bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Unusual Development of a Madura Foot: A Case Report
Authors: Benzarti S. , A. Triki M. , Kaziz H. , Mouelhi T. , L. Ben Ayeche M. , Naouar N. 
Published: November 2019

Mycetomas are chronic inflammatory pseudo-tumoral lesions caused by fungal or bacterial agents developing in subcutaneous soft tissues and bone. Mycetoma is frequently located in the foot, realizing the Madura foot.
We report the case of a 42-year-old male farmer, who presented two years following an injury to the plant of the right foot. He already had two excisions elsewhere with recurrence and aggravation of the swelling.
He had a large painless subcutaneous swelling of his right foot with plantar sinuses discharging pale white and yellow grains. A surgical biopsy with histological study confirmed the diagnosis of mycetoma.
He received an antibiotic therapy consisting in penicillin G followed by amoxicillin then an association of penicillin G and co-trimoxazole during almost three years without any improvement. A below-knee amputation was performed complicated with necrosis and infection of the stump, which was resumed twice followed by an above-knee amputation.
Through this case of unusual development of a Madura foot we discuss the diagnostic and especially therapeutic difficulties of this chronic infection.
Qualitative Exploration of Ebola Risk Perception among Mortuary Workers in Ibadan Metropolis, Nigeria
Authors: Ngodoo Adamu Helen , Aneshimi Lawani Mike 
Published: November 2019

Aim: To explore the risk perception of Ebola virus disease (EVD) among mortuary workers in Nigeria.
Study Design: A qualitative research approach method, using Focus Group Discussions (FGDs), conducted among 36 mortuary workers in Ibadan.
Place and Duration of Study: This study was conducted between October and November 2014 in Ibadan, Oyo state, Nigeria.
Methodology: A structured moderating approach with a non-directive style was developed. A Focus Group Discussion (FGD) guide was used to explore participants’ ideas and opinions. The FGD guide consisted of five sections. Each section was framed to probe into the following issues: (1). Knowledge of EVD (2). Participant’s attitude to EVD (3). Adherence to infection control practices (4). Risk perception of EVD; and (5). Behavioural predisposition to the risk of mortuary-related infections. A total of six FGD sessions were conducted among 36 mortuary attendants, drawn from two government and four private health facilities in Ibadan. Six participants made up each focus group and one focus group discussion was conducted at a time in the respective health facilities.
Results: The qualitative exploration of mortuary workers revealed gaps in the knowledge of workers with regards to EVD, the high-risk perception of mortuary workers to Ebola virus disease and the unavailability of PPE in conducting autopsies and daily operations. In addition, a poor attitude to convalescent individuals and certain harmful behavioural practices in the morgue were revealed as key findings.
Conclusion: Efforts at bridging the knowledge gaps concerning EVD among mortuary workers should be sustained, despite the decline in Ebola outbreaks. It is also recommended that standard precautions should be followed when handling corpses due to the risk of infection.
Prevalence of Some Enteropathogens among Diarrhoeic and Apparently Healthy Children in two Contiguous Petroleum Resources - Rich Areas of Niger Delta, Nigeria
Authors: Atting I. A. , Ibatt O. , Ekuma A. E. 
Published: November 2019

Aims: The study characterised some intestinal bacterial and parasitic infections involved in diarrhoea causation in contiguous communities between October 2013 and April 2014.
Study Design: A total of 150 freshly-voided diarrhoeic samples of children attending PHC, Eket and General Hospital, Ibeno, and 50 non–diarrhoeic samples (Controls) were collected. The controls were recruited from subjects outside the health facilities.
Methodology: Standard bacteriological procedures were used in the identification while antibiotic susceptibility test was done. Questionnaires were also administered.
Results: The mean prevalence rate recorded for enteropathogens among children was 73%. A high prevalence of enteropathogens was observed in the parameters examined. The bacterial pathogens considered were Escherichia coli, Salmonella enteritidis, Shigella dysenteriae and Enterobacter species. Escherichia coli were the most prevalent with the rates of 43.5% and 45% in Eket and Ibeno, respectively. Enteropathogenic Escherichia coli (EPEC) O26 and O111 were identified with an overall prevalence of 46.7%. Antibiotic susceptibility result shows that the organisms were most susceptible to Ciprofloxacin and resistant to Cotrimoxazole. The analyses of the questionnaires revealed that in the study area, children, whose parents have no formal education were more commonly infected with enteropathogens.
Conclusion: A systematic education of caregivers and children on personal hygiene is the best approach to reduce the intestinal pathogens.
Pattern of Anti-microbial Drug Resistance in Childhood Typhoid Fever in a Selected Hospital in Karachi, Pakistan
Authors: Siddiqui Hiba , Jahan Firdous , Siddiqui Muhammad A. 
Published: November 2019

Introduction: Typhoid fever is a major public health issue in Pakistan. Variations in clinical manifestations make diagnosis a challenging task. Over use of antibiotics make the organism resistant. Antibiotic resistance is currently the most threatening issue as regards to infection control and our study would be helpful in the understanding of this feature of the microbes. The main purpose of this study was to determine the antimicrobial drug resistance and sensitivity pattern in Salmonella typhi and S. paratyphi.
Methods: This is a descriptive study carried out in a private hospital in Karachi, Pakistan. One hundred consecutive patients, children from age one day till 12 years admitted in the hospital with the history of fever and had positive blood culture for Salmonella typhi and S.paratyphi were included, 9 antimicrobial drugs were taken into account to check their sensitivity. Statistical analysis was performed using SPSS (IBM SPSS Statistics 20.0). Data was expressed in frequencies and percentages.
Results: Most of the children belong to middle class 58% with 62% male and common age group (40%) was 1 day to 4 years. Nearly half of them drinking un-boiled water and had ladder pattern of high grade fever. Most pronounced symptoms were abdominal pain, nausea and anorexia. Resistance pattern was ciprofloxacin 100%, chloramphenicol 89.1%, Ampicillin 87.1% Ceftriaxone 76.2%, Cefixime 75.2%, Amoxicillin 65.3%.
Conclusion: Typhoid fever is most commonly observed with unhygienic practices, eating of unhealthy outside food and contaminated water. Pattern of anti microbial resistance gives us a little choice to select antibiotic for typhoid fever. Typhoid fever still remains the commonest bacteraemic illness in Pakistan with children being especially susceptible. Antimicrobial non-susceptibility continues to complicate management.
Prevalence and Antibiotic Susceptibility Pattern of Escherichia coli and Salmonella spp Isolated from Diarrhoeic Children in Selected Health Centres in Sokoto, Nigeria
Authors: Najim Zainab , Kakako Saheed Ladipo , Ochei John , Alkali Bello Rabiu , Mohammed Kabiru , Opaluwa Saraja Ahmodu 
Published: November 2019

Aim: To determine the prevalence and antibiotic susceptibility patterns of E. coli and Salmonella spp. associated with childhood diarrhoea in our locality.
Study Design: Cross-sectional study.
Place and Duration of Study: School of Medical Laboratory Science, Usmanu Danfodiyo University, Sokoto between May and October 2017.
Methodology: A total of 236 faecal samples were collected from children less than or equal to five years and were processed, isolates were identified following standard bacteriological procedures. Antibiotic susceptibility test was performed using disc diffusion method.
Results: About 96/236 (40.7%) of the sample yielded growth of E. coli, and 14/236 (5.9%) yielded growth of Salmonella species. Salmonella spp were 100% sensitive to ciprofloxacin, ofloxacin and ceftriaxone whereas they demonstrated low sensitivity of 35.7%, 14.3% and 7.1% to cefuroxime, ceftazidime and cotrimoxazole respectively and none of the isolates was sensitive to ampicillin and augumentin. E. coli on the other hand were 73.9% sensitive to ceftriaxone, 69.8% to ciprofloxacin, 62.5% to gentamycin and 61.5% sensitive to ofloxacin. Sensitivity of E. coli to cefuroxime and cotrimoxazole was very low and none of the isolates was sensitive to ampicillin and augumentin. Conclusion: The prevalence of E. coli causing infectious diarrhoea among children in Sokoto is significantly high. Both bacterial agents presented with marked resistance to most antibiotics. Ceftriaxone, ciprofloxacin and ofloxacin were found to be drugs of choice in the treatment of bacterial diarrhoea caused by both E. coli and Salmonella.
Central Nervous System (CNS) Manifestations in Probable Case of Rickettsial Infections in Children in Central Karnataka
Authors: Sachin K. R. , Pujar S. Madhu , Divya C. , Vinay K. M. 
Published: November 2019

Introduction: Central nervous system (CNS) manifestations in children with rickettsial diseases are increasingly being reported from various parts of India but still rickettsial disease, as a cause of central nervous system (CNS) infections are underdiagnosed because of lack of freely available rapid and cheap diagnostic tests and varied clinical spectrum of rickettsial fever.
Objective: To report CNS manifestations in probable cases of rickettsial diseases so as to increase awareness amongst pediatricians.
Materials and Methods: A retrospective analysis of children (birth to 18 years) hospitalized in Bapuji Child Health Institute, which is secondary referral centre catering to children from five districts of Karnataka, with diagnosis of rickettsial disease from January 2016 to December 2018. The diagnosis of rickettsial infections was made by scoring system proposed by Rathi Goodman Aghai (RGA), weil felix test, prompt response to doxycycline within 48 hours and exclusion of differential diagnoses.
Results: Out of 278 patients, who were diagnosed as probable case of rickettsia, 172 patients had neurological involvement. Out of 172 patients with diagnosis of rickettsial disease having symptomatic neurological involvement, 148 (86%) had neurological manifestation as the main presenting feature while remaining presented with non-neurological manifestations of rickettsial diseases too, along with neurological manifestations. The youngest patient was 3 month old infant. The various neurological manifestations seen were altered mental status (76%), irritability (61%), headache (48%), meningeal signs (32%), seizures (31%), papilloedema (26%), focal neurological deficits (18%), cerebrospinal fluid (CSF) abnormalities (76%) and neuroimaging abnormalities (28%).
Conclusions: The myriads of neurological manifestations were seen with varying range of severity. Pediatricians should be aware of neurological manifestations seen in rickettsial infections and should have high index of suspicion for rickettsial diseases in febrile patients having neurological features specially in endemic areas.
The Pathogenesis and Immune-Response in Dengue Haemorrhagic Fever
Authors: Ahmad A. M. Meer , Arumugam S. , Leong Chee Loon 
Published: November 2019

Introduction: Dengue fever has spread to be endemic in addition of 100 countries to a total estimate incidence of 50 – 100 million cases annually globally. About 0.7% of these cases become the complication that is dengue hemorrhagic fever which is severe and leads to about 22,000 deaths annually.
The pathogenesis of benign dengue fever becoming dengue hemorrhagic fever, and aspects of the immune-response behind it, have remained relatively unknown.
Methods: Existing literature on the Topic was retrieved through Google Scholar and PubMed searches, and the literature reviewed.
Results: Dengue hemorrhagic fever appears commoner in females and those with co-morbids such as diabetes-mellitus and obesity. Also, the case-fatality rate in severe dengue appears much bigger in females. The reasons for this are largely unknown but the additionally robust immune response in females, resulting in females to be additionally prone to develop bigger inflammatory response or enhanced susceptibility to capillary permeability could be the reason.
It has been shown that viremic-load, including the initial viremic-load at the bite of the Aedes-mosquito may be a factor leading to dengue hemorrhagic fever.
Yet different factors felt to be causative in the pathogenesis of dengue hemorrhagic fever include the role of the viral-protein, and then that which is termed the original antigenic-sin, the antibody-directed enhancement, autoimmunity, inhibition of interferon-alpha and cytokine-storm within the memory-cells.
Regionally, certain different strains of the DENV also seem to be associated with dengue hemorrhagic fever.
Newer-vaccines, based on the immunology of the disease, offer much hope in the near future.
Conclusion: Much knowledge has been forthcoming in realizing the pathogenesis of dengue hemorrhagic fever. But, additional studies need to be done.
Assessing Five Years of Management of Accidental Exposure to Blood at Gao Hospital, Mali
Authors: Cissoko Y. , Sidibé L. N. , Dembele J. P. , Oumar A. A. , Traoré A. , Samaké A. , Maïga A. A. , Diabira L. , Diarra D. , Dao S. 
Published: November 2019

Accidental exposure to blood (AEB) constitutes a risk of transmission of blood-borne viruses including HIV, hepatitis B and hepatitis C virus especially amongst health workers. This study aims to describe accidental exposure to blood and post exposure management five years after it begin at the Hospital of Gao, since 2012 there is insurrection in this area making difficult to maintain health care system. This study will help to identify gaps to fill in order to improve the prevention of blood borne pathogen infection in this hospital.
All cases of AEB declared at the Hospital from January 1st 2007 to December 31, 2011 have been enrolled. The sociodemographic profile of victims, the circumstances of the accident, the post exposure management and the follow up of subject have been registered. Data were entered and analyzed with the SPSS software. Chi square test was used with the level of significance p<0.05.
During the 60 months of the study, an average of 124 workers were employed at the Hospital of Gao and 15 cases of accidental blood exposure were declared equal to an incidence density of 4.2 cases per 100 persons per year. Males were the most affected (60%). Nurses and lab technicians represent the majority of victims (53.3%). The most frequent type of accident was the injury by cannula needle sticks during intravenous injections (73.3%). Most of the cases received High Activity Antiretroviral Therapy (HAART) within a mean delay of 25 Hours from the accident, and the regiment (AZT/3TC/LPV/r) is predominantly used. HIV serology was done in 53.3% of subjects and revealed 1 positive case. Initial blood tests in all victims were normal. The HAART observance was worst among medical doctors (p < 0.001). No contaminations by HIV were detected after 6 months of follow up.
The frequency of declared accidental exposures to blood at the Hospital of Gao is low. The post exposure management is facing a problem of observance of the treatment whenever it shows efficacy in all cases.
Eosinopenia Associated with Infection is an Independent Risk Factor for 28-day Mortality in Staphylococcus aureus Bloodstream Infection
Authors: Zhou Chunxia , Sun Jing , Xu Fengqin , Jiang Shanping 
Published: November 2019

Aims: This retrospective study aimed to evaluate the impact of eosinopenia on 28-day mortality in Staphylococcus aureus bloodstream infection (SABSI).
Methods: A retrospective study was designed to evaluate the impact of eosinopenia on 28-day mortality in SABSI.
Results: Patients who were ≥16 years old with SABSI at Sun Yat-Sen Memorial Hospital between January 1st 2014 and December 31st 2018 were included. The overall 28-day mortality of all patients was 14.3% (44 out of 307). Patients with eosinopenia in the onset of SABSI had a significantly higher 28-day mortality than those without eosinopenia (22.4% vs 6.5%; P<0.01). For patients who developed SABSI after the first 48 hours in the hospital, eosinophils decreased significantly from the baseline (P<0.01). Kaplan–Meier survival curve showed that patients with eosinopenia had a lower survival rate than those without eosinopenia (P<0.01). Multivariate Cox regression analysis revealed that eosinophils in the onset of SABSI were associated independently with 28-day mortality (hazard ratio [HR], 2.84; 95% confidence interval [CI], 1.36–5.91; P<0.01).
Conclusion: Eosinopenia associated with infection might be an independent risk factor for 28-day mortality in SABSI.
Retracted: Overexpression of RPN2 promotes osteogenic differentiation of hBMSCs through the JAK/STAT3 pathway
Authors: Ni Ling , Yu Jianhua , Gui Xueqiong , Lu Zhonghua , Wang Xiwen , Guo Hongyan , Zhou Ying 
Published: November 2019

Osteoporosis is characterized by decreased bone mass and degenerating bone structure, which cause severe bone fragility and increase the risk for fractures. Human bone mesenchymal stem cells (hBMSCs) differentiate into osteoblasts through osteogenesis, and disturbances in the balance between bone generation and degeneration underlie the pathogenesis of senile osteoporosis. The highly conserved glycoprotein Ribophorin II (RPN2) is involved in multiple biological reactions, but the role of RPN2 in the osteogenic differentiation of hBMSCs and their molecular etiology is incompletely understood. Here, we show that RPN2 expression is up‐regulated in hBMSCs during osteogenic differentiation. In vitro assays revealed that silencing of RPN2 inhibited hBMSC differentiation into osteoblasts. Moreover, RPN2 overexpression enhanced the expression of linked genes and resulted in high alkaline phosphatase activity. Our results suggest that RPN2 targets Janus kinase 1 (JAK1), and RPN2 overexpression was observed to induce JAK1 ubiquitination. Depletion of JAK1 facilitated osteogenic differentiation of RPN2‐silenced hBMSCs. Moreover, western blot analysis revealed that RPN2 silencing suppressed the stimulation and nuclear translocation of the downstream signal transducer and activator of transcription 3 sensor; this could be reversed via RPN2 overexpression. This research sheds light on an innovative molecular mechanism that is associated with hBMSC differentiation into osteoblasts and may facilitate bone anabolism through RPN2.
Dendrite‐Free Lithium Plating Induced by In Situ Transferring Protection Layer from Separator
Authors: Hu Zhiyu , Liu Fengquan , Gao Jian , Zhou Weidong , Huo Hong , Zhou Jianjun , Li Lin 
Published: November 2019

AbstractLithium (Li) metal anodes are regarded as a promising pathway to meet the rapidly growing requirements on high energy density cells, owing to their highest gravimetric capacity (3840 mAh g−1) and their lowest redox potential. The application of Li metal anodes, however, is still hindered by undesired dendrites formation and endless consumption of liquid electrolyte due to a continuous reaction on interface of electrolyte/Li‐metal without a stable solid–electrolyte–interface (SEI) layer. A stable protection layer is formed on Li metal anode by in situ transferring the coating layer from polymer separator. The Li anode protection strategy is developed with an in situ formed protection layer transferred through the reduction of a coating layer on polymer separator. A PbZr0.52Ti0.48O3(PZT) coating layer on polypropylene (PP) separator is reduced by Li metal anode to produce a Pb metal containing composite layer, which could form Pb–Li alloy and adhere to the surface of Li metal anode after the reaction and improves the Li plating/stripping efficiency owing to the formation of a more homogenized electric field. Both the Li/Li symmetric cells and LiFePO4/Li cells with this PZT precoated PP separators exhibit significantly improved Coulombic efficiency and cycling life.
Association between ELP4 rs986527 polymorphism and the occurrence and development of intracranial arachnoid cyst
Authors: Li Kai , Kong De‐Sheng , Zhang Jun , Wang Xin‐Sheng , Ye Xun , Zhao Yuan‐Li 
Published: November 2019

AbstractObjectiveThe association between ELP4 rs986527 polymorphism and the occurrence and development of intracranial arachnoid cyst was studied in this paper.MethodsEighty‐five patients diagnosed with intracranial arachnoid cysts by cerebral computed tomography scan were selected. Sixty‐three healthy volunteers for medical examination in hospitals served as controls. The cognition, depressive symptoms, and the likelihood of headache, dizziness, head trauma history, dementia, depression, and epilepsy were assessed. ELP4 genotypes and its allele frequency were determined by PCR, endonuclease restriction analysis, and gel electrophoresis.ResultsELP4 rs986527 had three genotypes: TT, TC, and CC. The intracranial arachnoid cyst group showed no statistically significant difference in genotype frequencies compared with healthy controls. There was no significant correlation between ELP4 rs986527 polymorphism and location of intracranial arachnoid cyst. TC and C genotype frequencies were associated with a higher incidence of clinical symptoms than TT genotype frequencies, and C allele frequencies were associated with a significantly higher incidence of clinical symptoms compared with T allele frequencies. There was no significant difference in TNF‐α and IL‐1β levels between TT/TC/CC genotypes before treatment. After treatment, the levels of TNF‐α and IL‐1β were significantly decreased in different genotypes, and the decrease in CC was the greatest. The frequency of TT and TC genotypes was higher than that of CC genotypes.ConclusionELP4 rs986527 polymorphism affected the incidence of clinical symptoms and the levels of TNF‐α and IL‐1β in patients with intracranial arachnoid cysts.
Reprioritizing Risk and Benefit: The Future of Study Design in Early‐Phase Cancer Research
Authors: Sisk Bryan Anthony , Dubois James , Hobbs Brian P. , Kodish Eric 
Published: November 2019

ABSTRACTThe scientific purpose of phase I trials is to determine the maximum tolerated dose and/or optimal biological dose of experimental agents. Yet most participants in phase I oncology trials enroll hoping for direct medical benefit. The most common phase I trial designs use low starting doses and escalate cautiously in a “risk‐escalation” model focused on minimizing risk for each participant. This approach ensures that a proportion of subjects will likely not receive any benefit, even if the intervention proves to be successful at appropriate doses. In this article, we propose that trial designs should employ dosing strategies that increase chances of providing benefit if the investigational agent should prove to be successful while limiting risk to reasonable levels. We then describe how adaptive trial designs can facilitate refined dose optimization based on both therapeutic benefit and toxicity, which can simultaneously decrease the risk of harm while increasing the chances of benefit.