bluuebunny/crossref_metadata_2025_split huggingface dataset:
Amikacin resistance due to the aphA6 gene in multi-antibiotic resistant Acinetobacter baumannii isolates belonging to global clone 1 from Iran
Authors: Aris Parisa , Boroumand Mohammad Ali , Douraghi Masoumeh 
Published: September 2019

AbstractBackgroundTnaphA6-carryingrepAci6plasmids have been detected inAcinetobacter baumanniiisolates belonging to global clones, GC1 and GC2, worldwide. Here, we examined whether RepAci6 plasmids family play a role in the dissemination of theaphA6in GC1A. baumanniiisolates from Iran.ResultsWe found that 22 isolates carried therepAci6gene, suggesting that they contain a RepAci6 plasmid family. Using the primers linking theaphA6gene to the backbone ofrepAci6plasmid,it was revealed that 16 isolates from different hospitals harbored TnaphA6on arepAci6plasmid.ConclusionsThis study provides evidence for the dissemination of TnaphA6on the plasmids encoding RepAci6 in IranianA. baumanniiisolates. Furthermore, it seems that TnaphA6might be acquired by distinct plasmids separately as it was found to be located on the variants ofrepAci6plasmids.
Gas exchange, biomass and non-structural carbohydrates dynamics in vines under combined drought and biotic stress
Authors: Savi Tadeja , García González Almudena , Herrera Jose Carlos , Forneck Astrid 
Published: September 2019

AbstractBackgroundIntensity of drought stress and pest attacks is forecasted to increase in the near future posing a serious threat to natural and agricultural ecosystems. Knowledge on potential effects of a combined abiotic-biotic stress on whole-plant physiology is lacking. We monitored the water status and carbon metabolism of a vine rootstock with or without scion subjected to water shortening and/or infestation with the sucking insect phylloxera (Daktulosphaira vitifoliaeFitch). We measured non-structural carbohydrates and biomass of different plant organs to assess the stress-induced responses at the root, stem, and leaf level. Effects of watering on root infestation were also addressed.ResultsHigher root infestation was observed in drought-stressed plants compared to well-watered. The drought had a significant impact on most of the measured functional traits. Phylloxera further influenced vines water and carbon metabolism and enforced the sink strength of the roots by stimulating photosynthates translocation. The insect induced carbon depletion, reprogramed vine development, while preventing biomass compensation. A synergic effect of biotic-abiotic stress could be detected in several physiological and morphological traits.ConclusionsOur results indicate that events of water shortage favour insects’ feeding damage and increase the abundance of root nodosities. Root phylloxera infestation imposes a considerable stress to the plants which might exacerbate the negative effects of drought.
A Bayesian non-inferiority approach using experts’ margin elicitation – application to the monitoring of safety events
Authors: Aupiais Camille , Alberti Corinne , Schmitz Thomas , Baud Olivier , Ursino Moreno , Zohar Sarah 
Published: September 2019

AbstractBackgroundWhen conducing Phase-III trial, regulatory agencies and investigators might want to get reliable information about rare but serious safety outcomes during the trial. Bayesian non-inferiority approaches have been developed, but commonly utilize historical placebo-controlled data to define the margin, depend on a single final analysis, and no recommendation is provided to define the prespecified decision threshold. In this study, we propose a non-inferiority Bayesian approach for sequential monitoring of rare dichotomous safety events incorporating experts’ opinions on margins.MethodsA Bayesian decision criterion was constructed to monitor four safety events during a non-inferiority trial conducted on pregnant women at risk for premature delivery. Based on experts’ elicitation, margins were built using mixtures of beta distributions that preserve experts’ variability. Non-informative and informative prior distributions and several decision thresholds were evaluated through an extensive sensitivity analysis. The parameters were selected in order to maintain two rates of misclassifications under prespecified rates, that is, trials that wrongly concluded an unacceptable excess in the experimental arm, or otherwise.ResultsThe opinions of 44 experts were elicited about each event non-inferiority margins and its relative severity. In the illustrative trial, the maximal misclassification rates were adapted to events’ severity. Using those maximal rates, several priors gave good results and one of them was retained for all events. Each event was associated with a specific decision threshold choice, allowing for the consideration of some differences in their prevalence, margins and severity. Our decision rule has been applied to a simulated dataset.ConclusionsIn settings where evidence is lacking and where some rare but serious safety events have to be monitored during non-inferiority trials, we propose a methodology that avoids an arbitrary margin choice and helps in the decision making at each interim analysis. This decision rule is parametrized to consider the rarity and the relative severity of the events and requires a strong collaboration between physicians and the trial statisticians for the benefit of all. This Bayesian approach could be applied as a complement to the frequentist analysis, so both Data Safety Monitoring Boards and investigators can benefit from such an approach.
Needs and skills of informal caregivers to care for a dependent person: a cross-sectional study
Authors: Dixe Maria dos Anjos Coelho Rodrigues , da Conceição Teixeira Liliana Fernanda , Areosa Timóteo João Teixeira Camacho Coelh , Frontini Roberta Caçador , de Jesus Almeida Peralta Teresa , Querido Ana Isabel Fernandes 
Published: September 2019

Abstract

Background
The world is facing many socio-demographic changes, such as an increased average life expectancy and the presence of chronic and non-communicable diseases, which in turn, leads to an enhanced dependency on others. Consequently, the demand for informal caregivers has significantly increased during the past few years. Caring for a dependent person is linked to a series of burdens that often leads to physical, psychological and emotional difficulties. Taking into consideration the difficulties faced by informal caregivers, knowing in which areas of functioning they need more guidance may help to relieve their burden. Therefore, the main goal of this study is to better understand the needs and competencies of the informal caregiver when caring for a dependent person in the different self-care domains.

Methods
This cross-sectional study used a questionnaire administered on a single occasion by face-to-face interview. Descriptive and inferential statistics alongside non-parametric statistical techniques such as the Mann-Whitney test and Spearman’s correlation were used.

Results
The average age of the 143 informal caregivers is 58 years old, with the youngest in our sample being 21 years of age. Most of them are female, and 50% of them are children taking care of one of their parents. Most of the dependent people are completely dependent in the areas of comfort and hygiene (53.8%) and medication management (55.9%). The female informal caregivers see themselves as having more competencies in sanitary hygiene than the male ones, with no significant differences in their competencies’ perception in the other areas of self-care. Older caregivers see themselves as less competent in certain areas of self-care such as feeding, mobility, transfers, medication and symptoms management and communication. Most of the information given to the informal caregiver is about the disease (82.3%) and the medication management (80.4%). There are still a lot of areas of self-care, where no information, or almost none, is given to the informal caregivers.

Conclusions
Before home discharge of a dependent person, it is important to acknowledge the needs and competencies of the informal caregiver, to capacitate them in looking after their relatives, to help decrease their burden and consequently, decrease the number of hospital readmissions.
Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016
Authors: Guo Xiaorong , Yang Dong , Liu Ruchun , Li Yaman , Hu Qingqing , Ma Xinrui , Li Yelan , Zhang Heng , Zhang Xixing , Zhao Benhua , Chen Tianmu 
Published: September 2019

Abstract

Background
Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease.

Methods
The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases.

Results
From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available.

Conclusions
The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.
Hepatitis B infection in the general population of China: a systematic review and meta-analysis
Authors: Wang Huai , Men Peixuan , Xiao Yufeng , Gao Pei , Lv Min , Yuan Qianli , Chen Weixin , Bai Shuang , Wu Jiang 
Published: September 2019

Abstract

Background
Hepatitis B virus (HBV) infection is a major public health problem in China. Over a decade has passed since the last National Hepatitis Seroepidemiological Survey was conducted in 2006. The lack of updated data on hepatitis B in China makes assessing the current prevalence and burden of the disease inadequate. In response to the above situation, a systematic review and meta-analysis was conducted to provide a better understanding of hepatitis B epidemiology in the general population of China.

Methods
A systematic search was conducted in international databases (Medline through PubMed, EMBASE, Cochrane, Web of Science) and national databases (CBM, CNKI, WanFang Data) to retrieve primary studies published between January 1, 2013 and December 31, 2017. The pooled prevalence of HBV infection and 95% confidence intervals were calculated. Quality assessment, heterogeneity testing and publication bias assessment were also performed.

Results
Of the 27 studies included in the meta-analysis, the pooled estimated prevalence of HBV infection in the general population of China from 2013 to 2017 was 6.89% (95% CI:5.84–7.95%), which could be extrapolated to an estimated population of 84 million living with HBsAg in 2018. The prevalence of HBV infection in males was higher than that in females (5.88% vs 5.05%), and rural areas had a higher prevalence than urban areas (5.86% vs 3.29%). The highest prevalence of HBV infection was reported in Western provinces (8.92, 95% CI: 7.19–10.64%). In adults older than 20 years, the prevalence of HBV infection was approximately 7%, which was higher than that in children.

Conclusion
The prevalence of HBV infection in the general population of China was classified as higher intermediate prevalence (5–7.99%), of which more than 90% of the HBV infection population included adults older than 20 years. The blocking of mother-to-infant hepatitis B transmission and plans involving timely birth dose of hepatitis B vaccine within 24 h should be implemented. Additionally, improving the quality of life and survival rate of the infected population through antiviral therapy and high-risk adult vaccination will be the priority of our future work. Moreover, various control measures should be implemented in different provinces across China.
Community-led delivery of HIV self-testing to improve HIV testing, ART initiation and broader social outcomes in rural Malawi: study protocol for a cluster-randomised trial
Authors: Indravudh Pitchaya P. , Fielding Katherine , Kumwenda Moses K. , Nzawa Rebecca , Chilongosi Richard , Desmond Nicola , Nyirenda Rose , Johnson Cheryl C. , Baggaley Rachel C. , Hatzold Karin , Terris-Prestholt Fern , Corbett Elizabeth L. 
Published: September 2019

Abstract

Background
Prevention of new HIV infections is a critical public health issue. The highest HIV testing gaps are in men, adolescents 15–19 years old, and adults 40 years and older. Community-based HIV testing services (HTS) can contribute to increased testing coverage and early HIV diagnosis, with HIV self-testing (HIVST) strategies showing promise. Community-based strategies, however, are resource intensive, costly and not widely implemented. A community-led approach to health interventions involves supporting communities to plan and implement solutions to improve their health. This trial aims to determine if community-led delivery of HIVST can improve HIV testing uptake, ART initiation, and broader social outcomes in rural Malawi.

Methods
The trial uses a parallel arm, cluster-randomised design with group village heads (GVH) and their defined catchment areas randomised (1:1) to community-led HIVST or continue with the standard of the care (SOC). As part of the intervention, informal community health cadres are supported to plan and implement a seven-day HIVST campaign linked to HIV treatment and prevention. Approximately 12 months after the initial campaign, intervention GVHs are randomised to lead a repeat HIVST campaign. The primary outcome includes the proportion of adolescents 15–19 years old who have tested for HIV in their lifetime. Secondary outcomes include recent testing in adults 40 years and older and men; ART initiation; knowledge of HIV prevention; and HIV testing stigma. Outcomes will be measured through cross-sectional surveys and clinic registers. Economic evaluation will determine the cost per person tested, cost per person diagnosed, and incremental cost effectiveness ratio.

Discussion
To the best of our knowledge, this is the first trial to assess the effectiveness of community-led HTS, which has only recently been enabled by the introduction of HIVST. Community-led delivery of HIVST is a promising new strategy for providing periodic HIV testing to support HIV prevention in rural communities. Further, introduction of HIVST through a community-led framework seems particularly apt, with control over healthcare concurrently devolved to individuals and communities.

Trial registration
Clinicaltrials.gov registry (NCT03541382) registered 30 May 2018.
Infections due to Cellulosimicrobium species: case report and literature review
Authors: Rivero María , Alonso Javier , Ramón María Fernanda , Gonzales Nancy , Pozo Ana , Marín Itxaso , Navascués Ana , Juanbeltz Regina 
Published: September 2019

Abstract

Background
Cellulosimicrobium species, formely known as Oerskovia species, are gram-positive bacilli belonging to the order Actinomycetales. They rarely cause human infections. The genus comprises two pathogenic species in humans: C. cellulans and C. funkei. Based on a case report, we provide a review of the literature of infections caused by Cellulosimicrobium/Oerskovia, in order to improve our knowledge of this unusual infection.

Case presentation
An 82-year-old woman with aortic prosthetic valve presented to the hospital with fever and heart failure. Further work up revealed the diagnosis of C. cellulans infective endocarditis (IE). The strain was identified by MALDI-TOF MS, API Coryne and 16S rRNA sequencing. The patient was deemed not to be an operative candidate and died despite the antibiotic therapy 35 days after admission.

Conclusions
Reviewing cases of Cellulosimicrobium species infections and communicating the successful and unsuccessful clinical experiences can assist future healthcare providers. Our case and those previously reported indicate that Cellulosimicrobium species usually infect immunocompromised patients or foreign body carriers. The most frequent pattern of infection is central venous catheter related bacteremia. The optimal treatment should include foreign body removal and valve surgery should be considered in case of IE.
Association between Toxoplasma gondii infection and thyroid dysfunction: a case-control seroprevalence study
Authors: Alvarado-Esquivel Cosme , Ramos-Nevarez Agar , Guido-Arreola Carlos Alberto , Cerrillo-Soto Sandra Margarita , Pérez-Álamos Alma Rosa , Estrada-Martínez Sergio , Gutierrez-Martinez Verónica Dayali , Sifuentes-Alvarez Antonio , Ramírez-Valles Eda Guadalupe , Contreras-Cisneros Edith 
Published: September 2019

AbstractBackgroundThe association betweenToxoplasma gondiiinfection and thyroid disease has been poorly studied. Therefore, we sought to determine the association betweenT. gondiiseropositivity and thyroid dysfunction.MethodsWe performed an age- and gender-matched case-control study of 176 patients suffering from hypothyroidism (n = 161) or hyperthyroidism (n = 15) and 528 control subjects without these diseases in a public hospital in Durango City, Mexico. Anti-ToxoplasmaIgG antibodies were determined in sera from cases and controls using a commercially available enzyme-linked immunoassay.ResultsAnti-T. gondiiIgG antibodies were found in 11 (6.3%) of 176 patients suffering from thyroid dysfunction and in 48 (9.1%) of 528 control subjects (OR = 0.66; 95% CI: 0.33–1.31;P = 0.23). Stratification by two groups of age (50 years and younger, and 51 year and older) showed that the youngest group of patients with thyroid dysfunction had a significantly lower seroprevalence ofT. gondiiinfection than its age- and gender-matched control group (1/83: 1.2% vs 23/257: 8.6%; OR = 0.12; 95% CI: 0.01–0.93;P = 0.01). This stratification also showed that the youngest group of patients with hypothyroidism had a significantly lower seroprevalence ofT. gondiiinfection than its age- and gender matched control group (0/75: 0% vs 21/233: 9.0%;P = 0.003).ConclusionsOur results suggest that thyroid dysfunction is not associated with seropositivity toT. gondiiin general; however, in young (50 years or less) patients, a negative association between infection and thyroid dysfunction and hypothyroidism was found. Further research to confirm this negative association is needed.
Hyperphosphatemia and risks of acute kidney injury, end-stage renal disease, and mortality in hospitalized patients
Authors: Moon Hongran , Chin Ho Jun , Na Ki Young , Joo Kwon Wook , Kim Yon Su , Kim Sejoong , Han Seung Seok 
Published: September 2019

Abstract

Background
Hyperphosphatemia is associated with vascular calcification and bone mineral disorders and is a major concern among patients with chronic kidney disease (CKD). However, the relationship between hyperphosphatemia and renal outcome in non-CKD patients has not been studied. Furthermore, the clinical implications of hyperphosphatemia in relation to the risks of acute kidney injury (AKI), end-stage renal disease (ESRD), and mortality after hospitalization remain unresolved.

Methods
A total of 20,686 patients (aged ≥18 years) admitted to Seoul National University Bundang Hospital from January 2013 to December 2013 were retrospectively reviewed. Patients were divided into quartiles according to serum phosphorus level at the time of admission. The odds ratios (ORs) for AKI and hazard ratios (HRs) for ESRD and all-cause mortality were calculated after adjustment of multiple covariates.

Results
AKI developed in 2319 patients (11.2%), with higher ORs for patients in the third and fourth quartiles (1.4 [1.24–1.68] and 2.8 [2.44–3.22], respectively) compared with the first quartile group. During a median follow-up period of 4.0 years, 183 patients (0.88%) developed ESRD and 3675 patients (17.8%) died. Patients in the fourth quartile had higher risks of ESRD and mortality than patients in the first quartile (HRs, 2.3 [1.46–3.75] and 1.4 [1.22–1.49], respectively). These trends remained consistent in patients with an estimated glomerular filtration rate > 60 ml/min/1.73 m2.

Conclusions
Hyperphosphatemia is related to the risks of AKI, ESRD, and mortality, and it may therefore be necessary to monitor serum phosphorus level in hospitalized patients, irrespective of kidney function.
Timing of first antenatal care attendance and associated factors among pregnant women in public health institutions of Axum town, Tigray, Ethiopia, 2017: a mixed design study
Authors: Gebresilassie Berhanu , Belete Tilahun , Tilahun Weyzer , Berhane Betell , Gebresilassie Senait 
Published: September 2019

Abstract

Background
Timely initiation of antenatal care can avoid pregnancy related problems and save lives of mothers and babies. In developing nations, however, only half of the pregnant mothers receive the recommended number of antenatal care visits, and start late in their pregnancy. Thus, the study was conducted to assess the magnitude of timely initiation of antenatal care and factors associated with the timing of antenatal care attendance in Axum in which studies regarding this issue are lacking.

Methods
An institution based cross-sectional study mixed with qualitative approach was conducted. A total of 386 pregnant women were selected using systematic sampling technique for the quantitative study. In addition, 18 participants were selected purposively for the qualitative part. The quantitative data were collected using structured interviewer administered questionnaire while the qualitative data were collected using an open-ended interview guide. Quantitative data were analyzed using SPSS version 22 and the qualitative data were analyzed using Atlas software. Multi-variable logistic regression was used to control the effect of confounders.

Results
The magnitude of timely attendance of antenatal care was 27.5% (95% CI: 23–32%). Unintended pregnancy (AOR = 2.87; CI 95%: 1.23–6.70), maternal knowledge (AOR = 2.75; CI 95%: 1.07–7.03), educational status of the women (AOR = 2.62; CI 95%: 1.21–5.64), perceived timing of antenatal care (AOR = 3.45; CI 95%: 1.61–7.36), problem in current pregnancy (AOR = 3.56; CI 95%: 1.52–8.48) and advice from significant others (AOR =2.33; CI 95%: 1.10–4.94) were found significantly associated with timely booking of antenatal care.

Conclusion
The magnitude of timely attendance of antenatal care is low. Educational status, maternal knowledge, unintended pregnancy, problem in current pregnancy, perceived timing of antenatal care, and advise from significant others were the significant factors for timing of antenatal care. Therefore more effort should be done to increase the knowledge of mothers about importance of antenatal care and timely ante natal care booking.