bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distinctive Features of Ertapenem-Mono-Resistant Carbapenem-Resistant Enterobacterales in the United States: A Cohort Study
Authors: Adelman Max W , Bower Chris W , Grass Julian E , Ansari Uzma A , Soda Elizabeth A , See Isaac , Lutgring Joseph D , Jacob Jesse T 
Published: December 2021

Abstract

Background
Carbapenem-resistant Enterobacterales (CRE) are highly antibiotic-resistant bacteria. Whether CRE resistant only to ertapenem among carbapenems (ertapenem “mono-resistant”) represent a unique CRE subset with regards to risk factors, carbapenemase genes, and outcomes is unknown.

Methods
We analyzed surveillance data from 9 CDC Emerging Infections Program (EIP) sites. A case was the first isolation of a carbapenem-resistant Enterobacter cloacae complex, Escherichia coli, Klebsiella aerogenes, K. oxytoca, K. pneumoniae, or K. variicola from a normally sterile site or urine in an EIP catchment area resident in 2016–2017. We compared risk factors, carbapenemase genes, antibiotic susceptibility, and mortality of ertapenem “mono-resistant” cases to “other” CRE cases (resistant to ≥1 carbapenem other than ertapenem) and analyzed risk factors for mortality.

Results
Of 2009 cases, 1249 (62.2%) were ertapenem-mono-resistant and 760 (37.8%) were other CRE. Ertapenem-mono-resistant CRE cases were more frequently ≥80 years old (29.1% vs 19.5%; P &lt; .0001) and female (67.9% vs 59.0%; P &lt; .0001). Ertapenem-mono-resistant isolates were more likely to be Enterobacter cloacae complex (48.4% vs 15.4%; P &lt; .0001) but less likely to be isolated from a normally sterile site (7.1% vs 11.7%; P &lt; .01) or to have a carbapenemase gene (2.4% vs 47.4%; P &lt; .0001). Ertapenem-mono-resistance was not associated with 90-day mortality in logistic regression models. Carbapenemase-positive isolates were associated with mortality (odds ratio, 1.93; 95% CI, 1.30–2.86).

Conclusions
Ertapenem-mono-resistant CRE rarely have carbapenemase genes and have distinct clinical and microbiologic characteristics from other CRE. These findings may inform antibiotic choice and infection prevention practices, particularly when carbapenemase testing is not available.
Detection of Rift Valley Fever Virus Lineage H From South Africa Through the Syndromic Sentinel Surveillance Network in Senegal
Authors: Bob Ndeye Sakha , Barry Mamadou Aliou , Diagne Moussa Moise , Faye Martin , Ndione Marie Henriette Dior , Diallo Amadou , Diop Mamadou , Diop Boly , Faye Oumar , Loucoubar Cheikh , Fall Gamou , Faye Ousmane 
Published: December 2021

Abstract

Background
Rift Valley fever virus (RVFV) is an arbovirus that causes epizootics and epidemics among livestock population and humans. Our surveillance system has revealed multiple emergences and re-emergences of RVFV in West Africa over the last decade.

Methods
The Sentinel Syndromic Surveillance Network in Senegal (4S) has been implemented since 2011. Samples from human suspected arbovirus infection in 4S sentinel sites were sent to Institut Pasteur de Dakar (IPD), where arbovirus diagnosis by enzyme-linked immunosorbent assay (ELISA), real-time reverse transcription polymerase chain reaction (RT-PCR), and virus isolation was performed. Overall, IPD has received a total of 1149 samples from arboviral suspected patients through the 4S network from January to December 2020. These samples were screened for 7 arboviruses including RVFV. Whole-genome sequencing of positive RVFV samples by RT-PCR was performed using the Illumina Miseq platform followed by genome assembly. Phylogenetic analyses were performed using MEGA X.

Results
Out of the 1149 arbovirus suspected cases, 4 RVFV-positive samples were detected with RT-PCR while 5 RVFV-positive samples were detected by ELISA. Complete genome sequences were obtained for 3 strains among the 4 positive samples by RT-PCR. Phylogenetic analyses indicated an emergence of a virus first described in South Africa during a major outbreak.

Conclusions
This strong surveillance system allowed the detection of an RVFV outbreak in Senegal in 2020. The obtained genomes clustered with strains from South Africa belonging to lineage H. This calls for implementation of a strong surveillance system for wild animals, humans, and livestock simultaneously in all African countries.
Simulation-based spectral analysis of X-ray CCD data affected by photon pile-up
Authors: Tamba Tsubasa , Odaka Hirokazu , Bamba Aya , Murakami Hiroshi , Mori Koji , Hayashida Kiyoshi , Terada Yukikatsu , Mizuno Tsunefumi , Nobukawa Masayoshi 
Published: December 2021

Abstract
We have developed a simulation-based method of spectral analysis for pile-up-affected data of X-ray CCDs without any loss of photon statistics. As effects of the photon pile-up appear as complicated nonlinear detector responses, we employ a detailed simulation to calculate the important processes in an X-ray observation including physical interactions, detector signal generation, detector readout, and a series of data reduction processes. This simulation naturally reproduces X-ray-like and background-like events as results of X-ray photon merging in a single pixel or in a chunk of adjacent pixels, allowing us to construct a nonlinear spectral analysis framework that can treat pile-up-affected observation data. For validation, we have performed data analysis of Suzaku X-ray Imaging Spectrometer (XIS) observations using this framework with various parameters of the detector simulation, all of which are optimized for that instrument. We present three cases of different pile-up degrees: PKS 2155−304 (negligible pile-up), Aquila X-1 (moderate pile-up), and the Crab Nebula (strong pile-up); we show that the nonlinear analysis method produces results consistent with a conventional linear analysis for the negligible pile-up condition, and accurately corrects well-known pile-up effects such as spectral hardening and flux decrease for the pile-up cases. These corrected results are consistent with those obtained by a widely used core-exclusion method or by other observatories with much higher timing resolutions (without pile-up). Our framework is applicable to any types of CCDs used for X-ray astronomy, including future missions such as X-ray Imaging and Spectroscopy Mission (XRISM), by appropriate optimization of the simulation parameters.
Low Risk for Persistent Back Pain Disability Is Characterized by Lower Pain Sensitivity and Higher Physical Performance
Authors: Butera Katie A , Fox Emily J , Bishop Mark D , Coombes Stephen A , Beneciuk Jason M , George Steven Z 
Published: December 2021

AbstractObjectiveThe STarT Back Tool (SBT) predicts risk for persistent low back pain (LBP)-related disability based on psychological distress levels. Other non-psychological factors associated with LBP, such as pain sensitivity and physical performance, may further characterize SBT-risk subgroups. The purpose of this study was to determine whether a low-risk SBT subgroup demonstrated lower pain sensitivity and/or higher physical performance compared with a medium-/high-risk SBT subgroup.MethodsIn this cross-sectional, secondary analysis, adults with LBP (N = 76) completed SBT and demographics (age, sex, race, chronicity) questionnaires. Participants underwent pain sensitivity (local and remote pressure pain thresholds, temporal summation, conditioned pain modulation) and physical performance (Back Performance Scale, walking speed, obstacle negotiation, Timed “Up & Go” [TUG], TUG Cognitive) testing. Independent samples t tests determined low- versus medium-/high-risk SBT subgroup differences. A follow-up discriminant function analysis was also conducted.ResultsThe medium-/high-risk subgroup demonstrated a lower proportion of participants with acute pain. The low-risk subgroup demonstrated lower pain sensitivity (higher local pressure pain thresholds and higher conditioned pain modulation) and higher physical performance (superior Back Performance Scale scores, faster walking speeds, faster obstacle approach and crossing speeds, and faster TUG completion). Discriminant function analysis results supported the 2-subgroup classification and indicated strong to moderate relationships with obstacle crossing speed, chronicity, and conditioned pain modulation.ConclusionLower pain sensitivity and higher physical performance characterized the low-risk SBT subgroup and may represent additional LBP prognostic factors associated with persistent disability. Longitudinal studies are needed to confirm whether these factors can enhance SBT prediction accuracy and further direct treatment priorities.ImpactSensory and physical factors contribute to SBT risk classification, suggesting additional, non-psychological factors are indicative of favorable LBP outcomes. Findings highlight the need for assessment of multiple factors to improve LBP clinical prediction.Lay SummaryPeople at low risk for back pain disability have less sensitivity to pain and better physical performance. By measuring these factors, physical therapists could guide treatment and improve outcomes for people with back pain.
Association of physical activity on blood glucose in individuals with type 2 diabetes
Authors: Wang Yajuan , Dzubur Eldin , James Roberta , Fakhouri Tamer , Brunning Scott , Painter Stefanie , Madan Anmol , Shah Bimal R 
Published: December 2021

Abstract
Regular physical activity (PA) has been shown to improve glycemic control in persons with type 2 diabetes. This study aimed to investigate the impact of PA on blood glucose after controlling for medication use, demographics, and week of activation using a real-world population of individuals with type 2 diabetes. A longitudinal, retrospective study was performed evaluating weekly PA of Livongo members (N = 9,509), which analyzed fasting blood glucose (FBG), step counts, and daily active minutes. Linear mixed-effect modeling technique was used to investigate within member and between member effects of input variables on average weekly FBG. Of members enrolled, 6,336 (32%) had self-reported body mass index, qualified week with diabetes medications, and FBG measures. Members’ baseline average age was 49.4 (SD 10.1) years old, 43% female, and 45,496 member weeks with an average of 7.2 qualified weeks (PA observable in ≥4 days) per member. Average weekly FBG was 140.5 mg/dL (SD 39.8), and average daily step counts were 4,833 (SD 3,266). Moving from sedentary (&lt;5,000 steps per day) to active (≥5,000 steps per day) resulted in mean weekly FBG reduction of 13 mg/dL (95% CI: −22.6 to −3.14). One additional day of ≥8,000 steps reduced mean weekly FBG by 0.47 mg/dL (95% CI: −0.77 to −0.16). Members who completed 30 min of moderate to vigorous PA above the population average reduced mean weekly FBG by 7.7 mg/dL (95% CI: −13.4 to −2.0). PA is associated with a mean weekly FBG reduction of 13 mg/dL when changing from a sedentary to active lifestyle while participating in a remote diabetes monitoring program.
A new strategy of enteral nutrition intervention for ICU patients targeting intestinal flora
Authors: Guo Yangyang , Xu Ming , Shi Guangzhi , Zhang Jindong 
Published: December 2021

Abstract

Background:
Enteral nutrition (EN) therapy is a routine supportive method for patients in the intensive care unit (ICU). However, the incidence of EN intolerance is prevalent, because most ICU patients suffer intestinal mucosal barrier damage and gastrointestinal motility disorder. There is no definite index to predict EN intolerance, and the current treatment methods are not effective in alleviating EN intolerance. Gut microbiota is an important component of the intestinal micro-ecological environment, and alterations in its structure and composition can reflect changes in intestinal function and microenvironment. The purpose of this study is to investigate the effect of EN on the gut microbiota of ICU patients by monitoring the dynamic alterations of gut microbiota and to screen out the microbial markers that can be used to predict the incidence of EN intolerance.

Methods:
One hundred ICU patients with trauma or in a period of acute stress after surgery will be enrolled, and their fecal samples will be collected at different timepoints for microbial sequencing and analysis. General clinical data (demographic information, surgical data, laboratory parameters, illness severity scores, and therapeutic drugs), nutritional status data (nutritional status assessment and nutrition therapy monitoring data), as well as clinical outcomes, will be recorded. The microbial and clinical data will be combined to analyze the baseline characteristics and dynamic alterations of gut microbiota along with the incidence of EN intolerance. Data related to the gut microbiota will be statistically analyzed by R software, and other data performed by SPSS23.0 software.

Conclusions:
The effect of EN on gut microbiota and microbial markers predicting the intolerance of EN will lead us to develop a new nutrition intervention strategy for ICU patients. Furthermore, the results of this study will provide a basis for the discovery of potential probiotics used for the prevention and treatment of EN intolerance.
Evaluation index system of education quality for nursing professional degree postgraduate using the analytic hierarchy process
Authors: Wei Wentong , Liu Jingying , Liu Yanhui , Kang Yannan , Luo Ruzhen , Zhang Xiaohong 
Published: December 2021

Abstract
Nursing is an inseparable job with the healthy life of human beings. High-level nursing talents have a greater influence on patients. It is the future trend for schools to train Nursing Professional Degree Postgraduate, and the evaluation of their education quality is the top priority.
To construct the education quality evaluation index system of Nursing Professional Degree Postgraduate and to determine the weight of each indicator.
Firstly, the indicators of the evaluation index system of education quality were identified from the literature review. Meanwhile, the Delphi questionnaire was designed and 13 experts evaluated and rated the indictors who were invited to conduct two rounds of the questionnaire. The weights associated with the factors were determined using the analytic hierarchy process and percentage methods, Finally, we developed the evaluation index system of education quality for a postgraduate nursing professional degree.
The evaluation system consisted of 4 first-level indicators, 17 second-level indicators, and 71 third-level indicators. According to the weights computed by analytic hierarchy process, first-level indicators are ranked as “Input quality” (0.1273), “Process quality” (0.3111), “Output quality” (0.0846), “Development quality” (0.4770). Among the secondary indicators, experts pay the most attention to career development (0.3180). The top three indicators of third-level indicators are workplace (0.2385), matching degree between personal expectations and job opportunities (0.1272), and promotion opportunities (0.0795).
The quality index system of nursing postgraduate education is scientific and reliable, and the weight distribution is reasonable. It is an effective tool for evaluating the quality of nursing graduate education.
Pre-operative nutrition assessments do not improve outcomes in cerebral palsy patients undergoing varus derotational osteotomy
Authors: Obana Kyle K. , Fan Bensen B. , Bennett James T. , Lin Adrian , Goldstein Rachel Y. , Andras Lindsay M. , Kay Robert M. 
Published: December 2021

Abstract
Pre-operative nutritional assessments have been used as a “cornerstone” to help optimize nutritional status and weight in children with cerebral palsy (CP) to lower the risk of postoperative complications. However, the potential value of nutritional assessments on surgical outcomes in patients with CP undergoing major orthopedic surgery remains unproven.
Do pre-operative nutritional assessments reduce complication rates of varus derotational osteotomy surgery in children with CP? Are complication rates higher in patients with a gastrostomy tube (G-tube) and can they be decreased by pre-operative nutritional assessment?
One-hundred fifty-five patients with CP who underwent varus derotational osteotomy from January 1, 2012 through December 31, 2017 at a tertiary pediatric hospital with minimum 6 months follow-up were retrospectively identified. One-hundred-ten (71%) were categorized as “non-ambulatory” (Gross Motor Function Classification System [GMFCS] IV–V), and 45 (29%) as “ambulatory” (GMFCS I–III). Variables assessed included age, GMFCS level, G-tube, body mass index (BMI) percentile, complications, and if patients underwent pre-operative nutritional assessment.
One-hundred-eleven patients (71.6%) underwent pre-operative nutritional assessment. Sixty-two of 155 patients (40.0%) had G-tubes. In non-ambulatory patients with G-tubes, BMI percentile changes were not significantly different between patients with a pre-operative nutritional assessment compared to those without at 1 (P = .58), 3 (P = .61), 6 (P = .28), and 12 months (P = .21) postoperatively. In non-ambulatory patients who underwent pre-operative nutritional assessment, BMI percentile changes were not significantly different between those with and without G-tubes at 1 (P = .61), 3 (P = .71), 6 (P = .19), and 12 months (P = .10). Pulmonary complication rates were significantly higher in non-ambulatory patients with G-tubes than in non-ambulatory patients without G-tubes (20% vs 4%, P = .03). Pre-operative nutritional assessments did not influence postoperative complication rates for non-ambulatory patients with or without a G-tube (P = .12 and P = .16, respectively). No differences were found in postoperative complications between ambulatory patients with and without G-tubes (P = .45) or between ambulatory patients with or without nutritional assessments (P = .99).
Nutritional assessments, which may improve long term patient nutrition, should not delay hip surgery in patients with CP and progressive lower extremity deformity. Patients and their families are unlikely to derive any short-term nutritional improvement using routine pre-operative evaluation and surgical outcomes are unlikely to be improved.

Level of Evidence: III, retrospective comparative.
Secondary synovial chondromatosis of the subacromial subdeltoid bursa with coexisting glenohumeral osteoarthritis
Authors: Lee Hyun June , Han Weoncheol , Kim Kyungil 
Published: December 2021

Abstract

Rationale:
Synovial chondromatosis of the shoulder joint is uncommon; this condition usually affects the knee joint and the hip joint. Lesions of multiple chondral nodules form in the synovium and are usually found within the joint capsule. Treatment of synovial chondromatosis consists of loose body removal and synovectomy. In synovial chondromatosis of the shoulder, arthroscopic loose body removal and synovectomy have been reported with good outcomes. Arthroplasty can be a treatment option when osteoarthritis co-occurs at the affected joint. Since incidence of glenohumeral joint osteoarthritis is low compared to osteoarthritis of the knee or hip joints, reports of shoulder synovial chondromatosis treated with arthroplasty are scarce.

Patient concerns:
A 79-year-old woman presented with right shoulder pain with loss of motion for several years without a history of trauma.

Diagnoses:
Degenerative changes in the humeral head and glenoid were noted and multiple loose bodies were found in the subdeltoid bursa, and the subacromial bursa. The pathology of loose bodies showed degenerated cartilage tissue and some bony components. Characteristic concentric rings of calcification were observed, indicative of secondary synovial chondromatosis. The diagnosis was secondary synovial chondromatosis of the subacromial subdeltoid bursa with coexisting glenohumeral osteoarthritis.

Interventions:
The patient was treated with loose body removal, extensive synovectomy, bursectomy and reverse total shoulder arthroplasty.

Outcomes:
Visual analog scale for shoulder pain, range of motion of shoulder joint had improved demonstrating a good short-term outcome and there was no radiographic evidence of disease recurrence.

Lessons:
In synovial chondromatosis of the shoulder, loose bodies may form in the bursa. In combination with degenerative osteoarthritis of the glenohumeral joint, arthroplasty is a viable option.
Improved oral hygiene care and chronic kidney disease occurrence
Authors: Chang Yoonkyung , Lee Ji Sung , Woo Ho Geol , Ryu Dong-Ryeol , Kim Jin-Woo , Song Tae-Jin 
Published: December 2021

Abstract
Oral diseases or poor oral hygiene have close connections with systemic inflammatory reaction, which is one of major mechanism in the development of chronic kidney disease (CKD). We conducted a research assuming that better oral hygiene care would be negatively related with the risk of developing new-onset CKD.
From 2003 to 2004, a total of 158,495 participants from the Korean national health insurance data sharing service which provides health screening data including variables as age, sex, vascular risk factors, medication information, indicators regarding oral hygiene, and laboratory results. The diagnosis of CKD and vascular risk factors were defined according to the International Statistical Classification of Diseases and Related Health Problems codes-10th revision. The follow-up period for the study subject was until the occurrence of CKD, until death, or Dec 31, 2015.
Approximately 13.3% of the participants suffered from periodontal disease, and 40.7% brushed their teeth at least three times a day. With a median of 11.6 (interquartile range 11.3–12.2) years’ follow-up, the cohort included 3223 cases of incident CKD. The 10-year incidence rate for CKD was 1.80%. In multivariable analysis with adjustment for age, sex, demographics, vascular risk factors, blood pressure, and blood laboratory results, frequent tooth brushing (≥3 times a day) was negatively related to occurrence of CKD (hazard ratio: 0.90, 95% confidence interval [0.83–0.99],
P

=
.043, P value for trend
=
.043).Participants with improved oral hygiene (≥3 times a day) have showed less risk of CKD. Additional interventional studies are in need to establish causative relationship between oral hygiene and risk of CKD.
Disseminated tuberculosis mimicking abdominal metastatic carcinoma
Authors: Zhou Qi , Zhang MiaoXin 
Published: December 2021

Abstract

Rationale:
Extra-pulmonary tuberculosis (TB) has long been a diagnostic challenge for clinicians, often requiring extensive workup and invasive procedures, with the risk of significant complications. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a minimally invasive and highly accurate diagnostic modality for the evaluation of mediastinal and abdominal lymphadenopathy and masses. Several reports on the utility of EUS-FNA as a favorable method for diagnosing extrapulmonary TB have been published.

Patient concerns:
A 54-year-old man complained of intermittent melena.

Diagnoses:
18 fluorine-fluorodeoxyglucose positron emission tomography/computed tomography revealed suspected carcinoma metastasis. EUS-FNA did not reveal any evidence of malignancy.

Interventions and outcomes:
Laparoscopy was performed, and frozen section pathology during surgery showed granulomas with focal necrosis. Mycobacterium tuberculosis polymerase chain reaction was positive, but acid-fast bacilli staining was negative. Anti-TB treatment was initiated, and the patient was advised to visit the local TB dispensary regularly.

Lessons:
The presence of atypical inflammation of inadequate material or non-representative samples of extra-pulmonary TB was observed on EUS-FNA cytology. Mycobacterium tuberculosis polymerase chain reaction and acid fast bacilli should be performed to diagnose TB because of its higher sensitivity.