bluuebunny/crossref_metadata_2025_split huggingface dataset:
The epidemiological characteristics of pediatric Streptococcus pneumoniae isolated from inpatients and outpatients at Beijing Children's Hospital
Authors: Lyu Shuang 
Published: June 2020

Abstract
Background: The epidemiological data of Streptococcus pneumoniae isolates are important for the practice of treatment and prevention. This research aiming to explore the epidemiological characteristics of pediatric S. pneumoniae isolated from outpatients and inpatients.Methods: S. pneumoniae were isolated from unsterile samples of inpatients and outpatients younger than five years old between March 2013 and February 2014. The serotypes were determined by diagnostic pneumococcal antisera, and resistance against 13 antibiotics was tested by either the E-test or the disc diffusion method. The sequence types (STs) were analyzed with multilocus sequence typing (MLST).Results: The five dominant serotypes obtained from inpatients were 19F(32.9%), 19A(20.7%), 23F(10.7%), 6A(10.0%), and 14 (8.6%), while those in the outpatients were 19F (13.6%), 23F (12.9%), 6A (10.0%), 6B (10.0%), and 19A (7.9%). The coverage rates of the 7-, 10- and 13-valent pneumococcal vaccine formulations were high. The non-susceptibility to penicillin, cefuroxime, imipenem, erythromycin, and trimethoprim-sulfamethoxazole among the inpatient isolates were 7.1%, 92.8%, 65.7%, 100%, and 85.0%, respectively, while those among the outpatient isolates were 0.7%, 50.0%, 38.6%, 96.4%, and 65.7%, respectively. There were 45 and 81 STs detected from the pneumococci from inpatients and outpatients, respectively. CC271 was more prevalent in inpatients.Conclusions: The vaccine related serotypes were still prevalent either in inpatient department or in outpatient department, the prevalent serotypes and MLSTs with serious antibiotic resistance. More effective measures should be implemented to prevent S. pneumoniae diseases.
Atrophy subtypes and the ATN classification scheme in Alzheimer’s disease
Authors: Cedres Nira , Ekman Urban , Poulakis Konstantinos , Shams Sara , Cavallin Lena , muehlboeck Sebastian , Granberg Tobias , Wahlund Lars-Olof , Ferreira Daniel , Westman Eric 
Published: June 2020

Abstract
BACKGROUND

We investigated the association between atrophy subtypes of Alzheimer’s disease (AD), the ATN classification scheme, and key demographic and clinical factors, in two cohorts with different source characteristics (a highly selective research-oriented cohort, ADNI; and a naturalistic heterogeneous clinically-oriented cohort, Karolinska Imaging Dementia Study (KIDS).
METHODS

A total of 382 AD patients were included. Factorial analysis of mixed data was used to investigate associations between AD subtype based on brain atrophy patterns, ATN profiles based on cerebrospinal fluid biomarkers, and age, sex, Mini Mental State Examination (MMSE), cerebrovascular disease (CVD) (burden of white matter signal abnormalities, WMSA), and APOE genotype.
RESULTS

Older patients with high WMSA burden, belonging to the typical AD subtype, and showing A + T + N + or A + T + N- profiles clustered together and were mainly from ADNI. Younger patients with low WMSA burden, limbic-predominant or minimal atrophy AD subtypes, and A + T-N- or A + T-N + profiles, clustered together and were mainly from KIDS. APOE ε4 carriers more frequently showed the A + T-N- and A + T + N- profiles.
CONCLUSIONS

Our findings align with the recent framework for biological subtypes of AD: the combination of risk factors, protective factors, and brain pathologies determines belonging of AD patients to distinct subtypes.
Usage Patterns, Knowledge and Attitudes Regarding Dietary Supplement Intake Among Sri Lankan Elite Athletes: A Cross-Sectional Study
Authors: Rashani Suraweera Arachchilage Nimesha , Fernando Punchividanelage Nilu Jayashika , Pigera Shehani , Niriella Madunil Anuk , Jayawickreme Seevali Jayantha , Silva Arjuna Priyadarsin De 
Published: June 2020

Abstract
Background: The use of dietary supplements without adequate knowledge regarding their constituents places professional athletes at great risk due to possibility of being positive in dope testing. The aim of this study was to identify the dietary supplements usage patterns among elite athletes in various sport types and investigate their knowledge and attitudes regarding that.Methods: A cross-sectional study was conducted in which a self -administered anonymous questionnaire was used to collect data from 387 elite athletes participating in individual (athletics, karate, weightlifting, wrestling and shooting), team (cricket, volleyball, netball, rugby, football, kabaddi and hockey) and both (wushu and badminton) sports. The data were analysed using nonparametric tests; Pearson’s chi square test with the level of significant of p < 0.05.Results: Out of 387 athletes, 354 (91.5%) used dietary supplements, multivitamin (57%), electrolyte (49.7%), protein (43.5%), calcium (19.7%) and creatine (17.4%) as the most prevalent types. Gender, social status, educational level, and professionalism had no impact with the supplement use whereas the type of sport played showed a significant impact on supplement intake (p < 0.05), with athletes in netball, rugby, wrestling, badminton and shooting showed 100% usage. Vitamin, protein and creatine usage were high among rugby, netball and weightlifting players (p < 0.05). The majority of athletes consume supplements to improve their performance (41.8%) and energy (54. 5%). Further,60.5% of the athletes claimed on self-prescription without medical advice. Two perceptions of, supplements are essential for maintain fitness and win awards were significantly high in males (p <0.05). Athletes having participated in educational workshops and competed internationally showed significant concern about the contamination risk associated with supplements (p < 0.05). Rugby, weightlifting and netball players showed significant multiple supplement usage among others (p <0.05).Conclusion: This study confirms that dietary supplements are readily used by Sri Lankan elite athletes, while multivitamins, protein and energy drink products are preferred. Additionally, the majority of athletes engaged in supplement use with the aim of performance enhancement and increase energy. Nature of sport played was a determinant factor of net supplement usage while higher multiple supplement usage appeared among intensive sports.
Effect of otolaryngology residency program on confidence of obstructive sleep apnea managements
Authors: Sadeghniiat-Haghighi Khosro , Heidari Farrokh , Sohrabpour Saeed , Najafi Arezu , Ahmadi Seyyed Amir Yasin , Erfanian Reza 
Published: June 2020

Abstract
Background

According to the importance of obstructive sleep apnea syndrome managements by otolaryngologists, this study was designed to investigate knowledge, attitudes and practice of junior and senior residents of otolaryngology and evaluate the effect of current residency training program on choosing the first lines of treatment.
Methods

A total of 110 residents of otolaryngology were selected. Our study tools were obstructive sleep apnea knowledge and attitudes (OSAKA and OSAKA-KIDS) questionnaires. The participants were classified as junior and senior.
Results

Senior residents had significantly higher total knowledge score for OSAKA based on independent t test (12.73 VS 10.52). No significant difference was observed for OSAKA-KIDS (11.31 VS 10.69). Also, senior residents had significantly higher total attitude score (except management with CPAP) for OSAKA. The most frequent choice for the first line treatment was CPAP (63.8%) and weight loss (41.5%) among junior and senior residents, respectively.
Conclusions

Although the knowledge of otolaryngology residents increased during their program, the choice of first line treatment in obstructive sleep apnea was different between junior and senior residents. We found a need for further multidisciplinary education for residents especially in the management of sleep apnea particularly toward CPAP usage and this syndrome in pediatrics.
Application of 3D Printing and Framework Internal Fixation Technology for High Complex Rib Fractures
Authors: Zhou Xuetao , Zhang Dongsheng , Xie Zexin , Yang Yang , Chen Menghui , Liang Zheng , Zhang Guoliang , Li Shujun 
Published: June 2020

Abstract
Objective

To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures.
Methods

Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS).
Results

The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to ten months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape.
Conclusion

The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.
WITHDRAWN: Mechanical Properties and Electrochemical Corrosion Behaviour of TiSZ-Reinforced HydroxyapatiteCoatings on Magnesium Substrate with Titanium Interlayer
Authors: Akçay Ayşe , Karabas Muhammet , Kayalı Yusuf 
Published: June 2020

Abstract
In this study, pure and 10% wt. TiSZ-reinforced HA coatings were deposited on magnesium substrate using plasma spray as a single layer and double layer with a HVOF sprayed Ti bond coat. The coated specimens were characterized by X-ray diffraction (XRD) analysis, and scanning electron microscopy (SEM, EDS). Rockwell-C adhesion and scratch tests were performed. The corrosion behaviours in simulated body fluid (SBF) of coatings were investigated by an electrochemical corrosion test. The microscopic observation shows that a dense, continuous Ti buffer layer and bioceramic HA, and HA+TiSZ coatings were produced successfully. The presence of the Ti intermediate layer reduced the corrosion rate of the bioceramic coatings. The double-layer HA-Ti coating on the magnesium substrate is more resistant to corrosion than the single-layer HA coating. Rockwell-C adhesion tests show that adhesion of coatings improves with the addition of TiSZ. Reinforcing HA with TiSZ negatively affected the scratch resistance of the coatings. The effect of the Ti bond layer on adhesion and cohesion behaviour of coatings is not significant.
Surgical and Postoperative Evaluations of Rectal Adenomas Ecised With a Novel Proctoscope.
Authors: Lima Roberta Denise Alkmin Lopes , Parra Rogerio Serafim , Feitosa Marley Ribeiro , Féres Omar , Rocha José Joaquim Ribeiro 
Published: June 2020

Abstract
Purpose

Many transanal endoscopic surgeries require a high level of technical expertise and surgeon experience. Considering the economic feasibility of material acquisition and the technical feasibility of training and experience with complex methods, a simpler technique with available resources is relevant for the excision of rectal adenomas. This study presents the surgical and postoperative results achieved with a novel proctoscope using the transanal endoscopic technique to excise rectal adenomas. The results are compared to the results obtained with other currently employed transanal techniques.
Methods

We retrospectively investigated the medical records of patients who underwent transanal endoscopic operations from April 2000 to June 2018 at two tertiary referral centers for colorectal cancer.
Results

This study included 99 patients. The mean age was 65.3 ± 13.3 years. The average size of the adenomas was 4.6 ± 2.3 cm, and their average distance to the anal border was 5.6 ± 3.3 cm. The average operative time was 65.3 ± 41.7 min. In 48.5% of the operations, the specimen was fragmented, and in 59.6% of the cases, the microscopic margins were free. The rates of postoperative complications and relapse were 5% and 19%, respectively. The mean follow-up was 80 ± 61.5 months.
Conclusions

The described proctoscope proved to be a viable technique with results similar to other techniques, with the advantage that it allowed greater accessibility for surgeons. Therefore, its use could be implemented and become widespread in surgical practice.
Bacterial culture and antibiotics susceptibility in chronic suppurative otitis media at the secondary care hospital in North India
Authors: Singh Anuj Kumar , Verma Amita 
Published: June 2020

Abstract
Background: Chronic suppurative otitis media (CSOM) is defined as a persistent infection of the middle ear with a perforated tympanic membrane and draining exudate for more than 6 weeks. Information about the organism responsible for COSM and their antibiotic susceptibility pattern is an important for effective treatment. Aim: This study aims to develop protocol for empirical treatment by determining aerobic bacterial profile and antibiotics susceptibility in patients of chronic suppurative otitis media (CSOM) at a secondary care hospital in North India. Material and Methods: A cross-sectional study was conducted at ENT department of the secondary care hospital in North India on 85 patients, middle ear discharge sample was collected under strict aseptic conditions and antibiotic susceptibility done as per Clinical Laboratory Standards Institute guidelines. Result: 85 ear swabs were collected, and 89 bacterial isolates were identified, of which 62 (72.94%) sample with mono-microbial growth, 14 (16.47%) with polymicrobial growth, 8 (9.41%) show no growth and rest 1(1.17%) was contaminant. Among 89 isolates, 35 (39.33%) were Gram-positive bacteria, while 54 (60.67%) were Gram-negative bacteria. The most common isolates were Pseudomonas spp. (36; 40.45%), followed by MSSA (34; 38.20%), Proteus spp. ( 7; 7.87%), Klebsiella spp.(3; 3.37%), Enterobacter spp.(3; 3.37%), E. coli (3; 3.37%), Actinobacteria spp. (2; 2.25%) and MRSA (1; 1.12%). Pseudomonas spp. showed 100% susceptible to colistin, linezolid, imipenem, amikacin (97%); ciprofloxacin (92%); gentamicin (95%); Ceftriaxone (83%); meropenem (93%); Netilmicin (98%) and SXT (90%). Proteus spp. was 100% susceptible to amikacin, ciprofloxacin, Imipenem, meropenem, netilmicin; ampicillin (71%); amoxicillin–clavulanic acid (85%); ceftriaxone (85%); gentamicin (85%) and SXT (85%). Among Gram-positive bacteria, MSSA was 100 % susceptible to meropenem and Imipenem, amikacin (97%); gentamicin (81%); amoxicillin–clavulanic acid (91%); linezolid (92%); Netilmicin (94%); Vancomycin (91%); Colistin (97%) and SXT (41%). MRSA showed 100% susceptibility to gentamicin, netilmicin and vancomycin. Conclusion: Pseudomonas and MSSA were the principal bacterial isolate responsible for causing CSOM in this study though the most common organism was Pseudomonas spp. We conclude the combination of amikacin and ceftriaxone to be used as systemic therapy
COVID19 infection in health care professionals: risks, work-safety and psychological issues.
Authors: Dabholkar Yogesh , Sagane Bhagyashree , Dabholkar Twinkle , Divity Shivakumar 
Published: June 2020

Abstract
Introduction: (COVID-19) infection has spread widely over past 5 months to become a pandemic of global proportions affecting almost every country. While HCPs are expected to tackle this crisis by working in hospital and intensive care setting, there is real risk of them contracting infection and even dying. This article aims to report cases of healthcare personnel (HCPs) contracting COVID19 in various settings in a tertiary care hospital, a designated COVID centre, with view to disseminate information and review safety and psychological health issues of healthcare professionals.Methods: This study is a cross-sectional hospital-based survey from April 2020-June 2020. Data on demographics, workplace safety and psychological parameters from HCPs was collected by both interview and an online questionnaire form.Results: A total of 40 healthcare workers were infected in the hospital in a period of 2 months since the first COVID case was admitted in the hospital. Almost 57.5 % reported positive on several psychological parameters like anxiety, fear, anger, irritability and insomnia. About 42.5 % had no psychological counselling after testing positive.Discussion: These cases illustrate work-place risks for healthcare workers of acquiring COVID19 and highlight the problems faced in terms of risks of transmission to patients and colleagues, isolation of contacts in departments leading to near-breakdown of services and psychological stress to healthcare workers.Conclusion: Healthcare workers being at frontline of exposure to corona patients are at increased risk of developing COVID19 infections. Healthcare workers are working under tremendous stress in this pandemic and it is necessary to combat fear with facts and work towards safe work atmosphere so that they can discharge their duties to best of their ability.
Impact of diabetes on COVID-19-related in-hospital mortality: a retrospective study from Northern Italy
Authors: Ciardullo Stefano , Zerbini Francesca , Perra Silvia , Muraca Emanuele , Cannistraci Rosa , Lauriola Marinella , Grosso Paolo , Lattuada Guido , Ippoliti Giovanbattista , Mortara Andrea , Manzoni Giuseppina , Perseghin Gianluca 
Published: June 2020

Abstract
Purpose. The purpose of this study was to evaluate the impact of pre-existing diabetes on in-hospital mortality in patients admitted for Coronavirus Disease 2019 (COVID-19).Methods. This is a single center, retrospective study conducted at Policlinico di Monza hospital, located in the Lombardy region, Northern Italy. We reviewed medical records of 373 consecutive adult patients who were hospitalized with COVID-19 between February 22 and May 15, 2020. Data were collected on diabetes status, comorbid conditions and laboratory findings. Multivariable logistic regression was performed to evaluate the effect of diabetes on in-hospital mortality after adjustment for potential confounding variables.Results. Mean age of the patients was 72 ± 14 years (range 17-98), 244 (65.4%) were male and 69 (18.5%) had diabetes. The most common comorbid conditions were hypertension (237 [64.8%]), cardiovascular disease (140 [37.7%]) and malignant neoplasms (50 [13.6%]). In-hospital death occurred in 142 (38.0%) patients. In the multivariable model older age (Odds Ratio [OR] 1.07 [1.04-1.10] per year), diabetes (OR 2.2 [1.10-4.73]), chronic obstructive pulmonary disease (OR 3.30 [1.22-8.90]), higher values of lactic dehydrogenase and C-reactive protein were independently associated with in-hospital mortality.Conclusion. In this retrospective single-center study, diabetes was independently associated with a higher in-hospital mortality. More intensive surveillance of patients with this condition is to be warranted.
Evaluate the Feasibility of Gd-based Contrast Clearance Differenceto Delineate Subvolume Target in Primary and Metastatic Brain Tumors Radiotherapy- A Prospective Study
Authors: Wang Yin Xing , Gong Guan Zhong , SU Ya , WANG Li Zhen , LU Jie , Yin Yong 
Published: June 2020

Abstract
Background: To evaluate the feasibility ofdelineating subvolume target in brain tumor radiotherapy using gd-based contrast clearance difference.Methods：Twenty-six patients with malignant brain tumor were scanned with MRI. The first and second acquisitions of standard T2-weighted images (T2WI) andT1-weighted images (T1WI) were respectively performed?> at 5 minutes and 60 minutesafter injection of contrast agent. Delayed contrast extravasation MRI(DCEM) computed by Brainlab concludesregions of contrast agent clearance which represent active tumor，andregions of contrast accumulation which represent non-tumor tissues. Based on T2WI images,14 patients were divided into group A and group B, with andwithout liquefaction necrosis, respectively. Then,gross target volume (GTV) was delineated on T1WI images. Based on the GTV, active tumor (GTV tumor) and non-tumorregions(GTV non-tumor) were delineated on T1WI-DCEM fusion images, whileliquefaction necrosis (GTVliquefaction)and non-liquefaction(GTVnon-liquefaction)were delineated on T1-T2WI fusion images. Finally, the differences between different subvolumes were compared by paired t-test.Results：In group A,the mean value of GTVA was 21.38±25.70 cm3, and the GTVnon-liquefaction and GTVliquefaction were 13.65±18.15cm3 and6.30±7.57cm3, respectively. The GTV tumor was 10.40±13.52 cm3 whilethe GTV non-tumor was 9.55±14.57 cm3, The GTVnon-liquefaction increased by an average of 28.2%（P＜0.05）,compared to GTV tumor . While the GTV non-tumor increased by an average of 46.3% (P＜0.05), compared tothe GTVliquefaction.In group B, the mean value of GTVB on enhanced T1WI was4.39±3.75 cm3. The GTV non-tumorreduced by an average of 50.3% (P＜0.05) , compared totheGTV tumor.Conclusion：Comparedto T2WI, the DCEM has advantages in identifyingthe liquefaction areaand could clearly differentiatesubvolume of active tumor from non-liquefaction necrosis.DCEMis meaningful in guiding the delineation of subvolume in primary and metastatic brain tumors.
The Effect of Infection Precautions on Colonization of Nursing Staff with Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae in Three Beirut Hospitals
Authors: Haddad Nicholas , Ghosn Joanna Abi 
Published: June 2020

Abstract
Background: ESBL-PE are emerging worldwide. This study assesses the effect of contact precaution (CP) on ESBL-PE-colonization rates among nurses in 3 hospitals in Beirut, where ESBL is endemic, to define risk factors for colonization, and evaluate the ongoing use of CP to prevent ESBL-PE transmission to healthy nurses. Methods: Cross-sectional, non-randomized study completed in three hospitals. Hospital 1 required CP, Hospital 2 recently stopped CP, and Hospital 3 had stopped it 3 years previously. Questionnaires and stool-collection containers were distributed to all patient care nurses in those 3 hospitals. Returned samples were tested using agar dilution technique. Results: 269 of 733 nurses volunteered; 140 met inclusion criteria (no recent hospitalization, antibiotic use, known ESBL-PE colonization). 15% were ESBL-positive. Compared to nurses from Hospital 3, nurses from Hospital 1 were 59% less likely to be colonized, while nurses from Hospital 2 were 62% more likely to be colonized. Discussion: In hospitals where CP is ongoing for ESBL-positive patients, transmission to nursing staff was reduced. Additionally, a work experience of 2-4 years increased the odds of ESBL-PE colonization in comparison with longer nursing experience. HIGHLIGHTS : • We examined the impact of contact precautions (CP) for Extended spectrum beta-lactamase- producing Enterobacteriaceae (ESBL-PE) colonized patients on rates of ESBL-PE colonization in nursing staff. • We found significantly decreased rates of colonization in nurses from a hospital utilizing CP, and significantly increased rates of colonization among nurses from a hospital that recently • discontinued CP, compared with nurses from a hospital that had discontinued CP 3 years previously. • Findings suggest that contact precaution may be required to prevent ESBL-PE transmission from patients to nursing staff.