bluuebunny/crossref_metadata_2025_split huggingface dataset:
The S68G polymorphism is a compensatory mutation associated with the drug resistance mutation K65R in CRF01_AE strains
Authors: Li Shengjia , Ouyang Jinming , Zhao Bin , An Minghui , Wang Lin , Ding Haibo , Zhang Min , Shang Hong , Han Xiaoxu 
Published: September 2019

Abstract
Background: The rate of S68G mutation in human immunodeficiency virus type 1 (HIV-1) reverse transcriptase has increased and is closely related to the K65R mutation among treatment-failure CRF01_AE-infected patients. We aim to explore the temporal association of S68G and K65R mutations among treatment-failure CRF01_AE-infected patients and disclose the role of the S68G mutation on nucleotide/nucleoside reverse transcriptase inhibitor (NRTI) susceptibility and viral replication with the K65R double mutation. Methods: Occurrence of S68G and K65R mutations was evaluated among HIV-1 of various subtypes in the global HIV Drug Resistance Database. The temporal association of S68G and K65R mutations was analyzed by next-generation sequencing (NGS). The impact of the S68G mutation on NRTI susceptibility and replication adaptability was analyzed with pseudovirus phenotypic resistance assays and growth competition assays, respectively. Results: The frequency of the S68G mutation increased significantly in all HIV subtypes and circulating recombinant forms in treatment-experienced patients (except for subtype F), as did the frequency of the K65R/S68G double mutation. NGS revealed that the S68G mutation occurred following K65R mutation among three out of four patients. No significant difference in fold-change for tenofovir, lamivudine or efavirenz was detected between K65R and K65R/S68G mutations in phenotypic resistance assays. The K65R/S68G double mutant outgrew the K65R mutant within 13 days of co-culture for any input ratio among all patients. Conclusions: S68G might be a natural polymorphism and compensatory mutation of K65R selected by NRTIs among the CRF01_AE strain of HIV-1, which does not affect NRTI susceptibility, but improves the replication adaptability on K65R mutants.
Prevalence of diarrhoea and associated risk factors among children under five years old in Pader district, Northern Uganda
Authors: Omona Stephen , Malinga Geoffrey Maxwell , Opoke Robert , Openy Geoffrey , Opiro Robert 
Published: September 2019

Abstract
Background: Diarrhoea remains a major cause of morbidity and mortality in children < 5 years in sub-Saharan Africa. Uganda has the worst mortality rate in children < 5 years among the three East African countries, with 22% of these deaths attributed to diarrhoea. For proper planning and implementation of control interventions, an understanding of the prevalence and determinants of the disease is crucial. This study assessed the prevalence of diarrhoea and related risk factors among children aged < 5 years in Pajule sub-county in Pader district in northern Uganda. Methods: A cross-sectional survey was conducted covering 244 randomly selected households having children < 5 years old in the study area. A semi-structured questionnaire was used to interview the households about diarrhoeal history in their children in the last two weeks preceding the survey, and on the risk factors predisposing children to diarrhoeal infections. Descriptive statistics was used to summarize the risk factors whereas bivariate and multivariate logistic regression analyses (95% confidence interval and p < 0.05) were used to identify the risk factors associated with childhood diarrhoea.Results: We found a prevalence of diarrhoea of 29.1% among children < 5 years of age in Pajule sub-county during the two weeks preceding the survey. Multivariate logistic regression revealed significant associations between diarrhoeal prevalence and use of unprotected water sources (adjusted Odd Ratio, aOR=2.866, 95% CI: [1.431 – 5.741]), presence of animals in respondents’ homes (aOR=3.950, 95%CI: [1.399 – 11.156]) and infrequent hand washing practices (aOR=2.737, 95% CI: [1.304 – 5.743]). Conclusion: The present study identified a high prevalence of diarrhoea among children < 5 years of age in Pajule sub-county, higher than the Ugandan national average. Extensive use of unprotected water sources, animals’ presence in homes and poor hand washing practices had significant associations with diarrhoeal occurrence. These findings underscore the need for continuous community health promotion emphasizing good hand washing practices and interventions that target improvement of hygiene practices at homes as the best methods for fighting childhood diarrhoea in the study area.
Investigation of the presence of NDM-1, VIM-1 and OXA-1 genes in MDR strains of Klebsiella pneumoniae isolated from clinical specimens
Authors: Taleb Melika , Hosseini Farzaneh 
Published: September 2019

Abstract
Background:Klebsiella pneumoniae has emerged as a significant opportunistic pathogen responsible for nosocomial infections. This bacteria is frequently resistant to multiple classes of antibiotics such as the family of beta-lactam antibiotics. The aim of this study was the molecular evaluation of resistant strains of Klebsiella pneumonia isolation of multiple resistant drugs from clinical specimens.Methods:60 clinical isolates of Klebsiella pneumoniae were isolated and identified by staining and biochemical tests during fall season from a laboratory in Tehran. Antimicrobial susceptibility testing was carried out using a disk diffusion method with CLSI standards. All isolates were examined by PCR test for the presence of NDM-1, VIM-1, and OXA-1 genes.Results:The highest resistance in the strains was related to antibiotic ampicillin (90%), followed by the highest resistance to ciprofloxacin (70%), cefixime (66.66%), trimethoprim-sulfamethoxazole (65%), piperacillin (50%). Also, most susceptibilities were to ampicillin antibiotics (85%), gentamicin (70%), piperacillin-tazobactam (60%) and amikacin (56.66%). Out of the 60 isolated strains, 3 isolates (5%) had the VIM-1 enzyme gene, 2 isolates (3.3%) had the OXA-1 enzyme gene and no isolates were found with the NDM-1 enzyme gene. Conclusion:The high levels of antibiotic resistance among the organisms that cause clinical infections suggest that the mechanisms involved in the development of resistance and the evaluation of antimicrobial activity of new drugs in vitro can help the process of effective treatment of these infections.
Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016
Authors: Brandwagt Diederik A.H. , Ende Arie van der , Ruijs Helma (W.) L.M. , de Melker Hester E. , Knol Mirjam J. 
Published: September 2019

Abstract
Background Enhanced surveillance for confirmed cases of invasive meningococcal disease (IMD) was introduced in the Netherlands in 2003, in which reference laboratory data (NRLBM) are linked with notification data (OSIRIS). The quality of surveillance information is important for public health decision making. Our objective was to describe the system and evaluate it for data completeness and timeliness. Methods Cases reported in the surveillance system from 2004 to 2016 were included. For the notification data, we used information on serogroup, vaccination status, mortality, and country of infection as indicators for record completeness. Notification times to regional and national level were calculated using the reported dates available in the notification database.  Results A total of 2,123 cases were reported in the years 2004-2016, of which 1.968 (93%) were reported by the reference laboratory and 1.995 (94%) in the notification system. Of all cases, 1.840 cases (87%) were reported in both systems and could be linked. The serogroup was known in 86% of the notified cases, and was significantly higher (94%) in the years 2013-2016. Information on vaccination status, mortality and country of infection was available in 88%, 99% and 97% of notified cases, respectively. Regional notification of cases occurred within one working day for 86% of cases and 98% were notified nationally within three days.  Conclusions A well performing IMD surveillance system was demonstrated and serogroup completeness has improved over the years. Underlining the need for reporting to both the clinical and laboratory surveillance system remains important to further improve the overall performance in supporting public health response and vaccination policy.
Active Mycobacterium tuberculosis Infection at a Comprehensive Cancer Center, 2006–2014
Authors: Kmeid Joumana , Kulkarni Prathit A. , Batista Marjorie V. , Chaer Firas El , Prayag Amrita , Ariza-Heredia Ella J. , Mulanovich Victor E. , Chemaly Roy F. 
Published: September 2019

Abstract
Background: Morbidity and mortality from Mycobacterium tuberculosis (Mtb) infection remain significant in cancer patients. We evaluated clinical characteristics, management, and outcomes in patients with active Mtb infection at our institution who had cancer or suspicion of cancer. Methods: We retrospectively examined medical records of all patients with laboratory-confirmed active Mtb infection diagnosed between 2006 and 2014. Results: A total of 52 patients with laboratory-confirmed active Mtb infection were identified during the study period, resulting in an average rate of 6 new cases per year. Thirty-two (62%) patients had underlying cancer, while 20 (38%) patients did not have cancer but were referred to the institution because of suspicion of underlying malignancy. Among patients with cancer, 18 (56%) had solid tumors; 8 (25%) had active hematologic malignancies; and 6 (19%) had undergone hematopoietic-cell transplantation (HCT). Patients with and without cancer were overall similar with the exception of median age (61 years in cancer patients compared to 53 years in noncancer patients). Pulmonary disease was identified in 32 (62%) patients, extrapulmonary disease in 10 (19%) patients, and disseminated disease in 10 (19%) patients. Chemotherapy was delayed in 53% of patients who were to receive such treatment. Eleven patients (all of whom had cancer) died; 3 of these deaths were attributable to Mtb infection. Conclusions: Although not common, tuberculosis remains an important infection in patients with cancer. Approximately one-third of patients were referred to our institution for suspicion of cancer but were ultimately diagnosed with active Mtb infection rather than malignancy.
Diacron reactive oxygen metabolites and biological antioxidant potential tests for patients with age-related macular degeneration
Authors: Matsuura Toshiyuki , Kaneko Hiroki , Takayama Kei , Shibata Rei , Kataoka Keiko , Ito Seina , Tsunekawa Taichi , Shimizu Hideyuki , Suzumura Ayana , Namba Rina , Ito Yasuki , Murohara Toyoaki , Terasaki Hiroko 
Published: September 2019

Abstract
Background : Previously,we showed that serum malondialdehyde (MDA) was significantly higher in patients with neovascular age-related macular degeneration (nAMD) than in those without AMD. The Diacron reactive oxygen metabolites(d-ROMs) andbiologicalantioxidant potential (BAP) tests are known markers ofoxidative stress. The aim of this study was to use d-ROMs and BAP tests to evaluate changes in systemic oxidative stressin patients with nAMD.
Methods : Blood serum samples were collected from 34 patients with nAMD (mean age: 76.5 ± 7.7 years; 22 men) and 20 control subjects (mean age: 62.9± 14.0 years; 10 men), and d-ROMs and BAP tests were examined.
Results : In men, the mean level of d-ROMs for the nAMD patients was significantly higher than that for the controls (312.0 ± 52.4 vs. 275.1 ± 45.5 U.CARR, respectively; P < .05). There was a significant correlation between d-ROM level and CNV lesion area in the male nAMD group (r =.42, P = .05). There were no significant differences in mean BAP test results between the nAMD patients and controls for either sex (men: 2241 ± 549 vs. 2136 ± 246 μmol/L; women: 2263 ± 292 vs. 2335 ± 161 μmol/L).
Conclusion : The d-ROMs test may provide a useful indicator of nAMD in men but not in women.
Analysis of Solar PV Energy Systems for Rural Villages of Nekemte Area, Oromiya Region, Ethiopia
Authors: Woldegiyorgis Tegenu Argaw 
Published: September 2019

Currently, the main energy source used in rural areas of Ethiopia for cooking and heating is unprocessed biomass and fossil fuel such as kerosene, paraffin and petrol/diesel. These energy sources generate large volume of indoor air pollution that increases the risk of chronic diseases. Solar energy is the most practical and economical way of bringing power to poor and remote communities in the long-term and Ethiopia is strategically located in a maximum sun shines hours zone. This study assessed the potential of a solar PV power system to provide the required electricity for a rural community near Nekemte city in Oromiya regions of Ethiopia. The sunshine hour’s data was obtained from the National Meteorological Service Agency (NMA). Results showed an abundant (average) solar energy potential of 5.52 KWh/m2/day. Electric load for a single household, school and clinic was estimated at 313, 2064 and 2040 Wh/day respectively. The cost of energy from solar PV system was estimated at about $1.2/kWh, $0.92/kWh and $0.87/KWh for household, school and clinic respectively. The findings encourage the use of the PV systems to electrify the remote sites of Ethiopia considering it long-term benefits and less cost of installation compared to national grid extension to the remote sites.
Overview of surface water hazards in China coalmines
Authors: Gui Herong , Hu Rongjie , Zhao Honghai , Li Jun , Song Xiaomei , Wang Meichen , Yu Hao , Fang Hongxia 
Published: September 2019

Abstract
Among all recorded water disasters in China coalmines, 10% can be attributed to surface water, making it one of the top water hazards. Based on the analysis of cases of surface water hazards in China coalmines, this article determined surface water sources and inrush conduits as the major factors that have caused water inrush disasters in mines, and classified surface water hazards in China coalmines into 15 types according to those major factors and gave definitions of each type of surface water hazard. Then, it is proposed that there are different types of surface water hazards in different coal-bearing regions by analyzing the relationship to terrain features, climatic impact and mining conditions. Finally, we discuss how typical water sources and inrush conduits work together in hazard formation, in addition to the characteristics and corresponding preventative technologies. The propositions can be of reference for exchanges with other mining countries and regions on surface water hazard treatment.
Estimating the impact of inhibitory substances on activated sludge denitrification process
Authors: Klein Kati , Tenno Taavo 
Published: September 2019

AbstractIndustrial wastewater frequently contains substances which inhibit activated sludge treatment processes. Inhibitory characteristics of different substances are usually evaluated based on testing the impact of respective substance on activated sludge nitrification or oxygen uptake rates. However, denitrification is always before aerobic processes in conventional activated sludge treatment plants and thereby more exposed to inhibitory compounds. There is no easily applicable and validated method available for determination of denitrification process efficiency and inhibition. In this study, a method for evaluation of inhibition on the activated sludge denitrification process was developed and validated using 3,5-dichlorophenol (3,5-DCP) as a model inhibitory compound and additionally controlled with real wastewater produced in the shale oil industry. Average IC50 value (5.5 ± 2.2 mg L−1) for 3,5-DCP showed that denitrifiers were less sensitive than nitrifiers (IC50 = 2.9 ± 0.7 mg L−1) and more sensitive than aerobic heterotrophs (IC50 = 7.2 ± 2.4 mg L−1). Methodological aspects like accumulation of nitrite nitrogen, acclimatization of biomass and technical issues were discussed. Achieved validation characteristics were similar with ISO Standards estimating activated sludge nitrification and oxygen uptake rates, which proves the reliability of the method: standard deviation, 95.4% confidence level, relative standard deviation were calculated to be 2.2 mg L−1, 1.2 … 9.8 mg L−1 and 39.2%, respectively.
Defining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study
Authors: Hibbert Alice , Vesala Markku , Kerr Micky , Fackrell Kathryn , Harrison Stephen , Smith Harriet , Hall Deborah Ann 
Published: September 2019

Background
A minimum standard based upon consensus decision making recommends a core set of tinnitus-specific health complaints (outcome domains) that should be assessed and reported in all clinical trials as this enables comparisons to be made across studies as well as data pooling for meta-analysis.

Objective
This study aimed to further clarify how the outcome domain concepts should be defined for 5 of the core set: tinnitus intrusiveness, sense of control, acceptance of tinnitus, concentration, and ability to ignore. This step requires a clear and fully elaborated definition for each outcome domain, moving from an abstract or a vague concept to an operationalized and measurable health-related construct, so that a suitable measurement instrument can then be identified.

Methods
A series of 5 focus group–style semistructured discussions were conducted via a Web-based discussion forum, each open for 2 weeks and ending with a vote. The participants included 148 tinnitus experts who completed a preceding e-Delphi survey that had generated the original set of minimum standards. The participants were health care users living with tinnitus, health care professionals, clinical researchers, commercial representatives, and funders.

Results
The Web discussions led to a revision of all 5 original plain language definitions that had been used in the preceding e-Delphi survey. Each revised definition was voted by 8 to 53 participants and reached the prespecified threshold of 70% consensus for all except tinnitus intrusiveness. Although a single definition was not agreed upon for tinnitus intrusiveness, the majority of participants shared the view that the concept should be sufficiently broad to encapsulate a range of subdomains. The examples included tinnitus awareness, unpleasantness, and impact on different aspects of everyday life. Thematic analysis of the 5 Web-based discussion threads gave important insights into expert interpretations of each core outcome domain, generating an operationalized and measurable health construct in each case.

Conclusions
The qualitative data gathered during the Web-based discussion forum provided an important in-depth understanding of the health concepts that had raised a debate during earlier face-to-face meetings. The descriptive summaries and definitions provide sufficient operationalization of those concepts to proceed to the second stage of core outcome set development that is to identify and evaluate suitable measurement instruments. This study supports the use of Web-based peer discussion forums in defining health concepts.
The Florida Mobile Health Adherence Project for People Living With HIV (FL-mAPP): Longitudinal Assessment of Feasibility, Acceptability, and Clinical Outcomes
Authors: Escobar-Viera César , Zhou Zhi , Morano Jamie P , Lucero Robert , Lieb Spencer , McIntosh Sean , Clauson Kevin A , Cook Robert L 
Published: September 2019

Background
For people living with HIV (PLWH), antiretroviral therapy (ART) adherence is crucial to attain better health outcomes. Although research has leveraged consumer health information technologies to enhance ART adherence, no study has evaluated feasibility and clinical outcomes associated with the usage of a commercially available, regularly updated mobile health (mHealth) app for improving ART adherence among PLWH.

Objective
This study aimed to assess the feasibility, acceptability, and clinical outcomes of Care4Today, an existing, free, biprogrammatic mHealth app for improving ART adherence among PLWH.

Methods
The Florida mHealth Application Adherence Project (FL-mAPP) was a 90-day longitudinal pilot study conducted in 3 public HIV clinics in Florida, United States. After obtaining informed consent, 132 participants completed a survey and then were given the option to try an existing mHealth app to help with ART adherence. Of these, 33.3% (44/132) declined, 31.1% (41/132) agreed but never used the app, and 35.6% (47/132) used the app. All were asked to complete follow-up surveys at 30 days and 90 days after enrollment. Usage data were used to assess feasibility. Clinical outcomes of self-reported ART adherence and chart-obtained HIV viral load and CD4+ T-cell counts were compared among those who used the platform (users) versus those who did not (nonusers). Participants and HIV care providers also provided responses to open-ended questions about what they liked and did not like about the app; comments were analyzed using thematic analysis.

Results
Of 132 participants, 47 (35.6%) and 85 (64.4%) were categorized as users and nonusers, respectively. Among users, a Kaplan-Meier plot showed that 25 persons (53%) continued using the app after the 90-day follow-up. At 30-day follow-up, 13 (81.3%) of those who used the mHealth app reported ≥95% ART adherence, compared with 17 (58.6%) nonusers (P=.12). Overall, 39 (82%) users liked or somewhat liked using the platform. Participants’ favorite features were medication reminders, ability to create custom reminders, and adherence reports.

Conclusions
This longitudinal study found that a commercially available medication adherence mHealth app was a feasible and acceptable intervention to improve ART adherence among PLWH and engaged in clinical care across 3 public HIV clinics in the state of Florida. Overall, participants liked the Care4Today app and thought the medication reminders were their favorite feature. Generally, self-reports of ART adherence were better among users than nonusers, both at 30- and 90-day follow-ups. Further clinical research needs to address user fatigue for improving app usage.