bluuebunny/crossref_metadata_2025_split huggingface dataset:
REDuction of Antibiotic RESistance (REDARES) in urinary tract infections using treatments according to national clinical guidelines: study protocol for a pragmatic randomized controlled trial with a multimodal intervention in primary care
Authors: Gágyor Ildikó , Greser Alexandra , Heuschmann Peter , Rücker Viktoria , Maun Andy , Bleidorn Jutta , Heintze Christoph , Jede Felix , Eckmanns Tim , Klingeberg Anja , Mentzel Anja , Schmiemann Guido 
Published: September 2021

Abstract
Background
Urinary tract infections (UTIs) are a common cause of prescribing antibiotics in family medicine. In Germany, about 40% of UTI-related prescriptions are second-line antibiotics, which contributes to emerging resistance rates. To achieve a change in the prescribing behaviour among family physicians (FPs), this trial aims to implement the guideline recommendations in German family medicine.

Methods/design
In a randomized controlled trial, a multimodal intervention will be developed and tested in family practices in four regions across Germany. The intervention will consist of three elements: information on guideline recommendations, information on regional resistance and feedback of prescribing behaviour for FPs on a quarterly basis. The effect of the intervention will be compared to usual practice. The primary endpoint is the absolute difference in the mean of prescribing rates of second-line antibiotics among the intervention and the control group after 12 months. To detect a 10% absolute difference in the prescribing rate after one year, with a significance level of 5% and a power of 86%, a sample size of 57 practices per group will be needed. Assuming a dropout rate of 10%, an overall number of 128 practices will be required. The accompanying process evaluation will provide information on feasibility and acceptance of the intervention.

Discussion
If proven effective and feasible, the components of the intervention can improve adherence to antibiotic prescribing guidelines and contribute to antimicrobial stewardship in ambulatory care.
Trial registration DRKS, DRKS00020389, Registered 30 January 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020389.
Re-emergence of syphilis in women of reproductive age and its association with the increase in congenital syphilis in Mexico during 2010–2019: an ecological study
Authors: García-Cisneros Santa , Herrera-Ortiz Antonia , Olamendi-Portugal Maria , Sánchez-Alemán Miguel Angel 
Published: September 2021

Abstract
Background
Syphilis is a sexually transmitted infection that is re-emerging in different parts of the world. This infection can be transmitted during pregnancy, causing neonatal syphilis. The objective of this study was to examine trend in syphilis, congenital syphilis, and neonatal deaths among the Mexican population during 2010–2019.

Methods
An ecological study was carried out to collect information about the incidence of syphilis, the incidence of congenital syphilis, and the incidence of neonatal death from congenital syphilis. The variables were described considering age, sex, Mexican state, and year. Trends across time (calendar year) were analyzed using linear regression, increases were estimated with 95% confidence intervals, and p < 0.05 was considered statistically significant.

Results
The incidence of syphilis increased by an average of 0.336 cases/100,000 per year and was higher among women aged 15–19 years (0.693 cases). Cases of congenital syphilis increased from 62 cases in 2010 to 372 cases in 2019; furthermore, the increase in syphilis cases among women aged 20 to 24 years was associated with an increase in cases of congenital syphilis. In 2010, 50% of Mexican states did not report cases of congenital syphilis, but in 2018, only 10% did not report cases of congenital syphilis. Between 2010 and 2018, 83 neonatal deaths were reported, with the highest incidence in 2018 (0.88 deaths/100,000 newborns).

Conclusion
The incidence of congenital syphilis is increasing in Mexico. As a consequence of the reemergence of syphilis among the population of reproductive age, it is necessary to address and treat syphilis in various population groups.
Changes in magnetic resonance imaging relaxation time on postmortem magnetic resonance imaging of formalin-fixed human normal heart tissue
Authors: Ebata Kiyokadzu , Noriki Sakon , Inai Kunihiro , Kimura Hirohiko 
Published: September 2021

Abstract
Background
Postmortem magnetic resonance imaging (MRI) has been used to investigate the cause of death, but due to time constraints, it is not widely applied to the heart. Therefore, MRI analysis of the heart after formalin fixation was previously performed. However, the changes in MRI signal values based on the fixation time of formalin were not investigated. The objective was to investigate changes over time in the T1- and T2-values of MRI signals in normal areas of hearts removed during autopsy, hearts subsequently fixed in formalin, and heart specimens sliced for the preparation of pathological specimens.

Methods
The study subjects were 21 autopsy cases in our hospital between May 26, 2019 and February 16, 2020 whose hearts were removed and scanned by MRI. The male:female ratio was 14:7, and their ages at death ranged from 9 to 92 years (mean age 65.0 ± 19.7 years). Postmortem (PM)-MRI was conducted with a 0.3-Tesla (0.3-T) scanner containing a permanent magnet. A 4-channel QD head coil was used as the receiver coil. Scans were performed immediately after removal, post-formalin fixation, and after slicing; 7 cases were scanned at all three time points.

Results
The T1- and T2-values were calculated from the MRI signals of each sample organ at each scanning stage. Specimens were sliced from removed organs after formalin fixation, and the changes in T1- and T2-values over time were graphed to obtain an approximate curve. The median T1-values at each measurement time point tended to decrease from immediately after removal. The T2-values showed the same tendency to decrease, but this tendency was more pronounced for the T1-values.

Conclusion
MRI signal changes in images of heart specimens were investigated. Formalin fixation shortened both T1- and T2-values over time, and approximation formulae were derived to show these decreases over time. The shortening of T1- and T2-values can be understood as commensurate with the reduction in the water content (water molecules) of the formalin-fixed heart.
Periphery kinetic perimetry: clinically feasible to complement central static perimetry
Authors: Ma Xiaoxiao , Tang Li , Chen Xiaoming , Zeng Liuzhi 
Published: September 2021

Abstract
Background
Existing evidence suggests that visual field defect in eyes with glaucoma significantly varies between individuals. The following study compared the central visual field defects with the peripheral visual field defects in patients with suspect glaucoma and primary open-angle glaucoma (POAG) and investigated whether using the central visual field test alone could result in loss of clinically valuable information.

Methods
In this prospective observational study, 167 eyes from 89 patients with suspect glaucoma or POAG were first examined with static automated perimetry (SAP), followed by a peripheral visual field test on Octopus 900 perimeter (Haag-Streit, Koeniz, Switzerland). The peripheral visual field test was performed by “Auto Kinetic Perimetry” program, in which Goldmann III4e stimuli randomly moved along 16 vectors at a constant angular velocity of 5 deg/s.

Results
Glaucomatous peripheral visual field defects were seen in 18% of the eyes with a normal central visual field. In addition, 86% of glaucoma patients with moderate-to-severe central visual field defects had corresponding peripheral visual field defects in the form of localized or diffuse depression of the isopters. Furthermore, a moderate correlation was found between the central and peripheral visual fields. The median test duration was 71 s for the peripheral test and 803 s for the central test (p < 0.001).

Conclusions
Our study demonstrated the diversity of glaucomatous visual field defects, as well as the possibility of losing the clinically valuable information due to focusing on the central visual field test alone. The peripheral kinetic perimetry is clinically feasible to complement the central static perimetry for a comprehensive assessment of visual function in glaucoma patients.
No difference in the incidence or location of deep venous thrombosis according to use of pharmacological prophylaxis following total knee arthroplasty
Authors: Itou Junya , Kuwashima Umito , Itoh Masafumi , Okazaki Ken 
Published: September 2021

Abstract
Background
The incidence and characteristics of deep vein thrombosis (DVT) following total knee arthroplasty (TKA) without pharmacologic prophylaxis have not been fully investigated. This study aimed to determine whether there are any differences in the incidence, location, and characteristics of DVT following TKA with pharmacologic prophylaxis and without pharmacologic prophylaxis.

Methods
A total of 156 knees were retrospectively evaluated for DVT following TKA by duplex ultrasound on postoperative day 7, after excluding 60 knees from 216 consecutive knees because of antiplatelet or anticoagulant use before surgery, history of venous thromboembolism, or bleeding risk. The 156 knees included in the analysis were divided into two groups: with pharmacologic prophylaxis (n = 79) and without pharmacologic prophylaxis (n = 77).

Results
The overall incidence of DVT was 34% (54/156 knees). DVT was detected in 31.6% of knees with pharmacologic prophylaxis and in 37.6% of knees without pharmacologic prophylaxis; the difference was not statistically significant. Soleal vein thrombus was observed in 74.6% of the knees with DVT and non-floating thrombus was observed in 98.7%. There were no obvious between-group differences in thrombus characteristics such as compressibility, echogenicity, mean vein diameter, and whether the thrombus was attached to the vein wall or free-floating.

Conclusions
No differences were found in the incidence, location, or characteristics of DVT following TKA with or without pharmacological prophylaxis.
Treatment of humeral shaft fractures: a new minimally-invasive plate osteosynthesis versus open reduction and internal fixation: a case control study
Authors: Yang Jing , Liu Dapeng , Zhang Lina , Lu Zhanxin , Liu Tang , Tao Cheng 
Published: September 2021

Abstract
Background
To evaluate the feasibility and safety of a new minimally-invasive surgical approach–anteromedial minimally-invasive plate osteosynthesis (MIPO)–in the treatment of middle and distal humeral shaft fractures.

Methods
Fourteen patients with humeral shaft fracture treated with anteromedial MIPO from November 2016 to March 2020 (MIPO Group) were selected as the study subjects. Open reduction and internal fixation (ORIF) were used to treat 14 patients with humeral shaft fractures as the control group (ORIF group). The two groups were fixed with a locking compression plate (LCP) or LCP + multi-directional locking screw system (MDLS). The incision length, intraoperative blood loss, intraoperative fluoroscopy time, operation time, length of hospital stay, fracture healing time, QuickDASH score and Constant score were observed and compared between the two groups.

Results
Fourteen patients were enrolled in each group. The incision length (7.79 ± 2.39 cm), intraoperative blood loss (96.07 ± 14.96 mL), operative time (110.57 ± 21.90 min), hospital stay (6.29 ± 1.49 days) and fracture healing time (14.94 ± 0.99 weeks) in the MIPO group were all lower than those in the ORIF group, and the difference was statistically significant for each parameter (P < 0.05). The intraoperative fluoroscopy time (20.07 ± 3.22) in the MIPO group was significantly higher than that in the ORIF group (P < 0.05). There were no significant differences in age (P = 0.078), QuickDASH score (P = 0.074) or Constant score (P = 0.293) between the two groups and no postoperative complications occurred in any of the patients.

Conclusion
The anteromedial approach MIPO technique has the advantages of less trauma, less bleeding, low risk of nerve injury and high rate of fracture healing. It is one of the most effective methods for the treatment of middle and middle–distal humeral shaft fractures.
Physical functioning and mental health treatment initiation and retention for veterans with posttraumatic stress disorder: a prospective cohort study
Authors: Duan-Porter Wei , Nelson David B. , Ensrud Kristine E. , Spoont Michele R. 
Published: September 2021

Abstract
Background
Most US adults with posttraumatic stress disorder (PTSD) do not initiate mental health treatment within a year of diagnosis. Increasing treatment uptake can improve health and quality of life for those with PTSD. Individuals with PTSD are more likely to report poor physical functioning, which may contribute to difficulty with treatment initiation and retention. We sought to determine the effects of poor physical functioning on mental health treatment initiation and retention for individuals with PTSD.

Methods
We used data for a national cohort of veterans in VA care; diagnosed with PTSD in June 2008-July 2009; with no mental health treatment in the prior year; and who responded to baseline surveys on physical functioning and PTSD symptoms (n = 6,765). Physical functioning was assessed using Veterans RAND 12-item Short Form Health Survey, and encoded as limitations in physical functioning and role limitations due to physical health. Treatment initiation (within 6 months of diagnosis) was determined using VA data and categorized as none (reference), only medications, only psychotherapy, or both. Treatment retention was defined as having ≥ 4 months of appropriate antidepressant or ≥ 8 psychotherapy encounters.

Results
In multinomial models, greater limitations in physical functioning were associated with lower odds of initiating only psychotherapy (OR 0.82 [95 % CI 0.68, 0.97] for limited a little and OR 0.74 [0.61, 0.90] for limited a lot, compared to reference “Not limited at all”). However, it was not associated with initiation of medications alone (OR 1.04 [0.85, 1.28] for limited a little and OR 1.07 [0.86, 1.34] for limited a lot) or combined with psychotherapy (OR 1.03 [0.85, 1.25] for limited a little and OR 0.95 [0.78, 1.17] for limited a lot). Greater limitations in physical functioning were also associated with lower odds of psychotherapy retention (OR 0.69 [0.53, 0.89] for limited a lot) but not for medications (e.g., OR 0.96 [0.79, 1.17] for limited a lot). Role limitations was only associated with initiation of both medications and psychotherapy, but there was no effect gradient (OR 1.38 [1.03, 1.86] for limitations a little or some of the time, and OR 1.18 [0.63, 1.06] for most or all of the time, compared to reference “None of the time”). Accounting for chronic physical health conditions did not attenuate associations between limitations in physical functioning (or role limitations) and PTSD treatment; having more chronic conditions was associated with lower odds of both initiation and retention for all treatments (e.g., for 2 + conditions OR 0.53 [0.41, 0.67] for initiation of psychotherapy).

Conclusions
Greater limitations in physical functioning may be a barrier to psychotherapy initiation and retention. Future interventions addressing physical functioning may enhance uptake of psychotherapy.
Self-organising human gonads generated by a Matrigel-based gradient system
Authors: Oliver Elizabeth , Alves-Lopes João Pedro , Harteveld Femke , Mitchell Rod T. , Åkesson Elisabet , Söder Olle , Stukenborg Jan-Bernd 
Published: September 2021

Abstract
Background
Advances in three-dimensional culture technologies have led to progression in systems used to model the gonadal microenvironment in vitro. Despite demonstrating basic functionality, tissue organisation is often limited. We have previously detailed a three-dimensional culture model termed the three-layer gradient system to generate rat testicular organoids in vitro. Here we extend the model to human first-trimester embryonic gonadal tissue.

Results
Testicular cell suspensions reorganised into testis-like organoids with distinct seminiferous-like cords situated within an interstitial environment after 7 days. In contrast, tissue reorganisation failed to occur when mesonephros, which promotes testicular development in vivo, was included in the tissue digest. Organoids generated from dissociated female gonad cell suspensions formed loosely organised cords after 7 days. In addition to displaying testis-specific architecture, testis-like organoids demonstrated evidence of somatic cell differentiation. Within the 3-LGS, we observed the onset of AMH expression in the cytoplasm of SOX9-positive Sertoli cells within reorganised testicular cords. Leydig cell differentiation and onset of steroidogenic capacity was also revealed in the 3-LGS through the expression of key steroidogenic enzymes StAR and CYP17A1 within the interstitial compartment. While the 3-LGS generates a somatic cell environment capable of supporting germ cell survival in ovarian organoids germ cell loss was observed in testicular organoids.

Conclusion
The 3-LGS can be used to generate organised whole gonadal organoids within 7 days. The 3-LGS brings a new opportunity to explore gonadal organogenesis and contributes to the development of more complex in vitro models in the field of developmental and regenerative medicine.
Glycerol or crude glycerol as substrates make Pseudomonas aeruginosa achieve anaerobic production of rhamnolipids
Authors: Zhao Feng , Wu Yuting , Wang Qingzhi , Zheng Mengyao , Cui Qingfeng 
Published: September 2021

Abstract
Background
The anaerobic production of rhamnolipids is significant in research and application, such as foamless fermentation and in situ production of rhamnolipids in the anoxic environments. Although a few studies reported that some rare Pseudomonas aeruginosa strains can produce rhamnolipids anaerobically, the decisive factors for anaerobic production of rhamnolipids were unknown.

Results
Two possible hypotheses on the decisive factors for anaerobic production of rhamnolipids by P. aeruginosa were proposed, the strains specificity of rare P. aeruginosa (hypothesis 1) and the effect of specific substrates (hypothesis 2). This study assessed the anaerobic growth and rhamnolipids synthesis of three P. aeruginosa strains using different substrates. P. aeruginosa strains anaerobically grew well using all the tested substrates, but glycerol was the only carbon source that supported anaerobic production of rhamnolipids. Other carbon sources with different concentrations still failed for anaerobic production of rhamnolipids by P. aeruginosa. Nitrate was the excellent nitrogen source for anaerobic production of rhamnolipids. FTIR spectra analysis confirmed the anaerobically produced rhamnolipids by P. aeruginosa using glycerol. The anaerobically produced rhamnolipids decreased air-water surface tension to below 29.0 mN/m and emulsified crude oil with EI24 above 65%. Crude glycerol and 1, 2-propylene glycol also supported the anaerobic production of rhamnolipids by all P. aeruginosa strains. Prospects and bottlenecks to anaerobic production of rhamnolipids were also discussed.

Conclusions
Glycerol substrate was the decisive factor for anaerobic production of rhamnolipids by P. aeruginosa. Strain specificity resulted in the different anaerobic yield of rhamnolipids. Crude glycerol was one low cost substrate for anaerobic biosynthesis of rhamnolipids by P. aeruginosa. Results help advance the research on anaerobic production of rhamnolipids, deepen the biosynthesis theory of rhamnolipids and optimize the anaerobic production of rhamnolipids.
Successful transplantation of spermatogonial stem cells into the seminiferous tubules of busulfan-treated mice
Authors: Azizi Hossein , Niazi Tabar Amirreza , Skutella Thomas 
Published: September 2021

Abstract
Background
Spermatogonial stem cells (SSCs) in the testis are crucial for transferring genetic information to the next generation. Successful transplantation of SSCs to infertile men is an advanced therapeutic application in reproductive biology research.

Methods
In this experimental research, both in vitro and in vivo characterization of undifferentiated and differentiated SSCs were performed by morphology—immunocytochemistry (ICC), immunohistochemistry (IMH), Fluidigm Real-Time polymerase chain reaction (RT-PCR) and flow cytometry analysis. The isolated SSCs were finally microinjected into the rete testis of busulfan-treated mice.
The compact undifferentiated and more loosely connected round differentiated SSCs were isolated during testicular cell expansion from their specific feeder layer.

Results
ICC analysis indicated high and low expression levels of Zbtb16 in undifferentiated and differentiated germ cells. Also, IMH analysis showed different expression levels of Zbtb16 in the two different germ stem cell populations of the testicular tissue. While Fluidigm RT-PCR analysis indicated overexpression of the TAF4B germ cell gene, the expression of DAZL, VASA, and Zbtb16 were down-regulated during the differentiation of SSCs (P < 0.05). Also, flow cytometry analysis confirmed the significant downregulation of Itgb1 and Itga4 during differentiation. By transplantation of SSCs into busulfan-treated NOD/SCID mice, GFP-labeled sperm cells developed.

Conclusions
In the current study, we performed a transplantation technique that could be useful for the future microinjection of SSCs during infertility treatment and for studying in vivo differentiation of SSCs into sperm.
Human adenoviruses in paediatric patients with respiratory tract infections in Beijing, China
Authors: Huang Yiman , Wang Chao , Ma Fenlian , Guo Qiong , Yao Lihong , Chen Aijun , Luo Xiaoyi , Zheng Lishu 
Published: September 2021

Abstract
Background
Human adenoviruse (HAdV) is a major pathogen of paediatric respiratory tract infections (RTIs). Mutation or recombination of HAdV genes may cause changes in its pathogenicity and transmission. We described the epidemiology and genotypic diversity of HAdV in hospitalized children with RTIs in Beijing, China.

Methods
Nasopharyngeal aspirates were collected from hospitalized children with RTIs from April 2018 to March 2019. HAdVs were detected by a quantitative real-time PCR, and the hexon gene was used for phylogenetic analysis.

Results
Among 1572 samples, 90 (5.72%) were HAdV-positive. The HAdV detection rate was highest in November and July. Among HAdV-positive children, 61.11% (55/90) were co-infected with other respiratory viruses, the most common of which were human respiratory syncytial virus and human rhinovirus. The main diagnosis was bronchopneumonia, most patient have cough and fever. Children with a high viral load were more likely to have a high fever (P = 0.041) and elevated WBC count (P = 0.000). Of 55 HAdV-positive specimens, HAdV-B (63.64%), HAdV-C (27.27%), and HAdV-E (9.09%) were main epidemic species. Phylogenetic analysis indicated that hexon sequences of three samples were on the same branch with the recombinant HAdV strain (CBJ113), which was circulating in Beijing since 2016.

Conclusion
The HAdV-B3 and HAdV-B7 are the main epidemic strains in Beijing, and the recombinant HAdV-C strain CBJ113 has formed an epidemic trend.