bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for, and molecular epidemiology and clinical outcomes of, carbapenem‐ and polymyxin‐resistant Gram‐negative bacterial infections in pregnant women, infants, and toddlers: a systematic review and meta‐analyses
Authors: Osei Sekyere John , Reta Melese Abate , Bernard Fourie Petrus 
Published: July 2021

AbstractIn the following systematic review and meta‐analyses, we report several conclusions about resistance to carbapenem and polymyxin last‐resort antibiotics for treating multidrug‐resistant bacterial infections among pregnant women and infants. Resistance to carbapenems and polymyxins is increasing, even in otherwise vulnerable groups such as pregnant women, toddlers, and infants, for whom therapeutic options are limited. In almost all countries, carbapenem‐/polymyxin–resistant Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii infect and/or colonize neonates and pregnant women, causing periodic outbreaks with very high infant mortalities. Downregulation of plasmid‐borne blaNDM, blaKPC, blaOXA‐48, blaIMP, blaVIM, blaGES‐5, and ompK35/36 in clonal strains accelerates the horizontal and vertical transmissions of carbapenem resistance among these pathogens. New Delhi metallo‐β‐lactamase (NDM)–positive isolates in infants/neonates have been mainly detected in China and India, while OXA‐48–positive isolates in infants/neonates have been mainly detected in Africa. NDM‐positive isolates in pregnant women have been found only in Madagascar. Antibiotic therapy, prolonged hospitalization, invasive procedures, mechanical ventilation, low birth weight, and preterm delivery have been common risk factors associated with carbapenem/polymyxin resistance. The use of polymyxins to treat carbapenem‐resistant infections may be selecting for resistance to both agents, restricting therapeutic options for infected infants and pregnant women. Currently, low‐ and middle‐income countries have the highest burden of these pathogens. Antibiotic stewardship, periodic rectal and vaginal screening, and strict infection control practices in neonatal ICUs are necessary to forestall future outbreaks and deaths.
Son Preference, Gender Discrimination, and Missing Girls in Rural Spain, 1750–1950
Authors: Marco‐Gracia Francisco J. , Beltrán Tapia Francisco J. 
Published: July 2021

AbstractRelying on longitudinal microdata from a Spanish rural region between 1750 and 1950 (almost 35,000 life courses), this article provides evidence that discriminatory practices affected sex‐specific mortality during infancy and childhood. Although it is likely that families also discriminated against girls during the first year of life, female excess mortality was especially visible in the 1–5 age group. While breastfeeding seems to have temporarily mitigated the effects of gender discrimination, sex‐specific mortality rates behaved very differently once children were weaned. Parents, therefore, prioritized boys during infancy and childhood in the allocation of food and/or care in order to enhance their survival chances.
Reasons for never receiving a pap test among Brazilian women: National health survey
Authors: Rodrigues Claudia Fernandes , Coutinho José Victor Afonso , Muzi Camila Drumond , Guimarães Raphael Mendonça 
Published: July 2021

AbstractObjectiveTo identify reasons among Brazilian women for never having a Pap test.DesignWe designed a cross‐sectional study that used data from the National Health Survey.SampleTwo thousand four hundred and two women 25–64 years old who never had a pap test.MeasuresVariables were age, race, education, marital status, housing condition, primary health care access, health insurance, self‐perceived health, and social support network. We calculated the prevalence of different reasons and odds ratios for each.ResultsThe most frequent reason for never having a test were linked to women thinking the test was unnecessary (42.3%) which had a significant association with marital status (OR = 1.52; 95% CI = 1.07–1.91), age (OR = 1.56; 95% CI = 1.21–1.99), area of residence (OR = 1.15; 95% CI = 1.02–1.39), having a health insurance (OR = 1.18; 95% CI = 1.01–1.36), and self‐perceived health (OR = 1.42; 95% CI = 1.28–1.56). The second most frequent reason was not knowing they needed a test (22.9%) which was associated with age (OR = 1.95; 95% CI = 1.74–2.16) and self‐perceived health (OR = 1.56; 95% CI = 1.33–1.80).ConclusionsThe findings suggest lack of knowledge about cervical cancer and its prevention among Brazilian women. We consider it essential that the health service can provide the test, as well as the necessary guidelines for raising the awareness of the target audience.
Multidisciplinary pharmacotherapy collaboration for home‐based older adults with dementia: a study focusing on physicians, pharmacists, and nursing professionals
Authors: Suwa Sayuri , Tsujimura Mayuko , Yumoto Akiyo , Iwata Naoko , Shimamura Atsuko 
Published: July 2021

AbstractBackgroundIt is imperative that a team consisting of a physician, pharmacist, and nursing professional provides pharmacotherapy support to achieve the optimal effect of pharmacotherapy for older adults with dementia. This study reviewed Japanese publications on the process of pharmacotherapy support practised by various professionals for home‐based older adults with dementia and investigated healthcare professionals' perceived importance and practice of pharmacotherapy support.MethodsThis study aimed to shed light on basic pharmacotherapy support for behavioural and psychological symptoms among home‐based older adults with dementia using multidisciplinary collaboration, through a literature review of Japanese publications. Based on the literature review, 13 items pertaining to basic pharmacotherapy support for home‐based older adults with dementia were extracted. A mail‐based, self‐administered, anonymous questionnaire survey was conducted with professionals including physicians, pharmacists, and nursing professionals who provide pharmacotherapy support to home‐based older adults with dementia. Participants rated 13 items on their perceived importance and practice of basic pharmacotherapy support using a four‐point Likert scale.ResultsThe results indicated that participants recognised the importance of all 13 items. At least 80% of all professionals indicated that they practised seven out of 13 items. Less than 80% of all professionals indicated they practised the other six items that should be provided after the commencement of pharmacotherapy. A relatively high proportion of nursing professionals (70%) indicated they practised the remaining six items. The 13 items were indeed deemed important for characterising pharmacotherapy support. However, in Japan, suboptimal support is provided following the commencement of medication. This may be because appropriate modifications to dementia care are not made as the patient's condition progresses.ConclusionsIt is suggested that multidisciplinary collaboration focusing on the progression of dementia and the process of pharmacotherapy, especially after the commencement of pharmacotherapy, may help provide effective, continuous pharmacotherapy.
Estimation of Causal Quantile Effects with a Binary Instrumental Variable and Censored Data
Authors: Wei Bo , Peng Limin , Zhang Mei-Jie , Fine Jason P. 
Published: July 2021

AbstractThe causal effect of a treatment is of fundamental interest in the social, biological and health sciences. Instrumental variable (IV) methods are commonly used to determine causal treatment effects in the presence of unmeasured confounding. In this work, we study a new binary IV framework with randomly censored outcomes where we propose to quantify the causal treatment effect by the concept of complier quantile causal effect (CQCE). The CQCE is identifiable under weaker conditions than the complier average causal effect when outcomes are subject to censoring, and it can provide useful insight into the dynamics of the causal treatment effect. Employing the special characteristic of the binary IV and adapting the principle of conditional score, we uncover a simple weighting scheme that can be incorporated into the standard censored quantile regression procedure to estimate CQCE. We develop robust non-parametric estimation of the derived weights in the first stage, which permits stable implementation of the second stage estimation based on existing software. We establish rigorous asymptotic properties for the proposed estimator, and confirm its validity and satisfactory finite-sample performance via extensive simulations. The proposed method is applied to a bone marrow transplant data set to evaluate the causal effect of rituximab in diffuse large B-cell lymphoma patients.
Atypical oral viral coinfection after allogeneic hematopoietic stem cell transplantation: Diagnosis and treatment challenge
Authors: Schepanski Natalia , Machado Edina Fernanda Martins , Sola Caroline Bonamin , Percicote Ana Paula , de Araujo Melissa Rodrigues 
Published: July 2021

AbstractBackgroundViral reactivation in patients undergoing immunosuppressive therapy after hematopoietic stem cell transplantation (HSCT) is a serious complication associated with significant morbidity and mortality. Infections caused by human herpes viruses such as herpes simplex virus (HSV), cytomegalovirus (CMV), and Epstein‐Barr virus (EBV) can result in oral lesions.Case PresentationA 40‐year‐old male patient who had undergone HSCT presented with ulcerated lesions in different areas of the mouth, for 7 months. The lesions had evolved to painful exophytic nodules with an erythematous, ulcerated surface. They were present on the tongue margins and soft and hard palate. Histological, immunohistochemical (IHC), and polymerase chain reaction analyses were performed, and the results were compatible with HSV‐1 and ‐2 and CMV infections. Treatment comprised five sessions of antimicrobial photodynamic therapy (aPDT) and oral valganciclovir. Thirty days after combined antiviral therapy and aPDT, the lesions were completely resolved. Patient was followed up for 12 months without recurrence.ConclusionDiagnosis and treatment of atypical oral infections in immunosuppressed patients is challenging. Assessment of both clinical and laboratory findings is mandatory for a conclusive diagnosis. The use of local antimicrobial and systemic therapies contributes to positive clinical response in such cases.
Evaluating the respective weights of some facial signs on the perceived radiance/glow in differently aged women of six countries
Authors: Flament Frederic , Ye Chengda , Mercurio Daiane Garcia , Abric Aurelie , Sewraj Poonam , Velleman Damien , Yamamoto Sawako , Prunel Anne , Colomb Loic 
Published: July 2021

AbstractObjectivesTo evaluate the impact of Facial radiance or Glow on the perception of age (PA) and to assess which facial signs most influence PA.Material and MethodsThe faces of 1058 differently aged women (18‐80 years) of six different ethnicities/countries (China, Japan, Korea, India, South Africa, and Brazil) were photographed under standard conditions. These allowed to focus on 20 different facial signs that were further graded by experts, using referential Atlases dedicated to facial aging. In each of the six countries, 100 local women were recruited as naïve panels to express their perceptions on Glow and Age on each full‐face photograph (blind coded) of the local studied woman.ResultsA decreased Glow/Radiance appears clearly associated with an increased perceived age in all studied subjects, especially among Chinese, Japanese, and South African women. With regard facial signs, Skin texture (Wrinkles of all kinds), Ptosis/Sagging, and Pigmentation signs prevail in almost all women at the exception of South African women where Pigmentation signs and Cheek skin pores largely predominate in the perception of both Glow and PA. Pigmentation signs are of a very high weight among Chinese and Japanese women.ConclusionDespite some collective agreements, the present study shows some specificities within the women of the six ethnicities/countries. PA, a core index of antiaging strategies, goes along with facial Glow in almost all studied women. The duller the facial skin, the older it is perceived.
Multilevel Governance or Scalar Clashes: Finding the Right Scale for EU Energy Policy
Authors: Palle Angélique , Richard Yann 
Published: July 2021

AbstractThe European energy policy is based on two major pillars: integration (of infrastructure networks, markets, standards, and policies) and transition, as set out by European climate policies and by the upcoming Green Deal. The governance model for this common EU policy and the shared energy system it supports is mostly based on multilevel governance (MLG) theories, grounded in the principle of subsidiarity. This paper questions the possibility of MLG in the field of energy, in compliance with the European subsidiarity principle. The coexistence of diverse energy models promoting different scales of reference and actors may result in ‘scalar clashes’: this hybrid model creates a chaotic status quo, disrupting the EU's transition towards renewable energy sources. Building a common European energy policy that combines the dual objectives of transition and integration does not just require upscaling energy systems, but also setting the adequate scale(s) to implement this transition.
iPOTs: Internet of Things‐based pot system controlling optional treatment of soil water condition for plant phenotyping under drought stress
Authors: Numajiri Yuko , Yoshino Kanami , Teramoto Shota , Hayashi Atsushi , Nishijima Ryo , Tanaka Tsuyoshi , Hayashi Takeshi , Kawakatsu Taiji , Tanabata Takanari , Uga Yusaku 
Published: July 2021

SUMMARYA cultivation facility that can assist users in controlling the soil water condition is needed for accurately phenotyping plants under drought stress in an artificial environment. Here we report the Internet of Things‐based pot system controlling optional treatment of soil water condition (iPOTs), an automatic irrigation system that mimics the drought condition in a growth chamber. The Wi‐Fi‐enabled iPOTs system allows water supply from the bottom of the pot, based on the soil water level set by the user, and automatically controls the soil water level at a desired depth. The iPOTs also allows users to monitor environmental parameters, such as soil temperature, air temperature, humidity, and light intensity, in each pot. To verify whether the iPOTs mimics the drought condition, we conducted a drought stress test on rice (Oryza sativa L.) varieties and near‐isogenic lines, with diverse root system architecture, using the iPOTs system installed in a growth chamber. Similar to the results of a previous drought stress field trial, the growth of shallow‐rooted rice accessions was severely affected by drought stress compared with that of deep‐rooted accessions. The microclimate data obtained using the iPOTs system increased the accuracy of plant growth evaluation. Transcriptome analysis revealed that pot positions in the growth chamber had little impact on plant growth. Together, these results suggest that the iPOTs system is a reliable platform for phenotyping plants under drought stress.
Quality of life in patients with IBD during the COVID-19 pandemic in the Netherlands
Authors: de Bock Ellen , Filipe Mando D , Meij Vincent , Oldenburg Bas , van Schaik Fiona D M , Bastian Okan W , Fidder Herma F , Vriens Menno R , Richir Milan C 
Published: July 2021

ObjectiveCOVID-19 has put a strain on regular healthcare worldwide. For inflammatory bowel disease (IBD), gastrointestinal surgeries were postponed and changes in treatment and diagnostic procedures were made. As abrupt changes in treatment regimens may result in an increased morbidity and consequent well-being of patients with IBD, the aim of this study was to determine the effect of the COVID-19 pandemic on health-related quality of life (HRQoL) in patients with IBD.DesignAll patients with IBD who completed both Inflammatory Bowel Disease Questionnaire (IBDQ) and 36-Item Short Form Health Survey (SF-36) questionnaire between 31 August and 13 September 2020 were included in our cohort study. The primary end point was to determine the HRQoL in patients with IBD, measured by the IBDQ and SF-36 questionnaire. The secondary end point was determining which factors influence the HRQoL in patients with IBD.Results582 patients with IBD filled in the IBDQ and SF-36 questionnaire. The HRQoL in our study population was low according to the questionnaires on both physical and mental subscales. In addition, multivariate analysis showed that increased age, female sex and patients who underwent surgery had a significantly lower HRQoL, most frequently on the physical domains in both questionnaires.ConclusionPatients with IBD had an overall low HRQoL during the COVID-19 pandemic. Furthermore, older patients, women and patients who underwent surgical procedures had the lowest physical HRQoL.
Effects of SARS-CoV-2 pandemic on follow-up and pharmacological treatment of chronic diseases in undocumented migrants
Authors: Fiorini Gianfrancesco , Franchi Matteo , Corrao Giovanni , Tritto Roberta , Fadelli Sara , Rigamonti Antonello Emilio , Sartorio Alessandro , Cella Silvano Gabriele 
Published: July 2021

BackgroundAll over the world, the COVID-19 pandemic, not unlikely other epidemics, has hit harder people in low socioeconomic conditions.In Western countries, undocumented migrants are a growing component of this disadvantaged segment of the population.Their health conditions are frequently burdened by a number of chronic conditions, and they experience many difficulties in accessing public health services. Frequently, the only medical assistance they can get is provided by non-governmental organisations.MethodsWe studied the medical records (including pharmacological treatments) of all patients attending the outpatient clinics of Opera San Francesco (OSF; a big charity in Milano, Italy), in the first 5 months of 2020. These comprise the outbreak of the pandemic and the lockdown period. The 1914 patients (1814 undocumented migrants and 100 Italians) seen during the lockdown were compared with those seen in the same period of 2019 and with those seen in the preceding months of 2020. We especially focused on three chronic conditions: cardiovascular diseases, diabetes and psychiatric disorders.ResultsThe number of consultations during the first 5 months of 2020 was much smaller than that of the same period of 2019. During the lockdown, we found 4048 consultations for 1914 patients, while they were 8051 in the same period of 2019 and 5681 in the first 2 months of 2020.The quantity of medicines dispensed by OSF showed a marked decrease in the period of the study and mainly during the lockdown.The decrease in consultations and dispensation of medicines was most evident for psychiatric patients and almost not existent for patients with diabetes. Female patients suffered a more pronounced reduction.ConclusionsWestern countries need strategies to better assist the very poor during epidemics.Differences among different groups of disadvantaged persons should be taken into account when designing recovery plans.
Sustainability drivers and inhibitors for the health system performance improvement projects in selected health facilities in Kenya: a qualitative study
Authors: Chelagat Tecla , Kokwaro Gilbert , Onyango Joseph , Rice Jim 
Published: July 2021

ObjectivesTo investigate the health managers perceived sustainability status of the health facilities institutional improvement projects and their experiences on factors that facilitated or constrained their maintenance, with intentions of informing relevant strategies or policies in Kenya’s health sector.MethodsA qualitative study, nested within a quasi-experimental study. Thirty-three project-teams of health managers were purposively selected and interviewed based on their project implementation success rates post-training. The managers had previously undergone a 9-month leadership training, complimented with facility-based team coaching around the chosen projects. The training was funded by the US Agency for International Development; however, the implementation of the projects was based on how the participants could innovatively use the existing resource to create a positive change. The projects were housed within 20 public, 9 faith-based and 4 private health facilities in 19 counties in Kenya. The interviews explored the manager’s experiences in sustaining the successfully implemented projects within the (24–60 months post-training period). We asked managers to describe factors they perceived enabled or hindered the sustainability of the successfully implemented institutional improvement project. The digitally audio-recorded interviews were transcribed verbatim. Data on barriers and enablers were thematically analysed.ResultsTwenty-nine out of the 33 successfully implemented projects reported sustainability within periods ranging from 24 to 60 months post-training. Seven themes related to drivers of sustainability emerged, namely; programme design, stakeholder’s buy-in, board members, communication, coaching, presence of change champion, devolution and political good-will. Four sustainability inhibitors identified were: human resources constraints, policy implementation, misalignment of projects with daily operations, devolution and political interference.ConclusionsThe sustainability of institutional improvement strategies such as projects implemented post-leadership training in public and private health facilities depends on the quality of board members, communication management and institutionalisation of coaching culture. These findings are pertinent for planning and implementing similar health systems strengthening intervention in low-income countries.
Distribution and determinants of hospital efficiency and relative productivity in county-level hospitals in rural China: an observational study
Authors: Zhong Jing , Wang Wei , Wang Hongxi , Huang Jingjing , Li Tao , Chen Jingjing , Chen Wan , Yuan Jin , Chen Weirong 
Published: July 2021

BackgroundCataract surgery is very important to prevent blindness, but its productivity and efficiency in China are unknown. Our study aimed to evaluate the geographical distribution of cataract surgeons and prospectively identify the factors associated with the increased productivity in cataract surgery and efficiency in outpatient ophthalmic services in rural Chinese hospitals.MethodsData were prospectively collated from various hospital datasets and the census registered by the geographical unit county. Prior to mapping, the geographical location data of counties were cross-linked with the equivalent ophthalmologist and service output data to create categories and map multiple data attributes. Descriptive statistical analyses were performed to characterise the data stratified by county. Linear regression analyses were used to explore the factors associated with the increased productivity/efficiency.ResultsThe ophthalmologists, surgical productivity of ophthalmologists and outpatient efficacy of ophthalmologists significantly varied across counties. During the period between 2016 and 2018, the median (IQR) change in surgical productivity of and outpatient efficacy of ophthalmologists were 31.627 (−3.33 to 29.94) and 118.08 (−132.30 to 740.89). In the simple regression analysis for predictors of a high productivity change, only the increased number of phaco machine had statistical significance (p=0.003). In addition, only the gross domestic product per capita in 2016 was associated with an increased improvement in efficiency of outpatient services (p=0.008).ConclusionsThis study demonstrated that the ophthalmologist productivity and the efficiency of outpatient services were unequally geographically distributed, and their predictors were identified. Further studies to elucidate the extent of the problem and improve the health service delivery models are required.