bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enigma of Respiratory Carriage of Kingella kingae and Neisseria meningitides in Young Jordanian Children
Authors: Khanfar Malak A , Badran Emman , Marrar Basma , Charvalos Ekatherina , Shehabi Asem A 
Published: November 2021

Background:
Kingella kingae and Neisseria meningitides are gram-negative bacteria, causing several life-threatening diseases and considered as opportunistic pathogens in the upper respiratory tract of healthy carriers. The detection of these both bacteria species is difficult in routine culture methods.
Objective:
This study aimed to find the occurrence rate of K. kingae and N. meningitides colonizing upper respiratory tract of young Jordanian children, and to determine the antimicrobial susceptibility profile of the isolates.
Methods:
A total of 300 samples of throat and nasal swabs were collected from out- patients Jordanian children aged between 6 months and 5 years, who were admitted to Pediatrics' clinics department at the Jordan University Hospital and Al-Bashir Hospital over the period October 2018 through January 2019. Samples were cultured for detection K. kingae and Neisseria species including specially N. meningitides. Their suspected growth was identified and tested using microbiology culture methods and polymerase chain reaction (PCR) method. Additionally, DNA was extracted directly from one 100 samples and was investigated only for K. kingae using real- time PCR assay.
Results:
This study showed the absence of K. kingae in all cultured samples, while Neisseriaspecies was detected in 21 (7 %)including one N. meningitides isolate(0.3%). The results of antibiotic susceptibility testing indicated presence of few percentage of Neisseria species isolates resistant 100 % to clindamycin, oxacillin and vancomycin, whereas all were susceptible for chloramphenicol (100%)levofloxacin and gentamycin , and less to ampicillin(90.6%) and erytromycin ( 85.7%), respectively.
Conclusion: This study shows the absence of K. kingae and the rare occurrence of N. meningitides colonizing the upper respiratory tract of young Jordanian children over the 4-month period of study.
The Poissonian Origin of Power Laws in Solar Flare Waiting Time Distributions
Authors: Aschwanden Markus J. , Johnson Jay R. , Nurhan Yosia I. 
Published: November 2021

Abstract
In this study we aim for a deeper understanding of the power-law slope, α, of waiting time distributions. Statistically independent events with linear behavior can be characterized by binomial, Gaussian, exponential, or Poissonian size distribution functions. In contrast, physical processes with nonlinear behavior exhibit spatiotemporal coherence (or memory) and “fat tails” in their size distributions that fit power-law-like functions, as a consequence of the time variability of the mean event rate, as demonstrated by means of Bayesian block decomposition in the work of Wheatland et al. In this study we conduct numerical simulations of waiting time distributions N(τ) in a large parameter space for various (polynomial, sinusoidal, Gaussian) event rate functions λ(t), parameterized with an exponent p that expresses the degree of the polynomial function λ(t) ∝ t

p
. We derive an analytical exact solution of the waiting time distribution function in terms of the incomplete gamma function, which is similar to a Pareto type II function and has a power-law slope of α = 2 + 1/p, in the asymptotic limit of large waiting times. Numerically simulated random distributions reproduce this theoretical prediction accurately. Numerical simulations in the nonlinear regime (p ≥ 2) predict power-law slopes in the range of 2.0 ≤ α ≤ 2.5. The self-organized criticality model yields a prediction of α = 2. Observations of solar flares and coronal mass ejections (over at least a half solar cycle) are found in the range of α
obs ≈ 2.1–2.4. Deviations from strict power-law functions are expected due to the variability of the flare event rate λ(t), and deviations from theoretically predicted slope values α occur due to the Poissonian weighting bias of power-law fits.
Resolving the Fastest Ejecta from Binary Neutron Star Mergers: Implications for Electromagnetic Counterparts
Authors: Dean Coleman , Fernández Rodrigo , Metzger Brian D. 
Published: November 2021

Abstract
We examine the effect of spatial resolution on initial mass ejection in grid-based hydrodynamic simulations of binary neutron star mergers. The subset of the dynamical ejecta with velocities greater than ∼0.6c can generate an ultraviolet precursor to the kilonova on approximately hour timescales and contribute to a years long nonthermal afterglow. Previous work has found differing amounts of this fast ejecta, by one to two orders of magnitude, when using particle-based or grid-based hydrodynamic methods. Here, we carry out a numerical experiment that models the merger as an axisymmetric collision in a corotating frame, accounting for Newtonian self-gravity, inertial forces, and gravitational wave losses. The lower computational cost allows us to reach spatial resolutions as high as 4 m, or ∼3 × 10−4 of the stellar radius. We find that fast ejecta production converges to within 10% for a cell size of 20 m. This suggests that fast ejecta quantities found in existing grid-based merger simulations are unlikely to increase to the level needed to match particle-based results upon further resolution increases. The resulting neutron-powered precursors are in principle detectable out to distances ≲200 Mpc with upcoming facilities.We also find that head-on collisions at the freefall speed, relevant for eccentric mergers, yield fast and slow ejecta quantities of order 10−2
M
⊙, with a kilonova signature distinct from that of quasi-circular mergers.
Epidemiological profile, spatial distribution, and syphilis time series: a cross-sectional study in a Brazilian municipality
Authors: Lino Carolina Matteussi , Sousa Maria da Luz Rosário de , Batista Marília Jesus 
Published: November 2021

Introduction: Syphilis is an infectious disease of bacterial nature, acting on organs and/or systems. The increase in the number of cases worldwide has been of concern and the infection has been considered a public health problem. Given this scenario, this study evaluates the epidemiological profile, spatial distribution, and time series of the cases of acquired syphilis, syphilis in pregnant women, and congenital syphilis in a Brazilian municipality.
Methodology: This is a cross-sectional and descriptive study with second data of the notified cases. For the definition of the population universe, an initial survey of syphilis cases notified in the municipality was carried out, from January 1, 2013 to December 31, 2017.
Results: There was an increase in the notified cases and the detection/incidence rates of syphilis. The epidemiological profile was composed of men (76.7%), adults (24.8%), white (60.4%), with eight or more years of study (53.7%) in addition to pregnant adolescents (36.7%) and young adults (26.0%), with inadequate treatment and untreated partners. A concentration of cases was identified in the regions with the lowest monthly income and the time series showed an increasing trend (p-value < 0.001).
Conclusions: Health actions should continue to improve access to diagnosis and to notification, focusing on treatment, cure and health education actions to control and prevent new cases.
Prevalence and risk factor analysis for HIV/HTLV 1/2 coinfection in Paraíba state, Brazil
Authors: Santos de Souza Marcela , Prado Gonçales Juliana , Santos deMorais Viviane Martha , Silva Júnior José Valter Joaquim , Lopes Thaísa Regina Rocha , Costa Joanne Elizabeth Ferraz da , Côelho Maria Rosângela Cunha Duarte 
Published: November 2021

Introduction: Human T-lymphotropic virus (HTLV) 1 and 2 infections can lead to neurological diseases, mainly in HIV/HTLV 1 coinfected. Furthermore, HTLV 1 infection in HIV/AIDS patients has also been associated with AIDS progression. Despite this, HTLV 1/2 infections are not of mandatory notification in Brazil. Here, we describe the prevalence of HTLV 1/2 in HIV/AIDS patients from Paraíba state, Brazil, as well as the sociodemographic characteristics of the coinfected individuals.
Methodology: Information about HIV viral load and TCD4 lymphocyte count were obtained from patients’ records. Data on the patients’ sociodemographic characteristics were obtained by interview conducted after signing the informed consent form. The serological diagnosis for HTLV 1/2 was performed by Enzyme-Linked Immunosorbent Assay (ELISA) and Western Blot (WB).
Results: A total of 401 HIV/AIDS patients participated in the study, of whom about 1.5% (6/401) were positive for antibodies against HTLV, specifically for HTLV 1, evaluated by both ELISA and WB. No risk factors were found associated with HIV/HTLV 1/2 coinfection.
Conclusions: We report a 1.5% prevalence of HTLV 1 infection in HIV/AIDS patients from Paraíba state. Although we have not identified risk factors associated with HTLV 1, we describe the most observed sociodemographic characteristics in HIV/HTLV 1 coinfection.
The burden of influenza and other respiratory viruses in hospitalized infants and children in a university hospital, Jordan
Authors: Al-Zayadneh Enas , Mohammad Abu Assab Dina , Adeeb Arabiat Esraa , Al-Iede Montaha , Ahmad Kayed Hanin , Daher Amirah 
Published: November 2021

Background: Acute lower respiratory infection (ALRI) is a major cause of morbidity and mortality worldwide in young children and is predominately caused by viral respiratory pathogens. This study aims to identify the viral etiologies of acute ALRI in hospitalized children in Jordan University Hospital and compare the clinical characteristics of influenza virus infection with other respiratory viruses. Methods: a retrospective viral surveillance study that included 152 children below 15 years of age admitted with ALRI from December 2018 through April 2019. We recorded results of real-time reverse transcriptase-polymerase chain reaction (RT- PCR ) for common respiratory viruses. Clinical and demographic information of the study population was collected from patients’ electronic medical records. Results: 152 were identified with a median age of 1 year (mean was 2.1 years). Ninety-five patients (62.5%) were males. One or more viral respiratory pathogens were detected in 145 (95.3%) children. Respiratory syncytial virus was the most commonly detected virus in 68 patients (44.8%). Influenza virus was detected in 25 (16.4%). Children with influenza infection had more fever and less leukocyte count compared to children infected with other viruses. The severity of the ALRI correlated significantly with several factors, including age less than 6 months and the presence of neuromuscular disease (p<0.05). Conclusion: Viral detection was common among children admitted with viral ALRI. Viruses, including influenza, are recognized as major contributors to the morbidity associated with ALRI. More attention is needed on strategies for the prevention and detection of viral ALRI in developing countries.
ICP-OES analysis of heavy metal and nutrient elements of yarrow sold in Turkey
Authors: Gokcena Ummusen , Koseb Yavuz B. , Aboul-Enein Hassan Y. , Arli Goksel 
Published: November 2021

Aim
The present study was to evaluate the local ‘yarrow’ drug − Millefoli herba − samples acquired from aktars, herbalists, and herbal shops.

Materials and methods
The samples were from Ankara (10 samples), Antalya (14 samples), Eskisehir (11 samples), Istanbul (10 samples), Izmir (10 samples), Mersin (10 samples), and Ordu (seven samples), which are used in the traditional medicine for various purposes. More than 70 samples were evaluated from seven different provinces.

Results
The taxonomic diagnosis of some of them is sold as Achillea millefolium L.; however, the study results show that the drugs do not belong to this species, and also five different A. L. taxa are sold as A. millefolium L. The selected heavy metals (Fe, Cd, and Co) and plant nutritional elements (Mn, Zn, Na, K, Ca, B, and Mg) were initially determined by quantitative ICP-OES analyses. Among the investigated samples, the lowest and highest results were 0.365–18.86 mg/kg for Fe; 0.007–0.294 mg/kg for Cd; 0.022–0.027 mg/kg for Co; 0.097 mg/kg–2.098 mg/kg for Mn; Zn 0.009–0.624 mg/kg; Na 1.539–15.80 mg/kg; K 39.8–390.3 mg/kg; Ca 31.24–223.1 mg/kg; B 0.046–3.970 mg/kg; Mg 7.058–43.84 mg/kg, respectively.

Conclusion
The results were compared with WHO recommended limits and daily intakes.
Behavior of hyperreflective spots noted on optical coherence tomography following intravitreal therapy in diabetic macular edema: A systematic review and meta-analysis
Authors: Ganne Pratyusha , Krishnappa Nagesha C , Karthikeyan Siddharth K , Raman Rajiv 
Published: November 2021

Purpose:
Hyperreflective spots (HRS) are considered as spectral domain optical coherence tomography biomarkers in predicting response to intravitreal therapy (IVT) in diabetic macular edema (DME). We aimed to determine if there was a quantitative reduction in HRS following IVT in DME, if the response to antivascular endothelial growth factor (anti-VEGF) drugs was different from steroids, and if HRS-response was associated with improvement in visual acuity (VA) or reduction in central macular thickness (CMT).

Methods:
PubMed/MEDLINE, Scopus, ProQuest, CINAHL, Wiley online, and Web of Science were searched (between January 1, 2011 and July 1, 2020). Publication bias and heterogeneity were assessed. Meta-analysis was done using the random-effects model.

Results:
Totally, 1168 eyes from 19 studies were eligible for inclusion. IVT was associated with a reduction in quantitative HRS (z = -6.3, P < 0.0001). Studies, however, showed heterogeneity (I
2 = 93.2%). There was no difference between anti-VEGF and steroid therapies (P = 0.23). The evidence on predicting VA and CMT outcomes were limited by the number of analyzable studies, owing to the wide variation in individual study designs, and lack of randomized controlled trials.

Conclusion:
We could conclude that there is a definite reduction in quantitative HRS following either form of IVT. We highlight the lacunae in the existing literature on HRS in DME and propose goals for future studies to harness the advantage of this promising biomarker.
Urine protein: Urine creatinine ratio correlation with diabetic retinopathy
Authors: Mujeeb Samya , Rodrigues Gladys R , Nayak Rajesh R , Kamath Ajay R , Kamath Sumana J , Kamath Gurudutt 
Published: November 2021

Purpose:
To investigate the urine protein (UP) and urine creatinine (UC) ratio in diabetes mellitus and report its influence as a risk factor for the presence and severity of diabetic retinopathy (DR).

Methods:
In total, 150 diabetic patients presenting to the outpatient department were included. Detailed history with informed consent and ophthalmic examination, including visual assessment, external ocular examination, anterior segment evaluation, dilated fundus examination by slit-lamp biomicroscopy, and indirect ophthalmoscopy, was done. The early morning spot urine sample was used to determine spot urine protein creatinine ratio. Association with hypertension, fasting blood sugar (FBS), and HBA1C (glycosylated Hb) were also noted.

Results:
Urinary PCR increased with the severity of the diabetic retinopathy (P < 0.001). HbA1c, FBS, and duration of diabetes had a direct correlation with urine PCR. ROC curve analysis showed that the optimal PCR cut-off value for predicting the risk of onset DR was 0.65. Retinopathy progressed with increasing urine PCR. Spot urine PCR strongly correlates with stages of diabetic retinopathy and proteinuria measured in 24-h urine samples.

Conclusion:
The study showed that urine PCR can be a marker for risk and progression of diabetic retinopathy.
Preferred practice pattern of physicians regarding diabetic retinopathy in diabetes mellitus patients
Authors: Moudgil Tania , Bains Barinder K , Bandhu Seema , Kanda Nancy 
Published: November 2021

Purpose:
To assess the perceptions of physicians about diabetic retinopathy (DR) screening, barriers to DR screening, and change in management protocol of Diabetes Mellitus (DM) patients with DR.

Methods:
A cross-sectional descriptive study was conducted using a standard predesigned and pretested structured questionnaire through online mode in the month of April 2021 to assess the criteria used for referral of diabetic patients for DR screening, barriers to DR screening, and the management plan among physicians after the patient has been diagnosed with DR.

Results:
In total, 100 physicians participated in the study. Physicians responded that criteria used for referral for DR screening according to duration was <5 years (n = 0), 5–10 years (n = 60), >10 years (n = 10), and irrespective of the duration (n = 30). According to severity, well-controlled DM without (n = 30) and with other system involvement (n = 50) and uncontrolled DM without (20) and with other system involvement (n = 50) and irrespective of the severity of disease (n = 30) was reported. Physicians (n = 40) responded that patients who were diagnosed with DR belonged to the Type 1 DM category rather than Type 2 DM (P < 0.05). With regard to the barriers and challenges faced in ensuring DR screening, the following themes emerged: no ocular symptoms, lack of compliance, time constraint for the patient, and lack of motivation.

Conclusion:
We found that the preferred practice pattern of physicians regarding referral for DR screening was dependent on the duration of the disease (mostly 5–10 years of the disease) and severity (when other systems were involved). Noncompliance with advice was the major barrier to DR screening.
Severity of diabetic retinopathy and its relationship with age at onset of diabetes mellitus in India: A multicentric study
Authors: Parameswarappa Deepika C , Rajalakshmi Ramachandran , Mohamed Ashik , Kavya Sanagavarapu , Munirathnam Haripriya , Manayath George , Kumar Mathangi Ashok , Raman Rajiv , Vignesh TP , Ramasamy Kim , Mani Sheena , Muralidhar Alankrita , Agarwal Manisha , Anantharaman Giridhar , Bijlani Neha , Chawla Gajendra , Sen Alok , Kulkarni Sucheta , Behera Umesh C , Sivaprasad Sobha , Das Taraprasad , Rani Padmaja Kumari ,   on behalf of India Retinal Disease Study group
Published: November 2021

Purpose:
To present clinical profile and risk factors of sight-threatening diabetic retinopathy (STDR) among people with age of onset of diabetes (AOD) <25 versus ≥25 years.

Methods:
A retrospective chart analysis of consecutive patients with diabetic retinopathy (DR) n = 654) treated at 14 eye care centers across India between 2018 and 2019 was performed. Patients were divided into two groups, Group 1: AOD <25 years and Group 2: AOD ≥25 years. DR and diabetic macular edema (DME) were classified using the International Clinical Classification of DR severity scale. STDR included severe nonproliferative DR (NPDR), proliferative DR (PDR), and moderate to severe DME. A multilevel mixed-effects model was used for comparison between two groups: 1) Patients with DR and AOD <25 years and 2) Patients with DR and AOD ≥25 years. Bivariate and multivariate regression analyses were used to evaluate risk factors between the two groups.

Results:
A total of 654 patients were included, 161 (307 eyes) in AOD <25 and 493 (927 eyes) in AOD >25 group. There was a higher prevalence of PDR with high-risk characteristics in AOD <25 group (24% vs. 12%) at baseline and 12-month follow-up (25% vs. 6%); P < 0.001. Systolic hypertension and poor glycemic control were risk factors in both groups, with no difference in these modifiable risk factors between groups.

Conclusion:
People with youth-onset DM are likely to present with severer form of STDR despite similar modifiable risk factors. Therefore, strict control of systolic blood pressure, glycemic status, and regular screening for DR are recommended to reduce the risk of STDR irrespective of the age of onset of diabetes.
Knowledge, attitude, and practice patterns and the purported reasons for delayed presentation of patients with sight-threatening diabetic retinopathy at a tertiary eye-care facility in Central India: A questionnaire-based study
Authors: Sen Alok , Pathak Parul , Shenoy Pratik , Kohli Gaurav Mohan , Bhatia Priyavrat , Shetty Sachin 
Published: November 2021

Purpose:
To identify the reasons for delayed presentation among patients with sight-threatening diabetic retinopathy (STDR) and to assess their knowledge, attitude, and practice (KAP) patterns in context to diabetes mellitus (DM) and diabetic retinopathy (DR).

Methods:
Single-center, cross-sectional, questionnaire-based KAP survey. All consecutive cases of STDR who presented to our tertiary eye care facility from June 2020 to November 2020 were recruited. The KAP scoring survey tool was incorporated into the questionnaire to help evaluate and represent the patient’s disease.

Results:
170 patients with STDR were enrolled in the study. The mean age of patients was 54 ± 9.34 years (Range: 21–70 years); 110 patients (64.7%) were between 41 and 60 years; 131 patients (76%) had DM for more than 5 years. The STDR changes were more prevalent in patients with an educational qualification of high school or less (n = 142; 83.5%). Fifty-two patients (30.6%) had been informed regarding the detrimental effect of diabetes on the eyes and were recommended to consult an ophthalmologist by the treating physician. Of these, 24 (46.15%) patients were educated about retinal changes due to diabetes. Eighty-five (50%) patients in our study had good knowledge about DM; 13 (7.6%) patients had good knowledge about DR. For patients not compliant for follow-ups with the treating physician, the use of “home glucometers for self-monitoring (n = 60, 35.3%) was the most prevalent reason. The main reason for poor compliance for undergoing a dilated fundus examination by the ophthalmologist was “Had good vision, so didn’t feel the need” in 143 (90.5%) patients.

Conclusion:
The absence of visual complaints, lack of knowledge, and failure to undergo a dilated fundus examination in the past were the prevalent risk factors in patients presenting with STDR. Knowledge/practice about DR was poor among the patients with STDR. The treating physicians and ophthalmologists were the most common sources for patient education.
Validation of choroidal hyperreflective foci in diabetic macular edema through a retrospective pilot study
Authors: Saurabh Kumar , Roy Rupak , Herekar Sujay , Mistry Suraj , Choudhari Shruti 
Published: November 2021

Purpose:
Choroidal hyperreflective foci (HCF) are novel spectral-domain optical coherence tomography (SDOCT) biomarkers in diabetic macular edema (DME). The present study intended to validate HCF and assess their role in the treatment outcome.

Methods:
It was a retrospective, longitudinal, records-based pilot study recruiting consecutive patients of nonproliferative diabetic retinopathy with treatment naïve DME. Patients were treated with three intravitreal anti-vascular endothelial growth factor injections and followed by a pro re nata regimen.

Results:
A total of 43 eyes of 28 patients were included in the study. Eyes were divided into two groups. Group A (n = 19) comprised eyes with retinal hyperreflective foci (HRF) and group B (n = 24) had eyes with both HRF and HCF. The mean age of patients in group A and B was 58.5 ± 2.1 years and 55.2 ± 8.8 years, respectively. Mean best-corrected visual acuity at presentation was 0.38 ± 0.25 in group A and 0.59 ± 0.29 in group B (P = 0.01). Final BCVA was 0.35 ± 0.39 in group A and 0.47 ± 0.34 in group B (P = 0.3). External limiting membrane was intact in 19 out of 19 eyes in group A and two (8.3%) eyes in group B (P = 0).

Conclusion:
Presence of HCF meant significantly worse initial BCVA compared to the eye that had HRF alone. The final BCVA was also worse in eyes with HCF compared to those with HRF and without HCF; however, the difference did not reach a significance level, probably pointing toward the fact that HCF and HRF are pathophysiologically identical. Further studies with a larger sample size and prospective design are needed to take these findings forward.