bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tazobactam/ceftolozane and tobramycin combination therapy in extensively drug-resistant Pseudomonas aeruginosa infections in severe burn injury: a case report
Authors: Ibe Yuta , Kakizaki Ryuichiro , Inamura Hirotoshi , Ishigo Tomoyuki , Fujiya Yoshihiro , Inoue Hiroyuki , Uemura Shuji , Fujii Satoshi , Takahashi Satoshi , Narimatsu Eichi , Fukudo Masahide 
Published: August 2023

Abstract
Background
Combination therapy with tazobactam/ceftolozane (TAZ/CTLZ) and high-dose aminoglycosides has been reported to be efficacious in extensively drug-resistant (XDR)-Pseudomonas aeruginosa infection. However, there are no reports of efficacy in XDR-P. aeruginosa infection for combination therapy with low-dose aminoglycosides and TAZ/CTLZ. Herein, we describe a rare case of severe burn injury patients with persistent bacteremia due to XDR-P. aeruginosa, which was successfully treated with TAZ/CTLZ and low-dose tobramycin (TOB).

Case presentation
A 31-year-old man was admitted to the intensive care unit with severe burn injury involving 52% of the total body surface area and a prognostic burn index of 79.5. The patient had recurrent bacterial infections since admission, and blood cultures collected on the 37th day of admission revealed the presence of P. aeruginosa strains that were resistant to all β-lactams and amikacin (AMK). The results of the antimicrobial synergistic study showed no synergistic effect of low-dose meropenem (MEPM) and AMK combination therapy. The patient had acute renal failure, and it was difficult to increase the dose of MEPM and AMK, respectively. Thus, we initiated TAZ/CTLZ 1.5 g/8 h instead of the AMK and MEPM combination therapy on the 43rd day of hospitalization. Low-dose TAZ/CTLZ was continued because of prolonged renal dysfunction and resulted in a transient clinical improvement. However, the dosage of TAZ/CTLZ could be increased as the renal function improved, but despite an increased TAZ/CTLZ dose, bacteremia persisted, and the blood cultures remained positive. Thus, TOB was added to TAZ/CTLZ at low doses for synergistic effect against Gram-negative bacteria. Blood cultures collected after initiation of combination therapy with TAZ/CTLZ and low-dose TOB were negative on two consecutive follow-up evaluations. Thereafter, although the patient had several episodes of fever and increased inflammatory response, blood cultures consistently tested negative, and all of the wounds healed. On the 93rd day, due to the good healing progress, the patient was transferred to another hospital.

Conclusions
TAZ/CTLZ and low-dose TOB combination therapy showed the potential for synergistic effects. Our present report suggests a novel synergistic treatment strategy for rare cases that are refractory to the treatment of infections, such as XDR-P. aeruginosa infection.
Long-term survival after multidisciplinary treatments for HER2-positive advanced gastric cancer with multiple liver and lung metastases
Authors: Yoshioka Satoshi , Takahashi Naoto , Fujisaki Muneharu , Takeshita Kenji , Takano Yuta , Yano Fumiaki , Toya Naoki , Eto Ken 
Published: August 2023

Abstract
Background
Trastuzumab-based chemotherapy is a standard treatment regimen for human epithelial growth factor 2 (HER2)-positive gastric cancer. This is a case of a patient who has survived 12 years after being diagnosed with advanced gastric cancer with multiple liver and lung metastases.

Case presentation
A woman in her 70s underwent total gastrectomy, cholecystectomy, and left hepatic lobectomy for gastric cancer with liver metastasis. One month after the surgery, multiple liver metastases appeared. After two courses of S-1 + CDDP chemotherapy, the liver metastases disappeared, and new lung metastases occurred. Because the primary tumor was HER2 positive, S-1 + CDDP + trastuzumab chemotherapy was performed. After one course of chemotherapy, the blood test showed pancytopenia, and CDDP was discontinued. S-1 + trastuzumab chemotherapy was then initiated, and as a result, the lung metastases disappeared. The patient is alive without recurrence 12 years after the surgery.

Conclusions
We encountered a case of long-term survival after multidisciplinary treatments for HER2-positive advanced gastric cancer with multiple liver and lung metastases.
Effects of marine sediment as agricultural substrate on soil microbial diversity: an amplicon sequencing study
Authors: Núñez-Gómez Dámaris , Melgarejo Pablo , Martínez-Nicolás Juan José , Hernández Francisca , Martínez-Font Rafael , Lidón Vicente , Legua Pilar 
Published: August 2023

Abstract
Background
The soil microbiota has a direct impact on plant development and other metabolic systems, such as the degradation of organic matter and the availability of microelements and metabolites. In the context of agricultural soils, microbial activity is crucial for maintaining soil health and productivity. Thus, the present study aimed to identify, characterize, and quantify the microbial communities of four types of substrates with varying proportions of marine port sediment used for cultivating lemons. By investigating microbial diversity and relative abundance, the work aimed to highlight the importance of soil microbial communities in agriculture when alternative culture media was used.

Results
The composition and structure of the sampled microbial communities were assessed through the amplification and sequencing of the V3-V4 variable regions of the 16 S rRNA gene The results revealed a diverse microbial community composition in all substrate samples, with a total of 41 phyla, 113 classes, 266 orders, 405 families, 715 genera, and 1513 species identified. Among these, Proteobacteria, Bacteroidota, Planctomycetota, Patescibacteria, Chloroflexi, Actinobacteriota, Acidobacteriota, Verrucomicrobiota, and Gemmatimonadota accounted for over 90% of the bacterial reads, indicating their dominance in the substrates.

Conclusions
The impact of the substrate origin on the diversity and relative abundace of the microbiota was confirmed. The higher content of beneficial bacterial communities for plant development identified in peat could explain why is considered an ideal agricultural substrate. Development of “beneficial for plants” bacterial communities in alternative agricultural substrates, regardless of the edaphic characteristics, opens the possibility of studying the forced and specific inoculation of these culture media aiming to be agriculturally ideals.
Input subsidies, public investments and agricultural productivity in India
Authors: Zafar Shadman , Aarif Mohammad , Tarique Md. 
Published: August 2023

AbstractThe fund allocation in agricultural sector in India is heavily tilted toward input subsidies provision; however, researchers seem to favor investment expenditure instead. The present paper seeks to compare the usefulness of input subsidies as compared to investment with regard to agricultural productivity so that policy makers hit the right tool and avoid less productive state expenditure. We investigated a total of four regression models using autoregressive and distributed lag cointegration in a time series framework covering period from 1983 to 2019. The first model considers all input subsidies in aggregate form, and the rest three models take input subsidies in disaggregate forms, namely fertilizer subsidy, irrigation subsidy and power subsidy, respectively. It is observed from the results that input subsidies still contribute more than what public investment does to agricultural productivity. It is also found that power subsidy is the most effective component of input subsidies followed by fertilizer subsidy. Hence, government expenditure on input subsidies is justified on the ground that it ensures all farmers to have access to affordable agricultural inputs. Targeted subsidies combined with adequate investment in agricultural infrastructure could deliver long-term agricultural development in India.
Reconstruction of the lost colonial architecture in the context of heritage tourism: Dutch Trading Post in Taiwan
Authors: Hsu Ping-hsiang 
Published: August 2023

AbstractTo strengthen brand identity, enrich tourist experiences, and promote heritage education, Taijiang National Park proposed to reconstruct Taiwan’s Dutch Trading Post in a different location from where it was initially erected in the 17th century. This paper is a case study of the reconstruction proposal for a lost colonial architectural complex in the context of heritage tourism. It discusses the practical and academic issues of rebuilding long-lost colonial heritage sites. The author provided a first-hand account of the technical and practical reasoning for reconstructing a bygone complex erected by Dutch settlers. Historical development phases of the Dutch Trading Post of Taiwan were first introduced, and then a reconstruction strategy was proposed to resolve conflicts with legal constraints. Additionally, a site selection process using GIS, a conceptually driven plan for reconstruction, and a 3D simulation were provided. Three specific issues in heritage rebuilding were further discussed, including the decision to reconstruct a heritage building (complex), the authenticity of the reconstructed building if done in a different location from where it was initially situated, and the need to discover more archaeological facts.
Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Advanced or Metastatic Bladder Cancer: Results of a Large, Randomized, Multinational, Multicenter, Phase III Study
Authors: von der Maase H. , Hansen S.W. , Roberts J.T. , Dogliotti L. , Oliver T. , Moore M.J. , Bodrogi I. , Albers P. , Knuth A. , Lippert C.M. , Kerbrat P. , Sanchez Rovira P. , Wersall P. , Cleall S.P. , Roychowdhury D.F. , Tomlin I. , Visseren-Grul C.M. , Conte P.F. 
Published: August 2023

PURPOSE: Gemcitabine plus cisplatin (GC) and methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) were compared in patients with locally advanced or metastatic transitional-cell carcinoma (TCC) of the urothelium. PATIENTS AND METHODS: Patients with stage IV TCC and no prior systemic chemotherapy were randomized to GC (gemcitabine 1,000 mg/m2 days 1, 8, and 15; cisplatin 70 mg/m2 day 2) or standard MVAC every 28 days for a maximum of six cycles. RESULTS: Four hundred five patients were randomized (GC, n = 203; MVAC, n = 202). The groups were well-balanced with respect to prognostic factors. Overall survival was similar on both arms (hazards ratio [HR], 1.04; 95% confidence interval [CI], 0.82 to 1.32; P = .75), as were time to progressive disease (HR, 1.05; 95% CI, 0.85 to 1.30), time to treatment failure (HR, 0.89; 95% CI, 0.72 to 1.10), and response rate (GC, 49%; MVAC, 46%). More GC patients completed six cycles of therapy, with fewer dose adjustments. The toxic death rate was 1% on the GC arm and 3% on the MVAC arm. More GC than MVAC patients had grade 3/4 anemia (27% v 18%, respectively) and thrombocytopenia (57% v 21%, respectively). On both arms, the RBC transfusion rate was 13 of 100 cycles and grade 3/4 hemorrhage or hematuria was 2%; the platelet transfusion rate was four patients per 100 cycles and two patients per 100 cycles on GC and MVAC, respectively. More MVAC patients, compared with GC patients, had grade 3/4 neutropenia (82% v 71%, respectively), neutropenic fever (14% v 2%, respectively), neutropenic sepsis (12% v 1%, respectively), and grade 3/4 mucositis (22% v 1%, respectively) and alopecia (55% v 11%, respectively). Quality of life was maintained during treatment on both arms; however, more patients on GC fared better regarding weight, performance status, and fatigue. CONCLUSION: GC provides a similar survival advantage to MVAC with a better safety profile and tolerability. This better-risk benefit ratio should change the standard of care for patients with locally advanced and metastatic TCC from MVAC to GC.
DNA Encoding Strategy for the Identification and Quantification of Poorly Reactive Target Metabolite Using Phenylboronic Acid-tethered Oligodeoxynucleotides
Authors: Motohashi Yuto , Nishihara Tatsuya , Tanabe Kazuhito 
Published: August 2023

Abstract
Information about poorly reactive metabolites, lactate and glucose could be encoded into DNA sequences. The sequential reaction steps, including H2O2 generation between the target metabolites and their corresponding oxidase, the reaction between phenylboronic acid-tethered oligonucleotide and H2O2, and biotinylation of product DNA allow the DNA encoding strategy to identify and quantify the target metabolites.
Pivot from Pain to Productive: Conversations about Weight Management in Youth with Obesity
Authors: Williams Dominique R. , Fischer Anastasia N. 
Published: August 2023

AbstractThe prevalence of childhood obesity is almost 20% and affects 14.7 million youth. It is not a matter ofifbutwhenandhow oftensports medicine clinicians will care for patients with obesity. Considering the social, emotional, medical, and physical impact of obesity, we need a nuanced approach to communicate with patients and develop effective treatment plans to maintain or encourage physical activity. Neuromusculoskeletal impairments, physical complications, pain, biomechanical differences, and physical deconditioning act as potential barriers to treatment. This article introduces ways to pivot the conversation from musculoskeletal pain to a productive, well-received conversation about a holistic approach to weight management that also promotes physical activity and overall wellness in youth with obesity. Special attention is given to equipping clinicians with recommendations that incorporate the use of inclusive language, health behavior theories, and tenets of motivational interviewing to deliver equitable treatment regardless of body habitus.
Exercise is the Most Important Medicine for COVID-19
Authors: Torres Georgia , Constantinou Demitri , Gradidge Philippe , Patel Deepak , Patricios Jon 
Published: August 2023

Abstract
COVID-19 infection and long COVID affect multiple organ systems, including the respiratory, cardiovascular, renal, digestive, neuroendocrine, musculoskeletal systems, and sensory organs. Exerkines, released during exercise, have a potent crosstalk effect between multiple body systems. This review describes the evidence of how exerkines can mitigate the effects of COVID-19 in each organ system that the virus affects. The evidence presented in the review suggests that exercise should be considered a first-line strategy in the prevention and treatment of COVID-19 infection and long COVID disease.
THE RELATIONSHIP OF MEANING-LIFE ORIENTATIONS AND EDUCATIONAL AND PROFESSIONAL MOTIVATION OF RESIDENTS WITH DIFFERENT LEVELS OF PROFESSIONAL EXPERIENCE
Authors: Zinkevich Elena R. , Korgozha Maria A. , Yatsevich Natalya A. 
Published: August 2023

Background. In the modern educational conditions of Russian reality, the pedagogical community of medical universities at the stage of postgraduate education pays great attention to the readiness of doctors for professional activities, which determines the conduct of research involving the study of the relationship between meaning-life orientations and educational and professional motivation of residents with different levels of professional experience. In the 2021-2022 academic year, a study illustrating the stated problems was conducted at the St. Petersburg State Pediatric Medical University at the Faculty of Clinical Psychology.
Purpose. To study the relationship between meaningful life orientations and educational and professional motivation of residents with different levels of professional experience.
Materials and methods. The present study involved 65 residents of 2 years of training in various clinical specialties, their average age is 25.5 years. The entire sample of study participants was divided into two subgroups according to the parameter of involvement in professional activities. This parameter was considered necessary for studying the relationship between meaning-life orientation and educational and professional motivation of residents.
Of the total number of respondents, 69% combined residency training with work in their specialty, 31% mastered the specialty at the stage of postgraduate education. Permission was obtained from the Ethics Committee of the St. Petersburg State Pediatric Medical University to organize the study. Respondents agreed to participate in the study. To evaluate the results, descriptive statistical methods, a comparative analysis using the U-Mann-Whitney criterion for explanatory variables and the Wilcoxon T-test for dependent variables, a correlation analysis of the relationships of indicators using the Spearman criterion, calculated using the STATISTICA 12.0 application package, were used.
Outcomes. The study allowed to form an idea of the relationship between meaning-life orientations and educational and professional motivation of residents with different levels of professional experience.
Conclusions. The results of the study will serve as the basis for rethinking the approaches to the organization of the educational process of students at the stage of residency, the search for ways of education and training that ensured the development of their educational and professional motivation and affect the formation of a system of meaning-life orientations.
Using quality improvement to tackle the triple aim for children and young people with asthma: improving outcomes, experience and costs
Authors: Aurelio Marco , Araujo Rita , Zoetmann Janeke , Moody Julia , Shah Amar 
Published: August 2023

Background/Aims Asthma in children and young people represents a substantial burden to the healthcare system, with these patients requiring frequent emergency care and having poorer health outcomes, leading to high system costs and poor patient experiences. This study used quality improvement methodology to achieve the triple aim of improved outcomes, better experience and reduced costs for those aged 0–16 years with asthma in north east London. Methods A multidisciplinary project team used quality improvement methods to implement and assess two interventions: a community high-risk asthma clinic and educational asthma-friendly school groups, both of which were delivered by a specialist asthma nurse. Population-level outcomes included asthma control test scores, accident and emergency department admissions and costs. Intervention-specific outcomes included number of clinic consultations delivered, did-not-attend rates and participant confidence ratings following the school sessions. Results Accident and emergency admissions for asthma reduced by 52%, with a 50% reduction in average monthly acute care costs. Asthma control test scores improved significantly, from an average of 18.56 to 22.34 out of a maximum score of 25 (P=0.000) following the interventions. Participants in the asthma-friendly school groups reported increased confidence in both day-to-day and emergency asthma management at the end of their sessions. Conclusions Having dedicated specialist asthma nurse input in the community and using school-based interventions can help to improve asthma care for children and young people, reducing the burden of frequent accident and emergency department admissions. Using quality improvement methods in pursuit of triple aim outcomes can help teams to work towards a shared goal.
CHANGES IN THE POSTERIOR TIBIAL SLOPE AND PATELLAR HEIGHT IN MEDIAL OPENING WEDGE HIGH TIBIAL OSTEOTOMIES: ARE THEY INEVITABLE OR SURGICAL ERRORS?
Authors: Mabrouk Ahmed , Ollivier Matthieu 
Published: August 2023

AbstractIntroductionChanges in posterior tibial slope (PTS) and patellar height (PH) following proximal tibial osteotomies have been a recent focus for knee surgeons. Increased PTS and decreased PH following medial opening wedge high tibial osteotomy (MOWHTO) have been repeatedly reported in the literature. However, this has been disputed in more recent biomechanical studies.MethodologyA total of 62 cases who underwent MOWHTO were included. Surgery was performed using a dedicated step-by-step protocol focusing on the risks of unintentional slope changes. Clinically, all patients were evaluated preoperatively and at 2 years follow-up with the KOOS scores and UCLA physical activity scale. Preoperative and postoperative radiographic lower limb alignment parameters were measured on full-length lower limb radiographs, including (HKA), (MPTA), (mLDFA), proximal posterior tibial angle (PPTA), (JLCA) and(JLO). PH measurements were assessed on radiographs.ResultsThere was a significant change in the coronal plane alignment; the mMPTA changed from 84.38° to 90.39°, and the HKA changed from 172.19° to 180.15° (Both P < 0.0001). There was no significant change in the PTS as evidenced by a postoperative PPTA of 80.56 ° from a preoperative of 80.36°. And no significant change in the PH with all the indices; preoperative Caton Deschamps, Insall Salvati, and Schröter indices measured 0.95, 1.03, and 1.56, respectively. In comparison to postoperative measures of 0.93, 1.03, and 1.54, respectively.ConclusionMOWHTO does not change the PTS or PH when accurate preoperative planning and precise intraoperative freehand technique are adopted. Involuntary modification of these anatomic parameters should be considered surgical errors.
PREHABILITATION FOR FRAIL PATIENTS UNDERGOING TOTAL HIP OR KNEE ARTHROPLASTY: PROTOCOL FOR THE JOINT PREP FEASIBILITY RANDOMIZED CONTROLLED TRIAL
Authors: Khalid Tanzeela , Ben-Shlomo Yoav , Bertram Wendy , Culliford Lucy , England Clare , Henderson Emily , Jameson Catherine , Jepson Marcus , Palmer Shea , Whitehouse Michael , Wylde Vikki 
Published: August 2023

AbstractIntroductionFrailty is associated with poorer outcomes after joint replacement. Targeting frailty pre-operatively via protein supplementation and exercise has the potential to improve outcomes after joint replacement. Before conducting a randomised controlled trial (RCT), a feasibility study is necessary to address key uncertainties and explore how to optimise trial design.MethodologyJoint PREP is a feasibility study for a multicentre, two-arm, parallel group, pragmatic, RCT to evaluate the clinical and cost-effectiveness of prehabilitation for frail patients undergoing total hip or knee replacement. Sixty people who are ≥65 years of age, frail and scheduled to undergo total hip or knee replacement at 2–3 NHS hospitals will be recruited and randomly allocated on a 1:1 ratio to the intervention or usual care group. The intervention group will be given a daily protein supplement and will be asked to follow a home-based, tailored daily exercise programme for 12 weeks before their operation, supported by fortnightly telephone calls from a physiotherapist. Embedded qualitative research with patients will explore their experiences of participating, reasons for non-participation and/or reasons for withdrawal or treatment discontinuation.ResultsOutcomes to be assessed include eligibility, recruitment and retention rates; intervention adherence; acceptability of the trial and intervention; and data completion. Data collection is ongoing.DiscussionThis study will generate important data regarding the feasibility of a RCT to evaluate a prehabilitation intervention for frail patients undergoing joint replacement. A future RCT will contribute to the evidence on interventions to optimise the benefit that frail patients gain from joint replacement.