and avoid the emergence of resistance for clinical ceftiofur use.
COVID-19 Pandemic Initial Case-Fatality Risk
Authors: Abugroun Ashraf , Ahmed Fatima , Abdel-Rahman Manar E , Dousa Khalid M , Osman Mohammed , Patel Pragnesh , Ahmed Mohammed E 
Published: May 2020

Abstract
Background

Coronavirus disease 2019 (COVID-19) pandemic continues to expand at alarming rates. We aimed to identify the effect of various health, economic and demographic indicators on the spread case fatality of COVID-19 during the initial pandemic phase.
Methods

Pearson's chi-squared (χ2) test and Wilcoxon rank-sum test were used compare categorical and continuous variables respectively.
Results

A total of 182 countries were included. The globally confirmed COVID-19 cases on March 21, 2020 were 266,073; with 11,183deaths. Countries with high COVID-19 case volumes had higher health expenditure, higher prevalence of smoking and alcohol use, more access to basic sanitation services and higher volume of tourists. Countries with high COVID-19 fatality had significantly lower number of nurses/midwives per 1000 people 2.6 vs 6.4, p = 0.028, higher prevalence of undernourishment 4.5 vs 2.5, p = 0.019, lower access to basic sanitation services 94.2 vs 98.7, p = 0.034 and higher mortality rates due to unsafe water, limited sanitation and lack of hygiene 0.6% vs 0.2%, p = 0.004 and higher number of total tourists’ departures 9.5 vs 5.9 million, p = 0.042.
Conclusion

Countries with primitive health structure and low income are at high risk for increased mortality. Additional measures to increase nurse staffing and address undernourishment and availability of easy access to basic sanitation services and good hygiene are crucial for pandemic control during initial phase.
Differentiation and management of hepatobiliary mucinous cystic neoplasms: a single centre experience for 8 years
Authors: Zheng Junhao , Cai Jingwei , Kirih Mubarak Ali , Xu Junjie , Tao Liye , Liang Yuelong , Feng Xu , Fang Jing , Liang Xiao 
Published: May 2020

Abstract
Background
Hepatobiliary mucinous cystic neoplasms (H-MCNs) are quite rare cystic neoplasms in the liver. The management and prognosis between the hepatic simple cyst (HSC) and H-MCNs are adverse, and the differential diagnosis of H-MCNs remains big challenging. This study aimed to present our experience in the management of H-MCNs and provide a preoperative H-MCNs risk prediction nomogram to differentiating H-MCNs from HSC.
Methods
29 patients diagnosed with H-MCNs and 75 patients diagnosed with HSC between June 2011 and June 2019 at Zhejiang University, School of medicine, Sir Run-Run Shaw Hospital, were reviewed in this study. Demographic and clinicopathological variables were analyzed.
Results
US, CT, and MRI could accurately diagnose only 3.4%, 46.1%, and 57.1% of H-MCNs, respectively. After univariate analysis and multivariate logistic regression analysis, the variables significantly associated with H-MCNs were enhancement after contrast (p = 0.009), tumour located in the left lobe (p = 0.02) and biliary ductal dilation (p = 0.027). An H-MCN risk predictive nomogram constructed by these factors and serum CA199 level showed excellent discrimination (areas under the receiver operating characteristic curve were 0.940) and agreement calibration between predicted probability and actual probability.
Conclusion
Among patients with the H-MCNs, the location of the tumour, enhancement in CT scan, and biliary ductal dilation are significantly independent risk factors. The reasonable treatment of H-MCNs is radical resection. Using our nomogram could facilitate screening and identification of patients with liver cystic lesions.
The positive impacts and unintended consequences of the nationwide pricing reform for drugs and medical services in the urban public hospitals in China
Authors: Zhang Xiaoxi , Lai Hongyu , Zhang Lidan , He Jiangjiang , Fu Bo , Jin Chunlin 
Published: May 2020

Abstract
Since 2015, China has been rolling out the pricing reform for drugs and medical services (PRDMS) in the urban public hospitals in order to reduce the drug expenditure and to relieve the financial burden of patients. This study aims at evaluating the effectiveness of the reform implementation and investigating its positive impacts and unintended consequences to provide evidence base for further policy making. The Difference-in-difference (DID) approach was employed to analyze the reform impact on the 31 provincial administrative areas in China based on the data abstracted from China Statistics Yearbooks and China Health Statistics Yearbooks from 2012 to 2018. The reform resulted in the decrease of 7.59% in drug cost per outpatient visit, the decrease of 5.73% in drug cost per inpatient admission, the decrease of 3.63% in total cost per outpatient visit and an increase of 9.10% in the surgery cost per inpatient admission in the intervention group. However, no significant change in examination cost was found, and the reduction in the medical cost per inpatient admission was yet to be demonstrated, nor was the total outpatient/ inpatient expenses. The nationwide pricing reform for drugs and medical services in the urban public hospitals (PRDMS-U) in China is demonstrated to be effective in cutting down the drug expenditure. However, the revealed unintended consequences indicate that there are still significant challenges for the reform to encounter in the way ahead to reach the ultimate goal in curbing the medical expenditure. The underlying issue with the incentives of providers in service delivery remains to be unsolved and the pricing instrument alone should not be enough to change the behavior of providers. Our conclusion holds lessons for other low- and middle-income countries (LMICs) who are also conducting reforms to public hospitals.Authors Xiaoxi Zhang and Hongyu Lai contributed equally to this work.
Experimental Pulmonary Tuberculosis Without Brain Infection in Male BALB/c Mice Induces Neuroinflammation and Behavioural Abnormalities
Authors: Espinosa Jacqueline Viridiana Lara , Marquina-Castillo Brenda , Santana-Martínez Ricardo A. , Zetter Mario A. , Maldonado Perla D. , Becerril-Villanueva Enrique , Pérez-Sánchez Gilberto , Pavón Lenin , Mata-Espinosa Dulce , Barrios-Payán Jorge , López-Torres Manuel Othoniel , Pando Rogelio Hernández 
Published: May 2020

Abstract
Background During the development of chronic peripheral inflammation, there is a complex activity of specific brain areas that produce neuronal activation and changes in the synthesis, production and activity of neurotransmitters and cytokines. These changes produced afferent responses that contribute to the regulation of inflammatory and immune responses but may also affect the neuropsicoaffective functions, such as learning ability, memory and mood. Pulmonary tuberculosis (TB) is an infectious disease that induces chronic inflammation, so it could produce these neural and immune changes that may occur in the absence of brain infection. In the present study, we determined the immune response in the Central Nervous System (CNS), in a murine model of pulmonary TB and its relationship with the neurotransmitters levels and behavioural abnormalities without brain infection. Methods Using a murine model of pulmonary TB, we studied the synthesis of cytokines by RT-PCR and IHC, the concentrations of the neurotransmitters by HPLC along with neuronal changes and the histopathology alterations within specific brain areas. Different behavioural tests were performed, which include the study of sickness behaviour, anxiety-like behaviour, neurological severity score, short and long-term memory and depression-like behaviour. We evaluated the activation of JNK and p38 and BNDF levels by Western blot. Data were analysed by Two-Way ANOVA, followed by Sidak tests. Results Pulmonary infected male animals showed a brain increased expression of the pro-inflammatory (TNFa, IFNg, IL-12) and anti-inflammatory (IL10, IL4 and TGFb) cytokines, as well as the enzymes indolamine 2-3 dioxygenase (IDO) and induced nitric oxide synthase (iNOS) in the hypothalamus, hippocampus and cerebellum; in coexistence with substantial cha nges in the production of the neurotransmitters norepinephrine, epinephrine, dopamine and serotonin. Neurodegenerative changes occurred in the early stage of the disease, and it led to neuronal death during advanced TB, with activation of p38, JNK and decrease of the BDNF levels. All these changes occurred with sickness behaviour, depressive-like and anxiety-like behaviour, neurological damage and impairment of both short and long-term memory. Conclusions Pulmonary TB produced a neuroinflammatory state and neuronal damage, which evoked several behaviour abnormalities that resembled depression/anxiety states and aroused the interest to control neuroinflammation in TB patients with neuropsychiatric abnormalities.