bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology, antimicrobial resistance, and incremental medical costs of hospital-acquired infections in the Intensive Care Unit: 2-year experience from Serbia
Authors: Despotovic Aleksa Jovan , Milosevic Branko , Milosevic Ivana , Cirkovic Andja , Jovanovic Snezana D , Stevanovic Goran 
Published: August 2019

Abstract
Background: Hospital-acquired infections are a major complication of hospital treatment. The growing presence of multidrug-resistant pathogens contributes to increased mortality and costs, particularly in intensive care units where patients are predisposed to numerous risk factors. Comprehensive data about hospital-acquired infections from Serbian intensive care units is scarce. The aim of this study was to determine the presence of hospital-acquired infections among intensive care unit patients and look into the patterns of antimicrobial resistance, risk factors, and incremental costs of diagnosis and antimicrobial treatment.
Methods: This retrospective study included 355 patients over a two-year period. Etiology, antimicrobial resistance patterns, and incremental costs of diagnosis and antimicrobial treatment were examined. Risk factors for infection acquisition, as well as length of stay, were statistically analyzed using Pearson’s chi-square tests and logistic regression analysis.
Results: At least one hospital-acquired infection was identified in 32.7% of patients. A total of 204 infection episodes were documented, the most common type being urinary tract infections (36.3%). Clostridium difficile , Klebsiella spp. , and Acinetobacter baumanii were the most common isolates. Antimicrobial resistance rates < 20% were observed for linezolid (0%), colistin (9%), and tigecycline (14%). Resistance rates > 50% were seen in all other tested antibiotic agents. Mortality rates were not higher in patients who acquired only one hospital-acquired infection (p=0.09), but were significantly higher for patients in whom more than one episode occurred (p=0.038). Length of stay > 20 days carried a 7.5-fold increase in odds of acquiring an infection (CI 4.4-12.7, p<0.001), whereas length of stay > 30 days carried a 10-fold increase (CI 5.5-16.1, p<0.001). During the study period, over 37,000 EUR was incrementally spent on diagnosis and antimicrobial treatment for hospital-acquired infections.
Conclusion: Our results suggest a high prevalence of hospital-acquired infections and very high antimicrobial resistance rates compared to most European countries. Together with the first published results regarding incremental costs from Serbia, our observations require large-scale prospective follow-up studies in order to obtain a deeper insight into the actual burden of hospital-acquired infections.
Prognostic factors for ARDS: clinical, physiological and atypical immunodeficiency
Authors: Song Min , Liu Yijie , Lu Zhiwen , Luo Hong , Peng Hong , Chen Ping 
Published: August 2019

Abstract
Background: The risk factors affecting the prognosis of acute respiratory distress syndrome (ARDS) in adults were investigated. The aim was to identify new predictors of prognosis in ARDS patients, including those with clinical, pathophysiological, and atypical immunodeficiency.
Methods: ARDS patients were retrospectively included. Patients were grouped and analysed according to different oxygenation index grades and prognosis, and the factors influencing prognosis and survival were analysed. Adolescent patients, patients with typical immunodeficiency and patients who died within 24 hours after being diagnosed with ARDS were excluded. The predictive value for mortality was determined by Cox proportional hazard analysis.
Results: In total, 201 patients who fulfilled the Berlin definition of ARDS were included. The severity of critical illness on the day of enrolment, as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score (P<0.05), Sequential Organ Failure Assessment (SOFA) score ( P<0.05 ), and PaO 2 /FiO 2 (P<0.001), worsened from mild to severe ARDS. Compared with survivors, non-survivors had significantly older age and higher APACHE II and SOFA scores. Moreover, significantly lower lymphocyte/neutrophil ratios and leukocyte counts were found in non-survivors than in survivors (P<0.01, P<0.05). Furthermore, there was a moderate positive correlation between the lymphocyte/neutrophil and PaO 2 /FiO 2 ratios (P<0.05). The area under the curve (AUC) for the lymphocyte/neutrophil ratio was significantly greater than those for the body mass index (BMI) alone, PaO 2 /FiO 2 ratio alone, and lymphocyte/neutrophil ratio alone for predicting 100-day survival in patients with ARDS (P=0.0062, 0.0001, and 0.0154). Age (per log 10 years), BMI<24, the SOFA score, leukocyte count, and the lymphocyte/neutrophil ratio were independent predictors of 28-day mortality in ARDS patients. Moreover, ARDS patients with a lymphocyte/neutrophil ratio <0.0537 had elevated 28-day mortality (P<0.05). Old age affected both 28-day and 100-day mortality (P<0.05).
Conclusions: Age (per log 10 years), BMI<24, SOFA score, lymphocytes, and the lymphocyte/neutrophil ratio were independent predictors of 100-day mortality in patients with ARDS. The lymphocyte/neutrophil ratio may represent a potential molecular marker to evaluate atypical immunosuppression or impairment in patients with ARDS.
The quality of and women’s satisfaction with maternal referral practices in Sub-Saharan African low and lower-middle income countries: A systematic review
Authors: Ameyaw Edward Kwabena , Njue Carolyne , Tran Nguyen Toan , Dawson Angela 
Published: August 2019

Abstract
Background: Sub-Saharan African Low and Lower-Middle Income Countries (SSA LLMICs have the highest burden of maternal and neonatal morbidity and mortality in the world. Timely and appropriate obstetric referral to a suitable health facility is a sign of effective health system. This paper presents the findings of a systematic review that aimed to identify what referral practices are delivered according to accepted standards for pregnant women and newborns in SSA LLMICs by competent healthcare providers and in line with the need and wishes of women.
Methods: Six electronic databases were systematically searched for primary data studies (2009-2018) in English reporting on maternal referral practices and effectiveness. We conducted a content analysis of data in the findings of each paper guided by a framework for assessing the quality of maternal referral.
Results: Seventeen articles were included in the study. Most studies were quantitative (n=11). Quality maternal referral was defined as occurring as a result of: the timely identification of signal functions, established guidelines or standards, adequate documentation, staff accompaniment and prompt care by competent healthcare providers at the receiving facility. Two studies reported that women were dissatisfied due to delays in referral processes that affected their health. We found lack of accompaniment to upper levels of healthcare, delays in referral processes, transportation challenges and poor documentation of referral cases. Some healthcare providers administered essential drugs such as misoprostol prior to referral.
Conclusions: Efforts to improve maternal health in LLMICs should aim to enhance maternal healthcare providers’ ability to identify signal functions that are integral to referral. Low cost transport is needed to mitigate transportation barriers to referral. To ensure quality maternal referral, mechanisms should be instituted for health managers at the district level to monitor and evaluate referral documentation, quality and efficiency of maternal referrals on regular basis.
Geographically weighted regression modelling of the spatial association between malaria cases and environmental factors in Cameroon.
Authors: Tewara Marlvin Anemey , Yunxia Liu , Lin Weiqiang , Barong Binang Helen , Mbah-Fongkimeh Prisca Ngetemalah , Zhaolei Zheng , Xinhui Liu , Miao Zhou , Liu Xiaojuan , Xue Fuzhong 
Published: August 2019

Abstract
Background: Studies have illustrated the association of malaria cases with environmental factors in Cameroon but limited in addressing how these factors vary in space for timely public health interventions. Thus, we want to find the spatial variability between malaria hotspot cases and environmental predictors using Geographically weighted regression (GWR) spatial modelling technique.
Methods: The global Ordinary least squares(OLS) in the modelling spatial relationships tool in ArcGIS 10.3. was used to select candidate explanatory environmental variables for a properly specified GWR model. The local GWR model used the global OLS candidate variables to examine, predict and explore the spatial variability between environmental factors and malaria hotspot cases generated from Getis-Ord Gi* statistical analysis.
Results: The OLS candidate environmental variable coefficients were statistically significant ( adjusted R 2 = 22.3% and p < 0.01) for a properly specified GWR model. The GWR model identified a strong spatial association between malaria cases and rainfall, vegetation index, population density, and drought episodes in most hotspot areas and a weak correlation with aridity and proximity to water with an overall model performance of 0.243 (adjusted R 2 = 24.3%).
Conclusion: The generated GWR maps suggest that for policymakers to eliminate malaria in Cameroon, there should be the creation of malaria outreach programs and further investigations in areas where the environmental variables showed strong spatial associations with malaria hotspot cases .
Keywords: Geographically weighted regression, Ordinary least squares, malaria, spatial statistics, mapping, Geographical information systems.
Characterization of Gas Injection Flow Patterns Subject to Gravity and Viscous Forces
Authors: Van De Ven Cole J.C. , Mumford Kevin G. 
Published: August 2019

Core Ideas
Air was injected into saturated 0.7‐mm sand at 0.1, 10, 100, 250, and 498 mL min−1.
Optical density and gas pressure were used to classify the gas flow pattern.
The gravity drive of highly buoyant gas quickly dominates over viscous forces.
Bo/Ca was used to predict the transition of flow from continuous to discontinuous.
Gas movement in otherwise water‐saturated porous media is complex and is important for a variety of applications. The interplay of gravity, capillary, and viscous forces influences the movement and resulting pattern of gas. To develop a better understanding of this competition among these forces, air injection experiments were performed in an intermediate‐scale, two‐dimensional flow cell at injection rates of 0.1, 10, 100, 250, and 498 mL min−1. The resulting gas patterns were characterized using gas pressure measurements and optical density measurements based on digital images to classify gas flow as continuous, transitional, or discontinuous, and near‐pore‐scale observations of transient gas flow were made to gain insight concerning the influence of gravity, viscous, and capillary forces. These observations highlighted the importance of gravity and viscous forces, along with capillary forces, for gas flow in water‐wet media. Based on these observations, a simplified dimensionless number (the ratio of the Bond and Capillary numbers) was proposed to quantify the interplay of gravity to viscous forces, and its validity for the prediction of the type of gas flow was assessed. This study provides a high spatiotemporal dataset of transient gas movement in homogeneous sand, which can be used to provide insight for multiphase flow modeling efforts and future understanding of gas movement coupled to mass transfer.
Two generations of exsolution lamellae in pyroxene from Asuka 09545: Clues to the thermal evolution of silicates in mesosiderite
Authors: Pittarello Lidia , McKibbin Seann , Yamaguchi Akira , Ji Gang , Schryvers Dominique , Debaille Vinciane , Claeys Philippe 
Published: August 2019

Abstract
Mesosiderite meteorites consist of a mixture of crustal basaltic or gabbroic material and metal. Their formation process is still debated due to their unexpected combination of crust and core materials, possibly derived from the same planetesimal parent body, and lacking an intervening mantle component. Mesosiderites have experienced an extremely slow cooling rate from ca. 550 °C, as recorded in the metal (0.25–0.5 °C/Ma). Here we present a detailed investigation of exsolution features in pyroxene from the Antarctic mesosiderite Asuka (A) 09545. Geothermobarometry calculations, lattice parameters, lamellae orientation, and the presence of clinoenstatite as the host were used in an attempt to constrain the evolution of pyroxene from 1150 to 570 °C and the formation of two generations of exsolution lamellae. After pigeonite crystallization at ca. 1150 °C, the first exsolution process generated the thick augite lamellae along (100) in the temperature interval 1000–900 °C. By further cooling, a second order of exsolution lamellae formed within augite along (001), consisting of monoclinic low-Ca pyroxene, equilibrated in the temperature range 900–800 °C. The last process, occurring in the 600–500 °C temperature range, was likely the inversion of high to low pigeonite in the host crystal, lacking evidence for nucleation of orthopyroxene.
The formation of two generations of exsolution lamellae, as well as of likely metastable pigeonite, suggest non-equilibrium conditions. Cooling was sufficiently slow to allow the formation of the lamellae, their preservation, and the transition from high to low pigeonite. In addition, the preservation of such fine-grained lamellae limits long-lasting, impact reheating to a peak temperature lower than 570 °C. These features, including the presence of monoclinic low-Ca pyroxene as the host, are reported in only a few mesosiderites. This suggests a possibly different origin and thermal history from most mesosiderites and that the crystallography (i.e., space group) of low-Ca pyroxene could be used as parameter to distinguish mesosiderite populations based on their cooling history.
Diffusion of F and Cl in dry rhyodacitic melt
Authors: Feisel Yves , Castro Jonathan M. , Dingwell Donald B. 
Published: August 2019

Abstract
Chemical diffusion of F and Cl has been experimentally determined in a rhyodacitic melt obtained from remelting a sample of Hekla pumice (Iceland). Diffusion couple experiments were conducted in a vertical tube furnace over a temperature range of 750–950 °C and in air for durations of 1 to 35 days. Concentration profiles of F and Cl were obtained for the quenched samples using an electron microprobe.
Fluorine and chlorine exhibit Arrhenian behavior over the range of temperature investigated here. The pre-exponential factors of F and Cl are D0(F) = 4.3 × 10−4 and D0(Cl) = 1.6 × 10−5 m2/s. Fluorine diffusion coefficients vary in the order of 1 × 10−15 to 1 × 10−13 m2/s, whereas Cl diffusivity is up to two orders of magnitude slower. The activation energies for F and Cl diffusivities are equal within error at 223 ± 31 and 229 ± 52 kJ/mol, respectively.
The difference in diffusivity between F and Cl is particularly pronounced in the melt of our study, compared to results obtained for other magmatic melt compositions. This means that the potential for diffusive fractionation exists and may occur especially under conditions of magma ascent and bubble growth, as this would favor partitioning of the relatively fast-diffusing halogens into growing bubbles, due to H2O exsolution. A dependence of diffusivity on atomic radius observed here is enhanced over that observed in more basic, less viscous melts, indicating that diffusive fractionation is more likely to be pronounced in more silicic, more viscous systems. A proper parameterization and modeling of diffusive fractionation of halogens in actively degassing volcanic systems thus holds the potential of serving as a tool for quantifying the processes responsible for volcanic unrest.
El estudio del estado en las Ciencias Políticas
Authors: Córdova Jaimes Edgar 
Published: August 2019

El trabajo tiene como objetivo estudiar el Estado como objeto de las ciencias políticas y jurídicas, para comprender las tendencias teóricas y epistemológicas involucradas en el desarrollo teórico del mismo; desde las tendencias utilitaristas y funcionalistas hasta llegar a un (re) descubrimiento de la visión weberiana del fenómeno. La metodología empleada se basó en la revisión de las tendencias desde las clásicas hasta aquellas surgidas en medio del furor por el neoinstitucionalismo real (aplicación de las reformas del Estado en América Latina). Concluimos que las concepciones sobre el Estado como actor autónomo, de exclusiva concepción jurídico-institucional e instrumento para la función en tanto procesador de demandas exógenas, así o como objeto exclusivo de la teoría y filosofía ha sido desbordada por la necesidades y urgencias explicativas que las ciencias sociales, y de manera especial a las políticas y jurídicas tienen hoy producto de las realidades políticas, posicionando al Estado en una acción promotora del desarrollo, regulando, concertando y hasta orientando el crecimiento de la economía, generando condiciones para el desarrollo político social, compensando las falencias del modelo económico.
Environmental monitoring of Aichi virus and human bocavirus in samples from wastewater treatment plant, drain, and River Nile in Egypt
Authors: Shaheen Mohamed N. F. , Abd El-Daim Sahar E. , Ahmed Nehal I. , Elmahdy Elmahdy M. 
Published: August 2019

Abstract
Wastewater plays a major role in water pollution causing transmission of several viral pathogens, including Aichi virus (AiV) and human bocavirus (HBoV), associated with gastrointestinal illness in humans. In this study, we investigated the presence of AiV and HBoV in aquatic, sludge, sediment matrices collected from Abu-Rawash wastewater treatment plant (WWTP), El-Rahawy drain, Rosetta branch of the River Nile in Egypt by conventional polymerase chain reaction (PCR). AiV RNA was detected in 16.6% (2/12), 8.3% (1/12), 8.3% (1/12), 22% (16/72), 12.5% (3/24), 4% (1/24), and 0/24 (0%) of untreated raw sewage, treated sewage, sewage sludge, drainage water, drain sediment, river water, and river sediment, respectively. On the other hand, HBoV DNA was detected in 41.6% (5/12), 25% (3/12), 16.6% (2/12), 48.6% (35/72), 29% (7/24), 3/24 (12.5%), 4% (1/24) of untreated raw sewage, treated raw sewage, sewage sludge, drainage water, drain sediment, river water, and river sediment, respectively. This study provides data on the presence of these viruses in various types of water samples that are valuable to environmental risk assessment. In addition, the current study demonstrates the importance of environmental monitoring as an additional tool to investigate the epidemiology of AiV and HBoV circulating in a given community.
Microbiota, Immune System and Autism Spectrum Disorders: An Integrative Model towards Novel Treatment Options
Authors: Carpita Barbara , Marazziti Donatella , Palego Lionella , Giannaccini Gino , Betti Laura , Dell'Osso Liliana 
Published: August 2019

Background:Autism Spectrum Disorder (ASD) is a condition strongly associated with genetic predisposition and familial aggregation. Among ASD patients, different levels of symptoms severity are detectable, while the presence of intermediate autism phenotypes in close relatives of ASD probands is also known in literature. Recently, increasing attention has been paid to environmental factors that might play a role in modulating the relationship between genomic risk and development and severity of ASD. Within this framework, an increasing body of evidence has stressed a possible role of both gut microbiota and inflammation in the pathophysiology of neurodevelopment. The aim of this paper is to review findings about the link between microbiota dysbiosis, inflammation and ASD.Methods:Articles ranging from 1990 to 2018 were identified on PUBMED and Google Scholar databases, with keyword combinations as: microbiota, immune system, inflammation, ASD, autism, broad autism phenotype, adult.Results:Recent evidence suggests that microbiota alterations, immune system and neurodevelopment may be deeply intertwined, shaping each other during early life. However, results from both animal models and human samples are still heterogeneous, while few studies focused on adult patients and ASD intermediate phenotypes.Conclusion:A better understanding of these pathways, within an integrative framework between central and peripheral systems, might not only shed more light on neural basis of ASD symptoms, clarifying brain pathophysiology, but it may also allow to develop new therapeutic strategies for these disorders, still poorly responsive to available treatments.
Promoting Identification and Use of Aid Resources by Caregivers of Seniors: Co-Design of an Electronic Health Tool
Authors: Giroux Dominique , Tremblay Mélanie , Latulippe Karine , Provencher Véronique , Poulin Valérie , Giguere Anik , Dubé Véronique , Sévigny Andrée , Guay Manon , Ethier Sophie , Carignan Maude 
Published: August 2019

Background
The importance of supporting caregivers is recognized in home care for older persons, and facilitating their help-seeking process is a way to meet that need. The use of electronic health (eHealth) is a potentially promising solution to facilitate caregivers’ help-seeking process.

Objective
The aim of this research was to develop, in partnership with community organizations, health and social service professionals and caregivers, an eHealth tool promoting the earlier identification of needs of older persons and an optimal use of available resources.

Methods
To design the tool, 8 co-design sessions (CoDs) were conducted and 3 advisory committees were created (in 11 regions) in Quebec between May 2017 and May 2018. A variety of methods were used, including the sorting method, the use of personas, eHealth tool analysis, brainstorming, sketching, prototyping, and pretesting.

Results
A total of 74 co-designers (women n=64 and men n=10) were recruited to participate in the CoDs or the advisory committees. This number allowed for the identification of needs to which the tool must respond and for the identification of its requirements (functionalities and content), as well as for the development of the information architecture. Throughout the study, adjustments were made to the planning of CoD, notably because certain steps required more sessions than expected. Among others, this was true for the identification of functionalities.

Conclusions
This study led to the development of an eHealth tool for caregivers of functionally dependent older persons to help them identify their needs and the resources available to meet them.

International Registered Report Identifier (IRRID)
RR2-10.2196/11634