bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using the knowledge translation framework to change practical care of central catheters in a Brazilian neonatal unit
Authors: Ramos Ferreira Curan Gabriela , Giovanini Rossetto Edilaine , Corrêa Castral Thaíla 
Published: July 2017

Introduction: The use of central catheters in intensive care is essential, but exposes the patient to the risk of a bloodstream infection. Although there is evidence to improve the care for these patients, there is a gap between knowledge and healthcare practices. This study was designed to describe the bundle implementation for central catheters in light of the knowledge translation (KT) conceptual framework in a neonatal unit and assess its impact on care practices with catheters.
Methodology: A time-series quasi-experimental study design was conducted in a Brazilian neonatal unit, through 289 non-participant observations of professional practices before and after the implementation of the bundles.
Results: The deployment of two bundles was guided through the steps of a careful selection of adopting KT evidence and context-related and investment factors in the facilitation process. The implementation of the bundles was planned by a group manager, mediated by a facilitator, and guided by targets established by professionals. The biggest impact was on the maintenance of catheters; seven of eleven practices improved significantly (p < 0.01). The insertion of catheters showed lesser impact of change, with high adequacy ratios before implementation, but also presented satisfactory adherence to recommendations.
Conclusions: This is the first Brazilian study using the KT conceptual framework to develop, implement, and evaluate the impact of central line bundles in a neonatal care environment, detailing the implementation process. It highlights the importance of accountability and staff involvement in all stages of the study.
Immune response to hepatitis B vaccine among north Iranian healthcare workers and its related factors
Authors: Joukar Farahnaz , Mansour-Ghanaei Fariborz , Naghipour Mohammad Reza , Asgharnezhad Mehrnaz 
Published: July 2017

Introduction: Hepatitis B virus (HBV) is an important occupational risk among healthcare workers (HCWs). Vaccination is the most cost-effective method of preventing and controlling HBV infection. Several factors have been suggested to effect response to the vaccine. The present study aimed to evaluate vaccine response among north Iranian HCWs and to determine the factors influencing vaccine response.
Methodology: Response to the standard three-dose vaccination regimen was evaluated in term of anti-hepatitis B surface antigen level among 1,010 HCWs using an enzyme-linked immunosorbent assay (ELISA) method. Logistic regression was applied to predict antibody response, with related factors including sex, age, years of working experience, marital status, history of transfusion, smoking, history of needle stick injury, rheumatic disease, steroid use, and elapsed time from vaccination measurement.
Results: Of the 1,010 HCWs, 898 (88.9%) acquired protective levels of antibody (> 10 IU/mL). Compared with those < 30 years of age, HCWs older than 50 years and between 40 and 50 years of age were more likely to have non-protective anti-HBs levels (odds ratio = 4.48; p = 0.001 and odds ratio = 1.85; p = 0.03, respectively).
Conclusions: HBV vaccine efficacy and immune response were satisfactory among north Iranian HCWs. Since it is predicted that anti-HBs levels decrease with aging, testing for anti-HBs titer is desirable for HCWs older than 50 years of age.
HCV related severe cryoglobulinemic vasculitis treated with plasma exchange and rituximab: case report and literature review
Authors: Arandjelovic Snezana , Bonaci-Nikolic Branka , Peric-Popadic Aleksandra , Tomic-Spiric Vesna , Bolpacic Jasna , Raskovic Sanvila , Andrejevic Sladjana 
Published: July 2017

Mixed cryoglobulinemia is the most prevalent extrahepatic manifestation of chronic HCV infection. It is usually a benign lymphoproliferative disorder which presents as vasculitis affecting different organs. Although life-threatening cryoglobulinemic vasculitis (CryoVas) is rare, it is sometimes the first and possibly lethal complication. Its treatment depends on the severity of vasculitis and can be challenging. High dose of corticosteroids, immunosuppressive agents and plasma exchange represent the first-line treatment, which should be followed by antiviral therapy. Rituximab is an effective and safe treatment option. However, the data about its use in life-threatening conditions are scarce. We report the case of a patient with severe, relapsing and life-threatening HCV-related CryoVas resistant to standard therapy who had had an initial beneficial response to rituximab added to plasma exchange that was later compromised by the development of sepsis. We also review the literature and discuss manifestations and therapy of life-threatening Cryovas with focus on rituximab use.
Occurrence and multilocus genotyping of Giardia duodenalis in pets and zoo animals in Shanghai, China
Authors: Liu Hua , Shen Yujuan , Liu Aiqin , Yin Jianhai , Yuan Zhongying , Jiang Yanyan , Pan Wei , Zhang Yumei , Zhao Wei , Cao Jianping 
Published: July 2017

Introduction: High prevalence of Giardia infections occurs in humans and animals, partly because of the increasing numbers of pets. We determined the presence and genotypes of G. duodenalis in pets and zoo animals.
Methodology: A total of 84 specimens were collected from dogs and cats from a pet hospital, and 54 specimens from a zoo, which included deer, tigers, yaks, and others. All the specimens were examined by microscopy and by polymerase chain reaction (PCR) amplification and subsequent sequencing of glutamate dehydrogenase (gdh), beta-giardin (bg), and triose phosphate isomerase (tpi) genes.
Results: Giardia infection was confirmed in 5.95% and 15.48% of animals by microscopy and by PCR, respectively; the detection levels were 13.33% and 26.67% for pets, and 1.85% and 9.26% for zoo animals. Four assemblages were identified: assemblage C in dogs, cats, and a sheep; D in dogs, a wolf, a yak, and a leopard; E in a sheep; and F in a cat and a leopard. PCR gave the highest amplification rate at the gdh locus. Eight, five, and four sequences were novel at the gdh, bg, and tpi loci, respectively. Two tpi sequences of dog-derived assemblage C had 100% homology with amino acid sequences from human-derived isolates.
Conclusions: The molecular characterization of G. duodenalis in pets and zoo animals in China is described. Assemblage D was identified in a yak and a leopard for the first time. Multilocus genotyping analysis identified the same tpi gene sequences of assemblage C in dogs and humans, indicating potential zoonotic transmission.
Clinical manifestations and treatment outcomes of scrub typhus in a rural health care facility on the Thailand-Myanmar border
Authors: Brummaier Tobias , Kittitrakul Chatporn , Choovichian Vorada , Lawpoolsri Saranath , Namaik-larp Chayadol , Wattanagoon Yupaporn 
Published: July 2017

Introduction: Scrub typhus is endemic in rural Southeast Asia. The district of Umphang in northwestern Thailand is a prototype environment for this disease. We report the clinical manifestations and outcomes of patients diagnosed with scrub typhus in this area.
Methodology: Patients diagnosed with scrub typhus between 2011 and 2014 were analyzed. Diagnosis was based on clinical symptoms in conjunction with a positive rapid test or a pathognomonic eschar lesion.
Results: A total of 857 patients were included, of which 488 were adults and 369 were children. Most patients (728; 84.9%) were included via a positive serology on rapid test, 86 patients (10.0%) had eschar only, and 43 patients (5.0%) had both sero-confirmation and presence of eschar. The most common symptom was fever (93.8%), followed by headache (48.1%) and cough (33.1%). Eschars were reported in 129 patients, with a significantly higher percentage in children (p < 0.001), and a different anatomical distribution was found when adults and children were compared. Common complications were elevated transaminases, acute kidney injury, and pneumonia. Most patients recovered from the disease.
Conclusions: Scrub typhus in Umphang district is common. Patients can present with a variety of clinical symptoms, regardless of the presence of fever. Standard treatment led to a favorable outcome in most patients.
Prevalence, resistance, and extended-spectrum beta-lactamases among Salmonella from patients in northeast China
Authors: Zhang Zhijie , Wang Xingning , Li Ruihua , Xue Wencheng , Zhai Rubo , Liu Liwen , Liu Yong , Jin Hong 
Published: July 2017

Introduction: Salmonella is an important infection in Liaoning Province. Serotype and resistance levels are poorly studied. Knowledge of cephalosporin-resistant genes is needed to provide information to support the clinical diagnosis and to guide therapy.
Methodology: A total of 172 isolates were collected from January 2009 to March 2014. Resistance to cephalosporin, fluoroquinolones, and other conventional first-line antibiotics was detected using the disk diffusion and agar dilution methods. The relatedness of isolates with the same serotype was analyzed by pulsed-field gel electrophoresis (PFGE). Genes encoding extended-spectrum β-lactamase enzymes (blaCTX-M, blaTEM, blaSHV, and blaOXA) were identified by polymerase chain reaction (PCR) and sequencing in cephalosporin-resistant strains.
Results: S. Enteritidis, 1,4,[5],12:i:-, and S .Typhimurium were the most common serotypes. The resistance rate of Salmonella to conventional first-line antibiotics sulfamethoxazole-trimethoprim, tetracycline, chloramphenicol, and ampicillin was 21%,33%,37%, and 55%,respectively. To fluoroquinolones (gatixacin, levofloxacin, and ciprofloxacin), the resistance rates were 7%,18%, and 23%, respectively, whereas for extended-spectrum cephalosporins(ceftazidime, cefepime, and ceftriaxone), there sistance rates were 4%,8%, and 9%. In total, 14blaCTX-M, 14 blaTEM-1, and 1blaOXA-1 were found in 15 Salmonella isolates resistant to cephalosporin. No blaSHVwas detected. The blaCTX-M-55 gene was the most frequently encountered gene. The blaCTX-M-65 gene from S. Enteritidis is described for first time in Salmonella from humans. Results of PFGE indicated strong similarity among Salmonella isolates in Liaoning Province.
Conclusions: Extended-spectrum cephalosporins are the first choice for the treatment of infection with Salmonella, but blaCTX-M-encoded resistance, including blaCTX-M-65, is present.
Sex and Gender Interactions in the Lives of Patients with Spondyloarthritis in Spain: A Quantitative-qualitative Study
Authors: Blasco-Blasco Mar , Ruiz-Cantero María Teresa , Juárez-Herrera y Cairo Lucero Aida , Jovaní Vega , Pascual Eliseo 
Published: July 2017

Objective.To illustrate the experiences and contextual support perceived by men and women with spondyloarthritis (SpA) in relation to their demanding productive and reproductive roles.Methods.A quantitative-qualitative study of 96 men and 54 women with SpA was conducted at the Alicante University General Hospital, in a Spanish Mediterranean city, from March 2013 to February 2014. Descriptive and qualitative content analyses compared working lives and family/partner relationships of male and female patients.Results.Working life: both women (55.6%) and men (51.04%) were similarly affected, but women had worse disease activity (5.4 vs 4.0, p = 0.01) and less antitumor necrosis factor-α therapy (56.7% vs 77.6%, p < 0.05). Different patterns were found by gender: women mostly practiced presenteeism whereas men practiced absenteeism, women took antiinflammatories prior to work and men after work, employers suggested more frequently the beneficial actions for men, and some women withdrew permanently from the labor market. Family/partner relationships: women were more affected (57.4%) than men (41.7%), with worse results for diagnostic delay (11.2 vs 6.4 yrs, p = 0.02), disease activity (5.8 vs 3.6, p < 0.001), and physical function (5.2 vs 3.8, p = 0.02). Gender role conflicts emerged, with women developing strategies to face compulsory housework whereas men avoided them; women regretted neglecting their children and men not sharing leisure activities with them.Conclusion.Our study highlights the vital complexity in which patients with SpA are immersed, especially for women in a country where a mix of new and traditional gender roles coexist. Awareness of its existence is crucial when professionals strive to provide healthcare focused on their well-being in addition to medical therapy.
Dietrich Bonhoeffer e a teologia pública no Brasil
Authors: Leal Jair Souza 
Published: July 2017

<p>Book Review: </p><p>CALDAS, Carlos. <strong>Dietrich Bonhoeffer e a teologia pública no Brasil</strong>. São Paulo: Garimpo Editorial, 2016. 221 p.</p><p>ISBN 978-85-62877-76-6 </p>
A systematic review and meta-analysis on the incubation period of Campylobacteriosis
Authors: AWOFISAYO-OKUYELU A. , HALL I. , ADAK G. , HAWKER J.I. , ABBOTT S. , McCARTHY N. 
Published: July 2017

AbstractAccurate knowledge of pathogen incubation period is essential to inform public health policies and implement interventions that contribute to the reduction of burden of disease. The incubation period distribution of campylobacteriosis is currently unknown with several sources reporting different times. Variation in the distribution could be expected due to host, transmission vehicle, and organism characteristics, however, the extent of this variation and influencing factors are unclear. The authors have undertaken a systematic review of published literature of outbreak studies with well-defined point source exposures and human experimental studies to estimate the distribution of incubation period and also identify and explain the variation in the distribution between studies. We tested for heterogeneity using I2 and Kolmogorov–Smirnov tests, regressed incubation period against possible explanatory factors, and used hierarchical clustering analysis to define subgroups of studies without evidence of heterogeneity. The mean incubation period of subgroups ranged from 2·5 to 4·3 days. We observed variation in the distribution of incubation period between studies that was not due to chance. A significant association between the mean incubation period and age distribution was observed with outbreaks involving only children reporting an incubation of 1·29 days longer when compared with outbreaks involving other age groups.
Attitudes of palliative care clinical staff toward prolonged grief disorder diagnosis and grief interventions
Authors: Davis Esther L. , Deane Frank P. , Barclay Gregory D. , Bourne Joan , Connolly Vivienne 
Published: July 2017

ABSTRACTObjective:The provision of psychological support to caregivers is an important part of the role of the clinical staff working in palliative care. Staff knowledge and attitudes may determine their openness to referring caregivers to a psychological intervention. We recently developed a self-help intervention for grief and psychological distress among caregivers and were interested in exploring the extent to which staff knowledge and attitudes might affect future implementation. The aims of our study were to: (1) examine the acceptability of self-help psychological intervention for caregivers among palliative care clinical staff; (2) examine potential attitudinal barriers toward prolonged grief disorder (PGD) as a diagnosis and interventions for grief; and (3) bolster staff confidence in skills and knowledge in identifying and managing caregiver psychological distress.Method:An anonymous survey was distributed among clinical staff at two inpatient units and two community health services that assessed the acceptability of self-help interventions for caregivers, attitudes about PGD diagnosis and grief intervention, and staff confidence in skills and knowledge in assessing caregiver psychological distress.Results:Overall, clinical staff were positively oriented toward self-help for caregivers and intervention for grief. They were also basically confident in their skills and knowledge. While it was positive PGD attitudes that were associated with acceptability of self-help for caregivers, it was both positive and negative PGD attitudes that were associated more specifically with a willingness to refer caregivers to such an intervention.Significance of results:Our findings are useful in highlighting the issues to be considered in the implementation of a self-help intervention within the healthcare service. Clinical staff seemed positively oriented toward engaging with a psychological intervention for caregivers and likely to act as key allies in implementation.
Young people's perspectives on open communication between family members when a parent is dying
Authors: Turner Nicola 
Published: July 2017

ABSTRACTObjective:Living with a parent who is approaching the end of life is profoundly troubling for young people. Research indicates that family communication about life-limiting parental illness can influence how young people manage living with dying. In particular, open communication between family members has been shown to be helpful. This paper reports on a study of young people's experiences of family interaction when a parent is dying and considers the practice of open communication in the context of young people's involvement in giving and receiving family care.Methods:A narrative approach was employed based on in-depth semistructured interviews with 10 young people (aged 13–21) living with a parent thought to be in the last year of life.Results:Young people's attitudes toward open communication between family members were more ambivalent and ambiguous than previous research suggests. Parental attempts at open communication were sometimes overlooked by young people, indicating that there may be differences between knowledge given and young people's acknowledgment of sensitive information. Some young people valued open communication as a signifier of the close relationships between family members, while others wanted to exercise more control over what they knew, when, and how. Young people's accounts challenged the positioning of young people as passive recipients of information. Young people were active in shaping family communication in their everyday lives, and deliberative acts of speaking or remaining silent were one way in which young people exercised care for themselves and others.Significance of Results:This study extends research on communication within families when a parent has a life-limiting illness and suggests that supporting young people's agency in determining how they receive information may be more beneficial than promoting open communication between family members.
Construing International Climate Change Law as a Compliance Regime
Authors: Mayer Benoit 
Published: July 2017

AbstractUnder the no-harm principle, states must prevent activities within their jurisdiction from causing extraterritorial environmental harm. It has been argued elsewhere that excessive greenhouse gas emissions (GHG) from industrial states constitute a breach of this principle and instigate state responsibility. Yet, the relevance of general international law for climate change does not obviate a need for more specific international climate change agreements. This article argues that the climate regime is broadly compatible with general norms. It can, furthermore, address a gap in compliance with general international law – namely, the systematic failure of industrial states to cease excessive GHG emissions and to provide adequate reparations. As a compliance regime, the international climate change law regime defines global ambition and national commitments and initiates multiple processes to raise awareness, set political agendas, and progressively build momentum for states to comply with their obligations under general international law.
The Role of Muscle Imaging in the Diagnosis and Assessment of Children with Genetic Muscle Disease
Authors: Warman Chardon Jodi , Straub Volker 
Published: July 2017

AbstractMuscle magnetic resonance imaging (MRI) and ultrasound (US) are emerging tools to assist in the diagnosis of children with genetic muscle disease. Increasing number of studies demonstrate that these imaging techniques can identify selective patterns of muscle atrophy, fatty degeneration, and muscle edema that help to distinguish between different early-onset genetic myopathies and muscular dystrophies. Recognizing patterns of pathology by muscle imaging can help to guide genetic testing and avoid the more invasive procedure of a muscle biopsy. Conversely, since massive parallel sequencing is now more commonly used as the initial step in diagnostic testing, imaging techniques can help to confirm or exclude if a variant of uncertain significance is indeed disease causing and compatible with a pattern of pathology as detected by muscle imaging. Whereas for diagnostic purposes and pattern recognition, muscle pathology does not need to be quantified, measuring disease progression is increasingly supported by quantitative muscle imaging, which is critical given the recent increment in rare disease therapeutic trials. Here, we discuss the value of muscle imaging techniques in pediatric muscle disease and summarize data identifying specific patterns of involvement in muscle MRI and US in some of the more common genetic myopathies and muscular dystrophies.
Emergence of Ceftazidime-Avibactam Resistance and Restoration of Carbapenem Susceptibility in Klebsiella pneumoniae Carbapenemase-Producing K pneumoniae: A Case Report and Review of Literature
Authors: Shields Ryan K. , Nguyen M. Hong , Press Ellen G. , Chen Liang , Kreiswirth Barry N. , Clancy Cornelius J. 
Published: July 2017

Abstract
We used meropenem to successfully treat a patient with bacteremia due to ceftazidime-avibactam-resistant, meropenem- susceptible Klebsiella pneumoniae that carried mutant blaKPC-3. Meropenem was bactericidal against ceftazidime-avibactam- resistant K pneumoniae isolates in vitro. Nevertheless, the role of carbapenems in treating such infections remains uncertain, because meropenem resistance is selected readily during passage experiments.
uvCLAP: a fast, non-radioactive method to identifyin vivotargets of RNA-binding proteins
Authors: Maticzka Daniel , Ilik Ibrahim Avsar , Aktas Tugce , Backofen Rolf , Akhtar Asifa 
Published: July 2017

AbstractRNA-binding proteins (RBPs) play important and essential roles in eukaryotic gene expression regulating splicing, localization, translation and stability of mRNAs. Understanding the exact contribution of RBPs to gene regulation is crucial as many RBPs are frequently mis-regulated in several neurological diseases and certain cancers. While recently developed techniques provide binding sites of RBPs, they are labor-intensive and generally rely on radioactive labeling of RNA. With more than 1,000 RBPs in a human cell, it is imperative to develop easy, robust, reproducible and high-throughput methods to determine in vivo targets of RBPs. To address these issues we developed uvCLAP (UV crosslinking and affinity purification) as a robust, reproducible method to measure RNA-protein interactionsin vivo. To test its performance and applicability we investigated binding of 15 RBPs from fly, mouse and human cells. We show that uvCLAP generates reliable and comparable data to other methods. Unexpectedly, our results show that despite their different subcellular localizations, STAR proteins (KHDRBS1-3, QKI) bind to a similar RNA motifin vivo. Consistently a point mutation (KHDRBS1Y440F) or a natural splice isoform (QKI-6) that changes the respective RBP subcellular localization, dramatically alters target selection without changing the targeted RNA motif. Combined with the knowledge that RBPs can compete and cooperate for binding sites, our data shows that compartmentalization of RBPs can be used as an elegant means to generate RNA target specificity.