bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular epidemiology of carbapenem-resistant Enterobacterales in Thailand, 2016–2018
Authors: Paveenkittiporn Wantana , Lyman Meghan , Biedron Caitlin , Chea Nora , Bunthi Charatdao , Kolwaite Amy , Janejai Noppavan 
Published: June 2021

Abstract
Background
Carbapenem-resistant Enterobacterales (CRE) is a global threat. Enterobacterales develops carbapenem resistance through several mechanisms, including the production of carbapenemases. We aim to describe the prevalence of Carbapenem-resistant Enterobacterales (CRE) with and without carbapenemase production and distribution of carbapenemase-producing (CP) genes in Thailand using 2016–2018 data from a national antimicrobial resistance surveillance system developed by the Thailand National Institute of Health (NIH).

Methods
CRE was defined as any Enterobacterales resistant to ertapenem, imipenem, or meropenem. Starting in 2016, 25 tertiary care hospitals from the five regions of Thailand submitted the first CRE isolate from each specimen type and patient admission to Thailand NIH, accompanied by a case report form with patient information. NIH performed confirmatory identification and antimicrobial susceptibility testing and performed multiplex polymerase chain reaction testing to detect CP-genes. Using 2016–2018 data, we calculated proportions of CP-CRE, stratified by specimen type, organism, and CP-gene using SAS 9.4.

Results
Overall, 4,296 presumed CRE isolates were submitted to Thailand NIH; 3,946 (93%) were confirmed CRE. Urine (n = 1622, 41%) and sputum (n = 1380, 35%) were the most common specimen types, while blood only accounted for 323 (8%) CRE isolates. The most common organism was Klebsiella pneumoniae (n = 2660, 72%), followed by Escherichia coli (n = 799, 22%). The proportion of CP-CRE was high for all organism types (range: 85–98%). Of all CRE isolates, 2909 (80%) had one CP-gene and 629 (17%) had > 1 CP-gene. New Delhi metallo-beta-lactamase (NDM) was the most common CP-gene, present in 2392 (65%) CRE isolates. K. pneumoniae carbapenemase (KPC) and Verona integron-encoded metallo-β-lactamase (VIM) genes were not detected among any isolates.

Conclusion
CP genes were found in a high proportion (97%) of CRE isolates from hospitals across Thailand. The prevalence of NDM and OXA-48-like genes in Thailand is consistent with pattern seen in Southeast Asia, but different from that in the United States and other regions. As carbapenemase testing is not routinely performed in Thailand, hospital staff should consider treating all patients with CRE with enhanced infection control measures; in line with CDC recommendation for enhanced infection control measures for CP-CRE because of their high propensity to spread.
Prevalence of self-medication with antibiotics and its related factors among Chinese residents: a cross-sectional study
Authors: Yin Xiaoxv , Mu Ketao , Yang Heping , Wang Jing , Chen Zhenyuan , Jiang Nan , Yang Fengjie , Zhang Guopeng , Wu Jianxiong 
Published: June 2021

Abstract
Background
Self-medication is one of the most common forms of inappropriate use of antibiotics. This study aimed to assess the prevalence of self-medication with antibiotics (SMA) in China and evaluate the related factors.

Methods
A cross-sectional survey was conducted in Wuhan, Hubei, China from July 1, 2019 to July 31, 2019. Participants were recruited in public places to answer a structured questionnaire. The information of participants’ social demographic characteristics, antibiotic knowledge and health beliefs were collected. Binary Logistics regression analysis was used to examine the associated factors of SMA.

Results
Of the 3206 participants, 10.32% reported SMA in the past 6 months. Participants who with middle or high perceived barriers to seek health care services showed a higher likelihood of SMA (P < 0.05). Participants who with middle or high perceived threats of self-medication, and who with middle or high self-efficacy to overcome obstacles showed a lower likelihood of SMA (P < 0.05).

Conclusions
Compared with developed countries, the prevalence of SMA in China is still higher. Measures to conduct public health education and improve the accessibility of health services are crucial to decrease the overall self-medication rate in China.
Genome-based therapeutic interventions for β-type hemoglobinopathies
Authors: Karamperis Kariofyllis , Tsoumpeli Maria T. , Kounelis Fotios , Koromina Maria , Mitropoulou Christina , Moutinho Catia , Patrinos George P. 
Published: June 2021

AbstractFor decades, various strategies have been proposed to solve the enigma of hemoglobinopathies, especially severe cases. However, most of them seem to be lagging in terms of effectiveness and safety. So far, the most prevalent and promising treatment options for patients with β-types hemoglobinopathies, among others, predominantly include drug treatment and gene therapy. Despite the significant improvements of such interventions to the patient’s quality of life, a variable response has been demonstrated among different groups of patients and populations. This is essentially due to the complexity of the disease and other genetic factors. In recent years, a more in-depth understanding of the molecular basis of the β-type hemoglobinopathies has led to significant upgrades to the current technologies, as well as the addition of new ones attempting to elucidate these barriers. Therefore, the purpose of this article is to shed light on pharmacogenomics, gene addition, and genome editing technologies, and consequently, their potential use as direct and indirect genome-based interventions, in different strategies, referring to drug and gene therapy. Furthermore, all the latest progress, updates, and scientific achievements for patients with β-type hemoglobinopathies will be described in detail.
Healthy, safe and responsible: the modern female traveller
Authors: Bauer Irmgard L. 
Published: June 2021

AbstractOne-half of all travellers are women; yet, there is a distinct lack of detailed travel health knowledge on topics of unique relevance to women. While there is medical advice relating to stages in the female lifecycle, it neglects women-specific practical aspects despite their ability to harm travellers’ health and cause inconvenience. This paper discusses comprehensively three major aspects of travel as they relate to women. First, it suggests the management of personal hygiene, bodily functions, menstruation and sexual behaviour, and alerts to the limited knowledge on travel mental health issues.Second, apart from travelling in a female body with its specific demands, being a woman requires special attention to safety and security. Within various travel contexts, women have many opportunities for minimising potential risks.Finally, guided by travel medicine’s acknowledgment of its role in the concept of responsible travel, this article goes beyond the usual general statements and broad advice and offers detailed and practical suggestions on how the female traveller can contribute to the overall goal of minimising any potential harm to fellow humans and the natural environment. Recognising the scarcity of women-specific travel information, pathways to better education, and a range of suggestions for urgent research facilitate the provision of high-quality travel health care tailored specifically to women’s needs.
Clinical advantages of a newly launched anti-thrombotic PMMA membrane for the nutritional status and dialysis-related symptoms in older chronic dialysis patients: a multicenter pilot study
Authors: Masakane Ikuto , Yamaguchi Ichiro , Matsumoto Yuji , Ataka Ken , Oyama Yuta , Nagaoka Michio , Matsushita Yasushi , Teramura Tomoko , Seino Koji , Amano Hiroyuki , Kobayashi Ai 
Published: June 2021

Abstract
Background
Malnutrition that is associated with inflammation is a key factor of poor outcome in chronic hemodialysis patients, especially in older dialysis patients. Polymethyl methacrylate (PMMA) membrane has been reported to improve the inflammatory status by removing pro-inflammatory cytokines via adsorption. However, older dialysis patients occasionally have multiple uncomfortable dialysis-related symptoms, which decrease their quality of life and survival rate. We investigated whether a new PMMA membrane, Filtryzer NF, can improve malnutrition and dialysis-related symptoms in older hemodialysis patients.

Methods
Patients over 70 years of age who were dialyzed using a polysulfone (PS) membrane were enrolled and randomly allocated into one of two groups: control or NF. In the NF group, the PS dialyzers were changed to NF, whereas in the control group, the PS membrane was continuously used. The primary outcome was the malnutrition–inflammation score (MIS). Secondary outcomes were C-reactive protein, normalized protein catabolism rate, percent of creatinine generation rate, arm circumference, and eight dialysis-related symptoms. The primary and secondary outcomes were measured every 3 months for 1 year.

Results
Fifty-four hemodialysis patients were randomly assigned to the NF group (n = 28) or the control group (n = 26). During the 12-month study period, 11 and 10 patients were withdrawn from the NF and control groups, respectively. There was no significant difference in the MIS between the groups during the study or between the beginning and the end of the study within each group. For the secondary outcomes, there was a significant reduction in the total score of dialysis-related symptoms in the NF group but not in the control group. During the study period, the total dialysis-related symptoms score in the NF group was significantly decreased from 6 (range, 1–16) to 3 (range, 0–11) (median [minimum–maximum], p < 0.05). Other secondary outcomes were not different between the groups or between the beginning and the end of the study.

Conclusions
This study showed no advantage for the nutritional status in older hemodialysis patients using NF compared with PS. However, our results indicated that NF may improve several dialysis-related symptoms. To clarify this clinical finding, large-scale prospective randomized clinical trials are required.

Trial registration
This study was registered with the Clinical Trials Registry of the University Hospital Medical Information Network (registration ID, UMIN000032990).
Homology modelling and analysis of structure predictions of human tumour necrosis factor ligand superfamily member 8
Authors: Oso Babatunde Joseph , Oyewo Emmanuel Bukoye , Oladiji Adenike Temidayo 
Published: June 2021

AbstractBackgroundTumour necrosis factor ligand superfamily member 8 (TNFL8) is a cytokine that plays vital roles in immune activations and inflammatory responses through its interaction with the tumour necrosis factor superfamily member. Despite multiple studies on the involvement of its receptor in the inflammatory response, there is limited information on the molecular characterization and structural elucidation of the cytokine. Considering the significance of the cytokine, the three-dimensional structure of TNFL8 model was generated by homology modelling through the Iterative Threading ASSEmbly Refinement (I-TASSER) server and validated through PROCHECK and Qualitative Model Energy Analysis (QMEAN) servers.ResultsThe predicted structure has 90.00% of residues in the most favoured region of the Ramachandran plot while the QMEAN value gives − 3.06. The sequence and structural alignment between the generated model of the cytokine and template (1XU2) reveal that similar active site residues such as ILE-142, THR-175, GLU-178, and PHE-228 could be involved in binding pocket formation. However, docking studies of the 3D model of TNFL8 with eight phytochemicals from the extract ofXylopia aethiopica(Dunal) A. Rich revealed the phytochemical bound to two different binding sites which could be the active regions of the cytokine that could be essential for inhibition. More so, the docking analysis showed most of the phytochemicals have good binding affinity to the cytokine with ellagic acid showing the highest affinity with a binding energy of − 6.58 ± 0.18 kcal/mol.ConclusionThe proposed model may shed light on the mechanisms of TNFL8 binding and provide insights into the identification of potential molecular targets for the development of the novel compound for the regulation of the functional activities of the cytokine.
Correlation Between Plasma Catecholamines, Weight, and Diabetes in Pheochromocytoma and Paraganglioma
Authors: Krumeich Lauren N , Cucchiara Andrew J , Nathanson Katherine L , Kelz Rachel R , Fishbein Lauren , Fraker Douglas L , Roses Robert E , Cohen Debbie L , Wachtel Heather 
Published: June 2021

Abstract

Context
Pheochromocytomas and paragangliomas (PCC/PGL) are neuroendocrine tumors with discrete catecholamine profiles that cause incompletely understood metabolic and physiologic changes.

Objective
The objective was to evaluate relationships between plasma catecholamines, body weight, and hemoglobin A1c (HbA1c). We hypothesized that individual catecholamines would correlate negatively with weight and glucose control.

Design
A retrospective cohort study was performed (1999-2020). Wilcoxon rank-sum tests compared nonparametric, continuous variables; mixed-effect linear modeling (MEM) evaluated relationships between catecholamines and weight or HbA1c. The median study duration was 54.2 months [interquartile range (IQR) 19.0-95.1].

Setting
Tertiary academic hospital.

Patients
360 patients were identified prospectively by referral to our center for management or surveillance of PCC/PGL. The median age was 59 years (IQR 45-67) and 56.4% (n = 203) were female.

Main outcome measures
The primary and secondary outcomes were weight and HbA1c, respectively.

Results
On multivariable MEM, norepinephrine (P &lt; 0.0005) negatively correlated with weight when all catecholamines and their derivatives were tried in the model, and normetanephrine (P &lt; 0.0005) correlated when only metanephrines were included. In the surgical cohort (n = 272), normetanephrine decreased postoperatively and was inversely associated with weight (P &lt; 0.0005). Elevated norepinephrine or normetanephrine at the study termination, indicative of metastatic and/or recurrent disease (MRD), correlated with weight loss. Norepinephrine and normetanephrine (P &lt; 0.0005) directly correlated with HbA1c.

Conclusion
Plasma norepinephrine and its metabolite directly correlate with HbA1c and inversely correlate with weight in PCC/PGL. After resection, declining normetanephrine levels correlate with improving HbA1c despite an increase in patient body weight. Persistently elevated catecholamines and decreasing weight are observed in MRD.
Secretin as a Satiation Whisperer With the Potential to Turn into an Obesity-curbing Knight
Authors: Schnabl Katharina , Li Yongguo , U-Din Mueez , Klingenspor Martin 
Published: June 2021

AbstractThe obesity pandemic requires effective preventative and therapeutic intervention strategies. Successful and sustained obesity treatment is currently limited to bariatric surgery. Modulating the release of gut hormones is considered promising to mimic bariatric surgery with its beneficial effects on food intake, body weight, and blood glucose levels. The gut peptide secretin was the first molecule to be termed a hormone; nevertheless, only recently has it been established as a legitimate anorexigenic peptide. In contrast to gut hormones that crosstalk with the brain either directly or by afferent neuronal projections, secretin mediates meal-associated brown fat thermogenesis to induce meal termination, thereby qualifying this physiological mechanism as an attractive, peripheral target for the treatment of obesity. In this perspective, it is of pivotal interest to deepen our as yet superficial knowledge on the physiological roles of secretin as well as meal-associated thermogenesis in energy balance and body weight regulation. Of note, the emerging differences between meal-associated thermogenesis and cold-induced thermogenesis must be taken into account. In fact, there is no correlation between these 2 entities. In addition, the investigation of potential effects of secretin in hedonic-driven food intake, bariatric surgery and chronic treatment using suitable application strategies to overcome pharmacokinetic limitations will provide further insight into its potential to influence energy balance. The aim of this article is to review the facts on secretin’s metabolic effects, address prevailing gaps in our knowledge, and provide an overview on the opportunities and challenges of the therapeutic potential of secretin in body weight control.
World Literature as a Speculative Literary Totality: Veselovsky, Auerbach, Said, and the Critical-Humanist Tradition
Authors: Etherington Ben 
Published: June 2021

AbstractThis essay revisits critical-humanist approaches to literary totality that have largely been sidelined during the recent revival of world literature studies. While there has been no shortage of defenses of close reading in the face of distant reading and other positivist approaches, this essay argues that it is precisely the hermeneutic attention to particular works that has allowed critical humanists to think about literary practice within the most encompassing purview. For those in this tradition, “world literature” can never be a stable object but is a speculative totality. The essay discusses three exemplary critical concepts that assume a speculative epistemology of literary totality: Alexander Veselovsky’s “historical poetics,” Erich Auerbach’s “Ansatzpunkt,” and Edward Said’s “contrapuntal reading.” Each, it is argued, is grounded in the distinctive qualities of literary experience, a claim for which Theodor Adorno’s account of speculative thinking serves as a basis.
ПРЕВЕНТИВНАЯ ИДЕНТИФИКАЦИЯ РАЙОНОВ СОЦИАЛЬНОЙ НАПРЯЖЕННОСТИ
Authors: Shangutov Oleg A. , Shangutov Anton O. 
Published: June 2021

Актуальность исследования обусловлена обострением военно-политических и социально-экономических условий в стране и мире, что потребовало разработки новых способов повышения эффективности функционирования органов государственной власти при решении задач обеспечения государственной и общественной безопасности.
Цель – разработка метода превентивной идентификации районов социальной напряженности на основе пороговых моделей коллективного поведения.
В результате проведенного исследования разработан соответствующий метод позволяющий прогнозировать динамику социальных явлений на основе учета таких объективных параметров как: неравенство доходов населения, уровень доверия граждан к лицам и институтам, представляющим интересы государства, пороговое поведение населения. Для практической реализации данного метода разработана программа для ЭВМ.
Выводы. Представленный метод превентивной идентификации районов социальной напряженности обладает широкими прикладными возможностями применения и значительным потенциалом дальнейшей модернизации.
Determination of the best method for processing gambier liquid by-product [Uncaria gambir (hunter) roxb] as natural antioxidant sources
Authors: Ismail A. S. , Rizal Y. , Armenia A. , Kasim A. 
Published: June 2021

The study was conducted to determine the best gambier liquid by-product (GLB) processing methods based on antioxidant activity as natural antioxidant sources. The processing methods were A (ethyl acetate fractionation), B (oven drying) and C (freeze drying) methods. The observed variables were dry extract (using weighing method), tannin (using hide powder method), catechin (using SNI 01- 339-2000 method), total phenol (using folin ciocalteu reagents) and antioxidant activities (DPPH method) based on ICAO50. These antioxidant activities were compared with vitamin C as a positive control. The results indicated that the different processing methods significantly affected (P<0.05) dry extract, tannin, catechin, total phenol and antioxidant activity of GLB. The highest dry extract, tannin, catechin, total phenol, and antioxidant activity from GLB were at treatment B (10.76%), B (39.69%), A (86.07%), C (80.97 mg GAE/g), and C (ICAO50 2.74 µg/mL), respectively. The antioxidant activity on treatment C was not different from vitamin C antioxidant activity (2.88µg/mL). Thus, the treatment C (freeze drying method) was the best method to process GLB based on antioxidant activity as natural antioxidant sources.
Posterior urethral valves (PUVs): prenatal ultrasound diagnosis and management difficulties: a review of three cases
Authors: Aliyu Labaran Dayyabu 
Published: June 2021

Abstract

Objectives
Lower urinary tract obstruction (LUTO) has different etiologies. The most common form is posterior urethral valve (PUVs). It is a condition that can lead to end stage renal disease (ESRD) in later life and severe renal and pulmonary damage in utero. Those born alive may end up with residual kidney disease leading to life long morbidity or death. This condition can be diagnosed through prenatal ultrasound but because diagnosis is done late when kidney injury has already happened it does not guarantee healthy survival after birth. There are various treatments in utero and after birth but they all have their complications. In developing countries diagnosis is possible but in most cases pregnant women with fetuses with PUVs present very late in pregnancy. In utero interventions are in most cases not possible and the only way out is expectant management with serial ultrasound assessment until the fetus has achieved level of maturity at which time it is delivered and further postnatal evaluations and treatment given. This series is aimed at highlighting the prenatal ultrasound features of PUVs and the management challenges faced by physicians in developing countries.

Case presentation
The three cases were managed in three different hospitals. All the cases presented at different gestational ages and different levels of fetal affectation. Because of these, outcomes of management and prognosis of each case differ.

Conclusions
Fetal PUVs pose specific challenges in management because of late presentation and lack of resource for intervention even where cases present early with minimal renal damage.
The Costumbrismo of Conflict inEl ideal de un calavera
Authors: Hanson Cody C. 
Published: June 2021

AbstractAlberto Blest Gana’s 1863 novelEl ideal de un calaveracontains frequent and highly detailedcuadros de costumbresdepictions of Chile’s unique national culture. In the novel, the parlour and rodeo scenes explore imbalances of power which result from Chile’s economic and social inequalities. These inequalities further exacerbate the rural versus urban divide to reveal a national identity that is hegemonic and contradictory. Power, money, and class coalesce in the aristocratic parlour. The parlour conversation between Abelardo Manríquez and don Calixto Arboleda reveals unscrupulous economic behaviour and questions the feasibility of a united and homogeneous society. In the rodeo, Manríquez and Juan Miguel Sendero compete against each other in a metaphorical contest between the rural versus urban and underprivileged versus elite segments of society. The contradictory nature of urban and rural cultures receives further attention through a depiction of folk medicine. The novel presents the role of religion in creating a shared national culture through the Christmas nativity tradition. These scenes contextualise Chile’s unique and contradictory national identity to reveal what it means to be Chilean. Chile is a heterogeneous nation that is trying to reconcile its social, economic, and regional inequalities.