bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Blood Stream Infections at a Level-1 Trauma Care Center of India
Authors: Mathur Purva , Varghese Prince , Tak Vibhor , Gunjiyal Jacinta , Lalwani Sanjeev , Kumar Subodh , Misra Mahesh C 
Published: March 2014

ABSTRACT
Purpose: Bloodstream infections (BSIs) are one of the major life-threatening infections in hospitals. They are responsible for prolonged hospital stays, high healthcare costs, and significant mortality. The epidemiology of BSIs varies between hospitals necessitating analysis of local trends. Few studies are available on trauma patients, who are predisposed due to the presence of multiple invasive devices.
Materials and Methods: A prospective surveillance of all BSIs was done at a level 1 trauma center from April, 2011 to March, 2012. All patients admitted to the different trauma intensive care units (ICUs) were monitored daily by attending physicians for subsequent development of nosocomial BSI. An episode of BSI was identified when patients presented with one or more of the following signs/symptoms, that is, fever, hypothermia, chills, or hypotension and at least one or more blood culture samples demonstrated growth of pathogenic bacteria. BSIs were further divided into primary and secondary BSIs as per the definitions of Center for Disease Control and Prevention. All patients developing nosocomial BSIs were followed till their final outcome.
Results: A total of 296 episodes of nosocomial BSIs were observed in 240 patients. A source of BSI was identified in 155 (52%) episodes. Ventilator-associated pneumonia was the most common source of secondary BSI. The most common organism was Acinetobacter sp. (21.5%). Candida sp. accounted for 12% of all blood stream organisms. A high prevalence of antimicrobial resistance was observed in Gram-negative and-positive pathogens.
Conclusions: Trauma patients had a high prevalence of BSIs. Since secondary bacteremia was more common, a targeted approach to prevention of individual infections would help in reducing the burden of BSIs.
Changing Trends of Vulvovaginal Candidiasis
Authors: Vijaya Doddaiah , Dhanalakshmi Tumkur Anjaneya , Kulkarni Sunanda 
Published: March 2014

ABSTRACT
Introduction: Vulvovaginal candidiasis is one of the most common infections seen in women.
Materials and Methods: A total of 300 symptomatic women were studied. High vaginal swabs collected from each patient were processed by Gram stain, culture on Sabourauds dextrose agar and CHROM agar plates. Isolates were identified and speciated using conventional methods and by the color of the colonies on the CHROM agar. Antifungal susceptibility was performed by disc diffusion method for fluconazole (25 μg) and voriconazole (1 μg) discs as per Clinical and Laboratory Standards Institute (CLSI) guidelines.
Results: Vulvovaginal candidiasis was found in 53 (17.7%) of cases. Gram stain was positive in 22 (41.41%) of culture positives. Speciation of isolates by conventional and CHROM agar methods showed similar results. C. albicans 35 (66.0%) was the most common species isolated followed by C. tropicalis 14 (26.4%), C. krusei 2 (3.8%), C. parapsilosis and C. glabrata in 1 (1.9%) case each. Sensitivity to fluconazole was found in 91.4% of C. albicans, 57.1% of C. tropicalis and 50.0% of C. krusei. Sensitivity to voriconazole was seen in 91.4% of C. albicans, 85.7% of C. tropicalis and 50.0% of C. krusei. C. parapsilosis and C. glabrata were found sensitive only to voriconazole.
Conclusion: CHROM agar has the advantage of being rapid, simple and cost effective method as compared to conventional methods in speciation of Candida. Routine susceptibility testing of Candida isolates help in selecting the most appropriate antifungal agent for vulvovaginal candidiasis.
Hospital Acquired Infections: Preventable Cause of Mortality in Spinal Cord Injury Patients
Authors: Lalwani Sanjeev , Punia Parul , Mathur Purva , Trikha Vivek , Satyarthee Gurudutta , Misra Mahesh C 
Published: March 2014

ABSTRACT
Background: There is an alarming rate of morbidity and mortality observed in the trauma victims who suffer spinal cord injuries (SCI). Such patients are admitted immediately and stay for longer periods of time and thus are at risk of acquiring nosocomial infections.
Aims: The aim of this study is to analyze the primary cause of mortality in SCI patients.
Design: Retrospective study.
Materials and Methods: We conducted a retrospective 4 year analysis of the postmortem data of 341 patients who died after sustaining SCI at a tertiary care apex trauma center of India. Epidemiological data of patients including the type of trauma, duration of hospital stay, cause of death and microbiological data were recorded.
Results: On autopsy, out of 341 patients, the main cause of death in the SCI patients was ascertained to be infection/septicemia in 180 (52.7%) patients, the rest 161 (47.2%) died due to severe primary injury. Respiratory tract infections (36.4%) were predominant followed by urinary tract infections (32.2%), blood stream infections (22.2%), wound infections (7.1%) and meningitis reported in only 5 (2.1%) cases. Acinetobacter sp (40%) was the predominant organism isolated, followed by Pseudomonas sp (16.3%), Klebsiella sp (15.1%), Candida sp (7.8%), Escherichia coli (6.9%), Staphylococcus aureus (6.9%), Proteus sp (3.3%), Enterobacter sp and Burkholderia sp (two cases each) and Stenotrophomonas sp (one case). A high level of multidrug resistance was observed.
Conclusions: Hospital acquired infections (HAI) are leading cause of loss of young lives in trauma patients; hence efforts should be made to prevent HAIs.
Thyroid Tuberculosis in a Child: A Rare Entity
Authors: Bodh Anita , Sharma Neelam , Negi Lalita , Chandel Suman S 
Published: March 2014

ABSTRACTThyroid tuberculosis is a rare disease even in countries where tuberculosis is endemic. Clinically tuberculosis is not often suspected in cases of thyroid nodule or swelling. We report a case of 11 years female child who presented with a thyroid swelling. Fine-needle aspiration cytology revealed caseating epithelioid granulomas and acid fast bacilli. Patient improved with antitubercular drugs. Tuberculosis may be considered as differential diagnosis of thyroid swelling.
A Unique Case of Diffuse Histiocytic Proliferations Mimicking Metastatic Clear Cell Carcinoma in the Hydrocele Sac
Authors: Chandanwale Shirish S , Vimal Shruti S , Rajpal Mohit , Mishra Neha 
Published: March 2014

ABSTRACTReactive histiocytic proliferations are extremely rare in paratesticular structures. Nodular histiocytic proliferations have been described in mesothelial-lined locations and only at few nonmesothelial sites. Diffuse histiocytic proliferations are described only in the pelvic peritoneum. We report the first case of diffuse histiocytic proliferation in the hydrocele sac of a 45-year-old man. Predominant histiocytes showed clear cytoplasm and signet ring-like change. Mucicarmin stain did not demonstrate mucin in the cytoplasm. Immunohistochemistry (IHC) staining showed nonspecific staining of these cells with carcinoembryonic antigen and negative staining with epithelial membrane antigen, pan-Cytokeratin, calretinin, cytokeratin 7, 20 and prostate-specific antigen. Strong diffuse cytoplasmic positivity for CD68 defined the mononuclear phagocyte nature of these cells. Diffuse histiocytic proliferations can occur in the hydrocele sac. Histochemical and IHC stainings are critical for accurate diagnosis and to avoid unnecessary surgery.
Angioleiomyoma of the Forearm
Authors: Dey Biswajit , Bharti Jyotsna Naresh , Gautam Parul , Kaushal Seema 
Published: March 2014

ABSTRACTAngioleiomyoma is a benign tumor of vascular smooth muscle origin. Although many factors have been implicated in its pathogenesis, presence of lipometaplasia suggests its hamartomatous nature. This tumor presents as a painful nodular mass in extremities. Thus angioleiomyoma should be considered as a differential diagnosis of any solitary painful mass of forearm. Herein we report a case of 37-years-old female presenting with a slow growing mass in the right forearm. Histopathological and immunohistochemical examination confirmed the diagnosis of angioleiomyoma.
Subcutaneous Mercury Injection by a Child: A Histopathology Case Report
Authors: Sukheeja Deepti , Kumar Pankaj , Singhal Maneesh , Subramanian Arulselvi 
Published: March 2014

ABSTRACTIntentional subcutaneous injection of mercury by mentally healthy children is rare. Usually, it is seen as a part of suicidal attempt in severely depressed patients or by athletes to enhance their performance. We report a case of a 15-year-old child, inspired by a movie, who deliberately self-injected mercury subcutaneously into his forearm that led to the formation of a non-healing ulcer. Histopathology of the biopsy confirmed the diagnosis. A surgical procedure was thereby performed to treat the ulcer and reduce the blood and urinary levels of mercury. However, the patient did not develop clinical signs of chronic poisoning, proving that subcutaneous mercury injection has a low risk of systemic toxicity, and that histopathology plays an important role in diagnosis.
Hymenolepis diminuta Infection in a Child from a Rural Area: A Rare Case Report
Authors: Tiwari Shreekant , Karuna Tadepalli , Rautaraya Bibhudutta 
Published: March 2014

ABSTRACTIn humans, infection with Hymenolepis diminuta is usually uncommon but has been reported from various areas of the world. Parasitization rates ranging between 0.001% and 5.5% have been reported according to different surveys. We report a rare case of H. diminuta infection in a 10-year-old female from the rural area of Kendrapada district of Odisha. The patient came to our pediatrics outpatient department with the chief complain of intermittent abdominal pain, anal pruritus and nocturnal restlessness. She responded well to praziquantel therapy.
Aspects culturels de la « reconnaissance » et de l’expérience canadienne-française
Authors: Gibson Andrew 
Published: March 2014

Cet article offre une analyse de la structure des liens sociaux de la « reconnaissance ». Il met l’accent sur l’aspect culturel de la reconnaissance au sein de la relation entre les Canadiens et les Canadiennes de langue anglaise et leurs compatriotes de langue française. L’article débute en esquissant la perspective du philosophe allemand Axel Honneth sur l’anthropologie de la reconnaissance comme pré-condition sociale à la formation de l’identité personnelle. Par la suite, il distingue entre la reconnaissance culturelle, qui caractérise la relation entre individus provenant de différents groupes culturels, et la reconnaissance de l’égalité de traitement et de respect devant la loi. L’article se termine par une exploration de la moralité de la reconnaissance culturelle en se basant sur les écrits journalistiques d’André Laurendeau qui traitent des attitudes du Canada anglais envers le Canada français.
Radyo frekans kestırme sonuçlarinin coğrafı bılgı sıstemlerı tabanli yazilim ve görüntüleme sıstemı ıle desteklenmesı
Authors: TEMİZEL Bora , GÖSE Ersin , AYDEMİR M.Emre 
Published: March 2014

Abstract

Finding the position of signal sources has been effectively used by military systems including targeting, positioning, orbiting primarily, as well as in civil applications such as detecting mine sources, observing the natural environment. Direction finding that explored the importance during the World War II, has been widely used at the present time while there has been considerable improvement. While systems could detect only one source at early times, they can be capable of detecting two or more signals at the same time today, with the exploring of subspace techniques.

In this study, we first give some information about direction finding systems then with these information, develop a study on evaluating a new space segment supported alternately methoded prototype hardware and software to cover the gap that direction finding systems have because of uncontrollable mistakes.

The aim of this study, to support the hardware which planned to be produced on these purpose with an factual software and by the way, based on the prototype measurements before the mass production to take out criterion for the final products.
Faulting within the Pacific plate at the Mariana Trench: Implications for plate interface coupling and subduction of hydrous minerals
Authors: Emry Erica L. , Wiens Douglas A. , Garcia‐Castellanos Daniel 
Published: March 2014

AbstractWe investigate faulting within the incoming Pacific plate at the Mariana subduction trench to understand stresses within the bending plate, regional stresses acting upon the plate interface, and the extent of possible faulting‐induced mantle serpentinization. We determine accurate depths by inverting teleseismic P and SH waveforms for earthquakes occurring during 1990–2011 with Global Centroid Moment Tensor (GCMT) solutions. For earthquakes with Mw 5.0+, we determine centroid depths and source time functions and refine the fault parameters. Results from Central Mariana indicate that all earthquakes are extensional and occur at centroid depths down to 11 km below the Moho. At the Southern Mariana Trench, extensional earthquakes continue to 5 km below the Moho. One compressional earthquake at 34 km below the seafloor suggests stronger plate interface coupling here. In addition, we model the stress distribution within the Pacific plate along two bathymetric profiles extending seaward from the Mariana subduction trench axis to better understand whether our earthquake depth solutions match modeled scenarios for plate bending under applied external forces. Results from our flexure models match the locations of extensional and compressional earthquakes and suggest that the Pacific plate at Southern Mariana is experiencing larger, compressional stresses, possibly due to greater interplate coupling. Additionally, we conclude that if extensional faulting promotes the infiltration of water into the subducting plate mantle, then the top 5–15 km of the Pacific plate mantle are partially serpentinized, and a higher percentage of serpentinization is located near the Central Mariana trench where extensional events extend deeper.
The signal of aerosol‐induced changes in sunshine duration records: A review of the evidence
Authors: Sanchez‐Romero A. , Sanchez‐Lorenzo A. , Calbó J. , González J. A. , Azorin‐Molina C. 
Published: March 2014

AbstractAerosols play a significant yet complex and central role in the Earth's radiation budget, and knowledge of long‐term changes in the atmospheric turbidity induced by aerosols is therefore fundamental for a better understanding of climate change. However, there is little available information on changes in aerosol concentration in the atmosphere, especially prior to the 1980s. The present paper reviews publications reporting the suitability of sunshine duration records with regard to detecting changes in atmospheric aerosols. Some of the studies reviewed propose methods for estimating aerosol‐related magnitudes, such as turbidity, from sunshine deficit at approximately sunrise and sunset, when the impact of aerosols on the solar beam is more easily observed. In addition, there is abundant evidence that one cause of the decadal changes observed in sunshine duration records involves variations in atmospheric aerosol loading. Possible directions for future research are also suggested: in particular, detailed studies of the burn (not only its length but also its width) registered by means of Campbell‐Stokes sunshine recorders may provide a way of creating time series of atmospheric aerosol loading metrics dating back to over 120 years from the present.
Some recent advances in learning and adaptation for uncertain feedback control systems
Authors: Xu Xin , Wang Cong , Lewis Frank L. 
Published: March 2014

SUMMARYLearning and adaptation are essential abilities for feedback control systems to improve performance under uncertainties and external disturbances. In the past decades, there are more and more research interests in developing feedback controllers with learning abilities to ensure stability or optimality of closed‒loop systems. In this guest editorial for the special issue, some recent advances in this area are introduced from three perspectives. The first one is about new developments in adaptive dynamic programming and reinforcement learning methods, which use function approximators such as neural networks to approximately solve the adaptive optimal control problem of uncertain nonlinear systems. The second perspective is related to the learning issues in adaptive control systems based on neural networks. The third perspective includes some new results to deal with uncertainties in feedback control systems based on traditional nonlinear control approaches such as multi‒step nonlinear model predictive control and nonlinear H‒∞ control.
Hyperintense cortical signal on magnetic resonance imaging reflects focal leukocortical encephalitis and seizure risk in progressive multifocal leukoencephalopathy
Authors: Khoury Michael N. , Alsop David C. , Agnihotri Shruti P. , Pfannl Rolf , Wuthrich Christian , Ho Mai‐Lan , Hackney David , Ngo Long , Anderson Matthew P. , Koralnik Igor J. 
Published: March 2014

ObjectiveTo determine the frequency of hyperintense cortical signal (HCS) on T1‐weighted precontrast magnetic resonance (MR) images in progressive multifocal leukoencephalopathy (PML) patients, its association with seizure risk and immune reconstitution inflammatory syndrome (IRIS), and its pathologic correlate.MethodsWe reviewed clinical data including seizure history, presence of IRIS, and MR imaging scans from PML patients evaluated at our institution between 2003 and 2012. Cases that were diagnosed either using cerebrospinal fluid JC virus (JCV) polymerase chain reaction, brain biopsy, or autopsy, and who had MR images available were included in the analysis (n = 49). We characterized pathologic findings in areas of the brain that displayed HCS in 2 patients and compared them with isointense cortex in the same individuals.ResultsOf 49 patients, 17 (34.7%) had seizures and 30 (61.2%) had HCS adjacent to subcortical PML lesions on MR images. Of the 17 PML patients with seizures, 15 (88.2%) had HCS compared with 15 of 32 (46.9%) patients without seizures (p = 0.006). HCS was associated with seizure development with a relative risk of 4.75 (95% confidence interval = 1.2–18.5, p = 0.006). Of the 20 patients with IRIS, 16 (80.0%) had HCS compared with 14 of 29 (49.3%) patients without IRIS (p = 0.04). On histological examination, HCS areas were associated with striking JCV‐associated demyelination of cortical and subcortical U fibers, significant macrophage infiltration, and a pronounced reactive gliosis in the deep cortical layers.InterpretationSeizures are a frequent complication in PML. HCS is associated with seizures and IRIS, and correlates histologically with JCV focal leukocortical encephalitis. Ann Neurol 2014;75:659–669
Homocysteine exacerbates β‐amyloid pathology, tau pathology, and cognitive deficit in a mouse model of Alzheimer disease with plaques and tangles
Authors: Li Jian‐Guo , Chu Jin , Barrero Carlos , Merali Salim , Praticò Domenico 
Published: March 2014

ObjectiveHigh level of homocysteine (Hcy) is a recognized risk factor for developing Alzheimer disease (AD). However, the mechanisms involved are unknown. Previously, it was shown that high Hcy increases brain β‐amyloid (Aβ) levels in amyloid precursor protein transgenic mice, but no data are available on the effect that it may have on the other main pathologic features of AD such as tau.Methods3xTg mice with diet‐induced high Hcy were compared with mice having normal Hcy. Neuronal cells were incubated with and without Hcy.ResultsDiet‐induced high Hcy resulted in an exacerbation of the entire AD‐like phenotype of the 3xTg mice. In particular, we found that compared with controls, mice with high Hcy developed significant memory and learning deficits, and had elevated Aβ levels and deposition, which was mediated by an activation of the γ‐secretase pathway. In addition, the same mice had a significant increase in the insoluble fraction of tau and its phosphorylation at specific epitopes, which was mediated by the cdk5 pathway. In vitro studies confirmed these observations and provided evidence that the effects of Hcy on Aβ and tau are independent from each other.InterpretationTaken together, our findings demonstrate that a dietary condition that leads to an elevation of Hcy levels results in an exacerbation of all 3 major pathological features of the AD phenotype: memory deficits, and Aβ and tau neuropathology. They support the concept that this dietary lifestyle can act as a risk factor and actively contribute to the development of the disease. Ann Neurol 2014;75:851–863
Streptococcus pneumoniae worsens cerebral ischemia via interleukin 1 and platelet glycoprotein Ibα
Authors: Dénes Ádám , Pradillo Jesus M. , Drake Caroline , Sharp Andrew , Warn Peter , Murray Katie N. , Rohit Bazaz , Dockrell David H. , Chamberlain Janet , Casbolt Helen , Francis Sheila , Martinecz Bernadett , Nieswandt Bernhard , Rothwell Nancy J. , Allan Stuart M. 
Published: March 2014

ObjectiveBacterial infection contributes to diverse noninfectious diseases and worsens outcome after stroke. Streptococcus pneumoniae, the most common infection in patients at risk of stroke, is a major cause of prolonged hospitalization and death of stroke patients, but how infection impacts clinical outcome is not known.MethodsWe induced sustained pulmonary infection by a human S. pneumoniae isolate in naive and comorbid rodents to investigate the effect of infection on vascular and inflammatory responses prior to and after cerebral ischemia.ResultsS. pneumoniae infection triggered atherogenesis, led to systemic induction of interleukin (IL) 1, and profoundly exacerbated (50–90%) ischemic brain injury in rats and mice, a response that was more severe in combination with old age and atherosclerosis. Systemic blockade of IL‐1 with IL‐1 receptor antagonist (IL‐1Ra) fully reversed infection‐induced exacerbation of brain injury and functional impairment caused by cerebral ischemia. We show that infection‐induced systemic inflammation mediates its effects via increasing platelet activation and microvascular coagulation in the brain after cerebral ischemia, as confirmed by reduced brain injury in response to blockade of platelet glycoprotein (GP) Ibα. IL‐1 and platelet‐mediated signals converge on microglia, as both IL‐1Ra and GPIbα blockade reversed the production of IL‐1α by microglia in response to cerebral ischemia in infected animals.InterpretationS. pneumoniae infection augments atherosclerosis and exacerbates ischemic brain injury via IL‐1 and platelet‐mediated systemic inflammation. These mechanisms may contribute to diverse cardio‐ and cerebrovascular pathologies in humans. Ann Neurol 2014;75:670–683