bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Rate of Multidrug-resistance Among Clinical Isolates of Gram-negative Bacteria in Hospitalized Patients With Febrile Diseases in Central Ethiopia
Authors: Tufa Tafese B , Mackenzie Colin R , Orth Hans Martin , Wienemann Tobias , Nordmann Tamara , Abdissa Sileshi , Hurissa Zewdu , Schönfeld Andreas , Bosselmann Matthias , Häussinger Dieter , Pfeffer Klaus , Luedde Tom , Fuchs Andre , Feldt Torsten 
Published: July 2021

Abstract
Background Infectious diseases are among the leading causes of death in many low-income countries such as Ethiopia. Without reliable local data concerning causative pathogens and antimicrobial resistance, empirical treatment is suboptimal. The objective of this study was the characterization of Gram-negative bacteria (GNB) as pathogens and their resistance pattern in hospitalized patients with infections in Central Ethiopia. MethodsPatients ≥1 year of age with fever admitted to the Asella Referral and Teaching Hospital from April 2016 to June 2018 were included. Blood and other appropriate clinical specimens were collected and cultured on appropriate media. Antibiotic susceptibility testing (AST) was performed using the Kirby-Bauer method and VITEK® 2. Species identification and detection of resistance-genes were conducted using MALDI-ToF-MS (VITEK® MS) and PCR respectively. ResultsOf 684 study participants, 54.2% were male and median age was 22.0 (IQR: 14-35) years. Blood cultures were positive in 5.4% (n=37). In other clinical samples, cultures were positive in 60.6% (20/33), 20.8% (5/24), and 37.5% (3/8) in swabs/pus, urine and other body fluids, respectively. Of 66 pathogenic isolates, 57.6% (n=38) were GNB, (39.4% (n=26) Gram-positive and 3.0% (n=2) were candida species. Among the isolated GNB, 42.1% (16/38) were E. coli, 23.7% (9/38) K. pneumoniae and 10.5% (4/38) P. aeruginosa. In total, 27/38 Gram-negative isolates were available for further analysis. Resistance rates were: ampicillin/sulbactam 92.6% (n=25), cefotaxime 88.9% (n=24), ceftazidime 74.1% (n=20), cefepime 74.1% (n=20), gentamicin 55.6% (n=15), piperacillin/tazobactam 48.1% (n=13), meropenem 7.4% (n=2), and amikacin 3.7% (n=1). The NDM-1 gene was detected in one K. pneumoniae and one A. baumannii isolate, which carried an additional OXA-51 gene. Genes for ESBLs were detected in 81.5% (n=22) isolates as follows: TEM 77.2% (n=17), CTX-M-1-group 68.2% (n=15), SHV-group 27.3% (n=6) and CTX-M-9-group 9.1% (n=2). Clinical treatment data revealed ineffective antimicrobial treatment in 13 of 18 (72.2%) patients.ConclusionWe report a high prevalence of ESBL-producing bacteria (81.5%) and carbapenem-resistance (7.4%), with more than half of the GNB carrying two or more ESBL genes resulting in sub-optimal empiric antibiotic therapy. These findings indicate a need for local and national antimicrobial resistance surveillance and strengthening of antimicrobial stewardship programs.
Secondary Malignancy in Giant Cell Tumor: A Single-Center Study
Authors: Joo Min Wook , Lee Yong-Suk , Park Hong Sik , Chung Yang-Guk , Yoon Chiyoung 
Published: July 2021

Abstract

Giant cell tumor of bone (GCTB) uncommonly undergoes sarcomatous transformation. Secondary malignancy in giant cell tumor (MGCT) develops at the prior treatment site, and is associated with radiotherapy and dismal prognosis. The objective of this study is to investigate the clinicopathological characteristics of MGCT patients. We reviewed medical records of patients with secondary MGCT. Twelve patients were analyzed including six females and six males, with a median age of 42.5 years. Benign recurrence occurred in five GCTB patients, who were not treated with radiotherapy. No pulmonary implants were observed. The median latency was 63 months. Nine patients were AJCC stage IIB, and three were stage IVA. The median follow-up period after malignant transformation was 62.5 months. Five patients developed local recurrence and six had metastasis. Five-year overall, recurrence- and metastasis-free survivals were 61.9%, 66.7% and 58.3%. The local recurrence of GCTB was a potential factor for metastasis-free survival. Difference in overall survival according to benign local recurrence was almost significant. In our series, the occurrence of secondary MGCT did not follow radiotherapy, contrary to the Western literature. The prognosis was better than the findings reported in previous studies. The local recurrence of benign GCTB could reflect the prognosis of MGCT.
Impact of Total Protein Level and Dysglycaemia on the Efficacy of Clopidogrel in Patients Underwent Carotid Artery Stenosis with CYP2C19 Genetic Variants
Authors: Hao Sijia , Hu Xinyuan , Yang Zhongxi , Yin Haoyuan , Li Yanjiao , Wang Xinlu , Zhao Yuhao , Piao Jianmin , Chen Xuan , Jiang Yanfang 
Published: July 2021

Abstract
BACKGROUND: CYP2C19polymorphisms are associated with the increased risk of major adverse cardiovascular/cerebrovascular events (MACCEs) in cerebral intervention. In this study, we wanted to investigate whether the CYP2C19 polymorphism and other nongenetic factors can influence the incidence of MACCEs in cerebral artery stenosis disease patients.METHODS: A total of 164 patients underwent cerebral artery stenting and 138 patients underwent conservative treatment among 1406 who patients underwent CYP2C19 gene screening and were enrolled in this study. A Cox proportional hazards model and Kaplan–Meier analyses were used to assess the predictive value of CYP2C19 loss-of-function (LOF) allele (*2, *3) carrier status and other risk factors.RESULTS: The CYP2C19 *1/*1 genotype was observed to be the most predominant among the patients (41.96%). The patients who underwent conservative treatment and had glucose levels> 6.5 mmol/L were more likely to experience MACCEs (p = 0.022). CYP2C19 LOF allele variants (p = 0.032), total protein < 65 g/L (p = 0.017) and glucose > 6.5 mmol/L (p = 0.028) were associated with an increased risk of MACCEs in patients who underwent cerebral artery stents in the multivariable Cox analysis.CONCLUSION: CYP2C19 polymorphisms, total protein levels and glucose can impact the risk of MACCEs in patients who undergo cerebral artery stents.
The Impact of the PCSK-9 / VLDL-Receptor Axis on Inflammatory Cell Polarization
Authors: Barcena Maria Luisa , Estepa Misael , Marx Louis , Breiter Anne , Haritonow Natalie , Stawowy Philipp 
Published: July 2021

Abstract

Background: Studies have shown that lipoproteins, including LDL, VLDL, and ApoE2 have an impact on macrophage polarization, important to atherosclerosis progression. PCSK9 is a key mediator regulating the expression of lipoprotein receptors. The present study investigates the effect of the VLDL/VLDL-R axis on mononuclear cell polarization, as well as the role of PCSK9 and PCSK9 inhibitors (PCSK9i) within this network.Methods: Human monocytic THP-1 cells and human monocyte-derived macrophages isolated from PBMC were treated with LPS/IFN-γ to induce a pro-inflammatory phenotype or with IL-4 /IL-13 to induce an anti-inflammatory phenotype. Cells were then subjected to further treatments including VLDL, LDL, PCSK9, PCSK9i, anti-LDL-R; PMA and TSP-1.Results: LPS/IFN-γ treatment promoted a pro-inflammatory state with an increased expression of pro-inflammatory mediators e.g., TNF-α, CD80, and IL-1β. VLDL co-treatment induced a switch of this pro-inflammatory phenotype to an anti-inflammatory phenotype. In pro-inflammatory cells, VLDL significantly decreased the expression of the M1-markers e.g., TNF-α, CD80, and IL-1β. These effects were eliminated by PCSK9 and restored by co-incubation with a PCSK9i. Migration assays demonstrated that pro-inflammatory cells displayed a significantly higher invasive capacity compared to untreated cells or anti-inflammatory cells. Moreover, pro-inflammatory cell chemotaxis was significantly decreased by VLDL-mediated acquisition of the anti-inflammatory phenotype. PCSK9 significantly lessened this VLDL-mediated migration inhibition, which was reversed by the PCSK9i.Conclusion: VLDL promotes macrophage differentiation towards the anti-inflammatory phenotype. PCSK9, via its capacity to inhibit VLDL-R expression, reverses the VLDL-mediated anti-inflammatory switch, thereby promoting a pro-inflammatory phenotype. Thus, anti-PCSK9 therapies may exert pro-inflammatory suppression within the vessel wall.
A Rapid and Highly Efficient Genotyping Pipeline for Screening Gene Targeted Mouse Embryonic Stem Cells
Authors: Caothien Roger , Yu Charles , Tam Lucinda , Newman Robert , Nakao Brian , Alcantar Tuija , Baccaro Natasha , Reyes Juan , Pham Anna , Roose-Girma Merone 
Published: July 2021

Abstract
Gene targeting in mouse ES cells replaces or modifies genes of interest; conditional alleles, reporter knock-ins, and amino acid changes are common examples of how gene targeting is used. For example, enhanced green fluorescent protein or Cre recombinase is placed under the control of endogenous genes to define promoter expression patterns. The most important step in the process is to demonstrate that a gene targeting vector is correctly integrated in the genome at the desired chromosomal location. The rapid identification of correctly targeted ES cell clones is facilitated by proper targeting vector construction, rapid screening procedures, and advances in cell culture. The addition of magnetic activated cell sorting (MACS) technology and multiplex droplet digital PCR (ddPCR) to the ES cell screening process can achieve a greater than 60% assurance that ES clones are correctly targeted. In a further refinement of the process, drug selection cassettes are removed from ES cells with adenovirus technology. This improved workflow reduces the time needed to generate preclinical animal models. Faster access to animal models for therapeutic target identification and experimental validation can accelerate the development of therapies for human disease.
Biomarkers of Ageing in Dogs
Authors: ISAKA MITSUHIRO , ARAKI RYUJI , UENO HIROSHI 
Published: July 2021

Abstract
Gerontology is a major research topic in veterinary medicine. Although several reports have shown that aging in companion dogs is similar to human aging, there are few reports on changes in biomarker levels in aged dogs. The purpose of this preliminary study was to evaluate the differences in biomarker levels between young and old companion dogs, focusing on cardiovascular and musculoskeletal biomarkers. The young dogs included those aged under 36 months (n = 16, 19.8 ± 9.3 months), while the old ones included those aged over 108 months (n = 16, 155.8 ± 22.8 months). All dogs were referred to our university due to patellar luxation. The mean weight of the young and old dogs was 2.9 ± 0.9 kg and 4.0 ± 1.1 kg, respectively. We measured the serum concentrations of brain-derived neurotrophic factor (BDNF), osteoprotegerin (OPG), angiotensin II (ANGII), and endothelin-1 (ET-1) in both groups. Although the concentrations of BDNF did not differ between the two groups, the OPG, ANGII, and ET- 1 levels were significantly higher in the old companion dogs than in the young dogs. The results showed that the concentration of some biomarkers may increase as dogs age, especially OPG, ANGII, and ET- 1. This may inspire further research on osteoporosis and cardiovascular diseases in elderly dogs.
Transmissibility of Hand, Foot, and Mouth Disease in 97 Counties of Jiangsu Province, China, 2015- 2020
Authors: Zhang Wei , Rui Jia , Cheng Xiaoqing , Deng Bin , Zhang Hesong , Huang Lijing , Zhang Lexin , Zuo Simiao , Li Junru , Huang XingCheng , Su Yanhua , Zhao Benhua , Niu Yan , Li Hongwei , Hu Jian-li , Chen Tianmu 
Published: July 2021

Abstract
Background: Hand, foot, and mouth disease (HFMD) has been a serious disease burden in the Asia Pacific region represented by China, and the transmission characteristics of HFMD in regions haven’t been clear. This study calculated the transmissibility of HFMD at county levels in Jiangsu Province, China, analyzed the differences of transmissibility and explored the reasons.Methods: We built susceptible-exposed-infectious-asymptomatic-removed (SEIAR) model for seasonal characteristics of HFMD, estimated effective reproduction number (Reff) by fitting the incidence of HFMD in 97 counties of Jiangsu Province from 2015 to 2020, compared incidence rate and transmissibility in different counties by non -parametric test, rapid cluster analysis and rank-sum ratio.Results: The average daily incidence rate was between 0 and 4 per 100,000 in Jiangsu province from 2015-2020. The 97 counties could be divided into three levels: low incidence, medium incidence and high incidence, and occurred that the average daily incidence rate dropped sharply in 2016-2017, and increased sharply in 2017-2018 years. The Quartile of Reff in Jiangsu Province from 2015 to 2020 was 1.54 (0.49, 2.50), Rugao district in Central Jiangsu and Jianhu district in Northern Jiangsu had the highest transmissibility by rank-sum ratio. Reff generally decreased in 2017 and increased in 2018 in most counties, and the median level of Reff was lowest in 2017 (P<0.05).Conclusion: Transmissibility was different in 97 counties of Jiangsu Province, and the reasons for the differences may be related to the climate, demographic characteristics, virus subtypes, vaccination and other infectious diseases.
Shielding surfaces from viruses and bacteria with a multifunctional coating
Authors: Ashok Deepu , Taheri Mahdiar , Webb Daryl , Parajuli Pawan , Garg Puneet , Wang Yi , Funnell Bronte , Taylor Bradley , Tscharke David , Tsuzuki Takuya , Verma Naresh , Tricoli Antonio , Nisbet David 
Published: July 2021

Abstract
The spread of viral and bacterial pathogens mediated by contact with surfaces is a leading cause of infection worldwide. COVID-19 as well as the continuous rise of deaths associated with antibiotic-resistant bacteria highlights the need to impede surface-mediated transmission. We report a sprayable coating with an intrinsic ability to resist the uptake of bacteria and viruses from surfaces and droplets, such as those generated by sneezing or coughing. Our coating also provides an effective microbicidal functionality against bacteria, providing a dual barrier against pathogen uptake and transmission. This antimicrobial functionality is fully preserved following scratching and other induced damage to its surface or 9 days of submersion in a highly concentrated suspension of bacteria.
Pretreatment with a GnRH Agonist and Hormone Replacement Treatment Protocol Could not Improve Live Birth Rate for PCOS Women Undergoing Frozen-Thawed Embryo Transfer Cycles: A Retrospective Cohort Study using Propensity Score Matching
Authors: Liu Xitong , Shi Juanzi , Bai Haiyan 
Published: July 2021

Abstract
Background: The optimal means to prepare the endometrial preparation for PCOS patients is a topic of ongoing controversy. Our objective was to compare the clinical outcomes of frozen-thawed embryo transfer (FET) with and without pretreatment gonadotropin-releasing hormone agonist (GnRHa) in polycystic ovary syndrome (PCOS) patients. Methods: In this retrospective cohort study, we evaluated 1638 consecutive cycles between June 2014 and December 2017 in the Assisted Reproduction Center of Northwest Women’s and Children’s Hospital. The patients who underwent FET were assigned to two groups as follows: hormone replacement treatment (HRT) group, comprising 1115 cycles; HRT with GnRHa pretreatment (GnRHa + HRT), comprising 523 cycles. Patients using GnRHa + HRT (n=519) were matched with 519 patients using HRT. Results: The live birth rate was higher in the GnRHa + HRT group compared with the HRT group with no significant difference (60.4% vs 55.5%, p=0.062). The clinical pregnancy rate (72.74% vs 75.33%), miscarriage rate (14.26% vs 13.96%) and ectopic pregnancy rate (0.36% vs 0.38%) were similar between the two groups. The preterm birth rate in HRT was lower than GnRHa + HRT (14.08% vs 20.08%). There were no significant interactions in any of the subgroups (p>0.05 for all comparisons). In the unadjusted model and adjusted model, the live birth rate was comparable between GnRHa + HRT and HRT group (OR 1.22, 95%CI, 0.99-1.51, p=0.062; aOR 1.56, 95%CI, 1.001-2.41, p=0.048). Similar results were obtained after propensity score matching in the entire cohort. Conclusions: GnRHa pretreatment could not improve the live birth rate in women with PCOS.
Early changes in lymphocyte/monocyte ratio on-treatment as a prognostic marker to predict overall survival in patients with advanced cancer treated with immune checkpoint inhibitors
Authors: Patel Sandip H. , Zhao Songzhu , Li Mingjia , Wei Lai , Husain Marium , Spakowicz Daniel , Grogan Madison , JohnS Andrew , Burkart Jarred , Lopez Gabrielle , He Kai , Bertino Erin M , Shields Peter G. , Carbone David P , Verschraegen Claire F. , Otterson Gregory A. , Kendra Kari , Presley Carolyn J. , Owen Dwight H. 
Published: July 2021

Abstract
Background

A low absolute lymphocyte/monocyte ratio (LMR) in the peripheral blood is associated with poor prognosis in various cancers; however, its role as a predictive biomarker has not been well defined in the era of treatment with immune checkpoint inhibitors (ICI).
Methods

We queried a database of advanced cancer patients treated with at least one dose of ICI from 2011 to 2017 to study the association of LMR with overall survival (OS). We calculated LMR at baseline and a median of 21 days after the first cycle of ICI (on-treatment LMR), and defined low if < 2 and high if ≥ 2. OS was calculated from the initiation of ICI to date of death or censored at last follow-up.
Results

1077 patients met the criteria for this study. Patients with low baseline LMR had a shorter median OS compared to patients with a high baseline LMR (8.5 vs 18.1 months, p < 0.01). In patients with a low baseline LMR, who on-treatment LMR increased to high had longer median OS compared to those whose on-treatment LMR remained low (16.8 vs 7.8 months, p < 0.001). Patients with a high baseline LMR and in whom on-treatment LMR remained high had longer median OS compared to patients with low on-treatment LMR (23.9 vs 9.2 months, p < 0.001). In multivariate analysis, high on-treatment LMR was most strongly associated with longer survival compared to low on-treatment LMR, regardless of baseline LMR.
Conclusions

Higher baseline and early changes in on-treatment LMR are associated with improved OS in cancer patients receiving ICI.
Characterising hospitals’ suitability for medical officer internship training in Kenya: analysis of the Kenya Harmonized Health Facility Assessment
Authors: Zhao Yingxi , Osano Boniface , Were Fred , Kiarie Helen , Nicodemo Catia , Gathara David , English Mike 
Published: July 2021

Abstract
Background

Kenya has significantly expanded its medical school numbers and internship training hospital numbers to address its workforce gap. The majority of newly accredited internship hospitals are first-level referral/district hospitals, which are considered to have shortage of staff, medications, have limited service capacity and are described as “not organized for training purpose”. Using data from the Kenya Harmonized Health Facility Assessment (KHFA) 2018, we characterise the readiness and capacity of 61 internship hospitals to understand whether they are suitable to provide internship training for medical doctors.
Methods

We used secondary data from KHFA 2018, which sampled 61 out of all 74 internship hospitals in Kenya. Comparing against the minimum requirement outlined in the national guidelines for medical officer interns, we filtered and identified 166 indicators from the KHFA survey questionnaire and grouped them into 12 domains. An overall readiness and capacity index was calculated as the mean of 12 domain-specific scores for each facility. We compared the readiness and capacity of each domain and overall between Level 4 small hospitals, Level 4 large hospitals and Level 5 & 6 hospitals.
Results

The average overall capacity and readiness index is 69% for all internship training centres. Hospitals have moderate capacity and readiness (over 60%) for most of the general domains, though there is huge variation between hospitals and only 29 out of 61 hospitals have five or more specialists assigned, employed, seconded or part-time - as required by the national guideline. Quality and safety score was low across all hospitals with an average score of 40%. As for major specialties, all hospitals have good readiness and capacity for surgery and obstetrics-gynaecology, while mental health was poorest in comparison. Level 5 & 6 facilities have higher capacity scores in all domains when compared with Level 4 hospitals.
Conclusion

Major gaps exist in staffing, equipment and service availability of Kenya internship hospitals. Level 4 hospitals are more likely to have a lower readiness and capacity index, and should be reviewed and improved to provide appropriate and well-resourced training for interns and to utilise appropriate resources to avoid improvising .
Achievement of Target Glucose Level among Newly Diagnosed Type 2 Diabetes Mellitus Patients in Public Teaching Hospitals in Addis Ababa, Ethiopia: a retrospective chart review
Authors: Leulseged Tigist Workneh 
Published: July 2021

Abstract
Background
Diabetes is a chronic illness that requires continuous medical care to reach target glycaemic level to prevent complications. Most studies around the world have showed that glycaemic control among type 2 diabetes mellitus (T2DM) patients is poor using measurements taken at one point and including all patients irrespective of the duration of illness. This study aimed to assess achievement of optimal glycaemic control at different points in time in relation to the time of diagnosis and initiation of treatment and to identify associated factors among T2DM patients attending diabetes clinic of public teaching hospitals in Addis Ababa, Ethiopia.
Methods
A retrospective chart review was conducted from May to July 2018 among randomly selected 685 medical charts of patients who were on follow-up from January, 2013 to December, 2017. Association was assessed using Binary logistic regression, where 95% CIs for odds ratio and P-values were used for testing significance and interpretation of results.
Results
The prevalence of optimal glycaemic control among T2DM patients at the end of 3 months, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years of diagnosis and treatment were 1.9%, 44.7%, 52.8%, 66.3%, 69.2%, 70.2% and 70.5% respectively. The significant factors were age group and type of treatment regimen.
Conclusions
Achievement of optimal glycaemic control increases as the follow-up duration increases; it was only 1.9% at the third month and 70.5% at the fifth year of observation. Close to one third of patients (29.5%) did not achieve target glucose even after five years and were at the verge of increased risk for diabetes related complications and death. Attention should be given to the time when patients achieve target glucoses level instead of just measuring the number of individuals who achieved glycaemic control in a short observation period.