bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the prevalence of malnutrition in chronic kidney disease patients undergoing hemodialysis in Kushtia District, Bangladesh
Authors: Reza Hasan Mahfuz , Shuvo Suvasish Das , Ahmad Tanvir 
Published: January 2018

PurposeThe purpose of this study is to evaluate the nutritional status of patients with end-stage kidney disease undergoing hemodialysis.Design/methodology/approachEnd-stage renal failure outpatients on hemodialysis were selected using simple random sampling technique from the dialysis unit of Sono Hospital Limited, Kushtia, Bangladesh. The nutritional status of 142 participant, of age 18-65 years, was screened. A direct method of nutritional assessment including anthropometric measurement, biochemical measurement, clinical assessment and dietary method was conducted. A logistic regression was applied to estimate the prevalence of malnutrition in hemodialysis patients.FindingsIn total 69.0 per cent participants were men and 31.0 per cent were women, whereas about 65.5 and 16.9 per cent patients of this study had a BMI of less than 23 kg/m2and 18.5 kg/m2(p< 0.05) where malnutrition was significantly prevalent. Mean ± SD hemoglobin level of both men and women participants was below the normal level which might increase the risk of malnutrition (p< 0.05). Of the total number of participants, 97.2 per cent were anemic, 66.9 per cent had anorexia, 63.4 per cent complained of nausea, 58.5 per cent complained of vomiting and 26.1 per cent complained of diarrhea, factors that can increase the risk of malnutrition in hemodialysis patients (p< 0.05). The creatinine and urea levels were higher in both men and women participants (p< 0.05). Results show significant difference in albumin levels among men and women (p< 0.05). The bicarbonate level was lower in both men and women, and the participants were suffering from metabolic acidosis (p< 0.05). About 87.3 per cent participants were taking inadequate amounts of protein which was a significant risk factor of malnutrition in hemodialysis patients (p< 0.01).Originality/valueThe result shows that renal failure is prevalent more in men than in women. The majority of patients on hemodialysis were at a risk of malnutrition including being underweight. Most of the patients were anemic. Malnutrition is related to low nutrient intake.
A comparative study on registration system of real estate between Hong Kong and Mainland China
Authors: Wang Hao , Wei Shuyan , Tang Bo-sin , Chen Junhua , Li Wenbin 
Published: January 2018

Purpose
The purpose of this paper is to review land/real estate registration practice in Hong Kong, and make an in-depth comparison with Mainland China and finally provide helpful suggestions for the government.

Design/methodology/approach
Research methods including document analysis/review and comparative study are used in this paper.

Findings
The main findings focus on the problems existing in the mainland, including narrow query subject, single way of query, limited query time, and lacking of incentive mechanism. Helpful suggestions for real estate registration system in Mainland China are offered based on the comparative study.

Practical implications
The unified registration system can improve the efficiency of administrative institutions to ensure an open and transparent environment of property right registration, which helps prevent the relevant departments from abusing administrative power and harming the interests of obligees. The findings of this research can serve as a useful reference for policy makers to improve the unified registration system in China.

Originality/value
The registration system/mechanism determines the efficiency and effectiveness of real estate/land market. However, land registration and query in some countries such as Mainland China have institutional problems which hinder the sustained and healthy development of the real estate industry. The value of this paper is to propose constructive suggestions for such countries/regions by comparing and learning from a good model.
Assessing determinants of PPP project performance
Authors: Swamy Raghu Rama D.T.V. , Tiwari Piyush , Sawhney Anil 
Published: January 2018

Purpose
The purpose of this paper is to understand the factors that affect the performance of projects being implemented on the public-private partnership (PPP) framework, with specific reference to urban drinking water sector in India.

Design/methodology/approach
A listing of factors that have a bearing on project performance have been developed based on a review of the literature. Through a survey, seven factors that are relevant to the Indian context were determined. Interviews were then conducted across a cross-section of government agencies, financial institutions, development agencies, private sector entities and consultants to understand the relative importance of these attributes. The analytical hierarchy process was used to develop relative weights of these factors.

Findings
Ranking and relative weights of the factors in descending order are stakeholder consent and support for water PPP projects (22.1 percent), appropriate project structure (17.4 percent), availability of realistic baseline information (16.2 percent), reasonable water tariffs (13.9 percent), public sector capacity (13.0 percent), well-developed market (9.5 percent) and water sector regulator (7.9 percent). Differences in perceptions amongst various stakeholder groups were also found.

Research limitations/implications
Water sector has not matured, and with the advent of newer formats of implementation models, there could be significant changes in the sector. As the number of projects available for study is limited, this exercise can be undertaken periodically and updated in relation to experiences in other infrastructure sectors.

Practical implications
This analysis provides inputs to policymakers and project proponents for structuring more sustainable urban drinking water PPP projects.

Originality/value
Indian infrastructure PPP market is attracting increased attention from researchers, though not much emphasis is being given to urban drinking water sector. This paper aims to contribute toward filling this research gap.
Molecular Epidemiology of Emerging
bla
OXA-23-Like
- and
bla
OXA-24-Like
-Carrying Acinetobacter baumannii in Taiwan
Authors: Kuo Shu-Chen , Huang Wei-Cheng , Huang Tzu-Wen , Wang Hui-Ying , Lai Jui-Fen , Chen Te-Li , Lauderdale Tsai-Ling 
Published: January 2018

ABSTRACT

The rate of recovery of carbapenem-resistant
Acinetobacter baumannii
(CRAB) isolates has increased significantly in recent decades in Taiwan. This study investigated the molecular epidemiology of CRAB with a focus on the mechanisms of resistance and spread in isolates with
bla
OXA-23-like
or
bla
OXA-24-like
. All 555 CRAB isolates in our multicenter collection, which were recovered from 2002 to 2010, were tested for the presence of class A, B, and D carbapenemase genes. All isolates with
bla
OXA-23-like
or
bla
OXA-24-like
were subjected to pulsed-field gel electrophoresis, and 82 isolates (60 isolates with
bla
OXA-23-like
and 22 isolates with
bla
OXA-24-like
) were selected for multilocus sequence typing to determine the sequence type (ST) and clonal group (CG) and for detection of additional β-lactamase and aminoglycoside resistance genes. The flanking regions of carbapenem and aminoglycoside resistance genes were identified by PCR mapping and sequencing. The localization of
bla
OXA
was determined by S1 nuclease and I-CeuI assays. The numbers of CRAB isolates carrying
bla
OXA-23-like
or
bla
OXA-24-like
, especially those carrying
bla
OXA-23-like
, increased significantly from 2008 onward. The
bla
OXA-23-like
gene was carried by antibiotic resistance genomic island 1 (AbGRI1)-type structures located on plasmids and/or the chromosome in isolates of different STs (CG92 and novel CG786), whereas
bla
OXA-24-like
was carried on plasmids in CRAB isolates of limited STs (CG92). No class A or B carbapenemase genes were identified. Multiple aminoglycoside resistance genes coexisted in CRAB. Tn
6180
-borne
armA
was found in 74 (90.2%) CRAB isolates, and 58 (70.7%) isolates had Tn
6179
upstream, constituting AbGRI3.
bla
TEM
was present in 38 (46.3%) of the CRAB isolates tested, with 35 (92.1%) isolates containing
bla
TEM
in AbGRI2-type structures, and 61% of
ampC
genes had IS
Aba1
upstream. We conclude that the dissemination and spread of a few dominant lineages of CRAB containing various resistance island structures occurred in Taiwan.
Population Pharmacokinetics of Polymyxin B in Acutely Ill Adult Patients
Authors: Miglis Cristina , Rhodes Nathaniel J. , Avedissian Sean N. , Kubin Christine J. , Yin Michael T. , Nelson Brian C. , Pai Manjunath P. , Scheetz Marc H. 
Published: January 2018

ABSTRACT

Polymyxin B (PB) has reemerged as a common treatment against multidrug-resistant Gram-negative pathogens. However, nephrotoxicity remains a significant dose-limiting side effect, and contemporary pharmacokinetic (PK) data are limited. This study sought to evaluate PB exposure differences in various loading and nonloading strategies according to total body weight (TBW) and adjusted body weight (ABW). Patients treated with PB had plasma samples obtained for clinical care and analyzed using liquid chromatography-tandem mass spectrometry. Compartmental PK models with linear and allometric scaling of TBW were explored. Semiparametric Monte Carlo simulation evaluated the total (i.e., protein bound plus unbound) area under the plasma concentration-time curve (AUC
total
) during the first 24 h of therapy and at 96 h posttherapy for each regimen at the 10th, 50th, and 90th percentiles of TBW and ABW in the derivation cohort. Literature-based values of the 24-h total AUC/MIC ratio (AUC/MIC
total
) of ≥50 defined efficacy, and literature-based values of the 72- to 96-h AUC
total
of ≥100 μg · h/ml defined toxicity. Fifty-two patients contributed 156 PB plasma samples. A two-compartment model with allometric scaling of TBW produced a comparable fit (Akaike information criterion [AIC] = 376.7) to that achieved with linear scaling (AIC = 378). The regimen of a loading dose of 2.5 mg/kg of body weight plus a fixed dose of 100 mg every 12 h had the highest probability of achieving a 24-h AUC/MIC
total
of ≥50 with the lowest probability of toxicity in all groups at 24 h, aside from those with the lowest 10th percentile of body weight. This is the first study to suggest that a weight-based loading and fixed maintenance (i.e., weight-independent) dosing strategy for polymyxin B may maximize efficacy while balancing toxicity concerns for most patients.
Deletion of
ADA2
Increases Antifungal Drug Susceptibility and Virulence in Candida glabrata
Authors: Yu Shang-Jie , Chang Ya-Lin , Chen Ying-Lien 
Published: January 2018

ABSTRACT

Candida glabrata
, the second most frequent cause of candidiasis after
Candida albicans
, is an emerging human fungal pathogen that is intrinsically drug tolerant. Currently, studies of
C. glabrata
genes involved in drug tolerance are limited. Ada2, a component serving as a transcription adaptor of the Spt-Ada-Gcn5 acetyltransferase (SAGA) complex, is required for antifungal drug tolerance and virulence in
C. albicans
. However, its roles in
C. glabrata
remain elusive. In this study, we found that
ada2
mutants demonstrated severe growth defects at 40°C but only mild defects at 37°C or 25°C. In addition,
C. glabrata ada2
mutants exhibited pleiotropic phenotypes, including susceptibility to three classes of antifungal drugs (i.e., azoles, echinocandins, and polyenes) and cell wall-perturbing agents but resistance to the endoplasmic reticulum stressor tunicamycin. According to RNA sequence analysis, the expression of 43 genes was downregulated and the expression of 442 genes was upregulated in the
ada2
mutant compared to their expression in the wild type.
C. glabrata ADA2
, along with its downstream target
ERG6
, controls antifungal drug tolerance and cell wall integrity. Surprisingly,
ada2
mutants were hypervirulent in a murine model of systemic infection, possibly due to the upregulation of multiple adhesin-like genes, increased agar invasion, and overstimulation of murine tumor necrosis factor alpha production.
Metals and Methanotrophy
Authors: Semrau Jeremy D. , DiSpirito Alan A. , Gu Wenyu , Yoon Sukhwan 
Published: January 2018

ABSTRACT
Aerobic methanotrophs have long been known to play a critical role in the global carbon cycle, being capable of converting methane to biomass and carbon dioxide. Interestingly, these microbes exhibit great sensitivity to copper and rare-earth elements, with the expression of key genes involved in the central pathway of methane oxidation controlled by the availability of these metals. That is, these microbes have a “copper switch” that controls the expression of alternative methane monooxygenases and a “rare-earth element switch” that controls the expression of alternative methanol dehydrogenases. Further, it has been recently shown that some methanotrophs can detoxify inorganic mercury and demethylate methylmercury; this finding is remarkable, as the canonical organomercurial lyase does not exist in these methanotrophs, indicating that a novel mechanism is involved in methylmercury demethylation. Here, we review recent findings on methanotrophic interactions with metals, with a particular focus on these metal switches and the mechanisms used by methanotrophs to bind and sequester metals.
Mycoplasma bovis-Induced Inhibition of Bovine Peripheral Blood Mononuclear Cell Proliferation Is Ameliorated after Blocking the Immune-Inhibitory Programmed Death 1 Receptor
Authors: Suleman Muhammad , Cyprian Farhan S. , Jimbo Steve , Maina Teresia , Prysliak Tracy , Windeyer Claire , Perez-Casal Jose 
Published: January 2018

ABSTRACT

Mycoplasma bovis
-induced immune suppression is a major obstacle faced by the host for controlling infections.
M. bovis
impairment of antigen-specific T-cell responses is achieved through inhibiting the proliferation of peripheral blood mononuclear cells (PBMCs). This impairment may contribute to the persistence of
M. bovis
infection in various sites, including lungs, and its systemic spread to various organs such as joints, with the underlying mechanisms remaining elusive. Here, we elucidated the role of the immune-inhibitory receptor programmed death 1 (PD-1) and its ligand (PD-L1) in
M. bovis
infection. Flow cytometry (FCM) analyses revealed an upregulation of PD-L1 expression on tracheal and lung epithelial cell lines after
M. bovis
infection. In addition, we found increased PD-L1 expression on purified lung lavage macrophages following
M. bovis
infection by FCM and determined its localization by immunofluorescence analysis comparing infected and control lung tissue sections. Moreover,
M. bovis
infection increased the expression of the PD-1 receptor on total PBMCs and in gated CD4
+
and CD8
+
T-cell subpopulations. We demonstrated that
M. bovis
infection induced a significant decrease in CD4
+
PD-1
INT
and CD8
+
PD-1
INT
subsets with intermediate PD-1 expression, which functioned as progenitor pools giving rise to CD4
+
PD-1
HIGH
and CD8
+
PD-1
HIGH
subsets with high PD-1 expression levels. We blocked PD-1 receptors on PBMCs using anti-PD-1 antibody at the beginning of infection, leading to a significant restoration of the proliferation of PBMCs. Taken together, our data indicate a significant involvement of the PD-1/PD-L1 inhibitory pathway during
M. bovis
infection and its associated immune exhaustion, culminating in impaired host immune responses.
Evaluation of Simplexa Group A Strep Direct Kit Compared to Hologic Group A Streptococcal Direct Assay for Detection of Group A Streptococcus in Throat Swabs
Authors: Church Deirdre L. , Lloyd Tracie , Larios Oscar , Gregson Daniel B. 
Published: January 2018

ABSTRACT

Diagnosis of bacterial pharyngitis is confirmed by detection of group A
Streptococcus
(GAS) in patient throat samples. Testing of throat samples has historically relied on culture, but new molecular methods allow much faster test turnaround time (i.e., same day versus 48 to 72 h for culture). Our laboratory uses the Hologic GAS Direct (GASD) assay for screening more than 125,000 throat samples per year. Simplexa GAS Direct is a new real-time quantitative PCR (qPCR) assay that does not require initial DNA extraction. Performance of Simplexa qPCR was compared to GASD. A total of 289 throat swabs were collected from patients attending ambulatory clinics in Calgary, Alberta, Canada. A total of 60 (20.8%) of the samples were initially GAS positive by either method: 54 by both methods, 4 by Simplex qPCR alone, and 2 by GASD alone. An in-house PCR using a unique GAS primer set was used to resolve the 6 discrepant results. Overall, GASD compared to Simplexa qPCR had a sensitivity, specificity, positive predictive value, and negative predictive value of 93.1% versus 100%, 100% versus 100%, 100% versus 100%, and 98.31% versus 100%, respectively. Implementation of Simplexa qPCR in our laboratory setting would cost more but allow the high sample volume to be reported in half the time and save 0.62 medical laboratory technician (MLT) full-time equivalent (FTE). In comparison to culture, the implementation of Simplexa qPCR would save 2.79 medical laboratory assistant (MLA) FTE plus 0.94 MLT FTE. Simplexa qPCR has improved performance and diagnostic efficiency in a high-volume laboratory compared to GASD for GAS detection in throat swabs.
Direct-from-Blood-Culture Disk Diffusion To Determine Antimicrobial Susceptibility of Gram-Negative Bacteria: Preliminary Report from the Clinical and Laboratory Standards Institute Methods Development and Standardization Working Group
Authors: Chandrasekaran Sukantha , Abbott April , Campeau Shelley , Zimmer Barbara L. , Weinstein Melvin , Thrupp Lauri , Hejna John , Walker Lindsey , Ammann Tracy , Kirn Thomas , Patel Robin , Humphries Romney M. 
Published: January 2018

ABSTRACT

The performance of a disk diffusion test using broth from positive blood cultures as inoculum (direct disk diffusion [dDD]) was evaluated for a collection of 20 challenge isolates of
Enterobacteriaceae
,
Acinetobacter baumannii
, and
Pseudomonas aeruginosa
. Isolates seeded into human blood were inoculated into Bactec Plus Aerobic/F, VersaTREK Redox 1, and BacT/Alert FA Plus bottles and incubated in the respective automated blood culture systems. Disk diffusion results were compared to reference disk diffusion results. Categorical agreement (CA) values for dDD, after removal of random errors due to natural MIC variation, were 87.8%, 88.4%, and 92.2% for the BacT/Alert, Bactec, and VersaTREK systems, respectively. No very major errors (VME) were observed, and major error (ME) rates were 3.0%, 2.3%, and 1.7%, respectively. Incubation of the dDD test samples for 6 h compared to incubation for 16 to 18 h resulted in 19.9% of tests having too light of growth to allow reading of zones of inhibition. Among the evaluable dDD tests, CA values were 58.9%, 76.6%, and 73.2% for the isolates seeded into the BacT/Alert, Bactec, and VersaTREK systems, respectively. VME rates for isolates seeded into these systems were 2.2%, 1.8%, and 3.0%, respectively, and ME rates were 25.4%, 6.1%, and 2.8%, respectively, at the 6-h reading. The best performance of dDD was found for blood cultures with bacterial concentrations in the range of 7.6 × 10
7
to 5.0 × 10
8
CFU/ml; CA values ranged from 94.7 to 96.2% for these concentrations after 18 h of incubation and from 76.9 to 84.1% after 6 h of incubation. These preliminary data demonstrate the potential accuracy of dDD testing by the clinical laboratory.
False-Positive Xpert MTB/RIF Results in Retested Patients with Previous Tuberculosis: Frequency, Profile, and Prospective Clinical Outcomes
Authors: Theron Grant , Venter Rouxjeane , Smith Liezel , Esmail Aliasgar , Randall Philippa , Sood Vishesh , Oelfese Suzette , Calligaro Greg , Warren Robin , Dheda Keertan 
Published: January 2018

ABSTRACT

Globally, Xpert MTB/RIF (Xpert) is the most widely used PCR test for the diagnosis of tuberculosis (TB). Positive results in previously treated patients, which are due to old DNA or active disease, are a diagnostic dilemma. We prospectively retested sputum from 238 patients, irrespective of current symptoms, who were previously diagnosed to be Xpert positive and treated successfully. Patients who retested as Xpert positive and culture negative were exhaustively investigated (repeat culture, chest radiography, bronchoscopy with bronchoalveolar lavage, long-term clinical follow-up). We evaluated whether the duration since previous treatment completion, mycobacterial burden (the Xpert cycle threshold [

C
T

] value), and reclassification of Xpert-positive results with a very low semiquantitation level to Xpert-negative results reduced the rate of false positivity. A total of 229/238 (96%) of patients were culture negative. Sixteen of 229 (7%) were Xpert positive a median of 11 months (interquartile range, 5 to 19 months) after treatment completion. The specificity was 93% (95% confidence interval [CI], 89 to 96%). Nine of 15 (40%) Xpert-positive, culture-negative patients reverted to Xpert negative after 2 to 3 months (1 patient declined further participation). Patients with false-positive Xpert results had a lower mycobacterial burden than patients with true-positive Xpert results (

C
T

, 28.7 [95% CI, 27.2 to 30.4] versus 17.6 [95% CI, 16.9 to 18.2];
P
< 0.001), an increased likelihood of a chest radiograph not compatible with active TB (5/15 patients versus 0/5 patients;
P
= 0.026), and less-viscous sputum (15/16 patients versus 2/5 patients whose sputum was graded as mucoid or less;
P
= 0.038). All patients who initially retested as Xpert positive and culture negative (“Xpert false positive”) were clinically well without treatment after follow-up. The duration since the previous treatment poorly predicted false-positive results (a duration of ≤2 years identified only 66% of patients with false-positive results). Reclassifying Xpert-positive results with a very low semiquantitation level to Xpert negative improved the specificity (+3% [95% CI, +2 to +5%]) but reduced the sensitivity (−10% [95% CI, −4 to −15%]). Patients with previous TB retested with Xpert can have false-positive results and thus not require treatment. These data inform clinical practice by highlighting the challenges in interpreting Xpert-positive results, underscore the need for culture, and have implications for next-generation ultrasensitive tests.
Assessing the Burden of Clostridium difficile Infection in Low- and Middle-Income Countries
Authors: Roldan G. A. , Cui A. X. , Pollock N. R. 
Published: January 2018

ABSTRACT

In contrast to the significant resources invested in the diagnosis and prevention of
Clostridium difficile
infection (CDI) in resource-rich settings, in resource-limited settings patients with community- and hospital-acquired diarrhea may not routinely be tested for CDI. Is CDI actually less frequent or severe in resource-limited settings, or might we be missing an important opportunity to prevent CDI-related morbidity and mortality (and to promote antibiotic stewardship) in these settings? Here, we review the literature to assess the overall burden of CDI in low- and middle-income countries.