bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occurrence and determinants of Klebsiella species bloodstream infection in the western interior of British Columbia, Canada
Authors: Reid Connor B. , Steele Lisa , Pasquill Kelsey , Parfitt Elizabeth C. , Laupland Kevin 
Published: September 2019

Abstract
BACKGROUND Klebsiella species are among the most common causes of bloodstream infection (BSI). However, few studies have evaluated their epidemiology in non-selected populations. The objective was to define the incidence of, risk factors for, and outcomes from Klebsiella species BSI among residents of the western interior of British Columbia, Canada.METHODS Population-based surveillance was conducted between April 1, 2010 and March 31, 2017.RESULTS 151 episodes were identified for an incidence of 12.1 per 100,000 per year; the incidences of K. pneumoniae and K. oxytoca were 9.1 and 2.9 per 100,000 per year, respectively. Overall 24 (16%) were hospital-onset, 90 (60%) were healthcare-associated, and 37 (25%) were community-associated. The median patient age was 71.4 (interquartile range, 58.8-80.9) years and 88 (58%) cases were males. Episodes were uncommon among patients aged ≤40 years old and no cases were observed among those aged ≤ 10 years. A number of co-morbid medical illnesses were identified as significant risks and included (incidence rate ratio; 95% confidence interval) cerebrovascular accident (5.9; 3.3-9.9), renal disease 4.3; 2.5-7.0), cancer (3.8; 2.6-5.5), congestive heart failure (3.5; 1.6-6.6), dementia (2.9; 1.5-5.2), diabetes mellitus (2.6; 1.7-3.9), and chronic obstructive pulmonary disease (2.3; 1.5-3.5). Of the 141 (93%) patients admitted to hospital, the median hospital length stay was 8 days (interquartile range, 4-17). The in-hospital and 30-day all cause case-fatality rates were 24/141 (17%) and 27/151 (18%), respectively.CONCLUSIONS Klebsiella species BSI is associated with a significant burden of illness particularly among those with chronic co-morbid illnesses.
Comprehensive investigation of the prevalence and risk factors of viral hepatitis B and C in PERSIAN Guilan Cohort Study
Authors: Joukar Farahnaz , Naghipour Mohammadreza , Hassanipour Soheil , Yeganeh Sara , Soltanipour Soheil , Samadani Ali Akbar , Paryad Ezzat , Sepehrimanesh Masood , Shafaghi Afshin , Mansour-Ghanaei Fariborz 
Published: September 2019

Abstract
Background Hepatitis B (HBV) and C (HCV) viruses are two serious infectious diseases with high global health impact. The aim of this study was to evaluate the prevalence of HBV and HCV in the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study through immunological and molecular methods.Methods The blood samples were obtained from 10520 enrolled participant. Complete biochemical and hematological assessments plus urine analysis were done. The presence of HBsAg, anti-HBs, anti-HBc and anti-HCV antibodies for all participants and HBeAg and anti-HBe antibody for HBV positive patients were evaluated. HBV genomic DNA and HCV genomic RNA were extracted from positive serum samples. Real time PCR assay was done to quantify HBV and HCV genomes. HCV genotyping was also performed.Results Most of our participants were female (53.5%), rural (56.1%), married (97.2%) with primary education (72.1%) without smoking (75.2%) or alcohol consumption (85.3%). The HBV and HCV prevalence was 0.24% (95% CI, 0.16% to 0.35%) and 0.11% (95% CI, 0.06% to 0.19%), respectively. Rural participants were significantly more HBV positive than urban peoples (P=0.045) while male individuals were significantly more HCV positive than female participants (P=0.013).Conclusion Our detected HBV and HCV prevalence were lower than other cities/provinces of Iran, which may be due to the lifestyle or other unknown reasons.
Prevalence and associated factors of hepatitis B virus infection among pregnant women attending antenatal care at Agena health center, South Ethiopia, 2019: a cross sectional study
Authors: Agazhu Haile Workye , Robele Melese Niguse , Ayele Ijigu Tadesse , Mohammed Amin A/Karim 
Published: September 2019

Abstract
Background; Hepatitis B virus (HBV) is the world’s most common and highly contagious liver infection. Its transmission methods are: mother to child, via open wounds, sexual contact, blood transfusion and other blood contact related activities. Prevalence of HBV among pregnant women in Africa ranges from 3.67 - 16.5% and in Ethiopia 2.4 to 8.4%. Hepatitis B infection leads to high morbidity and mortality for mother as well as for their infants due to the vertical transmission. Hence assessing the prevalence and associated factors of Hepatitis B Virus infection is a priority. Methodology : An institution based cross sectional study was conducted with a total of 194 of pregnant women attending antenatal care at Agena health center from May 1-30/2019. Frequency analysis and Logistic regression test was used to determine the associated factors associated with Hepatitis B virus by using SPSS version 25. Results: The prevalence of HBV in Agena health center among pregnant women were 4.1% and it was associated with marital status, history of hospital admission and history of abortion. Conclusion : The prevalence of HBV in Agena health center among pregnant women was intermediate. Since routine screening and immunization of all pregnant women is mandatory. Key words : Hepatitis B infection, pregnant women, Agena health center
Assessment of the Community Awareness and Exposure to Highly Pathogenic Avian Human influenza in Wet-land Areas of Ethiopia
Authors: Chekol Musse Tadesse , Teshome Bethel , Belayneh Rediet , Misganaw Ketema , Hassen Abdilhafiz , Tewolde Nega , Habtamu Luna 
Published: September 2019

Abstract
Background: The avian influenza virus has different subtypes which have the potential to cause disease in animals and humans. Human cases with influenza A (H5N1), A (H5N6) and A (H7N9) viruses, have been reported to WHO and various influenza A (H5) subtypes continue to be detected in birds globally. Little is known about the types of exposure that result in human infections. In Ethiopia, risk assessment studies were not conducted and the awareness of the community and the risk of exposure for potential avian influenza is undetermined. The aim off this survey is to assess the level of the community awareness and the risk for human exposure to avian influenza viruses (HPAI) in the wet land areas of Ethiopia.
Method: The survey was conducted from January 26 to February 28, 2018 in the wet land areas of Ethiopia by using a standard questionnaire and purposive random sampling method. Epi info version 7.0 and SPSS (V.20) were applied for data analysis.
Result: Off the total 200 respondents 94.7% don’t know about the mode of transmission and 43.5%, 27%, 16.9% of the respondents believed that HAI it transmitted by inhalation of air droplet (breathing), contact with ill person and eating raw poultry meat and egg products. 36.2% of respondents believed that Human avian influenza is preventable by keeping hand hygiene, followed by respiratory hygiene (28%) and environmental hygiene (19.3%). However, 68.6% had close contact with animals (poultry) and high exposure to raw animal products.
Conclusion: The awareness level of the community in the mode of transmission, risk factors and preventive measures is very low while the exposure for infected birds, food products remaining high. Further risk assessment studies and community awareness creation on the prevention and control of highly pathogenic avian influenza is recommended.
Key words: Avian Influenza, Exposure, Ethiopia
Next-generation Sequencing with cerebrospinal fluid for the diagnosis of progressive multifocal leukoencephalopathy in HIV-infected patients
Authors: Zhang Renfang , Qi Tangkai , Chen Jun , Sun Jianjun , Liu Li , Song Wei , Wang Zhenyan , Tang Yang , Lu Hong-zhou 
Published: September 2019

Abstract
Background To investigate the clinical manifestations, imaging findings, characteristics of cerebrospinal fluid, treatment and prognosis in patients with AIDS-related progressive white matter lesions diagnosed by second-generation sequencing with cerebrospinal fluid.Methods Patients with clinically suspected PML were diagnosed by second-generation sequencing with cerebrospinal fluid, and the clinical data of these patients were retrospectively reviewed.Results Ten patients with AIDS-related PML were diagnosed, including eight males (80%). The average age was 38.7±8.2 years, and the median CD4+ T cell count was 46×106/L. The median HIV RNA was 5.99 × 104 copies/ml. Main clinical manifestations included: dyskinesia in 4 patients (40%) and dizziness in 3(30%), cognitive decline in 2(20%), and speech disorder in 1(10%). Three patients (30%) developed convulsions throughout the course of the disease. Image findings involved lesions cerebellum in 3 cases (30%), and lesions above the cerebellum in 7 cases (70%). Mild increase of total protein was observed in the cerebrospinal fluid of 4 cases (40%), while white blood cell count, sugar and chloride were normal in all of the cases. The copies of JCV sequence in the cerebrospinal fluid ranged from 3-12531 reads (median=67 reads). All the patients received antiviral therapy including integrase inhibitors. Among the 10 patients, 2 died in hospital and 8 survived, 2 of them have survived for more than 1 year. Symptoms were improved in 5 patients and unchanged in 3 patients.Conclusions PML is common in patients with HIV/AIDS. It is reliable to diagnose the disease through clinical manifestations, routine detection of cerebrospinal fluid, imaging and cerebrospinal fluid NGS sequencing. Strong and effective antiretroviral treatment may improve the prognosis of patients.
Involvement of ABC-transporters and acyltransferase 1 in intracellular cholesterol-mediated autophagy in bovine alveolar macrophages in response to the Bacillus Calmette-Guerin(BCG) infection
Authors: Xu Jinrui , Zhou Yanbing , Yang Yi , Lv Cuiping , Liu Xiaoming , Wang Yujiong 
Published: September 2019

Abstract
Background: Mycobacterium tuberculosis ( M. tuberculosis, Mtb ) is the pathogen causing human Tuberculosis (TB). Mycobacterium bovis ( M. bovis ) infection is the cause of bovine TB, which occasionally infects other species of mammals including humans and wildlife, a main reason of the difficulty to eradicate TB around the world. Recent studies in immunometabolism demonstrated that host cholesterol levels have implications in the establishment of Mtb infection, which lead to the development of host-directed therapy (HDT) strategies for treatment of TB.
Methods: In the present report, the involvements of ATP-binding cassette transporters (ABC-transporters)- and cholesterol acyltransferase1 (ACAT1)-mediated intracellular cholesterol in autophagy of bovine macrophages induced by Bacillus Calmette-Guerin (BCG) were interrogated by enzymatic and biochemistry assays i n vitro, including quantitative RT-PCR and immunoblotting.
Results: The results showed that a down-regulated expression of the ABC-transporters and ACAT1 in primary bovine alveolar macrophages (AMs) and murine RAW264.7 cells in response to the BCG infection. The inhibited expression of ABC-transporters and ACAT1 was associated with the reduction of intracellular free cholesterol, which in turn induced autophagy in macrophages upon to the Mycobacterial infection. These results strongly suggest an involvement of ABC-transporters and ACAT1 in intracellular cholesterol-mediated autophagy in macrophages in response to Mycobacterial infections.
Conclusion: This study thus provides an insight into mechanism of immunometabolism of macrophages in response to the Mtb infection, and informative data for development of HDT in TB treatments.
Clinical and histologic tissue responses of skin incisions closed with glycomer 631 and lactomer 9-1 using subcutaneous and subcuticular techniques in pigs
Authors: Plavec Tanja , Švara Tanja , Zdovc Irena , Gombač Mitja , Damjanovska Marija , Pintarič Tatjana Stopar , Cvetko Erika , Seliškar Alenka 
Published: September 2019

Abstract
Background: Glycomer 631 and lactomer 9-1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds. Pigs are often used as surgical models in translational research, however, the reports of tissue reactions to both suture materials in pigs are deficient. The aim of this study was to assess clinical and histologic responses of skin incisions closed with subcutaneous and subcuticular techniques using glycomer 631 and lactomer 9-1 in pigs. Results: Skin incisions of 17 pigs were closed with glycomer 631 and lactomer 9-1 and clinical reactive score (CRS) including erythema, swelling, discharge, and dehiscence was calculated on postoperative days 7 and 14. Tissue reaction was assessed histologically on postoperative day 14 (the presence of extravascular neutrophils, macrophages, multinucleated giant cells, lymphocytes, fibroblasts, bacterial colonies, overall severity of inflammatory response to suture material), and the cumulative score of variables calculated as aggregate tissue irritation score (ATIS). Tissue samples were examined for suture extrusion and evaluated microbiologically. Clinical reactive score did not differ between the suture materials. Only one variable of ATIS, overall severity of inflammatory response, was lower (p = 0.029) when glycomer 631 was used. Suture extrusion was found in 10/17 of incisions closed by glycomer 631 and in 7/13 of incisions closed by lactomer 9-1. Trueperella pyogenes was isolated from the skin and from the area of tissue reaction in six pigs. Conclusions: No difference in CRS between the suture materials was observed. Glycomer 631 induced less tissue reaction only in terms of overall severity of inflammatory response. Suture extrusion was observed in more than 50% of incisions regardless of the suture material. Trueperella pyogenes was the only pathogen isolated from the tissue surrounding the suture material.
The effect of the laparoscopic primary suture of the common bile duct in elderly patients: a retrospective study
Authors: Liu Jinheng , Wang Yanting , Liu Xubao , Yin Sineng 
Published: September 2019

Abstract
Background Traditionally, Surgical treatment strategies for elderly patients diagnosed with choledocholithiasis combined with cholecystolithiasis include laparoscopic choledocholithotomy, cholecystectomy, and T-tube drainage. However, T-tube drainage in the biliary tract can still cause pain and other complications. This study was designed to compare the primary closure of choledochotomy and the use of T-tube after laparoscopic choledochotomy to determine whether primary suture can be as feasible and safe as suture with T-tube drainage in elderly patients. Methods From January 2017 to January 2018, 85 patients were selected to undergo laparoscopic surgery. They were divided into two groups: primary suture group (n=56) and T tube group (n=29). Preoperative data, intraoperative index, postoperative complications were recorded. Results There were no differences in preoperative data in both groups. Compared with the T-tube group, the postoperative total drainage volume on the first day and patients of residual stones were fewer, and all drainage tube extubation time was shorter in the primary suture group. And there were statistically significant differences in postoperative TBIL between the two groups. There were no pressure sores, hypostatic pneumonia, deep vein thrombosis, serious complications of heart, lung and brain and even death in both groups. Conclusion Only if accurate preoperative risk assessment and strict treatment of basic diseases in elderly patients, intraoperative fine suture of the common bile duct, primary suture in elderly patients are feasible, safe, and valid after laparoscopic choledochotomy for verification of ductal clearance.
The effectiveness and appropriateness of Interval Laparoscopic Appendectomy on adult appendiceal mass, a retrospective cohort
Authors: Fujihata Shiro , Kitagami Hidehiko , Kitayama Yosuke , Suzuki Ayumi , Tanaka Moritsugu , Hayakawa Shunsuke , Nakaya Seiichi , Okubo Tomotaka , Sagawa Hiroyuki , Tanaka Tatsuya , Takahashi Hiroki , Matsuo Yoichi , Ogawa Ryo , Takiguchi Shuji 
Published: September 2019

Abstract
Background: Appendiceal mass sometimes requires extended resection and difficult to treat postoperative complications. Interval appendectomy has been performed mainly in the field of pediatric surgery to avoid them. Recently, there are a few reports on interval laparoscopic appendectomy (ILA). We examined not only the safety and effectiveness of ILA for adult appendiceal mass (AAM), but also the appropriateness of ILA for which cases should be treated non-surgically for ILA or converted to surgical treatment. Methods: Among 956 appendectomies performed between April 2012 and March 2018, there were 49 cases of AAM, of which 34 cases underwent ILA; ILA group. The safety and efficacy of ILA were examined by comparing with 477 cases of adult uncomplicated appendicitis underwent laparoscopic appendectomy (LA); LA group. The appropriateness of ILA was examined by comparing with the remaining 15 cases of AAM; non-ILA group. Results: The ILA group had a longer operation time than the LA group, but the postoperative hospital stay was shorter, and no significant difference were found in the bleeding volume, the days required for oral intake of solid food, and the perioperative complications. Examining the factors for failure of non-surgical treatment or relapse of inflammation during interval period, higher WBC day3 / day0 was found to be an independent risk factor. Conclusion: ILA against AAM was almost as safe and effective as LA for adult uncomplicated appendicitis. WBC day3 / day0 may be effective as an objective parameter for judging the termination of non-surgical treatment for ILA. This determination to convert ineffective non-surgical treatment to surgical treatment earlier may reduce the burden on the patient.
Feasibility investigation of uniportal video-assisted thoracoscopic anatomical lung resection for pulmonary sequestration
Authors: Sun Yungang , Shao Feng , Zhang Qiang , Wang Zhao 
Published: September 2019

Abstract
Background Uniportal video-assisted thoracic surgery (UVATS) technique has been increasingly used for many thoracic diseases. Whether UVATS has equivalent or better perioperative outcomes for pulmonary sequestration (PS) patients remains controversial. Our study aimed to evaluate the feasibility of UVATS in anatomical lung resection for pulmonary sequestration.Methods A total of 24 patients with PS including fifteen males and nine females with the mean age of 40.54±14.49 (rang, 18-65) years old, who had received completely UVATS anatomical lung resection for PS in Nanjing Chest Hospital between January 2016 and December 2018 were retrospectively reviewed. Referring clinical data were retrieved from hospital records and analyzed.Results All 24 patients had been treated with the UAVTS approach successfully with no aberrant artery ruptured and no massive hemorrhage occurred, and no patients died during the perioperative period. Overall median surgery time was 102.21 ±28.00 mins (range, 55-150mins), the mean blood loss was 94.17±78.90 ml (range, 10-300ml), the mean days of chest tube maintained were 4.21±2.21 days (range,1-10days), and the mean postoperative hospitalization days was 5.79 ±2.35 days (range,2-11days). All patients were cured, without cough, fever, hemoptysis, and so on, occurring during the average follow-up of 17.42 ±2.00 months (range, 3-35months).Conclusions Our preliminary results revealed that anatomical lung resection by UVATS is a safe and feasible mini-invasive technique for PS patients, which might be associated with less postoperative pain, reduced paresthesia, better cosmetic results, and faster recovery.
Clinical application value of intraoperative transesophageal echocardiography in pediatric cardiac valvular disease
Authors: Qian Jingjing , Ye Jingjing , Yu Jin , Yang Xiuzhen , Zhao Lei 
Published: September 2019

Abstract
Background: To explore the value of intraoperative transesophageal echocardiography (TEE) in the surgical treatment of pediatric cardiac valvular disease. Methods: Transthoracic echocardiography (TTE) was performed in 64 children with cardiac valvular disease, of which 49 patients underwent TEE before and after cardiopulmonary bypass. Results: The coincidence rate of preoperative TEE with the surgical diagnosis on valvular lesions was 100%, higher than that of TTE (78%). TEE supplemented or corrected 10 cases of TTE valvular lesion diagnosis, improving the accuracy of valvular disease diagnosis. Besides, TEE can effectively evaluate the surgical results. Conclusions: Preoperative TEE can accurately diagnose valvular disease in children, which helps to develop a surgical plan. Postoperative TEE can find the remaining problems in time and improve the success rate of surgery.
Refractive outcome of cataract surgery in eyes filled with silicone oil
Authors: Kanclerz Piotr , Leisser Christoph , Grzybowski Andrzej , Lipowski Paweł 
Published: September 2019

Abstract
Background Cataract development is common in phakic eyes filled with silicone oil (SO), necessitating subsequent cataract removal. This study evaluated the refractive outcome in eyes filled with SO undergoing phacoemulsification cataract surgery (PCS). Methods This retrospective study evaluated patients with SO tamponade who were scheduled for PCS. Results Subjects (n=26) were followed-up for 29.5 ± 13.9 months after cataract surgery. The median spherical equivalent refraction (SER) was +5.3 D (interquartile range [IQR] +2.9 to +6.7) before PCS, and +3.4 D (IQR +2.0 to +4.4) after PCS. Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes (57.7%). In 13 eyes assessment of refraction after SO-removal was possible, and showed a myopic shift of -4.6 D (IQR -2.9 to -7.3) in the SER. After SO removal, 5 of 13 eyes (38.5%) were within ±1.0 D of the target refraction, while 9 out of 13 eyes (69.2%) were within ±2.0 D. Conclusions The refractive outcome after PCS for eyes filled with SO is less predictable than that for normal eyes. Some of the eyes undergoing silicone oil injection may require long-term tamponade.
Synchronous evaluation of early neurovascular changes in macula and optic nerve head in early diabetic retinopathy using combined optical coherence tomography angiography parameters
Authors: Wen Xin , Li Zijing , Liang Jiaqi , Xiao Jianhui , Zhang Yichi , Gao Xiang , Liao Yunru , Lan Yuqing 
Published: September 2019

Abstract
Background This study aim to evaluate neurovascular changes in both macula and optic nerve head (ONH) in early stages of diabetic retinopathy (DR) using combined quantitative optical coherence tomography angiography (OCTA) parameters.Methods We studied 194 right eyes from 64 type 2 diabetic patients without DR (DM), 64 diabetic patients with nonproliferative diabetic retinopathy (NPDR) and 64 age-matched healthy controls. OCTA parameters were analyzed using binary logistic regression models and receiver operating characteristic (ROC) curves.Results There was significant reduction of vessel density (VD) in both macula and ONH comparing DM patients with and without NPDR to controls. The area under the curve (AUC) of the ROC curve for NPDR versus control was 0.963 ( p <0.001), with sensitivity of 93.8% and specificity of 90.6%. The ROC curves for NPDR patients versus NoDR patients (including DM and control groups) exhibited an AUC of 0.923 ( p <0.001), with sensitivity of 90.6% and specificity of 82.8%. The thickness of the retinal nerve fiber layer (RNFL) in both macula and ONH was not significantly different among these three groups.Conclusions VD in both macula and ONH was simultaneously decreased prior to RNFL thinning in DM patients through the course proceeding from preclinical DR to NPDR. Combined analysis of macula and ONH parameters was an comprehensive and accurate OCTA metric to distinguish NPDR patients from healthy controls and DM patients without DR.