bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of fluoroquinolone resistance determinants in Carbapenem-resistant Klebsiella pneumoniae clinical isolates associated with bloodstream infections in China
Authors: Zhan Qing , Xu Yanlei , Wang Bingjie , Yu Jingyi , Shen Xiaofei , Liu Li , Cao Xingwei , Guo Yinjuan , Yu Fangyou 
Published: June 2021

Abstract
Background
The rate of fluoroquinolone (FQ) resistance among carbapenem-resistant Klebsiella pneumoniae (CRKP) is high. The present study aimed to investigate the distribution of fluoroquinolone resistance determinants in clinical CRKP isolates associated with bloodstream infections (BSIs).

Results
A total of 149 BSI-associated clinical CRKP isolates collected from 11 Chinese teaching hospitals from 2015 to 2018 were investigated for the prevalence of fluoroquinolone resistance determinants, including plasmid-mediated quinolone resistance (PMQR) genes and spontaneous mutations in the quinolone resistance-determining regions (QRDRs) of the gyrA and parC genes. Among these 149 clinical CRKP isolates, 117 (78.5%) exhibited resistance to ciprofloxacin. The GyrA substitutions (Ser83 → IIe/Phe) and (Asp87 → Gly/Ala) were found among 112 (75.2%) of 149 isolates, while the substitution (Ser80 → IIe) of ParC was found in 111 (74.5%) of the 149 isolates. In total, 70.5% (105/149) of the CRKP isolates had at least two mutations within gyrA as well as a third mutation in parC. No mutations in the QRDRs were found in 31 ciprofloxacin susceptible CRKP isolates. Eighty-nine (56.9%) of 149 were found to carry PMQR genes including qnrS1 (43.0%), aac(6′)-Ib-cr (16.1%), qnrB4 (6.0%), qnrB2 (2.7%), and qnrB1 (1.3%). Nine isolates contained two or more PMQR genes, with one carrying four [aac(6′)-Ib-cr, qnr-S1, qnrB2, and qnrB4]. The co-existence rate of PMQR determinants and mutations in the QRDRs of gyrA and parC reached 68.5% (61/89). Seventy-four (83.1%, 74/89) PMQR-positive isolates harbored extended-spectrum beta-lactamase (ESBL)-encoding genes. Multilocus sequence typing (MLST) analysis demonstrated that the ST11 was the most prevalent STs in our study.

Conclusions
Mutations in the QRDRs of gyrA and parC were the key factors leading to the high prevalence of fluoroquinolone resistance among BSI-associated CRKP. The co-existence of PMQR genes and mutations in the QRDRs can increase the resistance level of CRKP to fluoroquinolones in clinical settings. ST11 CRKP isolates with identical QRDR substitution patterns were found throughout hospitals in China.
A case of infective colitis due to Yersinia enterocolitica complicated by microliver abscesses mimicking multiple liver occult metastases: a case report
Authors: Norrito Rosario Luca , Pintus Chiara , Cataldi Marco , Del Cuore Alessandro , Daidone Mario , Vassallo Valerio , Puleo Maria Grazia , Di Chiara Tiziana , Miceli Salvatore , Pizzo Giuseppina Maria , Brancatelli Giuseppe , Tuttolomondo Antonino , Pinto Antonio 
Published: June 2021

Abstract
Background
We report an unusual case of infective colitis by Yersinia enterocolitica complicated by microliver abscesses mimicking multiple liver metastases in a 79 yr old female without any risk factors for bacteriaemia by this pathogen.

Case presentation
The patient was admitted to the Internal Medicine with Stroke Care ward of University Policlinico “P. Giaccone” in Palermo because of the appearance of diarrhoea. After the antimicrobial treatment for infective colitis, the clinicians observed a persistently increased white blood cells (WBC) count and multiple hepatic lesions; after having excluded any neoplastic disease and inflammatory bowel disease (IBD), blood cultures positive for Y. enterocolitica allowed to establish the final diagnosis was infective micro liver abscesses consequent to infective colitis due to Y. enterocolitica, which were successfully treated with cefixime and doxycycline.

Conclusions
This case report should make clinicians reflect on how complex the differential diagnosis between microliver abscesses and metastasis could be and the possibility of bacteriaemia by Y. enterocolitica even without iron overload conditions.
Lactobacillus gasseri liver abscess and bacteremia: a case report
Authors: Ramos-Coria David , Canto-Losa Jorge , Carrillo-Vázquez Daniel , Carbajal-Morelos Leonardo , Estrada-León Rodrigo , Corona-Rodarte Eduardo 
Published: June 2021

Abstract
Background
Lactobacillus is a genus of Gram-positive non-spore-forming rods usually found in the microbiota of the oral cavity, gastrointestinal tract, and female genitourinary tract. Also, they are commonly used in the food industry as supplements and probiotics. Lactobacilli are normally considered non-pathogenic to the human body, however, under certain circumstances such as immunosuppression, they can cause severe infections, with only a few cases of bacteremia, infective endocarditis, pneumonia, meningitis, and intra-abdominal infections reported. Among these presentations, a pyogenic liver abscess is rather rare.

Case presentation
We describe the case of a 59-year-old man with a history of diabetes mellitus and multiple abdominal surgeries with the latest being in 2014 presenting with bacteremia and multiple large pyogenic liver abscesses due to Lactobacillus gasseri, which did not appear to be related to the use of probiotics or immunosuppression.

Conclusions
Given the high prevalence of diabetes mellitus and the increased use of probiotics, it is expected that in the future we will see an increase in infections caused by Lactobacilli. Medical management with antibiotics and percutaneous drainage were successful strategies for the treatment of this unusual case of pyogenic liver abscesses and bacteremia caused by Lactobacillus gasseri.
The views of postnatal women and midwives on midwives providing contraceptive advice and methods: a mixed method concurrent study
Authors: Walker Susan H. , Hooks Claire , Blake Diane 
Published: June 2021

Abstract
Background
Provision of contraception to women in the immediate postnatal period has been endorsed by professional bodies, to reduce the incidence of short inter-pregnancy intervals. This study examined the views of postnatal women and practising midwives regarding provision of contraceptive advice and contraceptive methods by midwives, in a region of the United Kingdom.

Methods
A mixed-method approach using qualitative interviews with midwives, and a postnatal survey followed by qualitative interviews with postnatal women, in five hospitals in the East of England. Twenty-one practising midwives and ten women were interviewed. Two hundred and twenty-seven women returned a survey.
Survey data was analysed descriptively, augmented by Student’s t-tests and Chi-squared tests to examine associations within the data.
Interviews were recorded, transcribed and analysed guided by the phases of thematic analysis.

Results
Midwives and women supported the concept of increased midwifery provision of contraceptive advice, and provision of contraceptive methods in the postnatal period. Convenience and an established trusting relationship were reasons for preferring midwifery provision over visiting a doctor for contraception.
The best time for detailed discussion was reported to be antenatal and community visits. The Progesterone-only-pill (POP) was the method, in which women indicated most interest postnatally.
Concerns for midwives included the need for increased education on contraceptive methods and training in supplying these. Structural barriers to such provision were time pressures, low prioritisation of contraceptive training and disputes over funding.

Conclusions
Women reported interest in midwives supplying contraceptive methods and expressed the view that this would be convenient and highly acceptable. Midwives are supportive of the concept of providing enhanced contraceptive advice and methods to women in their care, and believe that it would be advantageous for women.
Institutional support is required to overcome structural barriers such as poor access to continuous professional development, and to allow contraceptive provision to be fully recognised as integral to the midwifery role, rather than a marginalised addition.
Health-related quality of life in patients with newly diagnosed multiple myeloma ineligible for stem cell transplantation: results from the randomized phase III ALCYONE trial
Authors: Knop Stefan , Mateos Maria-Victoria , Dimopoulos Meletios A. , Suzuki Kenshi , Jakubowiak Andrzej , Doyen Chantal , Lucio Paulo , Nagy Zsolt , Usenko Ganna , Pour Ludek , Cook Mark , Grosicki Sebastian , Crepaldi Andre , Liberati Anna Marina , Campbell Philip , Shelekhova Tatiana , Yoon Sung-Soo , Losava Genadi , Fujisaki Tomoaki , Garg Mamta , Wang Jianping , Wroblewski Susan , Kudva Anupa , Gries Katharine S. , Fastenau John , San-Miguel Jesus , Cavo Michele 
Published: June 2021

Abstract
Background
In the phase III ALCYONE trial, daratumumab plus bortezomib/melphalan/prednisone (D-VMP) significantly improved overall response rate and progression-free status compared with VMP alone in transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM). Here, we present patient-reported outcomes (PROs) from ALCYONE.

Methods
The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item (EORTC QLQ-C30) and EuroQol 5-dimensional descriptive system (EQ-5D-5L) questionnaire were administered at baseline, every 3 months (year 1) and every 6 months (until progression). Treatment effects were assessed using a repeated-measures, mixed-effects model.

Results
Compliance with PRO assessments was comparable at baseline (> 90%) and throughout study (> 76%) for both treatment groups. Improvements from baseline were observed in both groups for EORTC QLQ-C30 Global Health Status (GHS), most functional scales, symptom scales and EQ-5D-5L visual analog scale (VAS). Between-group differences were significant for GHS (p = 0.0240) and VAS (p = 0.0160) at month 3. Improvements in pain were clinically meaningful in both groups at all assessment time points. Cognitive function declined in both groups, but the magnitude of the decline was not clinically meaningful.

Conclusions
Patients with transplant-ineligible NDMM demonstrated early and continuous improvements in health-related quality of life, including improvements in functioning and symptoms, following treatment with D-VMP or VMP.

Trial registration
ClinicalTrials.gov identifier NCT02195479, registered September 21, 2014
Integration of circulating tumor cell and neutrophil-lymphocyte ratio to identify high-risk metastatic castration-resistant prostate cancer patients
Authors: Chong Weelic , Zhang Zhenchao , Luo Rui , Gu Jian , Lin Jianqing , Wei Qiang , Li Bingshan , Myers Ronald , Lu-Yao Grace , Kelly William Kevin , Wang Chun , Yang Hushan 
Published: June 2021

Abstract
Background
The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and circulating tumor cells (CTCs) have been associated with survival in castration-resistant prostate cancer (CRPC). However, no study has examined the prognostic value of NLR and PLR in the context of CTCs.

Methods
Baseline CTCs from mCRPC patients were enumerated using the CellSearch System. Baseline NLR and PLR values were calculated using the data from routine complete blood counts. The associations of CTC, NLR, and PLR values, individually and jointly, with progression-free survival (PFS) and overall survival (OS), were evaluated using Kaplan-Meier analysis, as well as univariate and multivariate Cox models.

Results
CTCs were detected in 37 (58.7%) of 63 mCRPC patients, and among them, 16 (25.4%) had ≥5 CTCs. The presence of CTCs was significantly associated with a 4.02-fold increased risk for progression and a 3.72-fold increased risk of death during a median follow-up of 17.6 months. OS was shorter among patients with high levels of NLR or PLR than those with low levels (log-rank P = 0.023 and 0.077). Neither NLR nor PLR was individually associated with PFS. Among the 37 patients with detectable CTCs, those with a high NLR had significantly shorter OS (log-rank P = 0.024); however, among the 26 patients without CTCs, the OS difference between high- and low-NLR groups was not statistically significant. Compared to the patients with CTCs and low NLR, those with CTCs and high levels of NLR had a 3.79-fold risk of death (P = 0.036). This association remained significant after adjusting for covariates (P = 0.031). Combination analyses of CTC and PLR did not yield significant results.

Conclusion
Among patients with detectable CTCs, the use of NLR could further classify patients into different risk groups, suggesting a complementary role for NLR in CTC-based prognostic stratification in mCRPC.
Comparison of the visual performance of iris-fixated phakic lens and implantable collamer lens to correct high myopia
Authors: Jiao Xiao-ling , Li Jun , Yu Zhe , Wei Ping-hui , Song Hui 
Published: June 2021

Abstract
Background
To compare visual performance between the iris-fixated phakic intraocular len (pIOL) and implantable collamer len (ICL) to correct high myopia.

Methods
Twenty-four eyes underwent iris-fixated pIOL implantation and 24 eyes underwent ICL implantation. At the 6-month follow-up, the best-corrected visual acuity (BCVA) and uncorrected distance visual acuity (UDVA) were compared between the iris-fixated pIOL and ICL groups. The objective scatter index (OSI), modulation transfer function (MTF) cutoff, and ocular aberrations were performed to evaluate postoperative visual quality between the two groups.

Results
No significant difference was found in UDVA, BCVA, and spherical equivalent between the iris-fixated pIOL and ICL groups (P > 0.05). Six months after surgery, the following values were significantly higher in the ICL group than in the iris-fixated pIOL group: MTF cutoff, strehl ratio and optical quality analysis system values at contrasts of 9 %, 20 %, and 100 % (P < 0.01). The OSI in the iris-fixated pIOL group was higher than in the ICL group 6 months after surgery (P < 0.01). All high-order aberrations were slightly more severe in the iris-fixated pIOL group than in the ICL group 6 months after surgery, although only trefoil (P = 0.023) differed significantly in this regard.

Conclusions
Both iris-fixated lenses and ICLs can provide good visual acuity. ICLs confer better visual performance in MTF-associated parameters and induce less intraocular light scattering than iris-fixated pIOLs.
Sleep and its relation to health-related quality of life in 3–10-year-old children
Authors: Sundell Anna Lena , Angelhoff Charlotte 
Published: June 2021

Abstract
Background
Considering the reports of increasing sleep problems in children, affecting health and well-being in young children and their families, we found it important to gain more knowledge about sleep and its correlation to health-related quality of life (HRQoL) in young, healthy children. The aims with this study were to describe sleep quality, sleep duration, and HRQoL in healthy 3–10-year-old children and to test associations between children’s sleep and HRQoL.

Methods
Parents of 160 children (average age: 6.9 years, SD ±2.2) participated in the study. Sleep onset problems (SOP), sleep maintenance problems (SMP), and sleep duration were measured by the Pediatric Insomnia Severity Index (PISI). KIDSCREEN-27 was used to measure HRQoL in five dimensions: physical well-being, psychological well-being, autonomy and parent relation, social support and peers, and school environment.

Results
The average score was 2.2 for SOP (SD +/− 2.2) and 1.3 for SMP (SD +/− 1.6). Few children (2%) were reported to sleep less than 8 h per night. Younger children had statistically significant higher SOP and SMP than older children. Correlations were found between SOP and poor psychological well-being (p < 0.05, ρ = − 0.16), and between SMP and poor physical wellbeing (p < 0.05, ρ = − 0.16), psychological well-being (p < 0.05, ρ = − 0.21), poor school environment (p < 0.01, ρ = − 0.29), autonomy and parent relation (p < 0.05, ρ = − 0.16), and poor social support and peers (p < 0.05, ρ = − 0.19).

Conclusion
Children’s sleep associates with health-related quality of life and needs to be acknowledged in child health care settings and schools.
When can physical distancing be relaxed? A health production function approach for COVID-19 control policy
Authors: Wibowo Dradjad H. 
Published: June 2021

Abstract
Background
To assess if physical distancing measures to control the COVID-19 pandemic can be relaxed, one of the key indicators used is the reproduction number R. Many developing countries, however, have limited capacities to estimate R accurately. This study aims to demonstrate how health production function can be used to assess the state of COVID-19 transmission and to determine a risk-based relaxation policy.

Methods
The author employs a simple “bridge” between epidemiological models and production economics to establish the cumulative number of COVID-19 cases as a short-run total product function and to derive the corresponding marginal product, average product, and production elasticity. Three crucial dates defining the states of transmission, labelled red, yellow, and green zones, are determined. Relaxation policy is illogical in the “red zone” and is not recommended in the “yellow zone”. In the “green zone”, relaxation can be considered. The Bayesian probability of near term’s daily cases meeting a policy target is computed. The method is applied to France, Germany, Italy, the UK, and the US, and to Indonesia as an example of application in developing countries.

Results
This study uses data from the WHO COVID-19 Dashboard, beginning from the first recording date for each country until February 28, 2021. As of June 30, 2020, France, Germany, Italy, and the UK had arrived at the “green zone” but with a high risk of transmission re-escalations. In the following weeks, their production elasticities were rising, giving a signal of accelerated transmissions. The signal was corroborated by these countries’ rising cases, making them leaving the “green zone” in the later months. By February 28, 2021, the UK had returned to the “green zone”, France, Germany, and Italy were still in the “yellow zone”, while the US reached the “green zone” at a very high number of cases. Despite being in the “red zone”, Indonesia relaxed its distancing measures, causing a sharp rise of cases.

Conclusions
Health production function can show the state of COVID-19 transmission. A rising production elasticity gives an early warning of transmission escalations. The elasticity is a useful parameter for risk-based relaxation policy.
Experiences and factors associated with transphobic hate crimes among transgender women in the San Francisco Bay Area: comparisons across race
Authors: Gyamerah Akua O. , Baguso Glenda , Santiago-Rodriguez Edda , Sa’id Aria , Arayasirikul Sean , Lin Jess , Turner Caitlin M. , Taylor Kelly D. , McFarland Willi , Wilson Erin C. , Wesson Paul 
Published: June 2021

AbstractBackgroundTrans women experience high rates of gender-based violence (GBV)—a risk factor for adverse health outcomes. Transphobic hate crimes are one such form of GBV that affect trans women. However, little is understood about factors that shape transphobic hate crimes and racial/ethnic variation in these experiences. To contextualize GBV risk and police reporting, we examined self-reported types and correlates of transphobic hate crimes by racial/ethnic group of trans women in the San Francisco Bay Area.MethodsFrom 2016 to 2018, trans women participated in a longitudinal cohort study of HIV. Secondary data analyses (N = 629) examined self-reported experiences of transphobic hate crimes (i.e., robbery, physical assault, sexual assault, and battery with weapon) by race/ethnicity, and whether hate crimes were reported to the police. Chi-square tests and simple logistic regression examined demographic, sociocultural, and gender identity factors associated with transphobic violence experiences and police reporting.ResultsAbout half (45.8%) of participants reported ever experiencing a transphobic hate crime; only 51.1% of these were reported to the police. Among those who reported a hate crime experience, Black (47.9%) and Latina (49.0%) trans women reported a higher prevalence of battery with a weapon; White (26.7%) and trans women of “other” race/ethnicities (25.0%) reported a higher prevalence of sexual assault (p = 0.001). Having one’s gender questioned, history of sex work, homelessness as a child and adult, and a history incarceration were associated with higher odds of experiencing a transphobic hate crime. Trans women who felt their gender identity questioned had lower odds of reporting a hate crime to the police compared to those did not feel questioned.ConclusionsA high proportion of trans women experienced a transphobic hate crime, with significant socio-structural risk factors and racial differences by crime type. However, crimes were underreported to the police. Interventions that address structural factors, especially among trans women of color, can yield violence prevention benefits.
Cryptolepine inhibits hepatocellular carcinoma growth through inhibiting interleukin-6/STAT3 signalling
Authors: Domfeh Seth A. , Narkwa Patrick W. , Quaye Osbourne , Kusi Kwadwo A. , Awandare Gordon A. , Ansah Charles , Salam Alimatu , Mutocheluh Mohamed 
Published: June 2021

AbstractBackgroundDiverse signalling pathways are involved in carcinogenesis and one of such pathways implicated in many cancers is the interleukin 6/signal transducer and activator of transcription 3 (IL-6/STAT3) signalling pathway. Therefore, inhibition of this pathway is targeted as an anti-cancer intervention. This study aimed to establish the effect of cryptolepine, which is the main bioactive alkaloid in the medicinal plantCryptolepis sanguinolenta, on the IL-6/STAT3 signalling pathway.MethodsFirst, the effect of cryptolepine on the IL-6/STAT3 pathway in human hepatoma cells (HepG2 cells) was screened using the Cignal Finder Multi-Pathway Reporter Array. Next, to confirm the effect of cryptolepine on the IL-6/STAT3 signalling pathway, the pathway was activated using 200 ng/mL IL-6 in the presence of 0.5–2 μM cryptolepine. The levels of total STAT3, p-STAT3 and IL-23 were assessed by ELISA.ResultsCryptolepine downregulated 12 signalling pathways including the IL-6/STAT3 signalling pathway and upregulated 17 signalling pathways. Cryptolepine, in the presence of IL-6, decreased the levels of p-STAT3 and IL-23 in a dose-dependent fashion.ConclusionOur results demonstrated that cryptolepine inhibits the IL-6/STAT3 signalling pathway, and therefore cryptolepine-based remedies such asCryptolepis sanguinolentacould potentially be used as an effective immunotherapeutic agent for hepatocellular carcinoma and other cancers.