bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clonal Relatedness, Phylotyping and Antimicrobial Susceptibility of Extended- spectrum-beta-lactamase Producing Uropathogenic Escherichia coli Isolates from Outpatients and Inpatients
Authors: Azimzadeh Negar , Derakhshandeh Abdollah , Motamedifar Mohammad , Naziri Zahra 
Published: July 2019

Objectives:
Antibiotic resistance, phylogenetic groups and Pulsed-Field Gel Electrophoresis
(PFGE) patterns were evaluated in urinary tract infection (UTI) Escherichia coli (E. coli)
isolates from outpatients and inpatients.

Methods:
In this study, antibiotic resistance to E. coli isolated from non-hospitalized and hospitalized
patients (153 outpatients and 147 inpatients ) was evaluated in Shiraz County, Iran. Phylogenetic
groups and Pulse Field Gel Electrophoresis (PFGE) patterns of 143 ESBLs-producing E. coli
were also assessed.

Results:
The prevalence of ESBL-producing E. coli was shown to be 46.4% and 49% in the outpatient
and inpatient UTI E. coli isolates, respectively. Most ESBL-producers were detected on patients
hospitalized in clinical surgery units (66.7%) and intensive care units (62.5%). Phylogenetic
group D was the dominant group in both the outpatient and inpatient isolates (67.6% and 61.1%,
respectively) and also in internal, clinical surgery and ICU units. PFGE results showed more relatedness
(>80% similarity) among inpatient isolates. PFGE analysis of 49 ESBL-producing inpatient
E.coli in hospital units revealed 17 different pulsotypes, consisting of 11 clones and 6 single
patterns. There were no clonal patterns in outpatient isolates, and similarity among the outpatient
isolates and also between inpatient and outpatient isolates was less than 80% (75% and 66%, respectively).

Conclusions:
The results showed extreme genomic diversity among the ESBL-producing E. coli
isolates in terms of the community and multiclonal dissemination of ESBL-producing E. coli isolated
from hospital units.
Suicide by Inhalation of Carbon Monoxide of Car Exhausts Fumes
Authors: Valente-Aguiar Murilo Sérgio , Magalhães Teresa , Dinis-Oliveira Ricardo Jorge 
Published: July 2019

Background:
Carbon monoxide (CO) is a major and ubiquitous component of fire atmospheres
produced when organic matter is burned in an inadequate supply of oxygen. Accidental
poisoning by CO is common in cold climates where fireplaces, a gas, electric or kerosene heaters or
grills are used inside ill-ventilated buildings. In the Brazilian Amazon, with its hot and humid climate,
there is no need for the use of heaters and accidents may occur in cases of residential fires or
burning of the forests for land use in agriculture.

Objective:
We present a case of CO suicide of twenty-six-year-old men.

Methods:
A forensic autopsy was performed to evaluate the circumstances, cause and medio-legal
death etiology.

Results:
Autopsy evidenced the typical but also not commonly published cherry-red color of the hypostasis,
lungs and other organs, and the very fluid cherry-red blood. The cause of death was due to
a massive CO inhalation.

Conclusion:
While these poisonings are well recognized, and a vast number of publications on CO
toxicity exist, both in an environmental and industrial context, suicide is infrequently encountered in
forensic practice and the typical signs are rarely seen in the literature.
Electronic Health Literacy Among Magnetic Resonance Imaging and Computed Tomography Medical Imaging Outpatients: Cluster Analysis
Authors: Hyde Lisa Lynne , Boyes Allison W , Mackenzie Lisa J , Leigh Lucy , Oldmeadow Christopher , Riveros Carlos , Sanson-Fisher Rob 
Published: July 2019

Background
Variations in an individual’s electronic health (eHealth) literacy may influence the degree to which health consumers can benefit from eHealth. The eHealth Literacy Scale (eHEALS) is a common measure of eHealth literacy. However, the lack of guidelines for the standardized interpretation of eHEALS scores limits its research and clinical utility. Cut points are often arbitrarily applied at the eHEALS item or global level, which assumes a dichotomy of high and low eHealth literacy. This approach disregards scale constructs and results in inaccurate and inconsistent conclusions. Cluster analysis is an exploratory technique, which can be used to overcome these issues, by identifying classes of patients reporting similar eHealth literacy without imposing data cut points.

Objective
The aim of this cross-sectional study was to identify classes of patients reporting similar eHealth literacy and assess characteristics associated with class membership.

Methods
Medical imaging outpatients were recruited consecutively in the waiting room of one major public hospital in New South Wales, Australia. Participants completed a self-report questionnaire assessing their sociodemographic characteristics and eHealth literacy, using the eHEALS. Latent class analysis was used to explore eHealth literacy clusters identified by a distance-based cluster analysis, and to identify characteristics associated with class membership.

Results
Of the 268 eligible and consenting participants, 256 (95.5%) completed the eHEALS. Consistent with distance-based findings, 4 latent classes were identified, which were labeled as low (21.1%, 54/256), moderate (26.2%, 67/256), high (32.8%, 84/256), and very high (19.9%, 51/256) eHealth literacy. Compared with the low class, participants who preferred to receive a lot of health information reported significantly higher odds of moderate eHealth literacy (odds ratio 16.67, 95% CI 1.67-100.00; P=.02), and those who used the internet at least daily reported significantly higher odds of high eHealth literacy (odds ratio 4.76, 95% CI 1.59-14.29; P=.007).

Conclusions
The identification of multiple classes of eHealth literacy, using both distance-based and latent class analyses, highlights the limitations of using the eHEALS global score as a dichotomous measurement tool. The findings suggest that eHealth literacy support needs vary in this population. The identification of low and moderate eHealth literacy classes indicate that the design of eHealth resources should be tailored to patients’ varying levels of eHealth literacy. eHealth literacy improvement interventions are needed, and these should be targeted based on individuals’ internet use frequency and health information amount preferences.
Design and Development of a Viral Hepatitis and HIV Infection Screening Program (Hprolipsis) for the General, Greek Roma, and Migrant Populations of Greece: Protocol for Three Cross-Sectional Health Examination Surveys
Authors: Touloumi Giota , Karakosta Argiro , Sypsa Vana , Petraki Ioanna , Anagnostou Olga , Terzidis Agis , Voudouri Niki Maria ,   Doctors Of The World Greek Delegation, Gavana Magda , Vantarakis Apostolos , Rachiotis George , Kantzanou Maria , Rosenberg Theofilos , Papatheodoridis George , Hatzakis Angelos ,   Hprolipsis Study Group
Published: July 2019

BackgroundAlthough infectious diseases are globally on the decline, they remain a major global public health problem. Among them, the hepatitis B virus (HBV) or hepatitis C virus (HCV) and HIV infection are of primary interest. Valid prevalence data on these infections are sparse in Greece, especially for vulnerable populations.ObjectiveThis study aimed to present the design and methods of Hprolipsis, an integrated viral hepatitis and HIV screening program administered to adults (≥18 years) from the general, Greek Roma, and migrant populations. Its aims were to estimate the prevalence of HBV, HCV, and HIV; assess infectious disease knowledge level; design, implement, and assess population-specific awareness actions; and offer individual counseling and referral when indicated and HBV vaccination to susceptible Roma and migrants.MethodsMultistage, stratified, random sampling based on the 2011 Census was applied to select the general population sample, and nonprobability multistage quota sampling was used for Roma and migrant sample selection. Trained personnel made home (general population) or community (Roma and migrants) visits. Collected blood samples were tested for Hepatitis B surface Antigen, Hepatitis B core Antibody, Hepatitis B surface Antibody, Hepatitis C Antibody, and HIV 1,2 Antibody. The surveys were conducted during May 2013 and June 2016. To estimate an HCV prevalence of 1.5% with 0.3 precision, the required general population sample size was estimated to be 6000. As migrants constitute 10% of the whole Greek population, the migrant sample size was set to 600. A feasible sample size of 500 Greek Roma was set.ResultsIn total, 6006 individuals from the general population (response rate 72%), 534 Greek Roma, and 612 migrants were recruited. Blood test results are available for 4245 individuals from the general population, 523 Roma, and 537 migrants.ConclusionsHprolipsis is the first nationwide survey on HBV, HCV, and HIV. Its results will enhance our understanding of the health needs and disease burden of these diseases in the 3 studied populations. Its implementation provided useful recommendations for future studies, particularly in vulnerable populations.International Registered Report Identifier (IRRID)DERR1-10.2196/13578
Interaction Patterns of Men Who Have Sex With Men on a Geosocial Networking Mobile App in Seven United States Metropolitan Areas: Observational Study
Authors: Abuelezam Nadia N , Reshef Yakir A , Novak David , Grad Yonatan Hagai , Seage III George R , Mayer Kenneth , Lipsitch Marc 
Published: July 2019

Background
The structure of the sexual networks and partnership characteristics of young black men who have sex with men (MSM) may be contributing to their high risk of contracting HIV in the United States. Assortative mixing, which refers to the tendency of individuals to have partners from one’s own group, has been proposed as a potential explanation for disparities.

Objective
The objective of this study was to identify the age- and race-related search patterns of users of a diverse geosocial networking mobile app in seven metropolitan areas in the United States to understand the disparities in sexually transmitted infection and HIV risk in MSM communities.

Methods
Data were collected on user behavior between November 2015 and May 2016. Data pertaining to behavior on the app were collected for men who had searched for partners with at least one search parameter narrowed from defaults or used the app to send at least one private chat message and used the app at least once during the study period. Newman assortativity coefficient (R) was calculated from the study data to understand assortativity patterns of men by race. Pearson correlation coefficient was used to assess assortativity patterns by age. Heat maps were used to visualize the relationship between searcher’s and candidate’s characteristics by age band, race, or age band and race.

Results
From November 2015 through May 2016, there were 2,989,737 searches in all seven metropolitan areas among 122,417 searchers. Assortativity by age was important for looking at the profiles of candidates with correlation coefficients ranging from 0.284 (Birmingham) to 0.523 (San Francisco). Men tended to look at the profiles of candidates that matched their race in a highly assortative manner with R ranging from 0.310 (Birmingham) to 0.566 (Los Angeles). For the initiation of chats, race appeared to be slightly assortative for some groups with R ranging from 0.023 (Birmingham) to 0.305 (Los Angeles). Asian searchers were most assortative in initiating chats with Asian candidates in Boston, Los Angeles, New York, and San Francisco. In Birmingham and Tampa, searchers from all races tended to initiate chats with black candidates.

Conclusions
Our results indicate that the age preferences of MSM are relatively consistent across cities, that is, younger MSM are more likely to be chatted with and have their profiles viewed compared with older MSM, but the patterns of racial mixing are more variable. Although some generalizations can be made regarding Web-based behaviors across all cities, city-specific usage patterns and trends should be analyzed to create targeted and localized interventions that may make the most difference in the lives of MSM in these areas.
A Tablet-Based App for Carpal Tunnel Syndrome Screening: Diagnostic Case-Control Study
Authors: Fujita Koji , Watanabe Takuro , Kuroiwa Tomoyuki , Sasaki Toru , Nimura Akimoto , Sugiura Yuta 
Published: July 2019

Background
Carpal tunnel syndrome (CTS), the most common neuropathy, is caused by a compression of the median nerve in the carpal tunnel and is related to aging. The initial symptom is numbness and pain of the median nerve distributed in the hand area, while thenar muscle atrophy occurs in advanced stages. This atrophy causes failure of thumb motion and results in clumsiness; even after surgery, thenar atrophy does not recover for an extended period. Medical examination and electrophysiological testing are useful to diagnose CTS; however, visits to the doctor tend to be delayed because patients neglect the symptom of numbness in the hand. To avoid thenar atrophy-related clumsiness, early detection of CTS is important.

Objective
To establish a CTS screening system without medical examination, we have developed a tablet-based CTS detection system, focusing on movement of the thumb in CTS patients; we examined the accuracy of this screening system.

Methods
A total of 22 female CTS patients, involving 29 hands, and 11 female non-CTS participants were recruited. The diagnosis of CTS was made by hand surgeons based on electrophysiological testing. We developed an iPad-based app that recorded the speed and timing of thumb movements while playing a short game. A support vector machine (SVM) learning algorithm was then used by comparing the thumb movements in each direction among CTS and non-CTS groups with leave-one-out cross-validation; with this, we conducted screening for CTS in real time.

Results
The maximum speed of thumb movements between CTS and non-CTS groups in each direction did not show any statistically significant difference. The CTS group showed significantly slower average thumb movement speed in the 3 and 6 o’clock directions (P=.03 and P=.005, respectively). The CTS group also took a significantly longer time to reach the points in the 2, 3, 4, 5, 6, 8, 9, and 11 o’clock directions (P<.05). Cross-validation revealed that 27 of 29 CTS hands (93%) were classified as having CTS, while 2 of 29 CTS hands (7%) did not have CTS. CTS and non-CTS were classified with 93% sensitivity and 73% specificity.

Conclusions
Our newly developed app could classify disturbance of thumb opposition movement and could be useful as a screening test for CTS patients. Outside of the clinic, this app might be able to detect middle-to-severe-stage CTS and prompt these patients to visit a hand surgery specialist; this may also lead to medical cost-savings.
Accuracy of the Multisensory Wristwatch Polar Vantage's Estimation of Energy Expenditure in Various Activities: Instrument Validation Study
Authors: Gilgen-Ammann Rahel , Schweizer Theresa , Wyss Thomas 
Published: July 2019

BackgroundSport watches and fitness trackers provide a feasible way of obtaining energy expenditure (EE) estimations in daily life as well as during exercise. However, today’s popular wrist-worn technologies show only poor-to-moderate EE accuracy. Recently, the invention of optical heart rate measurement and the further development of accelerometers in wrist units have opened up the possibility of measuring EE.ObjectiveThis study aimed to validate the new multisensory wristwatch Polar Vantage and its EE estimation in healthy individuals during low-to-high-intensity activities against indirect calorimetry.MethodsOverall, 30 volunteers (15 females; mean age 29.5 [SD 5.1] years; mean height 1.7 [SD 0.8] m; mean weight 67.5 [SD 8.7] kg; mean maximal oxygen uptake 53.4 [SD 6.8] mL/min·kg) performed 7 activities—ranging in intensity from sitting to playing floorball—in a semistructured indoor environment for 10 min each, with 2-min breaks in between. These activities were performed while wearing the Polar Vantage M wristwatch and the MetaMax 3B spirometer.ResultsAfter EE estimation, a mean (SD) of 69.1 (42.7) kcal and 71.4 (37.8) kcal per 10-min activity were reported for the MetaMax 3B and the Polar Vantage, respectively, with a strong correlation of r=0.892 (P<.001). The systematic bias was 2.3 kcal (3.3%), with 37.8 kcal limits of agreement. The lowest mean absolute percentage errors were reported during the sitting and reading activities (9.1%), and the highest error rates during household chores (31.4%). On average, 59.5% of the mean EE values obtained by the Polar Vantage were within ±20% of accuracy when compared with the MetaMax 3B. The activity intensity quantified by perceived exertion (odds ratio [OR] 2.028; P<.001) and wrist circumference (OR −1.533; P=.03) predicted 29% of the error rates within the Polar Vantage.ConclusionsThe Polar Vantage has a statistically moderate-to-good accuracy in EE estimation that is activity dependent. During sitting and reading activities, the EE estimation is very good, whereas during nonsteady activities that require wrist and arm movement, the EE accuracy is only moderate. However, compared with other available wrist-worn EE monitors, the Polar Vantage can be recommended, as it performs among the best.
Dropout and Abstinence Outcomes in a National Text Messaging Smoking Cessation Intervention for Pregnant Women, SmokefreeMOM: Observational Study
Authors: Kamke Kristyn , Grenen Emily , Robinson Cendrine , El-Toukhy Sherine 
Published: July 2019

Background
Population-level text messaging smoking cessation interventions may reduce racial and ethnic differences in smoking among pregnant women.

Objective
Our objective was to examine racial and ethnic differences in dropout, response, and abstinence rates among users of a US national, publicly available text messaging cessation intervention targeting pregnant women, SmokefreeMOM.

Methods
Participants were online subscribers to SmokefreeMOM who set a prospective quit date within the 9 months before their due date. We examined demographics, smoking frequency, number of cigarettes smoked per day, and prequit time (up to 14 days of preparation time before quit date) as correlates of response rate and abstinence at 8 time points: quit date, day 7, day 14, day 21, day 28, day 35, day 42 (intervention end), and day 72 (1-month follow-up). We conducted survival analysis of time from quit date to dropout by race and ethnicity.

Results
The mean age of the analytic sample of 1288 users was 29.46 (SD 7.11) years. Of these, 65.81% (848/1288) were white, 16.04% (207/1288) were black, 8.86% (114/1288) were Latina, and 9.29% (120/1288) were multiracial, American Indian/Alaska Native, Native Hawaiian Pacific Islander, or other; 82.68% (1065/1288) had some college education or less. Point-prevalence abstinence was 14.51% (157/1082) on quit day, 3.51% (38/1082) at intervention end, and 1.99% (21/1053) at 1-month follow-up. Black users (hazard ratio 0.68, 95% CI 0.51-0.91) and those with a high school degree or less (hazard ratio 0.66, 95% CI 0.49-0.89) or some college education (hazard ratio 0.75, 95% CI 0.57-0.99) were less likely to drop out than whites or users with a bachelor’s degree or higher. Response and abstinence rates were similar across race, ethnicity, and education.

Conclusions
Enrollment was low among racial and ethnic minority women but high among less-educated women. Abstinence at intervention end and 1-month follow-up was lower than that in controlled trials of text messaging cessation interventions for pregnant women (range 7%-20%). Increasing the reach, engagement, and effectiveness of SmokefreeMOM, especially among women with high rates of smoking during pregnancy, must be prioritized.
A Web-Based Intervention for Social Media Addiction Disorder Management in Higher Education: Quantitative Survey Study
Authors: Dogan Huseyin , Norman Helmi , Alrobai Amen , Jiang Nan , Nordin Norazah , Adnan Anita 
Published: July 2019

Background
Social media addiction disorder has recently become a major concern and has been reported to have negative impacts on postgraduate studies, particularly addiction to Facebook. Although previous studies have investigated the effects of Facebook addiction disorder in learning settings, there still has been a lack of studies investigating the relationship between online intervention features for Facebook addiction focusing on postgraduate studies.

Objective
In an attempt to understand this relationship, this study aimed to carry out an investigation on online intervention features for effective management of Facebook addiction in higher education.

Methods
This study was conducted quantitatively using surveys and partial least square-structural equational modeling. The study involved 200 postgraduates in a Facebook support group for postgraduates. The Bergen Facebook Addiction test was used to assess postgraduates’ Facebook addiction level, whereas online intervention features were used to assess postgraduates’ perceptions of online intervention features for Facebook addiction, which are as follows: (1) self-monitoring features, (2) manual control features, (3) notification features, (4) automatic control features, and (5) reward features.

Results
The study discovered six Facebook addiction factors (relapse, conflict, salience, tolerance, withdrawal, and mood modification) and five intervention features (notification, auto-control, reward, manual control, and self-monitoring) that could be used in the management of Facebook addiction in postgraduate education. The study also revealed that relapse is the most important factor and mood modification is the least important factor. Furthermore, findings indicated that notification was the most important intervention feature, whereas self-monitoring was the least important feature.

Conclusions
The study’s findings (addiction factors and intervention features) could assist future developers and educators in the development of online intervention tools for Facebook addiction management in postgraduate education.
Der ungarische Lebensbezirk im literarischen Schaffen von Emil Witting Ausgehend von einer neueren Veröffentlichung
Authors: Wittstock Joachim 
Published: July 2019

Abstract
The writer Emil Witting (1880-1952), known by German readers through the descriptions of the forests and pastures of the Carpathian Mountains, author of extensive relations dedicated to the bear (Frate Nicolae) and to deer (Scrimerul), conceives a novel dedicated to a painter connected to the Szekler’s world. Imre Nagy (1893-1976) served as a model for the main character. From this unfinished writing, three fragments were published. These have recently been translated into Hungarian, printed in Miercurea Ciuc in an illustrated edition containing Imre Nagy’s paintings and graphic works.
Deutsch-rumänische Sprachinterferenzen bei Herta Müller und Balthasar Waitz
Authors: Nubert Roxana , Dascălu-Romiţan Ana-Maria 
Published: July 2019

Abstract
Herta Müller’s leaning towards word for word transfer of Romanian set phrases in her texts can be explained by the environment in which she lived until her emigration to West Germany and this admittedly intensifies with the gradually increasing general interest in multi-lingualism. The fact that the authoress speaks of the German-Romanian transfer in her acceptance speech on the occasion of the Nobel Prize award proves the important role, which Hertha Müller ascribes to this procedure.
Also at the centre of the latest books by Balthasar Waitz stands the multicultural region of the Banat. The author seems to be gripped by the plurilingualism of the immediate surroundings of his homeland. Different forms of Romanian, from slang to everyday speech, but occasionally also Hungarian, Slovak and Serbian phrases find their way into the texts of the Banat author. In this manner just as with Hertha Müller, language images come into being, new light. Thus literary multilingualism in both writers enables one to have a novel access to the relation between literature and reality.