bluuebunny/crossref_metadata_2025_split huggingface dataset:
An alarming rise of non-albicans Candida species and uncommon yeasts in the clinical samples; a combination of various molecular techniques for identification of etiologic agents
Authors: Taei Mohireh , Chadeganipour Mostafa , Mohammadi Rasoul 
Published: October 2019

Abstract
Objective: Yeasts are opportunistic microorganisms can cause human fungal infection among immunocompromised patients. This study aimed to identify Candida species and uncommon yeasts obtained from clinical specimens in Kashani university hospital and Shefa Lab as a referral medical mycology laboratory, in Isfahan, Iran, by combination of various molecular techniques. Results: A total of 202 yeast strains were isolated from 341 clinical samples between February 2017 to May 2019. All clinical isolates were identified using phenotypic and molecular tests. PCR-RFLP, duplex-PCR, multiplex-PCR, and PCR-sequencing were applied for molecular identification of yeasts. The most clinical samples were obtained from urine (66.8%), nail (9.4%), bronchoalveolar lavage (5.9%), sore (4.4%), and blood (3.9%). One hundred and twenty-one Candida species were identified as non- albicans against 76 Candida albicans. Trichosporon asahii, and Pichia terricola were uncommon non- Candida yeasts isolated from urine samples. For the first time, we isolated P. terricola as etiologic agent of urinary tract infection in a pregnant female. Since non- albicans Candida species and non- Candida yeasts have various virulence factors and antifungal susceptibility profile, precise molecular identification can help us to reach to the advantageous strategies for treatment of these fungal infections.
An integrated intervention for chronic care management in rural Nepal: a type 2 hybrid effectiveness-implementation study
Authors: Schwarz Dan , Dhungana Santosh , Kumar Anirudh , Acharya Bibhav , Agrawal Pawan , Aryal Anu , Baum Aaron , Choudhury Nandini , Citrin David , Dangal Binod , Dhimal Meghnath , Gauchan Bikash , Gupta Tula , Halliday Scott , Karmacharya Biraj , Kishore Sandeep , Koirala Bhagawan , Kshatriya Uday , Levine Erica , Maru Sheela , Rimal Pragya , Sapkota Sabitri , Schwarz Ryan , Shrestha Archana , Thapa Aradhana , Maru Duncan 
Published: October 2019

Abstract
Background In Nepal, the burden of non-communicable, chronic diseases is rapidly rising, and disproportionately affecting low- and middle-income countries. Integrated interventions are essential in strengthening primary care systems and addressing the burden of multiple comorbidities. A growing body of literature supports the involvement of frontline providers, namely mid-level practitioners and community health workers, in chronic care management. Important operational questions remain, however, around the digital, training, and supervisory structures to support the implementation of effective, affordable, and equitable chronic care management programs. Methods A twelve-month, population-level, type 2 hybrid effectiveness-implementation study will be conducted in rural Nepal to evaluate an integrated non-communicable disease care management intervention within Nepal’s new municipal governance structure. The intervention will leverage the government’s planned roll-out of the World Health Organization’s Package of Essential Non-communicable disease interventions (WHO-PEN) program in four municipalities in Nepal, with a study population of 80,000. The intervention will leverage both the WHO-PEN and its cardiovascular disease specific technical guidelines, HEARTS, and include three evidence-based components: 1) non-communicable disease care provision using mid-level practitioners and community health workers; 2) digital clinical decision support tools to ensure delivery of evidence-based care; and 3) training and digitally-supported supervision of mid-level practitioners to provide motivational interviewing for modifiable risk factor optimization, with a focus on medication adherence, and tobacco and alcohol use. The study will evaluate effectiveness using a pre-post design with stepped implementation. The primary outcomes will be disease-specific, “at-goal” metrics of chronic care management; secondary outcomes will include alcohol and tobacco consumption levels. Discussion This is the first population-level, hybrid effectiveness-implementation study of an integrated chronic care management intervention in Nepal. As low- and middle-income countries plan for the Sustainable Development Goals and universal health coverage, the results of this pragmatic study will offer insights into policy and programmatic design for non-communicable disease care management in the future.
Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation
Authors: Michel-Kabamba Nzaji , Christophe-Luhata Lungoyo , Ngatu Nlandu Roger , Othepa Charlotte , Bertin-Lora Mwimba , Arsene-Kabwaya Mukola , Bateyi Stephane H. , Hoff Nicole A. , Leon-Kabamba Ngombe , Muzembo Basilua Andre , Wada Koji , Ikeda Shunya , Mukamba Elisabeth , Guillaume-Ngoie Mwamba , Oscar-Luboya Numbi 
Published: October 2019

Abstract
Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC.Methods This was a longitudinal study conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test).Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located.Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.
Characterization of genetic determinants of the resistance to phylloxera, Daktulosphaira vitifoliae, and the dagger nematode Xiphinema index from muscadine background
Authors: Rubio Bernadette , Lalanne-Tisné Guillaume , Voisin Roger , Tandonnet Jean-Pascal , Portier Ulysse , Ghelder Cyril Van , Lafargue Maria , Petit Jean-Pierre , Donnart Martine , Joubard Benjamin , Bert Pierre-Francois , Papura Daciana , Cunff Loïc Le , Ollat Nathalie , Esmenjaud Daniel 
Published: October 2019

Abstract
Muscadine ( Muscadinia rotundifolia ) is known as a resistance source to many pests and diseases in grapevine. The genetics of its resistance to two major grapevine pests, the phylloxera D. vitifoliae and the dagger nematode X. index , vector of the Grapevine fanleaf virus (GFLV) was investigated in a backcross progeny between the F1 resistant hybrid material VRH8771 ( Muscadinia-Vitis ) and V. vinifera cv. ‘Cabernet-Sauvignon’. Phylloxera resistance was assessed by monitoring root nodosity number in an “ in planta ” experiment and larval development in a root “ in vitro ” assay. Nematode resistance was studied using 10-12 month long tests for the selection of durable resistance and rating criteria based on nematode reproduction factor and gall index. A major QTL for phylloxera larval development, explaining more than 70% of the total variance and co-localizing with a QTL for nodosity number, was identified on LG 7. Additional QTLs were detected on LG 3 and LG 10, depending on the “ in planta ” or “in vitro” experiments, suggesting that various loci may influence or modulate nodosity formation and larval development. Using a Bulk Segregant Analysis approach and a proportion test, markers clustered in three regions on LG 9, LG 10 and LG 18 were shown to be associated to the nematode resistant. All these results open the way to the development of marker-assisted selection in grapevine rootstock breeding programs based on muscadine derived resistance to phylloxera and to X. index in order to delay GFLV transmission.
Role of the KNOTTED1-LIKE HOMEOBOX Protein (KD1) in regulating tomato flower pedicel abscission at early and late stages of the process
Authors: Sundaresan Srivignesh , Philosoph-Hadas Sonia , Ma Chao , Jiang Cai-Zhong , Riov Joseph , Kochanek Betina , Salim Shoshana , Reid Michael S. , Meir Shimon 
Published: October 2019

Abstract
Background The KNOTTED1-LIKE HOMEOBOX PROTEIN1 ( KD1 ) gene is highly expressed in flower and leaf abscission zones (AZs). RNA-antisense silencing of KD1 was shown to delay tomato pedicel and petiole abscission, induced by flower or leaf removal, respectively. KD1 was found to regulate flower pedicel abscission via alteration of auxin gradient through the flower AZ (FAZ), and disruption of the auxin response at the early stages of the abscission process. The present work was aimed to further understand how KD1 regulates signaling factors and regulatory genes involved in the delay of pedicel abscission using the silenced KD1 lines. For this purpose we performed a large scale transcriptome profiling of the FAZ at various time points after flower removal, using a customized AZ-specific microarray. Results The results highlighted a differential expression of regulatory genes in the FAZ of KD1 -silenced plants compared to the wild type (WT). These genes were controlled by KD1 before and after abscission induction. In the KD1 -silenced plants, KD1 expression already decreased at zero time before flower removal, resulting in altered expression of regulatory genes, including epigenetic modifiers, transcription factors (TFs), post-translation regulators, and antioxidative defense components. The increased expression of these regulatory genes, and genes related to exocytosis and gibberellin perception, observed in the WT FAZ, was inhibited in the KD1- silenced plants at 4 h after flower removal. This response led to an inhibited abscission phenotype and downregulation of genes involved in abscission execution and defense in the KD1 -silenced plants. Conclusions The data suggest that KD1 is a master regulator in tomato flower abscission. Some of the altered genes might directly affect auxin homeostasis and transport, resulting in slowing down auxin depletion in the FAZ. This probably delayed the subsequent cascade of the molecular events described above. The data obtained suggest that the inhibitory effect of KD1 silencing on flower pedicel abscission is not limited to manipulation of auxin levels and response as previously reported, but it probably also operates via alteration of other regulatory pathways that delay the acquisition of the competence of the FAZ cells to respond to ethylene signaling.
3-D digital modeling and bio-mechanics research of the anterior disk displacement without reduction temporomandibular joint system
Authors: Lai Linfeng , Xiong Guofeng , Huang Chenyao , Zhou Fan , Xia Fujian 
Published: October 2019

Abstract
Background： Anterior and/or medial displacement of the articular disc or intra-articular disorders( ID) is the most common form of TMJ dysfunction.In the present study,3D finite elements analysis (FEA) models including the maxilla, disc and mandible were established using 3D data registration technology. Materials and Methods： Six healthy volunteers and 20 TMD patients were selected.CT and MRI data were collected to build 3D FEA model of mandibular and TMJ disc. Result: Results showed that maximum stress of the normal lateral articular disc in the normal and pathological models appeared in the lateral part of the middle band. In the normal model, stress distribution was more uniform and the joint disc and the condyle were also subjected to higher load at the junction of the articular disc and the condyle. Conclusion: When the friction coefficient of the side with anterior displacement increased, stress on the disc, condyle and mandible of the opposite side increased. Simultaneously, stress values of the disc, condyle and mandible were cd32fvhigher than those of the normal lateral joint.
Continuous Incremental Heavy Halo Traction Combined with Posterior-only Approach for Severe Cervical Kyphosis with Neurofibromatosis-1.
Authors: Guo Chaofeng , Zhang Hongqi , Zhou Zhenhai , Liu Jinyang , Deng Ang 
Published: October 2019

Abstract
Background Surgical management of cervical kyphosis in patients with NF-1 is a challenging task. Presently, anterior-only (AO), posterior-only (PO) and combined anterior-posterior (AP) spinal fusion are common surgical strategies. However, the choice of surgical strategy and application of Halo traction remain controversial. Few studies have shown and recommended posterior-only approach for cervical kyphosis correction in patients with NF-1. The aim of this study is to evaluate the safety and the effectiveness of Continuous-Incremental-Heavy Halo Traction (CIH-HT) combined with posterior-only approach for treatment of cervical kyphosis with NF-1.
Methods 19 patients with severe cervical kyphosis due to NF-1 were reviewed retrospectively between January 2010 and April 2017. All the cases underwent CIH-HT combined with posterior instrumentation and fusion surgery. Correction result, neurologic status and complications were analyzed.
Results In this study, cervical kyphosis Cobb angle decreased from initial 63.0 ± 21.0 degrees to postoperative 10.8 ± 4.0 degrees(P＜0.01),with total correction rate of 92%, which consist of 44% from CIH-HT and 48% from surgical correction. JOA scores were improved from preoperative 13.6±1.6 to postoperative 16.0±1.0(P＜0.01). Neurological status was also improved. There was no correction loss and the neurological status was stable in mean 3.7 years follow-up. The incidence of complications was 36.8% (7/19). Six patients underwent local complications and one patient underwent a second surgery.
Conclusion CIH-HT combined PO approach is safe and effective method for cervical kyphosis correction in patients with NF-1. A satisfied correction result, and successful bone fusion can be achieved via this procedure, even improvement of neurological deficits can also be obtained. Our study suggested that CIH-HT combined PO approach is another consideration for cervical kyphosis correction in patients with NF-1.
Key words : Neurofibromatosis-1; Cervical kyphosis; Continuous-Incremental-Heavy Halo Traction; posterior-only approach;
Assessment of postoperative analgesic effect of rectus sheath block for patients who had emergency midline laparatomy, in University of Gondar Compressive Specialized Hospital, Northwest Ethiopia: an observational prospective cohort study.
Authors: Chekol Wubie Birlie , Tawuye Hailu Yimer , denu zewuditu abdissa , agegnehu Abatneh Feleke 
Published: October 2019

Abstract
Background : Postoperative pain is a major concern after midline abdominal surgeries. Rectus sheath block (RSB) has been indicated after midline laparatomy ; however, the analgesic effect of landmark technique on postoperative pain was not well investigated.
Objectives: we tested the hypothesis that RSB reduces pain scores, decreased total analgesic consumption and prolong first analgesic request time after emergency midline laparatomy .
Methods : Prospective cohort study was done from February 1 to May 10, 2018. Eighty eight patients were observed in this study, 44 in the RSB group and 44 in the non exposed group. Pain severity was assessed in first 24 hours postoperative period in terms of total analgesic consumption, first analgesic request time and visual analogue scale (VAS) score at 1 hour , 2 hours , 4 hours , 6 hours , 8 hours , 10 hours, 12 hours and 24 hours.
Results : The RSB group had significantly reduced VAS score at rest and on movement at (1, 2, 4, 6 and 8 hours), but not at (10, 12 and 24 hours) point assessed. Patients in RSB group had reduced tramadol requirement compared to non exposed group in 24 hours (255.68±80.13) VS (314.77±97.40), P=0.003). The 24 hours diclofenac consumption was significantly lowered in RSB group (75 ( 75-150) than non exposed group (150 ( 75-150), P=0.031.Mean time to first analgesic request was significantly longer in RSB group (372.95±131.41) than non exposed group (50.34±14.12), p≤0 . 001).
Conclusions : The RSB group resulted in less pain scores, reduced total analgesic utilization and stayed for longer time for first analgesic request. Therefore we recommend RSB as part of multimodal analgesia after emergency midline laparatomy.
Keywords: midline abdominal surgery, rectus sheath block, abdominal field block
Item Analysis: The impact of distractor efficiency on the discrimination power of multiple choice items
Authors: Rezigalla Assad Ali , Ibrahim Elwathiq Khalid , ElHussein Amar Babiker 
Published: October 2019

Abstract
Background Distractor efficiency of multiple choice item responses is a component of item analysis used by the examiners to to evaluate the credibility and functionality of the distractors.Objective To evaluate the impact of functionality (efficiency) of the distractors on difficulty and discrimination indices.Methods A cross-sectional study in which standard item analysis of an 80-item test consisted of A type MCQs was performed. Correlation and significance of variance among Difficulty index (DIF), discrimination index (DI), and distractor Efficiency (DE) were measured.Results There is a significant moderate positive correlation between difficulty index and distractor efficiency, which means there is a tendency for high difficulty index go with high distractor efficiency (and vice versa). A weak positive correlation between distractor efficiency and discrimination index.Conclusions Non-functional distractor can reduce discrimination power of multiple choice questions. More training and effort for construction of plausible options of MCQ items is essential for the validity and reliability of the tests.
Safety and long-term impacts on quality of life of segmental bowel resection for bowel endometriosis: a single-centred 5-year follow-up
Authors: Liu Duo , Liang Yanchun , Chen Ming , Pan Wenwei , Liu Lin , Yao Shuzhong 
Published: October 2019

Abstract
Purpose: To evaluate the long-term efficacy of segmental bowel resection for bowel endometriosis and the impact of post-operative complications on clinical outcomes.Methods: 62 symptomatic patients with bowel endometriosis undergoing segmental bowel resection from Jun. 2010 to Jan. 2014 were recruited. A visual analogue scale (VAS) and SF-36 questionnaire were administered before and at least 5 years after surgery. Post-operative complications and pregnancy were also recorded. Median follow-up after operation was 76 months (62-105 months).Results: 62 patients underwent laparoscopic segmental bowel resection, one of which converted to laparotomy. All patients complained of obvious pain symptoms, including dysmenorrhea, dyspareunia, bowel movement pain, chronic pelvic pain and tenesmus. Dysmenorrhea was the most frequent. The relief of all pain symptoms after surgery was statistically significant (P<0.001). The scores for 8 domains of SF-36 questionnaire were significant improved after operation (P<0.001), and the post-operative scores were improved to the level of Chinese female population. Post-operative complication included 18 cases of urinary retention, 4 rectovaginal fistulas, 2 cases of vaginal dehiscence, and 1 case each of thrombogenesis, diffuse peritonitis, peripheral nerve injury, bacteraemia, incomplete intestinal obstruction and mucus bloody stool. All of these patients recovered well. There was no significant difference in post-operative SF-36 questionnaire scores between the patients with and without complications.Conclusion: Segmental bowel resection can significantly relieve pain and improve long-term quality of life for patients with bowel endometriosis. Despite the relatively high complication rate, the complications had little impact on the improvement of quality of life.
In-hospital Mortality and Failure to Rescue Following Hepatobiliary Surgery in Germany - A Nationwide Analysis.
Authors: Krautz Christian , Gall Christine , Gefeller Olaf , Nimptsch Ulrike , Mansky Thomas , Brunner Maximilian , Weber Georg F. , Grützmann Robert , Kersting Stephan 
Published: October 2019

Abstract
Objective To determine the risk-adjusted in-hospital mortality for hepatobiliary resections at the national level in Germany and to examine the effect of hospital volume on in-hospital mortality, and failure to rescue. Summary Background Data There is a paucity of population-based outcome data on hepatobiliary surgery in European countries, including Germany. Methods We studied all inpatient cases of hepatobiliary surgery (n = 31,114) in Germany from 2009 to 2015, using national hospital discharge data. After ranking hospitals according to increasing hospital volumes, five volume categories were established based on all hepatobiliary resections. We evaluated the association between hospital volume and in-hospital mortality following minor and major hepatobiliary resections by using multivariable regression methods. Results Minor hepatobiliary resections were associated with an overall mortality rate of 3.9% and showed no significant volume-outcome associations. In contrast, overall mortality rate of major hepatobiliary resections was 10.3%. In this cohort, risk-adjusted in-hospital mortality following major resections varied widely across hospital volume categories, from 11.4% (95% CI 10.4–12.5) in very low volume hospitals to 7.4% (95% CI 6.6–8.2) in very high volume hospitals (risk-adjusted OR 0.59, 95% CI 0.41–0.54). Moreover, rates of failure to rescue decreased from 29.38% (95% CI 26.7-32.2) in very low volume hospitals to 21.38% (95% CI 19.2-23.8) in very high volume hospitals. Conclusions In Germany, patients who are undergoing major hepatobiliary resections have improved outcomes if they are admitted to higher volume hospitals. Given the high rates of nationwide in-hospital mortality, health political strategies to initiate a sufficient centralization process of major hepatobiliary surgery in Germany are needed.