bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can the Xpert MRSA/SA BC assay be used as an antimicrobial stewardship tool? A prospective assay validation and descriptive impact assessment study in a South African setting
Authors: Reddy Kessendri , Whitelaw Andrew Christopher 
Published: January 2021

Abstract
Background: Positive blood cultures showing Gram positive cocci in clusters signifies either Staphylococcus aureus or the less-virulent coagulase-negative staphylococci. Rapid identification and methicillin susceptibility determination with the Xpert MRSA/SA BC assay can improve management of S. aureus bloodstream infection and reduce inappropriate antibiotic use. Methods:We prospectively evaluated the Xpert MRSA/SA BC assay in comparison with culture, on samples referred to our laboratory in the Western Cape, South Africa. We interviewed attending clinicians upon culture result availability, to assess antibiotic choices and estimate potential impact of the assay.Results: Of the 231 samples included, there was 100% concordance between the Xpert MRSA/SA BC assay and culture (methicillin-resistant S. aureus 15/15, methicillin-susceptible S. aureus 42/42, coagulase-negative staphylococci 170/170). Time to final result could be reduced by approximately 30 hours with the assay. Of the 178 patients with adequate antibiotic history, optimisation of antistaphylococcal therapy could have occurred more than one day sooner in 68.9% with S. aureus bloodstream infection (31/45, 95% CI 53.2-81.4%). Six of the 11 patients with methicillin-resistant S. aureus bloodstream infection (54.5%) could have received anti-MRSA cover sooner. Fifty-four days of antibiotic therapy could have been spared, equating to 0.3 days (95% CI, 0.2-0.4) saved per patient, driven by broad-spectrum beta-lactams (32 days, in 18.0% of the cohort).Conclusion:This assay has potential as an antimicrobial stewardship tool; costing and impact on clinical outcome in patients with S. aureus bloodstream infection should be assessed.
The effect of cognitive dysfunction on mid- and long-term mortality after vascular surgery
Authors: Szabo Andras , Toth Krisztina , Nagy Adam , Domokos Dominika , Czobor Nikoletta , Eke Csaba , Sandor Agnes , Merkely Bela , Susánszky Éva , Gal Janos , Szekely Andrea 
Published: January 2021

Abstract
Background: In recent decades, previous studies have noted the importance of frailty, which is a frequently used term in perioperative risk evaluations. Psychological and socioeconomical domains were investigated as part of frailty syndrome. The aim of this study was to assess the importance of these factors in mortality after vascular surgery.Methods: In our prospective, observational study (ClinicalTrials.gov Identifier: NCT02224222), we examined 164 patients who underwent elective vascular surgery between 2014 and 2017. At the outpatient anaesthesiology clinic, patients completed a questionnaire about cognitive functions, depression and anxiety, social support and self-reported quality of life were assessed using a comprehensive frailty index, in addition to medical variables. Propensity score matching was performed to analyse the difference between patients and controls in a nationwide population cohort. The primary outcome was 4 year mortality. The Kaplan-Meier method and Cox regression analysis were used for statistical analyses.Results: The patients’ mean age was 67.05 years (SD: 9.49 years). Mini-Mental State Examination scores of less than 27 points were recorded for 41 patients. Overall mortality rates were 22.4% and 47.6% in the control and cognitive impairment groups, respectively (p=0.013). In the univariate Cox regression analysis, cognitive impairment measured using age- and education-adjusted MMSE scores increased the risk of mortality (AHR: 2.842, 95% CI: 1.389-5.815, p=0.004).Conclusion: Even mild cognitive dysfunction measured preoperatively using the MMSE represents a potentially important risk factor for mortality after vascular surgery.
Liver resections for metastasis: surgical outcomes of a single center academic institution.
Authors: Abreu Phillipe , Ferreira Raphaella , Bussyguin Danilo Saavedra , Cás Eduardo Da , Venkatasamy Vighnesh Vetrivel , Tomasich Flávio Daniel Saavedra , Szutan Luiz Arnaldo 
Published: January 2021

Abstract
Background: Hepatic metastasis are frequent and liver resection may be an option for some cases, despite the high complexity of the procedure and the possibility of postoperative complications.Methods: This retrospective comparative descriptive study aims to evaluate a series of 86 consecutive liver resections (LRs) performed for the treatment of metastatic liver tumors, comparing the results between patients undergoing major and minor LR. All patients submitted to LR from October 2010 to July 2015 at the Erasto Gaertner Hospital in Curitiba-PR were included. Quantitative numerical variables were analyzed with the Student t-test. The nonparametric Mann-Whitney U test was used for numerical variables of non-normal distribution. Categorical variables were analyzed with the Chi-square test with Fisher's correction. The data were analyzed with the SPSS 23.0 and STATA 15 programs, being p<0.05 considered statistically significant. Results: Eighty-six LR were performed, 56 cases by colorectal metastasis. The major LR corresponded to 68 cases, with 13.2% of Clavien-Dindo III-V complications and 2.9% of reoperation rate. Eighteen minor LR were performed and one patient had a postoperative complication requiring reoperation. Conclusion: Preoperative elevation of transaminases and jaundice negatively influence surgical outcomes in patients undergoing LR. Tumors greater than 3 cm presented worse postoperative survival. Major LR did not significantly increase the surgical morbidity rate. Institutional Review Board registration: 1.122.319/2015
Poor health-related physical fitness performance increases the overweight and obesity risk in elderly people from Taiwan
Authors: Ho Chien-Chang , Lee Po-Fu , Chen Hui-Ling , Tseng Ching-Yu , Hsieh Xin-Yu , Chiu Chih Hui 
Published: January 2021

Abstract
Background: The purpose of the present study was to investigate the associations between health-related physical fitness performance and overweight/obesity risk among Taiwanese healthy older adults.Methods: A secondary dataset from the nationwide survey was applied in this study. Data from a total of 21,630 respondents aged 65-96 years were collected in this study. Demographic characteristics, life habits, perceived health status, anthropometric assessments, and health-related physical fitness measurements from this dataset were analyzed using the chi-square test, one-way analysis of variance, and logistic regression analysis.Results: The results indicated that overweight and obesity significantly associated with health-related physical fitness performance in the Taiwanese older adult population. In particular, the upper extremity muscular endurance scores of older adults with poor activity and physical fitness scores revealed obesity as a critical indicator of health-related physical fitness performance.Conclusions: Future studies can use muscle quality or body fat classification to predict obesity in older adults, which could more precisely portray the relationship between obesity and health-related physical fitness performance.
A heat-health watch and warning system with extended season and evolving thresholds.
Authors: Issa Mahamat Abdelkerim , Chebana Fateh , Masselot Pierre , Campagna Celine , Lavigne Éric , Gosselin Pierre , Ouarda Taha B.M.J. 
Published: January 2021

Abstract
Background Many countries have developed heat-health watch and warning systems (HHWWS) or early-warning systems in an attempt to mitigate the health consequences of extreme heat events. HHWWS usually focus on the four hottest months of the year and impose the same threshold over these months. However, according to climate projections, hot season is expected to extend and/or shift. Some studies demonstrated that health impacts of heat waves are more severe when the human body is not acclimatized to heat. In order to adapt those systems to potential heat waves occurring outside the hottest months of the season, this study proposes specific health-based monthly heat indicators and thresholds over an extended season from April to October in the northern hemisphere. Methods The proposed approach, an extension of the HHWWS methodology currently adopted in the province of Quebec, Canada, was developed in the Greater Montreal area (current population 4.3 million) based on historical health and meteorological data over the years. This approach consists of determining excess mortality episodes and then choosing indicators and thresholds that may involve excess mortality.Results We obtain thresholds for the maximum and minimum temperature couple (in °C) that range from (23 and 12, respectively) in April, to (32 and 21) in July and back to (25 and 13) in October. The resulting HHWWS is flexible, with health-related thresholds taking into account the seasonality as well as the monthly variability of temperatures in the threshold definition process for an extended summer season. Conclusions This adaptive system has the potential to prevent, by data-driven health alerts, heat-related mortality outside the typical July-August months of heat waves. The proposed methodology is general and can be applied or adapted to other regions and situations.
Effects of aging on the skin and gill microbiota of farmed seabass and seabream
Authors: Rosado Daniela , Pérez-Losada Marcos , Pereira Ana , Severino Ricardo , Xavier Raquel 
Published: January 2021

Abstract
Background: Important changes in microbial composition related to sexual maturation have been already reported in the gut of several vertebrates including mammals, amphibians and fish. Such changes in fish are linked to reproduction and growth during developmental stages, diet transitions and critical life events. We used amplicon (16S rRNA) high-throughput sequencing to characterize the skin and gill bacterial microbiota of farmed seabass and seabream belonging to three different developmental age groups: early and late juveniles and mature adults. We also assessed the impact of the surrounding estuarine water microbiota in shaping the fish skin and gill microbiota. Results: Microbial diversity, composition and predicted metabolic functions varied across fish maturity stages. Alpha-diversity in the seabass microbiota varied significantly between age groups and was higher in older fish. Conversely, in the seabream, no significant differences were found in alpha-diversity between age groups. Microbial structure varied significantly across age groups; moreover, high structural variation was also observed within groups. Different bacterial metabolic pathways were predicted to be enriched in the microbiota of both species. Finally, we found that the water microbiota was significantly distinct from the fish microbiota across all the studied age groups, although a high percentage of ASVs was shared with the skin and gill microbiotas.Conclusions: We report important microbial differences in composition and potential functionality across different ages of farmed seabass and seabream. These differences may be related to somatic growth and the onset of sexual maturation. Importantly, some of the inferred metabolic pathways could enhance the fish coping mechanisms during stressful conditions. Our results provide new evidence suggesting that growth and sexual maturation have an important role in shaping the microbiota of the fish external mucosae and highlight the importance of considering different life stages in microbiota studies.
PacBio full-length transcriptome of wild apple (Malus sieversii) provides insights into canker disease dynamic response
Authors: Liu Xiaojie , Li Xiaoshuang , Wen Xuejing , Zhang Yan , Ding Yu , Zhang Yiheng , Gao Bei , Zhang Daoyuan 
Published: January 2021

Abstract
Background: Cytospora canker is a serious disease in the stem of Malus sieversii, caused by Cytospora mali. However, little is known about the global response mechanism in M. sieversii to C. mali infection. Results: Phytohormone jasmonic acid (JA) and salicylic acid (SA) profiles and transcriptome analysis were used to elaborate on the dynamic response mechanism. We determined that the JA was initially produced to respond to the necrotrophic pathogen C. mali infection at the early response stage, then get synergistically transduced with SA to respond at the late response stage. Furthermore, we adopted Pacific Biosciences (PacBio) full-length sequencing to identify differentially expressed transcripts (DETs) during the canker response stage. We obtained 52,538 full-length transcripts, of which 8,139 were DETs. Total 1,336 lncRNAs, 23,737 alternative polyadenylation (APA) sites and 3,780 putative transcription factors (TFs) were identified. Additionally, functional annotation analysis of DETs indicated that the wild apple response to the infection of C. mali involves plant-pathogen interaction, plant hormone signal transduction, flavonoid biosynthesis, and phenylpropanoid biosynthesis. The co-expression network of the differentially expressed TFs revealed 264 candidate TF transcripts. Among these candidates, the WRKY family was the most abundant. The MsWRKY7 and MsWRKY33 were highly correlated at the early response stage, and MsWRKY6, MsWRKY7, MsWRKY19, MsWRKY33, MsWRKY40, MsWRKY45, MsWRKY51, MsWRKY61, MsWRKY75 were highly correlated at the late stage. Conclusions: The full-length transcriptomic analysis revealed a series of immune responsive events in M. sieversii in response to C. mali infection. The phytohormone signal pathway regulatory played an important role in the response stage. Additionally, the enriched disease resistance pathways and differentially expressed TFs dynamics collectively contributed to the immune response. This study provides valuable insights into a dynamic response in M. sieversii upon the necrotrophic pathogen C. mali infection, facilitates understanding of response mechanisms to canker disease for apple, and provides supports in the identification of potential resistance genes in M. sieversii.
The Mitigating Toxic Stress Study Design: Approaches to Developmental Evaluation of Pediatric Health Care Innovations addressing Social Determinants of Health and Toxic Stress
Authors: McCrae Julie S. , Robinson JoAnn L , Spain Angeline K , Byers Kaela , Axelrod Jennifer L 
Published: January 2021

Abstract
Background. Health care administrators must establish and promote effective partnerships with community agencies to address social determinants of health, including reducing exposure of infants and young children to chronic stress. Because infants’ experiences are inextricably tied to their caregivers, an important target for mitigating “toxic” stress exposure in early childhood is through reducing parents’ experiences of chronic stress in addition to protecting children from direct experiences of harm such as physical or sexual abuse. Conducting screening to identify when children are exposed to early life adversity is a first step; connecting families to needed support services is an essential component to addressing identified challenges. This paper presents the methodology of a three-year study of health care systems innovations designed to engage and support parents of infants to prevent and mitigate children’s toxic stress exposures. Methods. Key study features included: 1) multi-component study in five U.S. communities and nine pediatric health care clinics and the families they serve, 2) a developmental evaluation approach to describe how innovations are experienced over time at three levels—community systems, pediatric providers, and families, and 3) rapid cycle feedback conducted with communities, clinics and families to co-interpret data and findings. Data sources included: 1) focus groups and interviews with community stakeholders, clinic staff, and families, 2) electronic health record and Medicaid services data extracted to assess health care quality, utilization, and financial impact, and 3) clinic-recruitment of 908 parents of infants in a longitudinal survey. Results. The sample is briefly characterized based on responses to the enrollment phase of the parent survey. Conclusions. We discuss the study design elements’ contribution to generating evidence needed by innovators, communities, and clinics to modify and sustain investments in these innovations to prevent or mitigate the effects of exposure to toxic stress on young children.
LacminCC: Lightweight Anonymous Communication Model In Cloud Computing
Authors: Li Fengyin , Wang Yanli , Ju Hongwei , Yu Xinying , Wang Zhaojie , Zhou Huiyu 
Published: January 2021

Abstract
With increasing application of cloud computing and big data technologies, a large amount of personal information is stored on the Internet, which raises the issue of privacy leakage.To protect people's data privacy, this paper firstly presents a new anonymous Identify-Based Encryption (IBE) scheme and gives the proof of its security under the Bilinear Diffie-Hellman Security Assumption. Then, by introducing the anonymous IBE scheme into anonymous communication fields, this paper introduces a new lightweight anonymous communication model for cloud computing, which guarantees the anonymity of system users and the security of messages in small groups. Our analysis shows that, the proposed communication model cannot only reduce memory consumption and improve message transmission efficiency, but also effectively resist traffic-analysis attacks, node eavesdropping, and finally achieve secure anonymous communication in cloud computing.
Comprehensive analysis of allergen-specific IgE in COPD: Mite-specific IgE specifically related to the diagnosis of asthma-COPD overlap
Authors: Toyota Hikaru , Sugimoto Naoya , Kobayashi Konomi , Suzuki Yuki , Takeshita Yuri , Ito Ayaka , Ujino Mariko , Tomyo Fuminori , Sakasegawa Hirokazu , Koizumi Yuta , Kuramochi Michio , Yamaguchi Masao , Nagase Hiroyuki 
Published: January 2021

Abstract
Background: Although the relationship between allergic sensitization and increased respiratory symptoms of chronic obstructive pulmonary disease (COPD) has been suggested, which allergen has a significant effect on COPD pathology is unclear. This study aimed to identify the specific IgE related to clinical features of COPD and the diagnosis of asthma-COPD overlap (ACO).Methods: We recruited 76 patients with COPD and analyzed 39 IgE using panel IgE test (View Allergy 39®). ACO was diagnosed according to the Japanese Respiratory Society Guidelines.Results: As for perennial aeroallergens, the positivity for moth (31.5%), Candida (23.7%), Dermatophagoides pteronyssinus (22.4%) and house dust (22.4%), and concerning pollen, Japanese cedar (35.5%) and Japanese cypress (22.2%) exceeded 20%. Only the positivity of IgE for Dermatophagoides pteronyssinus and house dust was significantly higher in ACO compared with that in non-ACO COPD. Moreover, it contributed to the diagnosis of ACO in an IgE class-dependent manner. Patients with cockroach IgE exhibited higher residual volume, whereas those with Japanese cedar IgE exhibited better diffusion capacity than negative patients. The contribution for ACO diagnosis by the receiver operating characteristic curve analysis was comparable among total IgE (cutoff value: 158 IU/mL), blood eosinophil count (234/μl), and fraction of exhaled nitric oxide (31.0 ppb).Conclusions: The prominent role of mite-specific IgE in the diagnosis and pathology of ACO and the potentially detrimental effect of cockroach sensitization on air trapping in COPD were suggested. The finding highlights the future development of a treatment targeting IgE as a treatable trait in COPD.
An integer programming model to assign patients based on mental health impact for tele-psychotherapy intervention during the Covid–19 emergency
Authors: Miniguano-Trujillo Andrés , Salazar Fernanda , Torres Ramiro , Arias Patricio , Sotomayor Koraima 
Published: January 2021

Abstract
The Covid–19 pandemic challenges health-care systems worldwide while severely impacting mental health. As a result, the rising demand for psychological assistance during crisis times requires early and effective intervention. This contributes to the well-being of the public and front-line workers and prevents men-tal health disorders. Many countries are offering di-verse and accessible services of tele-psychological inter-vention; Ecuador is not the exception. The present study combines statistical analyses and discrete optimization techniques to solve the problem of assigning patients to therapists for crisis intervention with a single tele-psychotherapy session. The statistical analyses showed that professionals and healthcare workers in contact with Covid–19 patients or with a confirmed diagnosis had a significant relationship with suicide risk, sadness, experiential avoidance, and perception of severity. Moreover, some Covid–19-related variables were found to be predictors of sadness and suicide risk as unveiled via path analysis. This allowed categorizing patients according to their screening and grouping therapists according to their qualifications. With this stratification, a multi-periodic optimization model and a heuristic are proposed to find an adequate assignment of patients to therapists over time. The integer programming model was validated with real-world data, and its results were applied in a volunteer program in Ecuador.
Development and characterization of thirteen novel microsatellite markers for use in Greenland sharks (Somniosus microcephalus), with cross-amplification in Pacific sleeper sharks (Somniosus pacificus)
Authors: Swintek Meaghan A , Walter Ryan P 
Published: January 2021

Abstract
Objective: The objectives of this work are to isolate, develop, and characterize polymorphic microsatellite markers for use in Greenland sharks (Somniosus microcephalus). Results: Thirteen microsatellite loci were successfully amplified and yielded multi-locus genotypes for 36 S. microcephalus individuals from Grise Fjord (n = 16) and Svalbard (n = 20). Each locus yielded between 2 to 9 alleles and observed heterozygosity ranged from 0.11 to 0.70 when estimated across both sites. One locus and three loci deviated from HWE following Bonferroni correction, for individuals sampled from Grise Fjord and Svalbard, respectively. Cross-amplification was successful at every locus for five of the ten S. pacificus individuals.