bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge and attitudes of physicians in caring for transgender and transsexual patients
Authors: Garcia Marquez CG , Villegas Dominguez JE , Espinoza Mejia E , Morales Aguilar AM , Marquez Celedonio FG 
Published: October 2021

Abstract

Background
Currently, care for the community of transgender and transsexual patients has been specialized in different countries of the European Union, thereby favoring better medical care for this community of patients, however, in countries like Mexico there is still no these spaces, thereby favoring the lack of dignified treatment.

Objective
To determine the correlation between knowledge and attitudes of doctors in the care of transgender and transsexual patients in doctors from the State of Veracruz Ignacio de la Llave.

Material and methods
A cross-sectional, prospective, observational, analytical and correlational study was carried out. Doctors from the state of Veracruz were included and the tests of ‘Knowledge about transsexuality' and ‘evaluation of attitudes towards the transgender and transsexual community' (Cronbach's alpha of 0.75 and 0.85) were applied by means of electronic surveys, being selected by non-probability sampling.

Results
359 doctors were included, of which 201 (56%) were men, with Catholic religion in 197 (54.4%) of the cases, cisgender in 333 (92.8%), hetero sexual 296 (82.5%) with older age. frequent between 23 to 29 years (56.3%). The correlation between the level of knowledge about transsexuality and the scale of attitude towards the transgender community was -0.08, while that of the level of knowledge about transsexuality and the scale of attitude towards the transgender community was -0.39. The Catholic religion, being a biological man, and being heterosexual showed values of p &lt; 0.05 with respect to the presence of prejudices for the transgender and transsexual community.

Conclusions
There is no correlation between knowledge about transsexuality and the attitude towards this group by the doctors of the state of Veracruz.

Key messages
There is no correlation between knowledge about transsexuality and the attitude towards this group by the doctors of the state of Veracruz. To practice the catholic religion, being a biological man, and being heterosexual its associated to the presence of prejudices for the transgender and transsexual community.
Scabies in wildlife animals, pets and humans: a re-emerging zoonosis?
Authors: Rubini S , Zaghi S , Tazzari A , Lo Chiano F , Govoni G , Cavazzini M , Taddei R , Fontana MC , Barbieri S , Defilippo F 
Published: October 2021

Abstract

Background
Scabies or sarcoptic mange is an infestation of the skin caused by the mite Sarcoptes scabiei. Transmission from animals to humans occurs through close contact. The most common symptoms are papules, erythema, excoriations, hyperkeratosis, and hypotrichosis. In the province of Ferrara (Emilia Romagna, Italy) mange is endemic in wild animals, mostly in foxes, which can act as vectors for domestic animals and humans.

Methods
From 2012 to 2020, 564 foxes were surveyed within the Wildlife Health Surveillance Re-gional Program, including microscopic examination in cases of skin lesions referable to scabies. In 2018, a domestic dog (10-year border collie, male), frequenting an uncultivated area colonized by foxes and located in the outskirts of Ferrara, showed scabby lesions mainly on the nose, around the eyes and on the back.

Results
11 out of 564 foxes resulted positive (1,95%), 6 cases out of 38 being in 2018 (15,8%). The parasite was detected by skin biopsy and direct microscopic examination in the domestic dog. The parasite was transmitted by the dog to the owner and the other two family members.

Conclusions
The increased density of dogs and foxes in the Ferrara province, and the attitude of foxes to live near to human settlements, increase the risk of contacts between foxes, domestic animals and humans, even though stray dogs are uncommon. This case illustrates the interdependencies between animal health, human health and environment, a synergy that can enable exacerbation of diseases of zoonotic origin as highlighted by the One Health concept. It is therefore important to increase the investigation on paths as well as vectors of diseases and to find collaborative, multi-sectorial and transversal approaches to ensure quality health outcomes. The control of the disease requires an appropriate monitoring of dogs' health being skin lesions in both, humans and animals, very similar to allergic dermatitis, which can delay the proper diagnosis of the disease.

Key messages
Sarcoptic mange is a zoonosis still present in Emilia Romagna, Italy. The One Health approach is key to control the cycle of the zoonotic sarcoptic mange.
Genotyping of Listeria monocytogenes strains in Italian food-processing environments
Authors: Torresi M , Chiaverini A , Acciari VA , Centorame P , Centorotola G , Guidi F , Russini V , Pomilio F 
Published: October 2021

Abstract

Background
In 2019, case fatality from Listeria monocytogenes (Lm) was higher than the previous years confirming Lm as a major public health problem. Food is the main source of Lm infection and cross-contamination from the food-processing environment (FPEs) is the most common route of contamination. The aim of this work was to characterize FPEs Lm strains collected from the National Reference Laboratory (NRL) for Lm in order to evaluate circulating clonal complexes (CCs) and their environmental adaptation.

Methods
NRL Lm database actually consists of 798 FPEs sequenced strains. In silico MLST was evaluated. Sequences related to prevalent CCs were further investigated using Pasteur's cgMLST scheme and detecting metal and detergent resistance genes and stress survival islet (SSI).

Results
MLST identified 25 CCs and 4 singleton. Nine isolates gave inexact match with existing alleles and were not classified. CC9 (17.4%) and CC121 (14.2%) were the prevalent clones. CC9 cgMLST analysis revealed a relatedness among strains isolated from the same establishment type (meat or dairy), even if sampled in different regions. Indeed, CC121 cgMLST clustering analysis was strictly associated to the point of sampling. Regarding stress adaptation genes, SSI1 and brcABC genes were detected in 100% and 2.9% of the CC9 strains, respectively. Meanwhile, SSI2 and transposon Tn6188 were detected, respectively, in 100% and 97.3% of CC121 strains.

Conclusions
Results confirmed, in Italian FPEs, prevalence of hypovirulent Lm strains, as previously observed in Italian food. Tested isolates highlighted adaptation to low pH and high salt concentration (SSI1 genes for CC9), to alkaline and oxidative stress (SSI2 genes for CC121) and benzalkonium chloride tolerance (Tn6188 in CC121) resulting in a best survival under stress conditions. Interestingly, CC9 clustering denoted allelic proximity among strains isolated in different Italian regions paying attention to clones spreading at national level.

Key messages
Listeria monocytogenes CC9 and CC121 prevalence in Italian establishment confirms environment is the main route of food contamination at production level. Prevalent food-processing environmental Italian Listeria monocytogenes strains denotes adaptation to environmental stress and clones spreading at national level.
Shiga-toxin producing Escherichia coli detection in samples from Abruzzo and Molise regions, Italy
Authors: Ciarrocchi A , Iannetti L , Cornacchia A , Di Marzio V , Torresi M , Centorotola G , Antoci S , Pomilio F , Marfoglia C 
Published: October 2021

Abstract

Background
Top five serogroups (O157, O111, O26, O103 and O145) of Shiga-toxin producing Escherichia coli (STEC) represent the third most important increasing zoonosis reported in European Union. The ISO methods of analysis, used in foods and environmental samples, quite often does not confirm the molecular detection of STEC genes (stx1 and stx2) in enrichment broth. The aim of this study was to summarize the results of the tests carried out at Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise in the last six years (2016-2021), comparing genes detection in enrichment broth and in colonies grown on agar plates.

Methods
Along the 2016-2021, a total of 1716 foods and environmental samples from Abruzzo and Molise regions were tested, according to ISO/TS 13136:2012.

Results
Out of 1716 samples, 16 (0.9%) shown presumptive positive presence of STEC (stx1 and/or stx2) in broth. In spite of that, the presence of STEC (positive colonies for stx1 and/or stx2) was confirmed only in 4 out of 16 samples (one sample of cheese and 3 of minced meat). Then, eae gene was found in 54 samples in broth and only in 3 samples from colonies, during a foodborne outbreak investigation. Serogroup specific targets were detected in 6 broth samples (O26, O145 and O157) and confirmed in colonies only in 2 minced meat samples (O157).

Conclusions
STEC are a heavy hazard for the consumers and the number of cases is slightly increasing since 2015. Our results highlight a low number of presumptive positive samples and even lower number of STEC detection obtained with the ISO classical method. Furthermore, detection of the target genes in broth was rarely confirmed after plating, highlighting a weak point of the analytical method that needs to be investigated. Efforts are necessary to improve the method and the STEC confirmation from colonies. Immunomagnetic beads targeting the top five serogroups and digital PCR could help in increasing the recovery rate of cultivable STEC.

Key messages
The presumptive positive samples for STEC genes in foodstuffs from the Abruzzo and Molise regions are quite rare, even lower is the number of confirmed colonies by agar plate isolation. Specific immunomagnetic beads for the top five STEC serogroups could improve the method and the STEC colonies detection, increasing the recovery rate of cultivable strains.
Drinking water quality surveillance status for Amazonas state's 62 counties
Authors: Menezes MDS , Ribeiro NL , Melo GSB , Magalhaes ALTG , Figueira EAM , Menezes ACS , Araujo VC 
Published: October 2021

Abstract

Introduction
The state of Amazonas is the largest state in Brazil and it has 62 counties, including Manaus, its capital, all of which have plenty of water resources. The control and surveillance of water quality, as well as the sewage treatment must be carried out satisfactorily in order to avoid a favorable environment for the development of pathogens that cause water related diseases.

Objectives
Assess the quality of the water supplied to the population of the 62 counties in the period of 2015-2019.

Methods
Quantitative and qualitative descriptive study, based on secondary data taken from Water Quality Surveillance Information System for Human Consumption. and analyzed from the available database at the Health Surveillance Foundation. Information was gathered on the type of collection, treatment, control, surveillance and microbiological (total coliforms and Escherichia coli).

Results
it was observed that 73% of the counties use underground water (well), 19% superficial (rivers) and 8% mixed combination (underground and superficial); 35% undergo chlorine treatment; less than 50%, averaging 26 counties, carry out control, surveillance and/or combined control and surveillance activities; on average: 29% have control data; 23% of surveillance and of these, 19% embody it effectively (≥ 7 months/year) and 19% of control and surveillance simultaneously. During the study, 46,670 microbiological analysis were carried out and of these 10,603 (23%) presented total coliforms and 2.265, approximately 4.9%, unsatisfactory result for human consumption due to the presence of Escherichia coli. The data demonstrate that the control and surveillance of water quality is carried out in an unsatisfactory manner, highlighting the need to strengthen the performance of the health sector and those responsible for an alternative water supply system or alternative solution in the state Amazonas.

Key messages
Measuring the effectiveness of surveillance actions are necessary for water quality control. Vigilance actions are important to reduce morbidity and mortality due to water transmission problems.
Health literacy in phases of health information processing in the Czech population
Authors: Polcrova A , Lustigova M , Pavlovska I , Maranhao Neto GA , Pikhart H , Kucera Z , Gonzalez-Rivas JP 
Published: October 2021

Abstract

Background
Low level of health literacy (HL), defined as an individual's ability to process health information, is strongly associated with higher mortality and morbidity. In earlier analysis of cross-sectional survey in Czechia in 2014, 59% of subjects showed a low level of HL, with particularly worrying results in area of health promotion (64% with low levels of HL). The levels of HL in phases of health information processing, however, were not included.

Aim
To describe the level of HL in phases of obtaining, understanding, evaluating, and applying health information, and to assess social determinants of HL in these phases.

Methods
18 to 65 years old subjects from a random population-based Czech sample from 2014 were evaluated using a cross-sectional design. The level of HL was determined by Health Literacy Index (HLI, range 0-50). A low level of HL was defined as HLI &lt;33. Logistic regression was used to assess the association between a low level of HL and social status.

Results
In total, 996 participants (51% females) were included. The prevalence of low level of HL was 64% in obtaining, 56% in understanding, 70% in evaluating and 64% in applying. A low level of HL was associated with a low perceived social status in all phases of information processing even after adjustment for age, gender, education, self-reported health condition, physical activity, BMI and smoking status (ORs 3.2, 2.0, 3.4 and 2.8, respectively, for obtaining, understanding, evaluating and applying, all p-values&lt;0.05).

Conclusions
People with lower social status have a higher risk of a low level of HL in all phases, with the highest risk in the phase of health information evaluation which was determined as the most problematic. Further intervention should aim to support individual skills in decision making and actions in fields of healthcare, disease prevention, and health promotion including the availability of relevant understandable information for all social groups in the population.

Key messages
The most problematic area of health literacy is health information evaluation. People with lower social status have a higher risk of a low level of health literacy.
The Use of Different Sepsis Risk Stratification Tools on the Wards and in Emergency Departments Uncovers Different Mortality Risks: Results of the Three Welsh National Multicenter Point-Prevalence Studies
Authors: Unwin Harry J. A. , Kopczynska Maja , Pugh Richard , Tan Laura J. P. , Subbe Christian P. , Ellis Gemma , Morgan Paul , Havalda Peter , Sharif Ben , Burke John , Szakmany Tamas 
Published: October 2021

OBJECTIVES:
To compare the performance of Sequential Organ Failure Assessment, systemic inflammatory response syndrome, Red Flag Sepsis, and National Institute of Clinical Excellence sepsis risk stratification tools in the identification of patients at greatest risk of mortality from sepsis in nonintensive care environments.

DESIGN:
Secondary analysis of three annual 24-hour point-prevalence study periods.

SETTING:
The general wards and emergency departments of 14 acute hospitals across Wales. Studies were conducted on the third Wednesday of October in 2017, 2018, and 2019.

PATIENTS:
We screened all patients presenting to the emergency department and on the general wards.

MEASUREMENTS AND MAIN RESULTS:
We recruited 1,271 patients, of which 724 (56.9%) had systemic inflammatory response syndrome greater than or equal to 2, 679 (53.4%) had Sequential Organ Failure Assessment greater than or equal to 2, and 977 (76.9%) had Red Flag Sepsis. When stratified according to National Institute of Clinical Excellence guidelines, 450 patients (35.4%) were in the “High risk” category in comparison with 665 (52.3%) in “Moderate to High risk” and 156 (12.3%) in “Low risk” category. In a planned sensitivity analysis, we found that none of the tools accurately predicted mortality at 90 days, and Sequential Organ Failure Assessment and National Institute of Clinical Excellence tools showed only moderate discriminatory power for mortality at 7 and 14 days. Furthermore, we could not find any significant correlation with any of the tools at any of the mortality time points.

CONCLUSIONS:
Our data suggest that the sepsis risk stratification tools currently utilized in emergency departments and on the general wards do not predict mortality adequately. This is illustrated by the disparity in mortality risk of the populations captured by each instrument, as well as the weak concordance between them. We propose that future studies on the development of sepsis identification tools should focus on identifying predicator values of both the short- and long-term outcomes of sepsis.
Gram-negative endocarditis: disease presentation, diagnosis and treatment
Authors: Bouza Emilio , Muñoz Patricia , Burillo Almudena 
Published: October 2021

Purpose of review
Gram-negative bacilli (GNB) cause between 1% and 10% of infective endocarditis (IE). Most episodes are caused by microorganisms of the Haemophilus spp., Aggregatibacter spp. Cardiobacterium spp., Eikenella spp., and Kingella spp (HACEK) group. The frequency of IE caused by non-HACEK (GNB-IE) has increased in recent years. Uncertainties persist regarding its best medical treatment and the appropriateness and timing of surgical treatment. In addition, there are new drugs with activity against multiresistant microorganisms, of which there is little experience in this disease. We review this topic by answering the most frequently asked questions that arise among our colleagues.

Recent findings
HACEK microorganisms cause 1.5–2% of IE with only a 2% mortality. In contrast, non-HACEK GNB-IE accounts for 2.5–3% of all IE cases and is associated with nosocomial acquisition, advanced age, solid organ transplantation and 20–30% mortality. Drug addiction is important in areas with epidemic opioid abuse.

Summary
The frequency of IE caused by GNB has been modified in recent years. HACEK episodes are no longer treated with ampicillin and aminoglycosides. In non-HACEK GNB-IE, combination therapy with a beta-lactam and a quinolone or aminoglycoside is recommended. The surgical indication and its value are evident in many patients. Management should rely on a collaborative group with experience in this disease.
Accuracy of 3 Soft Tissue Prediction Methods After Double-Jaw Orthognathic Surgery in Class III Patients
Authors: Demirsoy Kevser Kurt , Kurt Gökmen 
Published: October 2021

Purpose
We aimed to evaluate the accuracy and validity of conventional manual prediction method (CM) and 2-dimensional and 3-dimensional (3D) soft tissue prediction methods for Class III bimaxillary orthognathic surgery patients.

Methods
Twenty skeletal Class III patients were included in this study. Soft tissue prediction was achieved with a traditional manual technique, 2-dimensional software (Dolphin Imaging, version 11.5), and 3-dimensional software (SimPlant Master, version 16.0) on preoperative lateral cephalometric radiographs and cone beam computurized tomography (CBCT) images and then compared with postoperative lateral cephalometric radiographs obtained at least 6 months after surgery (mean, 11.5 ± 6.77 months). Forty-eight measurements were done to determine the reliability of the methods.

Results
All prediction methods have limited postsurgery prediction accuracy for the subnasal upper lip area. Most of the differences were not more than 3 mm for all study groups, except the 3D software, which predicted the upper lip area to be, on average, 3.08 ± 1.38 mm further back (P < 0.001). Although the conventional method predicted 20 of 48 measurements similar to the final results, the poorest predictions were found at the nasal and labiomental areas (P < 0.001). Two-dimensional software predicted 23 of 48 measurements very close to the final results but made significantly different predictions for the nasolabial and labiomental angles, labrale superius point, and the chin area.

Conclusions
The 3D method predicted, especially the upper lip area, to be significantly and clinically incorrect, and its soft tissue prediction was insufficient compared with the other 2 methods. The 3D software needs to be updated, especially in evaluating soft tissue A point and upper lip changes after surgery.
The Membrane-Like Structure From Extensor Tendon to the Nail in the Distal End of Digits
Authors: Aoki Shimpo , Nagano Hisato , Kiyosawa Tomoharu , Matsui Toshiyasu , Kobayashi Yasushi 
Published: October 2021

Abstract
In distal dorsal finger injuries, the delicate structures of the nail matrix or insertion of the extensor tendon to the distal phalangeal bone should be preserved or repaired for esthetic and functional results. To explore these structures for a safer surgical approach, we focused on a membrane-like structure (the superficial extended portion of the extensor tendon [SEP]), poorly described previously, that attaches between the nail halter and the extensor tendon.

Methods
The nail structures of 6 cadavers were investigated in each of the 10 digits of the hand. In the histological study, the thickness, length, and location of the SEP were measured in each digit of 3 cadavers. In the other 3 cadavers, the moving distance of the SEP was measured macroscopically with the distal interphalangeal joint in flexion at 0 to 60 degrees for confirmation of the function. This moving distance could be considered as an indicator of the SEP straining the surrounding (retaining) structure and improving the stability of the nail in pinches.

Result
The SEP was recognized in all the digits. The average length of the SEPs was 2.38 ± 0.11 mm (mean ± SE). The average thickness of the SEPs was 0.35 ± 0.02 mm. The nail matrix and its feeding artery were found beneath the SEP in all digits. The average moving distance of the SEP was 1.38 ± 0.06 mm. This moving distance could be considered sufficiently large to support the role of SEP in the pinches compared with the excursion of the extensor tendon at the DIP joint in a previous report.

Conclusions
The SEP has been shown to play an essential role in fingertip stabilization in pinches. It can serve as an anatomical marker to avoid iatrogenic damage to the nail matrix in surgical approaches.