bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal healthcare-associated infections in Brazil: systematic review and meta-analysis
Authors: de Mello Freitas Felipe Teixeira , Viegas Anna Paula Bise , Romero Gustavo Adolfo Sierra 
Published: June 2021

Abstract
Background
Healthcare-associated infections (HAI) are important causes of neonatal morbidity and mortality in developing countries. We reviewed the incidence and the pathogens involved in HAI among infants admitted to neonatal intensive care units (NICU) in Brazil.

Methods
A search was conducted in the MEDLINE, LILACS and SciELO databases from January 1995 to October 2019. Two authors scrutinized potential articles independently, after one author selected them from screening abstracts from every article flagged as related to neonatal HAI. Then, they were included in the review if they met our inclusion criteria. The studies were evaluated based on a quality score proposed by the authors, rated 0 to 1, with 1 point as the best quality rate. Pooled estimates and 95% confidence intervals (95% CI) for HAI cumulative incidence and incidence density were calculated, when the same denominators were available, using meta-analysis. A quality effect was applied to the models using the MetaXL software. Heterogeneity was assessed using I2 statistics and the Cochran’s Q test.

Results
Of a total of 5596 citations identified, 15 studies met the inclusion criteria for this review, which comprised 24,408 patients and 312,744 patient-days. Quality of the studies varied between 0.36 and 1 according to the adopted score, and six (40.0%) studies presented a score of 1. Pooled HAI incidence was 36.1 (95% CI 22.8–50.7) infections and 26.3 (95% CI 18.4–35.0) infected patients per 100 patients. Pooled HAI incidence density was 23.5 (95% CI 16.3–33.9) per 1000 patient-days. Pooled incidence density rates of bloodstream infection and ventilator-associated pneumonia were 13.1 per 1000 catheter-days (95% CI 4.3–40.1) and 7.9 per 1000 ventilator-days (95% CI 1.1–55.5), respectively. A high degree of heterogeneity was observed in all models (I2 > 98% and Cochran’s Q test with p < 0.05). Coagulase-negative Staphylococci (32.1%), Staphylococcus aureus (13.8%) and Klebsiella spp. (12.4%) were the most prevalent causative bacterial pathogens.

Conclusions
The findings show high incidence of neonatal HAI in Brazilian NICU; therefore, efforts to standardize the collection and notification of HAI are needed in order to strengthen surveillance in the country and implement preventive measures, routine assessment, and close monitoring of neonates.
Essential newborn care practice and associated factors among health care providers in Northeast Ethiopia: a cross-sectional study
Authors: Ashenef Gebrehana , Eshete Akine , Zegeye Betregiorgis , Tarekegn Tadesse Tsehay , Taderegew Mitku Mammo 
Published: June 2021

Abstract
Background
Globally, 2.7 million children die during the neonatal period annually. Ethiopia is one of the ten countries with the highest number of neonatal deaths. The practice of poor essential newborn care contributes to the problem. Hence the study was conducted to assess the essential newborn care practice and associated factors among health care providers from selected health facilities in Northeast Ethiopia.

Methods
Facility-based cross-sectional study was conducted among health care providers working in selected health facilities in Northeast Ethiopia from February-25 to March-25, 2019. Data were collected by a pre-tested questionnaire and an observational checklist. Then data were edited into Epi-data-7.2.0.1 and analyzed by using SPSS-25 software. The degree of association was assessed using binary logistic regression analysis. P-value < 0.05 was considered statistically significant.

Results
A total of 256 health care providers were included in the study. Overall, 62.9% (95%CI: 57.0–68.8%), and 73.8% (95%CI: 68.4–79.2%) of the health care providers had adequate knowledge and good practice on essential newborn care activities, respectively. The presence of supportive supervision (AOR = 2.09, 95%CI = 1.07–4.11), the interest of health care providers to work at delivery room (AOR = 1.97, 95%CI = 1.00–3.88), and availability of vitamin-K (AOR = 4.81, 95%CI = 1.07–21.64) were significantly associated with essential newborn care practices.

Conclusions
A significant number of health care providers had inadequate knowledge and poor practice of essential newborn care. Availability of vitamin-K, the interest of the health care providers to work in the delivery room and the presence of supportive supervision were the factors affecting essential newborn care practice. Hence, giving in-service training, supportive supervision, and providing supplies should be strengthened to enhance essential newborn care activities.
Prognostic factors affecting the short-term efficacy of non-surgical treatment of chronic periodontitis: a multilevel modeling analysis
Authors: Liu Hui-Jie , Wang Bo , Wang Ao-Chen , Zhang Dan-Hong , Mao Cui , Li Qiu-Hong 
Published: June 2021

Abstract
Background
This study is aimed to analyze the prognostic factors affecting the short-term efficacy of non-surgical treatment of patients in periodontitis from stage II to stage IV by the multilevel modeling analysis.

Materials and methods
A total of 58 patients with chronic periodontitis were included in this study. Patients were clinically explored before and 3 months after the treatment and the difference in probing depth was determined [Reduction of probing depth (Δ PD) = baseline PD – finial probing depth (FPD)] which is considered as the therapeutic evaluation. Three different levels were analyzed: patients, teeth and sites to construct a multi-layer linear model.

Results
Probing depth (PD) improved significantly compared with that before treatment (p < 0.05), in which FPD was (3.90 ± 1.39) mm, and the ΔPD was (1.79 ± 0.97) mm. Compared with the mesial sites and distal sites of the multi-rooted teeth, the number of PD ≥ 5 mm or PD < 5 mm after the treatment was significantly different (P < 0.05), and the proportion of PD < 5 mm was higher in mesial sites. The null model showed that Δ PD varied greatly between groups at various levels (P < 0.001), with prediction variable of site level, tooth level, and patient level accounted for 66%, 18%, and 16% of the overall difference, respectively. The complete model showed that the Δ PD of smokers was significantly lower than that of non-smokers (P < 0.001). The Δ PD of the mesial and distal sites was larger than that of the buccolingual central site (P < 0.001). The Δ PD of single-rooted teeth was larger than that of multi-rooted teeth (P < 0.001). The baseline PD, tooth mobility (TM), bleeding index (BI), clinical attachment loss (CAL) were significantly negatively correlated with Δ PD (P < 0.001).

Conclusions
Patients with periodontitis from stage II to stage IV, who were non-smoking, have good compliance, good awareness of oral health, and low percentage sites with PD ≥ 5 mm at baseline, single-rooted teeth with hypomobility, less clinical attachment loss and lower bleeding index and sites of mesial or distal can obtain an ideal short-term efficacy of non-surgical treatment.
Analytical protocols for Phobos regolith samples returned by the Martian Moons eXploration (MMX) mission
Authors: Fujiya Wataru , Furukawa Yoshihiro , Sugahara Haruna , Koike Mizuho , Bajo Ken-ichi , Chabot Nancy L. , Miura Yayoi N. , Moynier Frederic , Russell Sara S. , Tachibana Shogo , Takano Yoshinori , Usui Tomohiro , Zolensky Michael E. 
Published: June 2021

AbstractJapan Aerospace Exploration Agency (JAXA) will launch a spacecraft in 2024 for a sample return mission from Phobos (Martian Moons eXploration: MMX). Touchdown operations are planned to be performed twice at different landing sites on the Phobos surface to collect > 10 g of the Phobos surface materials with coring and pneumatic sampling systems on board. The Sample Analysis Working Team (SAWT) of MMX is now designing analytical protocols of the returned Phobos samples to shed light on the origin of the Martian moons as well as the evolution of the Mars–moon system. Observations of petrology and mineralogy, and measurements of bulk chemical compositions and stable isotopic ratios of, e.g., O, Cr, Ti, and Zn can provide crucial information about the origin of Phobos. If Phobos is a captured asteroid composed of primitive chondritic materials, as inferred from its reflectance spectra, geochemical data including the nature of organic matter as well as bulk H and N isotopic compositions characterize the volatile materials in the samples and constrain the type of the captured asteroid. Cosmogenic and solar wind components, most pronounced in noble gas isotopic compositions, can reveal surface processes on Phobos. Long- and short-lived radionuclide chronometry such as 53Mn–53Cr and 87Rb–87Sr systematics can date pivotal events like impacts, thermal metamorphism, and aqueous alteration on Phobos. It should be noted that the Phobos regolith is expected to contain a small amount of materials delivered from Mars, which may be physically and chemically different from any Martian meteorites in our collection and thus are particularly precious. The analysis plan will be designed to detect such Martian materials, if any, from the returned samples dominated by the endogenous Phobos materials in curation procedures at JAXA before they are processed for further analyses.
Neuroendocrine tumor arising from the greater omentum treated with laparoscopic tumor resection: a case report
Authors: Terai Taichi , Nakagawa Kenji , Nakamura Kota , Doi Shunsuke , Morita Kohei , Ohbayashi Chiho , Sho Masayuki 
Published: June 2021

Abstract
Background
Primary omental tumors are extremely rare. Herein, we report the first case of a primary omental neuroendocrine tumor (NET).

Case presentation
A 59-year-old woman was referred to our hospital for the treatment of an 18-mm tumor located at the ventral side of the duodenum. No other tumor was detected. The preoperative imaging diagnosis was omental tumor. A laparoscopic tumor resection was performed. Histopathological examination revealed that the tumor consisted of cuboidal cells with eosinophilic, granular cytoplasm showing trabecular or ribbon architecture. No other component was seen. The mitotic count was of 5 per 10 high-power fields. Immunohistochemical staining was positive for chromogranin A, synaptophysin, and CD56. Her Ki-67 index was 5%. These results led to the diagnosis of grade 2 omental NET. The patient was discharged on the 3rd postoperative day without any complications and did not develop any recurrence for 3 years.

Conclusions
We encountered a very rare case of omental NET. Complete resection is recommended with minimally invasive surgery for the diagnosis of NET.
Hypertension, renin-angiotensin-aldosterone-system-blocking agents, and COVID-19
Authors: Kang Si-Hyuck , Lee Dong-Hoon , Han Kyung-Do , Jung Jin-Hyung , Park Sang-Hyun , Dai Andrew M. , Wei Henry G. , Yoon Chang-Hwan , Youn Tae-Jin , Chae In-Ho , Kim Cheol-Ho 
Published: June 2021

Abstract
Background
There have been concerns regarding the safety of renin-angiotensin-aldosterone-system (RAAS)-blocking agents including angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) during the coronavirus disease 2019 (COVID-19) pandemic. This study sought to evaluate the impact of hypertension and the use of ACEI/ARB on clinical severity in patients with COVID-19.

Methods
A total of 3,788 patients aged 30 years or older who were confirmed with COVID-19 with real time reverse transcription polymerase chain reaction were identified from a claims-based cohort in Korea. The primary study outcome was severe clinical events, a composite of intensive care unit admission, need for ventilator care, and death.

Results
Patients with hypertension (n = 1,190, 31.4 %) were older and had higher prevalence of comorbidities than those without hypertension. The risk of the primary study outcome was significantly higher in the hypertension group, even after multivariable adjustment (adjusted odds ratio [aOR], 1.67; 95 % confidence interval [CI], 1.04 to 2.69). Among 1,044 patients with hypertensive medical treatment, 782 (74.9 %) were on ACEI or ARB. The ACEI/ARB subgroup had a lower risk of severe clinical outcomes compared to the no ACEI/ARB group, but this did not remain significant after multivariable adjustment (aOR, 0.68; 95 % CI, 0.41 to 1.15).

Conclusions
Patients with hypertension had worse COVID-19 outcomes than those without hypertension, while the use of RAAS-blocking agents was not associated with increased risk of any adverse study outcomes. The use of ACE inhibitors or ARBs did not increase the risk of adverse COVID-19 outcomes, supporting current guidance to continue these medications when indicated.
Clinical application and technical details of cook zenith devices modification to treat urgent and elective complex aortic aneurysms
Authors: Manunga Jesse , Jordano Lia , Mirza Aleem K. , Teng Xiaoyi , Skeik Nedaa , Eisenmenger Laura 
Published: June 2021

Abstract
Purpose
To describe technical details of modifying four different Cook Zenith devices to treat complex aortic aneurysms.

Material
In the first three cases, the modification process involved complete stent graft deployment on a sterile back table. Fenestrations were created using an ophthalmologic cautery and reinforced with a radiopaque snare using a double-armed 4–0 Ethibond locking suture based on measurements obtained on centerline of flow. In each instance, a nitinol wire was withdrawn and redirected through and through the fabric and used as a constraining wire. In the fourth patient, modification involved partial stent graft deployment and creation of additional two fenestrations to accommodate renal arteries. The devices are resheathed and implanted in the standard fashion.

Results
Four patients underwent exclusion of their aneurysms, including thoracoabdominal aneurysms (n = 2), a contained ruptured juxtarenal aneurysm (n = 1), and a ruptured failed previous endovascular repair (n = 1). Fifteen fenestrations were successfully bridged with Atrium iCAST stent grafts. Average graft modification time, operative time, contrast volume, radiation dose, estimated blood loss, and hospital length of stay were 89 min, 155.25 min, 58.8 mL, 2451 mGy, 175 mL, and 4.3 days, respectively. One patient required a secondary intervention to treat a type Ib endoleak. During an average follow-up of 25 months, aneurysm sacs progressively shrank without additional intervention.

Conclusion
Physician-modified fenestrated/branched endografts are a safe alternative to custom made devices, especially in urgent cases and should be part of the armamentarium of any complex aortic program.
Dielectric properties of edible fungi powder related to radio-frequency and microwave drying
Authors: Qi Siying , Han Jiping , Lagnika Camel , Jiang Ning , Qian Chunlu , Liu Chunquan , Li Dajing , Tao Yang , Yu Zhifang , Wang Libin , Zhang Zhongyuan , Liu Chunju , Xiao Yadong , Zhang Min 
Published: June 2021

AbstractEdible fungi are rich in nutrition, but they are susceptible to spoilage, and often prolonged by drying. RF and microwave energy drying have the advantages of short drying time, high energy efficiency and good process control. However, to develop an effective dielectric drying method, it is important to understand dielectric properties, the major factor characterizing the interaction between the electromagnetic energy and the food. At present, there is a lack of research on dielectric properties of edible fungi. In this study, a vector network analyzer and an open-ended coaxial-line probe were employed to measure the dielectric parameters. The dielectric parameters were observed at different temperatures (25–85 °C) for edible fungi powder with moisture content ranging from 5 to 30% wet basis over a frequency range of 1–3000 MHz. The relationship between the dielectric properties and frequency, temperature, and moisture content were obtained via regression analysis. Further, the dielectric penetration depth was calculated, and the effects of frequency, moisture content, and temperature on the penetration depth were also analyzed. The results showed that the dielectric properties of edible fungi powder increased with an increase in moisture content and temperature, while they decreased with increasing frequency. At high moisture content and temperature, the increase in dielectric properties was slightly larger than that at low moisture content and temperature. The dielectric properties changed more evidently at lower radio frequencies than at higher radio frequencies. The penetration depth decreased with an increase in temperature, moisture content, and frequency. It can be concluded that a large penetration depth at radio frequencies below 100 MHz could be used to dry edible fungi on a large scale, whereas microwave energy could be employed for drying edible fungi on a small scale.
Feasibility of a pharmacy-led intervention to de-implement non-guideline-concordant proton pump inhibitor use
Authors: Musuuza Jackson S. , Fong Emily , Lata Paul , Willenborg Katie , Knobloch Mary Jo , Hoernke Margaret J. , Spiel Andrew R. , Tischendorf Jessica S. , Suda Katie J. , Safdar Nasia 
Published: June 2021

Abstract
Background
Proton pump inhibitors (PPIs) are among the most prescribed medications and are often used unnecessarily. PPIs are used for the treatment of heartburn and acid-related disorders. Emerging evidence indicates that PPIs are associated with serious adverse events, such as increased risk of Clostridioides difficile infection. In this study, we designed and piloted a PPI de-implementation intervention among hospitalized non-intensive care unit patients.

Methods
Using the Systems Engineering Initiative for Patient Safety (SEIPS) model as the framework, we developed an intervention with input from providers and patients. On a bi-weekly basis, a trainee pharmacist reviewed a random sample of eligible patients’ charts to assess if PPI prescriptions were guideline-concordant; a recommendation to de-implement non-guideline-concordant PPI therapy was sent when applicable. We used convergent parallel mixed-methods design to evaluate the feasibility and outcomes of the intervention.

Results
During the study period (September 2019 to August 2020), 2171 patients with an active PPI prescription were admitted. We randomly selected 155 patient charts for review. The mean age of patients was 70.9 ± 9 years, 97.4% were male, and 35% were on PPIs for ≥5 years. The average time (minutes) needed to complete the intervention was as follows: 5 to assess if the PPI was guideline-concordant, 5 to provide patient education, and 7 to follow-up with patients post-discharge. After intervention initiation, the week-to-week mean number of PPI prescriptions decreased by 0.5 (S<0.0001). Barriers and facilitators spanned the 5 elements of the SEIPS model and included factors such as providers’ perception that PPIs are low priority medications and patients’ willingness to make changes to their PPI therapy if needed, respectively. Ready access to pharmacists was another frequently reported facilitator to guideline-concordant PPI. Providers recommended a PPI de-implementation intervention that is specific and tells them exactly what they need to do with a PPI treatment.

Conclusion
In a busy inpatient setting, we developed a feasible way to assess PPI therapy, de-implement non-guideline-concordant PPI use, and provide follow-up to assess any unintended consequences. We documented barriers, facilitators, and provider recommendations that should be considered before implementing such an intervention on a large scale.
Quality of information in news media reports about the effects of health interventions: Systematic review and meta-analyses
Authors: Oxman Matt , Larun Lillebeth , Pérez Gaxiola Giordano , Alsaid Dima , Qasim Anila , Rose Christopher James , Bischoff Karin , Oxman Andrew David 
Published: June 2021

Background Many studies have assessed the quality of news reports about the effects of health interventions, but there has been no systematic review of such studies or meta-analysis of their results. We aimed to fill this gap (PROSPERO ID: CRD42018095032). Methods We included studies that used at least one explicit, prespecified and generic criterion to assess the quality of news reports in print, broadcast, or online news media, and specified the sampling frame, and the selection criteria and technique. We assessed criteria individually for inclusion in the meta-analyses, excluding inappropriate criteria and criteria with inadequately reported results. We mapped and grouped criteria to facilitate evidence synthesis. Where possible, we extracted the proportion of news reports meeting the included criterion. We performed meta-analyses using a random effects model to estimate such proportions for individual criteria and some criteria groups, and to characterise heterogeneity across studies. Results We included 44 primary studies in the qualitative summary, and 18 studies and 108 quality criteria in the meta-analyses. Many news reports gave an unbalanced and oversimplified picture of the potential consequences of interventions. A limited number mention or adequately address conflicts of interest (22%; 95% CI 7%-49%) (low certainty), alternative interventions (36%; 95% CI 26%-47%) (moderate certainty), potential harms (40%; 95% CI 23%-61%) (low certainty), or costs (18%; 95% CI 12%-28%) (moderate certainty), or quantify effects (53%; 95% CI 36%-69%) (low certainty) or report absolute effects (17%; 95% CI 4%-49%) (low certainty). Discussion There is room for improving health news, but it is logically more important to improve the public’s ability to critically appraise health information and make judgements for themselves.
Activation of regulatory T cells triggers specific changes in glycosylation associated with Siglec-1-dependent inflammatory responses
Authors: Wu Gang , Murugesan Gavuthami , Nagala Manjula , McCraw Alex , Haslam Stuart M. , Dell Anne , Crocker Paul R. 
Published: June 2021

Background: Siglec-1 is a macrophage lectin-like receptor that mediates sialic acid-dependent cellular interactions. Its upregulation on macrophages in autoimmune disease was shown previously to promote inflammation through suppressing the expansion of regulatory T cells (Tregs). Here we investigate the molecular basis for Siglec-1 binding to Tregs using in vitro-induced cells as a model system. Methods: Glycosylation changes that affect Siglec‑1 binding were studied by comparing activated and resting Tregs using RNA-Seq, glycomics, proteomics and binding of selected antibodies and lectins. A proximity labelling and proteomics strategy was used to identify Siglec-1 counter-receptors expressed on activated Tregs. Results: Siglec-1 binding was strongly upregulated on activated Tregs, but lost under resting conditions. Glycomics revealed changes in N-glycans and glycolipids following Treg activation and we observed changes in expression of multiple ‘glycogenes’ that could lead to the observed increase in Siglec-1 binding. Proximity labelling of intact, living cells identified 49 glycoproteins expressed by activated Tregs that may function as Siglec-1 counter-receptors. These represent ~5% of the total membrane protein pool and were mainly related to T cell activation and proliferation. We demonstrate that several of these counter-receptors were upregulated following activation of Tregs and provide initial evidence that their altered glycosylation may also be important for Siglec-1 binding. Conclusions: We provide the first comprehensive analysis of glycan changes that occur in activated Tregs, leading to recognition by the macrophage lectin, Siglec-1 and suppression of Treg expansion. We furthermore provide insights into glycoprotein counter-receptors for Siglec-1 expressed by activated Tregs that are likely to be important for suppressing Treg expansion.