bluuebunny/crossref_metadata_2025_split huggingface dataset:
ANTIMICROBIAL RESISTANCE PATTERN IN ESCHERICHIA COLI ISOLATED FROM CHILDREN ADMITTED AT SELECTED HEALTH CARE FACILITIES IN MOSHI MUNICIPALITY, TANZANIA
Authors: Daud Mzelifa , Nyombi Balthazar 
Published: August 2019

Abstract
Background

The emergence of antimicrobial resistance is a great challenge in preventing, controlling and treatment Gram-negative bacteria and has become a significant public health threat worldwide. The study aimed at determination of the prevalence and pattern of antimicrobial resistance in Escherichia coli isolated in children admitted at health facilities in Moshi municipality, Tanzania.

Methodology

A descriptive cross sectional study was carried out on archived rectal swabs collected from 282 children aged 3 to 168 months admitted at Kilimanjaro Christian Medical Centre (KCMC), Mawenzi Regional Referral Hospital and Pasua health centre in Moshi municipality. Rectal swabs were cultured on MacConkey agar media. The isolated Escherichia coli was identified and antimicrobial susceptibility test was done by using Kirby–Bauer disc diffusion method on Muller Hinton agar media.
Results

Escherichia coli were isolated in all 282 cultured archived rectal swabs and all isolates were susceptible to amikacin and meropenem. ESBL producers were 13.1% and 86.9% were non-ESBLs.

Conclusion

High resistance rate were observed on ampicillin, ceftriaxone, ceftazidime, cefuroxime, trimethoprim and ciprofloxacin among ESBL producing Escherichia coli. Among non ESBL producing Escherichia coli high resistance rate were observed on ampicillin and trimethoprim; however all isolates were sensitive to amikacin and meropenem.
Female sex workers perspectives and concerns regarding HIV self-testing: An exploratory study in Tanzania
Authors: Nnko Soori , Nyato Daniel , Kuringe Evodius , Casalini Caterina , Shao Amani , Komba Albert , Changalucha John , Wambura Mwita 
Published: August 2019

Abstract
Background
HIV testing is a gateway to HIV care and treatment for those testing positive, and can link those with negative reactive tests to HIV preventive services, including enrolment into pre exposure prophylaxis (PrEP). While benefits of HIV testing services (HTS) are known, uptake of HTS among female sex workers (FSWs) in Tanzania and across sub-Saharan Africa (SSA) remains suboptimal. Introduction of HIV self-testing (HIVST) may mitigate some of the barriers for the uptake of HTS, and contribute to greater linkage to care and prevention services. This study explored perspectives of FSWs towards HIVST, to inform a large-scale combination HIV prevention program addressing key populations (KPs) in Tanzania.

Methods
We conducted an exploratory study employing in-depth interviews (IDI) and participatory group discussions (PGD) with FSWs. PGD collected normative data e.g. perceptions and attitudes towards HTS, whereas IDI collected personal information e.g. sexual practices and HIV risk perceptions. Study participants were recruited through snowball sampling. Data were thematically analysed using NVivo software. Emerging themes were explored in the tradition of Grounded Theory. The analysis was informed by the social ecological model and focused on factors associated with feasibility of scale up of HIVST.

Results
A total of 20 PGD sessions were conducted involving 227 participants. We also conducted IDIs with 21 FSWs. Study participants were enthusiastic toward HIVST. Convenience (time and cost saved), and belief that HIVST will increase privacy and confidentiality were primary in participants’ support for the HIVST. Participants did express concerns about their ability to interpret and trust the results of the test. Participants also expressed concern that HIVST could cause personal harm, including severe distress and self-harm for the FSWs with reactive test – this was related to the lack of professional counselling support in the self-testing environment.

Conclusions
Increased confidentiality, reduced cost for care, and increased autonomy were among the leading motivations to use HIVST. Major concerns included fear of HIV positive results, and not trusting self-diagnoses. We underscore the importance of providing adequate support services in conjunction with HIVST, e.g. access to counselling and referral services, and user-accessible support to the interpretations of test results.
Incidence, clinical implications and impact on public health of infections with Shigella spp. and entero-invasive Escherichia coli (EIEC): results of a multicenter cross-sectional study in the Netherlands during 2016-2017
Authors: Beld Maaike van den , Warmelink Esther , Friedrich Alexander W. , Reubsaet Frans A.G. , Schipper Maarten , Boer Richard F. de , Notermans Daan W. , Petrignani Mariska W. F. , Zanten Evert van , Rossen John W.A. , Friesema Ingrid H.M. , Kooistra A.M.D. (Mirjam) 
Published: August 2019

Abstract
Background

Shigella spp. and entero-invasive E. coli (EIEC) use the same invasive mechanism to cause diarrheal diseases. Public health regulations apply only to Shigella spp. infections, but are hampered by the lack of simple methods to distinguish them from EIEC. In the last decades, molecular methods for detecting Shigella spp. and EIEC were implemented in medical microbiological laboratories (MMLs). However, shigellosis cases identified with molecular techniques alone are not notifiable in most countries. Our study investigates the impact of EIEC versus Shigella spp. infections and molecular diagnosed shigellosis versus culture confirmed shigellosis for re-examination of the rationale for the current public health regulations.

Methods

In this multicenter cross-sectional study, fecal samples of patients suspected for gastro-enteritis, referred to fifteen MMLs in the Netherlands, were screened by PCR for Shigella spp. or EIEC. Samples were also cultured to discriminate between the two pathogens. We compared, risk factors, symptoms, severity of disease, secondary infections and socio-economic consequences for (i) culture-confirmed Shigella spp. versus culture-confirmed EIEC cases (ii) culture positive versus PCR positive only shigellosis cases.

Results

In 2016-2017, 777 PCR positive fecal samples with patient data were included, 254 of these were culture-confirmed shigellosis cases and 32 were culture-confirmed EIEC cases. EIEC cases were more likely to report ingestion of contaminated food or water and were less likely to be men who have sex with men (MSM). Both pathogens were shown to cause serious disease although differences in specific symptoms were observed. Additionally, culture-negative but PCR positive cases were more likely report travel or ingestion of contaminated food or water and were less likely to be MSM than culture-positive cases. Culture-negative cases were more likely to suffer from multiple symptoms. No differences in degree of secondary infections were observed between both Shigella spp. and EIEC, and culture-negative and culture-positive cases.

Conclusions

No convincing evidence was found to support the current guidelines. Therefore, culture and molecular detection methods for Shigella spp. and EIEC should be considered equivalent for case definition and public health regulations regarding shigellosis. Differences were found regarding risks factors, indicating that different prevention strategies may be required.
Efficacy and Safety of Allogenic Canine Adipose Tissue-derived Mesenchymal Stem Cell Therapy for Insulin Dependent Diabetes Mellitus in Dogs: A pilot study
Authors: Rhew Sung-Yong , Song Woo-Jin , Li Qiang , An Ju-Hyun , Chae Hyung-Kyu , Jeung So-Young , Park Seol-Gi , Lee Jeong-Ha , Cho Hee-Seon , Sohn Sang-June , Youn Hwa-Young 
Published: August 2019

Abstract
Background

Since mesenchymal stem cells (MSCs) possess regenerative and immunomodulatory properties, and are capable of controlling the immune dysregulation that leads to β-cell destruction, stem cell transplantation could be used in the management of insulin-dependent diabetes mellitus (IDDM). In this pilot study, we assessed whether canine adipose tissue-derived MSC (cAT-MSC) therapy could be an option for treatment of canine diabetes mellitus.

Results

With the written informed consent of the owners, allogenic cAT-MSCs were infused intravenously in IDDM dogs. C-peptide was elevated by about 5–15% in 3 of 4 cases, and hyperlipidemia was resolved in 2 of 4 cases. Additionally, fructosamine and Hb/A1c levels were improved in 2 of 4 cases.

Conclusions

Considering that C-peptide secretion capacity and lipid metabolism are related to diabetic complications, these results suggest that cAT-MSC therapy in diabetic dogs might help to improve the insulin secretory capacity of dogs with IDDM and prevent diabetic complications.
Characterization of Pasteurella multocida isolated from dead rabbits with respiratory disease in Fujian, China
Authors: Wang Jinxiang , Sang Lei , Sun Shikun , Chen Yanfeng , Chen Dongjin , Xie Xiping 
Published: August 2019

Abstract
Background

Pasteurella multocida is one of the important pathogens infects rabbits, causing major economic losses in commercial rabbit farming. In this study, 205 P. multocida isolates recovered from lungs of dead rabbits with respiratory disease were defined capsular serogroups, lipopolysaccharide (LPS) genotypes and multi-locus sequence types, screened virulence factors, and tested antimicrobial susceptibility.

Results

The 205 isolates were assigned into 2 capsular types, A and D, and 2 LPS genotypes, L3 and L6. When combining capsular types with LPS genotypes, 4 serotypes were detected. A:L3 (51.22%, 105/205) was the most predominant serotype, followed by A:L6 (24.88%, 51/205), D:L6 (19.02%, 39/205), and D:L3 (4.88%, 10/205). The 205 isolates were grouped into 3 sequence types, ST10, ST11 and ST12. ST12 (56.10%, 115/205) was the most prevalent sequence type, followed by ST10 (24.88%, 51/205) and ST11 (19.02%, 39/205). In the 205 isolates, the virulence genes of ptfA, fur, hgbB, ompA, ompH and oma87 were positive, whereas the toxA and tbpA genes were negative. Notably, the 156 capsular serogroup A isolates carried pmHAS gene. All the 205 isolates were susceptible to most of the used antibiotics, except for streptomycin, gentamycin, kanamycin and ceftriaxone, and the resistance rates of which were 27.80%, 15.61%, 9.27% and 2.44%, respectively.

Conclusions

This study, for the first time, described the prevalence and characteristics of P. multocida causing respiratory disease in rabbits in Fujian Province, which might be useful for tracking the epidemic strains and development of efficient vaccines and methods to prevent and control the pathogen.
Early-stage clinical outcomes and rotational stability of TECNIS toric intraocular lens implantation in cataract cases with long axial length
Authors: He Suhong , Chen Xiang , Wu Xingdi , Ma Yajuan , Yu Xuewen , Xu Wen 
Published: August 2019

Abstract
Background: A major focus of toric intraocular lens (IOL) implantation is the rotational stability, especially in the patients with moderate to high myopia. In this study, we aimed to evaluate the clinical outcomes after implantation of TECNIS toric IOL in eyes with long axial length（AL）and identify factors influencing their early-stage stability with preoperative corneal astigmatism.
Methods: The study population consisted of 64 eyes from 52 cataract patients, and these patients had preoperative corneal astigmatism between 1.0 and 3.7 diopters (D) and underwent phacoemulsification and TECNIS toric IOL implantation. Ophthalmic biological measurements were carried out preoperatively, including AL, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), anterior chamber volume (ACV) and sulcus-to-sulcus (STS). The 1- and 3-month clinical outcomes included visual acuity, manifest refraction, keratometry, postoperative toric IOL axis, the area of capsulorhexis, and the overlapped area between IOL optic and anterior capsulorhexis.
Results: The mean best corrected distance visual acuity (BCDVA) was improved from 0.93±0.35 logarithms of the minimal angle of resolution (logMAR) preoperatively to 0.07±0.10 logMAR postoperatively at 3 months after surgery. The mean residual astigmatism (RAS) was 0.91±0.74D at 3 months, which was significantly decreased compared with the preoperative corneal astigmatism of 1.71±0.55 D. The mean absolute rotation of TECNIS toric IOL at 1 and 3 months was 7.41±11.32 degree (°) and 7.48±11.19° (0°-79°), respectively. A positive correlation was found between IOL rotation and the area of capsulorhexis (Pearson’s r=0.297, P=0.017) at 3 months after surgery. No correlation was found between IOL rotation and AL (Pearson’s r=-0.020, P=0.876), ACD (Pearson’s r=-0.123, P=0.387), LT (Pearson’s r=0.083, P=0.523), VL (Pearson’s r=-0.082, P=0.546), ACV (Pearson’s r=-0.094, P=0.480), STS (Pearson’s r=0.019, P=0.884), or the overlapped area between capsulorhexis and optic (Pearson’s r=-0.191, P=0.131) .
Conclusions: The area of capsulorhexis was a risk factor for toric IOL rotation. Implantation of TECNIS toric IOL in cataract cases with long AL was effective and safe.
Recurrence in Stage I and II Triple-Negative Breast Cancer: Analysis of Clinicopathologic and Imaging Factors
Authors: Eom Hye Joung , Cha Joo Hee , Choi Woo Jung , Chae Eun Young , Shin Hee Jung , Kim Hak Hee 
Published: August 2019

Abstract
Background

To describe the outcomes of patients with early stage triple-negative breast cancer (TNBC) and to investigate whether certain imaging and clinicopathologic factors were associated with recurrence in patients with early stage TNBC.

Methods

We identified stage I and II TNBC patients treated between 2009 and 2011. Data included patient and tumor characteristics, time of recurrence, and findings on mammography, ultrasonography, and magnetic resonance imaging (MRI). Kaplan-Meier method was used to estimate recurrence free survival and Cox proportional hazards model was used to determine the association between imaging and clinicopathologic factors and recurrence.

Results

The study included 702 patients with mean age of 49.0 years (range, 24–82 years) and mean follow-up of 61 months (range, 6 - 93 months). Overall, 115 (115/702, 16.4%) had recurrence. Clinicopathologic factors associated with recurrence included increasing tumor size, positive nodal status, ki-67 index more than 14, presence of lymphovascular invasion (LVI), mastectomy, and neoadjuvant or adjuvant chemotherapy. Imaging factors associated with recurrence included moderate or marked background parenchymal enhancement on MRI. After controlling for all potential confounders, tumor size, nodal status, LVI, and adjuvant chemotherapy were independently associated with recurrence.

Conclusion

Sixteen percent of patients with early stage TNBC experienced recurrence, with 3 and 5 year recurrence rates being 12.4% and 15.3%, respectively. Tumor size, nodal status, LVI, and adjuvant chemotherapy were independently associated with recurrence, while none of the imaging factors showed association.
Prevalence and Factors Associated with Early Sexual Debut among Preparatory School Students in Gondar Town, North West Ethiopia 2018
Authors: Gudeta Betelihem , Habitu Yohannes Ayanaw , Atnafu Asmamaw 
Published: August 2019

Abstract
Objective: Early sexual debut increases youth exposure to risky sexual behaviors, STIs including HIV/AIDS, and unsafe abortion. There is study limitation on this specific issue on the study area. Therefore, this study aimed to determine the prevalence and associated factors of early sexual debut among preparatory school students in Gondar town, North West Ethiopia.
Results: From a total of 797 students, 750 respondents complete the questionnaire giving a response rate of 94.1%. About 20.5% with 95%CI (17.6, 23.3%) of the respondents had early sexual debut. Had lesson on sexuality education (AOR=2.14, 95%CI 1.15, 3.98), drinking alcohol (AOR= 14.5, 95%CI 7.81, 27.22), had good parental monitoring (AOR=3.6, 95%CI 1.8, 7.45), had discussion on sexual issues with parents (AOR=3.05, 95%CI 1.04, 8.88), and had good academic achievement (AOR=4.2, 95%CI 1.72, 10.26) were found to be significantly associated with early sexual debut. Sexual education programs at earlier life may help to delay sexual debut for school youths and is recommended to incorporate it in the curriculum.
Key words: Early sexual debut, factors, preparatory students, Gondar, Ethiopia
Role of inferior vena cava collapsibility index in the prediction of hypotension associated with general anesthesia: an observational study
Authors: Szabó Marcell , Bozó Anna , Darvas Katalin , Horváth Alexandra , Iványi Zsolt Dániel 
Published: August 2019

Abstract
Background: Intraoperative hypotension increases 30-day mortality and the risks of myocardial injury and acute renal failure. Patients with inadequate volume reserve before the induction of anesthesia are highly exposed. The identification of latent hypovolemia is therefore crucial. Ultrasonographic measurement of the inferior vena cava collapsibility index (IVCCI) is able to detect volume responsiveness in circulatory shock. No current evidence is available regarding whether preoperative measurement of the IVCCI could identify patients at high risk for hypotension associated with general anesthesia.
Methods: A total of 102 patients undergoing elective general surgery under general anesthesia with standardized propofol induction were recruited for this prospective observational study. The IVCCI was measured under spontaneous breathing. A collapsing (IVCCI≧50%) (CI+) and a noncollapsing (CI-) group were formed. Immediate postinduction changes in systolic and mean blood pressure were compared. The performance of the IVCCI as a diagnostic tool for predicting hypotension (systolic pressure <90 mmHg or a ≥30% drop from the baseline) was evaluated by ROC curve analysis.
Results: A total of 83 patients were available for analysis, with 20 in the CI+ and 63 in the CI- group, we excluded 19 previously eligible patients due to inadequate visualization of the IVC (7 cases), lack of adherence to the protocol (8 cases), missing data (2 cases) or change in anesthesiologic management (2 cases). The mean decrease in systolic pressure in the CI+ group was 53.8±15.3 compared to 35.8±18.1 mmHg in CI- patients (P=0.0001). The relative mean arterial pressure change medians were 34.1% (IQR 23.2%-43.0%) and 24.2% (IQR 17.2%-30.2%), respectively (P=0.0029). The ROC curve analysis for IVCCI showed an AUC of 64.8% (95%CI 52.1-77.5%). The selected 50% level of the IVCCI had a sensitivity of only 45.5% (95%CI 28.1-63.7%), but the specificity was high at 90.0% (78.2-96.7%). The positive predictive value was 75.0% (95%CI 50.9-91.3%), and the negative predictive value was 71.4% (95%CI 58.7-82.1%).
Conclusion: In spontaneously breathing preoperative noncardiac surgical patients, preoperatively detected IVCCI≧50% can predict postinduction hypotension with high specificity but low sensitivity. Despite moderate performance, IVCCI is an easy, noninvasive and attractive option to identify patients at risk and should be explored further.
Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study
Authors: yan wei , Xiong Yun , Yao Yu , Zhang Feng-jiang , Yu Li-an , Yan Min 
Published: August 2019

Abstract
Abstract
Background: Unsatisfactory analgesia would occur frequently during repeated cesarean section under epidural anesthesia. The aim of this study is to observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeated cesarean section under epidural anesthesia.
Methods: A total of 80 parturients undergoing repeated cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil- assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded.
Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.0±0.9, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05).
Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeated cesarean section under epidural anesthesia, without noticeable maternal or neonatal adverse effects.
Paramyotonia congenita with persistent distal and facial muscle weakness: A case report with literature review
Authors: Taminato Tomoya , Mori-Yoshimura Madoka , Miki Jun , Sasaki Ryogen , Satoh Noriko , Oya Yasushi , Nishino Ichizo , Takahashi Yuji 
Published: August 2019

Abstract
Introduction

Paramyotonia congenita (PC; OMIM 168300) is a non-dystrophic myotonia caused by mutations in the SCN4A gene. Transient muscle stiffness, usually induced by exposure to cold and aggravated by exercise, is the predominant clinical symptom, and interictal persistent weakness is uncommon.

Case presentation

We report a family with a history of PC accompanied by persistent distal hand dominant muscle weakness with masticatory muscle involvement. Persistent weakness was exacerbated with age, and MR analysis showed marked atrophy of temporal, masseter, and finger flexor muscles with fatty replacement. Cases within the family harbor the prevalent PC causative mutation, T1313M, in the SCN4A gene. Administration of acetazolamide chloride improved clinical symptoms and the results of cold and short exercise tests. Phenotypic variation within the family was remarkable, as the two younger affected patients did not present with persistent weakness or muscle atrophy.

Conclusions

PC associated with the T1313M mutation is a possible cause of persistent distal hand weakness.