bluuebunny/crossref_metadata_2025_split huggingface dataset:
Klebsiella infections in a pediatric intensive care unit: incidence, antimicrobial susceptibility, and resistance genes
Authors: El-Nawawy Ahmed , Meheissen Marwa A. , Badr Ahmed M. , Antonios Manal A. M. 
Published: December 2022

Abstract
Background
Infections with multidrug-resistant K. pneumoniae is associated with high morbidity and mortality especially among critically ill patients. This was the main principle to conduct a detailed study about this organism, its resistance pattern, and type of its resistance genes

Subjects and methods
A cross-sectional study was carried out in a pediatric intensive care unit on patients with age range from 1 month to 12 years over a period of 1 year with positive K. pneumoniae using standard microbiological culture and antibiogram sensitivity testing. All collected samples were processed using multiplex PCR technique to identify the most relevant resistant genes.

Results
Forty-four patients had 54 positive cultures for K. pneumoniae, out of which 17 patients (38.6%) passed away. The most prevalent-resistant gene was New Delhi metallo-beta lactamase (NDM) gene (65.4%) followed by cefotaximase (CTX-M) gene (57.7%). Extensively drug-resistant K. pneumoniae was detected in (15.9%) of the results and was proved to be independent risk factor increasing mortality odds 139 folds.

Conclusion
The evolution of resistance of Klebsiella pneumoniae was proved to be associated with a high mortality rate. Continuous widespread surveillance of Klebsiella pathogen focusing on identification of resistance genes and antibiotic resistance pattern is highly recommended.
Advances in modeling boundary layer turbulence and its effects on motion independent aerodynamic force of bridge decks
Authors: Zhao Lin , Wu Fengying , Liu Zhenbiao , Yan Aiguo , Ge Yaojun 
Published: December 2022

AbstractWind tunnel tests remain crucial to solving the wind-induced issues, such as buffeting. The turbulence impacts on the aerodynamic forces is vital to buffeting responses of a bridge, which has been neglected, for that traditional passive wind tunnel test simulations are mainly to perform smaller turbulence integral scale, compared with the reduced-scale similarity. A turbulence hybrid simulation device that integrates vibrating grids and active fans was proposed, realizing a detectable adjustment of the bi-directional pulse energy of the incoming turbulence. The simulation development of the active turbulence in the wind tunnel test was reviewed briefly firstly. To investigate turbulence influence on the aerodynamic forces, the pressure-measurement wind tunnel tests of typical bridge decks were carried out in active control wind tunnel. The impacts of different incoming turbulence on the aerodynamic force and buffeting response were furtherly discussed. Results revealed that the bi-direction (along-wind and vertical wind) influenced aerodynamic forces synergistically. Otherwise, turbulence integral scale strongly influenced aerodynamic characteristics, such as buffeting responses, notably, the buffeting responses obtained in active controlled wind tunnel would be reasonable for a safety evaluation of bridges under construction and operation.
Nudging Timely Wage Reporting: Field Experimental Evidence from the U.S. Supplemental Security Income Program
Authors: Zhang C. Yiwei , Hemmeter Jeffrey , Kessler Judd B. , Metcalfe Robert D. , Weathers Robert 
Published: December 2022

We study a large-scale (n = 50,000) natural field experiment implemented by the U.S. Social Security Administration aimed at increasing the timely and accurate self-reporting of wages by Supplemental Security Income (SSI) recipients. A letter reminding SSI recipients of their wage reporting responsibilities significantly increased both the likelihood of reporting any earnings and the total earnings reported. However, the specific letter content—providing social information or highlighting the salience of penalties—had no systematic effect. We develop a conservative estimate that the letters generated roughly $5.91 in savings per dollar spent, highlighting the value of such a nudge in this important context. This paper was accepted by Yan Chen, behavioral economics and decision analysis. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4645 .
Determining factors of neonatal mortality in Ethiopia: An investigation from the 2019 Ethiopia Mini Demographic and Health Survey
Authors: Sahile Abay , Bekele Dereje , Ayele Habtamu 
Published: December 2022

Background
Neonatal mortality is the probability of dying during the first 28 days of life. Of approximately 5 million children who die in the first year of life in the world, about 3 million are within their first 28 days of birth. In Ethiopia, the neonatal mortality rate is high about 37 per 1000 live births, and the factors are not well documented. Then, this study aimed to determine the key factors that have a significant influence on neonatal mortality.

Methods
A total of 5753 neonatal mortality-related data were obtained from Ethiopia Mini Demographic and Health Survey (2019) data. A frequency distribution to summarize the overall data and Binary Logistic Regression to identify the subset of significant risk factors for neonatal mortality were applied to analyze the data.

Results
An estimated 36 per 1000 live children had died before the first 28 days, with the highest in the Benishangul Gumuz region (15.9%) and the lowest in Addis Ababa (2.4%). From the Binary logistic regression analysis, the odds ratio and 95% CI of age 25–34 (OR = 0.263, 95% CI: 0.106–0.653), Afar (OR = 0.384, 95% CI: 0.167–0.884), SNNPR (OR = 0.265, 95% CI: 0.098–0.720), Addis Ababa (OR = 5.741, 95% CI: 1.115–29.566), Urban (OR = 0.253, 95% CI: 0.090, 0.709), toilet facility (OR = 0.603, 95% CI: 0.404–0.900), single birth (OR = 0.261, 95% CI: 0.138–0.495), poorest (OR = 10.573, 95% CI: 2.166–51.615), poorer (OR = 19.573, 95% CI: 4.171–91.848), never breastfed (OR = 35.939, 95% CI: 25.193–51.268), public health delivery (OR = 0.302, 95% CI: 0.106–0.859), private health facility (OR = 0.269, 95% CI: 0.095–0.760).

Conclusion
All regional states of Ethiopia, specially Benishangul Gumuz, and the Somali region must take remedial actions on public health policy, design strategies to improve facilities, and improve the capacities of stakeholders living in their region toward those major factors affecting neonatal mortality in the country.
Association between skull bone mineral density and periodontitis: Using the National Health and Nutrition Examination Survey (2011–2014)
Authors: Jin Fuqian , Song Jukun , Luo Yi , Wang Beichuan , Ding Ming , Hu Jiaxin , Chen Zhu 
Published: December 2022

Background and objective
Bone mineral density (BMD) and periodontitis have been the subject of many studies. However, the relationship between skull (including mandible) BMD and periodontitis has not been extensively studied. An objective of this cross-sectional study was to examine the relationship between skull BMD and periodontitis using data from the National Health and Nutrition Examination Surveys (NHANES) for 2011–2012 and 2013–2014.

Materials and methods
From NHANES 2011–2014, 3802 participants aged 30–59 were selected. We divided the skull BMD level into quartiles to check the distribution of variables. Periodontitis was defined by the Centers for Disease Control and Prevention (CDC) and the American Association of Periodontology (AAP) in 2012. Multivariate logical regression analysis was used to explore the independent relationship between skull BMD and periodontitis. The generalized additive model (GAM), smooth curve fitting (penalty spline) and threshold effect analysis was used to evaluate dose-response relationship between skull BMD and periodontitis and the potential nonlinear relationship between skull BMD and periodontitis. Finally, subgroup analysis and interaction test were conducted to determine the role of covariates between skull BMD and periodontitis.

Results
The overall average skull BMD of 3802 participants was 2.24g/cm2, the average age was 43.94 years, and the prevalence of periodontitis was 41.03%. In the fully adjusted logistic regression model, skull BMD and periodontitis showed an independent negative correlation (OR 0.73, 95% CI 0.59–0.90, P = 0.0032) and a linear relationship. Compared with the lowest quartile array (Q1:1.22–1.98) of skull BMD, the highest quartile array(Q4: 2.47–3.79) had a significantly lower risk of periodontitis (OR 0.70,95% CI 0.56–0.87, P = 0.0014). Subgroup analysis showed a highly consistent negative correlation between skull BMD and periodontitis. In the interaction test, people with moderate poverty income ratio (1.57–3.62) and those who had more than 12 alcohol drinks in the past year had a lower risk of periodontitis.

Conclusions
This result suggested that periodontal disease can be related to low skull BMD, for those people, oral hygiene and health care should be more closely monitored. Validation of our findings will require further research.
The gestational diabetes future diabetes prevention study (GODDESS): A partially randomised feasibility controlled trial
Authors: Parsons Judith , Forde Rita , Brackenridge Anna , Hunt Katharine F. , Ismail Khalida , Murrells Trevor , Reid Anna , Rogers Helen , Rogers Rebecca , Forbes Angus 
Published: December 2022

ObjectivesTo assess the feasibility of an ante- and post-natal lifestyle intervention for women with gestational diabetes mellitus (GDM) to reduce type 2 diabetes risk.DesignA partially randomised patient preference feasibility trial.SettingDiabetes antenatal clinics in two inner-London hospitals, UK.ParticipantsPregnant women ≥18 years with a GDM diagnosis and pre-pregnancy body mass index of ≥25kg/m2.InterventionParticipants in the intervention group were offered four motivational interview-based sessions (two antenatally and two postnatally, at 3 and 6 months postpartum), a WhatsApp support group, a FitBit and electronic self-help resources.Outcome measuresRecruitment; retention; intervention dose received; data completion; adaptions; proportion achieving ≥5% weight loss; weight change, blood glucose; blood pressure; diet, physical activity, breastfeeding and depression. Clinical outcomes were measured at baseline and 6 months postpartum.Results50 participants were recruited from 155 eligible women (32% recruitment rate). Thirty-four were recruited to the intervention group (23 following randomisation (RI-group) and 11 based on preference (PI-group)); and 16 to the control group (13 randomised (RC-group) and 3 preference (PC-group)). Attrition was 44% (n = 22/50). Forty-six percent (n = 6) of the intervention group (25% (n = 2) of the RI-group and 80% (n = 4) of the PI-group) achieved ≥5% weight loss compared to 8% (n = 1) in the control group (95% confidence interval (CI) -0.69 to 0.07). Mean weight change was -2.1kg±9.0 in the intervention group (0kg±5.4 in the RI-group and -5.4kg±13.0 in the PI-group) compared to +4.4kg±4.9 in the control group (RC +4.4kg ±5.3 and PC +4.7kg ±3.1, 95% CI -12.4 to 0.2).ConclusionsRecruitment was feasible, but strategies to improve retention are needed. The findings suggest the intervention can support women with GDM to lose weight. The observed weight loss was primarily in women who preferred the intervention. Therefore, future trials may need to adopt a preference design and consider factors associated with preference.Trial registrationTrial registration:ISRCTN52675820https://www.isrctn.com/ISRCTN52675820?q=ISRCTN52675820&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search.
Clinical anastomosis leakage and associated factors among patients who had intestinal anastomosis in northwest referral hospitals, Ethiopia
Authors: Kassahun Chanyalew Worku , Melekamu Senetsuhuf , Alemu Mahlet Temesgen 
Published: December 2022

Background
Clinical anastomosis leakage leads to increased hospital costs, lengths of stay, readmissions, reoperations, and death. Therefore, this study aimed to assess clinical anastomotic leakage and associated factors among patients who had intestinal anastomosis in Northwest referral Hospitals, Ethiopia.

Method
A retrospective cross-sectional study design was conducted among 411 randomly selected patients. The patient’s medical records from February 2017 to February 2020 were used. The date range during which patients’ medical records were extracted was from March 1 to June 2020. Patient medical record charts and data extraction sheets were used to collect the data. Data was entered into EPI—DATA version 3.1 and exported into SPSS version 25 for analysis. Binary and multiple logistic regression analysis was used to assess the association between dependent and independent variables. P-value of less than 0.05 and odds ratio with 95% CI were used to declare the presence of association.

Results
The response rate of the study was 99.8%. Of 411 patients, 38 (9.2%) patients developed clinical anastomotic leakage. Age group 0–10 years (AOR = 6.85 95% CI: 1.742–26.97), emergency presentation (AOR = 3.196 95% CI: 1.132–9.025), and pre-operative comorbid disease (AOR = 7.62 95% CI: 2.804–20.68) were significantly associated with anastomotic leak.

Conclusions
Clinical anastomotic leakage is higher than the expected rate (4.9%-7.2%). Age, emergency presentation, and comorbidities were associated with clinical anastomotic leak. Hence, attention to early identification of risk factors and providing optimal pre-operative, operative, and post-operative care is necessary.
A case-control study on the driving factors of childhood brain volume loss: What pediatricians must explore
Authors: Sungura Richard , Shirima Gabriel , Spitsbergen John , Mpolya Emmanuel , Vianney John-Mary 
Published: December 2022

BackgroundThe brain volume loss also known as brain atrophy is increasingly observed among children in the course of performing neuroimaging using CT scan and MRI brains. While severe forms of brain volume loss are frequently associated with neurocognitive changes due to effects on thought processing speed, reasoning and memory of children that eventually alter their general personality, most clinicians embark themselves in managing the neurological manifestations of brain atrophy in childhood and less is known regarding the offending factors responsible for developing pre-senile brain atrophy. It was therefore the goal of this study to explore the factors that drive the occurrence of childhood brain volume under the guidance of brain CT scan quantitative evaluation.MethodsThis study was a case-control study involving 168 subjects with brain atrophy who were compared with 168 age and gender matched control subjects with normal brains on CT scan under the age of 18 years. All the children with brain CT scan were subjected to an intense review of their birth and medical history including laboratory investigation reports.ResultsResults showed significant and influential risk factors for brain atrophy in varying trends among children including age between 14-17(OR = 1.1), male gender (OR = 1.9), birth outside facility (OR = 0.99), immaturity (OR = 1.04), malnutrition (OR = 0.97), head trauma (OR = 1.02), maternal alcoholism (OR = 1.0), antiepileptic drugs & convulsive disorders (OR = 1.0), radiation injury (OR = 1.06), space occupying lesions and ICP (OR = 1.01) and birth injury/asphyxia (OR = 1.02).ConclusionsPathological reduction of brain volume in childhood exhibits a steady trend with the increase in pediatric age, with space occupying lesions & intracranial pressure being the most profound causes of brain atrophy.
Sparse canonical correlation to identify breast cancer related genes regulated by copy number aberrations
Authors: Dutta Diptavo , Sen Ananda , Satagopan Jaya 
Published: December 2022

Background
Copy number aberrations (CNAs) in cancer affect disease outcomes by regulating molecular phenotypes, such as gene expressions, that drive important biological processes. To gain comprehensive insights into molecular biomarkers for cancer, it is critical to identify key groups of CNAs, the associated gene modules, regulatory modules, and their downstream effect on outcomes.

Methods
In this paper, we demonstrate an innovative use of sparse canonical correlation analysis (sCCA) to effectively identify the ensemble of CNAs, and gene modules in the context of binary and censored disease endpoints. Our approach detects potentially orthogonal gene expression modules which are highly correlated with sets of CNA and then identifies the genes within these modules that are associated with the outcome.

Results
Analyzing clinical and genomic data on 1,904 breast cancer patients from the METABRIC study, we found 14 gene modules to be regulated by groups of proximally located CNA sites. We validated this finding using an independent set of 1,077 breast invasive carcinoma samples from The Cancer Genome Atlas (TCGA). Our analysis of 7 clinical endpoints identified several novel and interpretable regulatory associations, highlighting the role of CNAs in key biological pathways and processes for breast cancer. Genes significantly associated with the outcomes were enriched for early estrogen response pathway, DNA repair pathways as well as targets of transcription factors such as E2F4, MYC, and ETS1 that have recognized roles in tumor characteristics and survival. Subsequent meta-analysis across the endpoints further identified several genes through the aggregation of weaker associations.

Conclusions
Our findings suggest that sCCA analysis can aggregate weaker associations to identify interpretable and important genes, modules, and clinically consequential pathways.
Why health system diagnosis delay among tuberculosis patients in Illubabor, Oromia region, South West Ethiopia? A qualitative study
Authors: Feyisa Jira Wakoya , Lemu Jiregna Chalcisa , Hunde Megersa Dinku , Berhanu Robera Demissie , Jaleta Debela Dereje , Abdisa Diriba Kumara , Garedow Tadesse Sime , Kitila Keno Melkamu 
Published: December 2022

BackgroundThe main target of tuberculosis control and prevention is to detect incident cases as quickly as possible and also to prevent the occurrence of disease. It is also the responsibility of the health facility to screen the contacts, identifying children for prophylactic therapy. However, the target is difficult to meet due to issues within health facilities that cause health system diagnostic delays. Despite this, there is no information explored why health system diagnostic delays among tuberculosis patients.MethodA qualitative study was conducted by using different data collection methods and sources. Seventeen DOT providers, five laboratory professionals, six program managers, and seven Tuberculosis patients were interviewed. In addition, 22 governmental health facilities were observed for the availability of resources. Data obtained from the in-depth interviews was transcribed, coded, categorized, and thematized manually.ResultHealth system Diagnosis delays reasons were related with sample collection procedures, poor competency of health professionals, in addition to absences or scarcity of health professionals, medical products, and basic infrastructure. We found 18 health facilities without skilled personnel in the OPD, 7 health facilities with a broken microscope, and almost all health facilities without a separate room for sputum examination. Furthermore, 12 (54.5%) and 14 (63.6%) health facilities lacked access to water and electric power, respectively.ConclusionMany reasons for TB diagnosis delays have been identified in the study area. Poor competence of health workers and scarcity of resources were identified. Depending on the finding, we suggest strengthening the health workers’ training. Concrete strategies need to be designed to retain professionals. Training on human resource planning and budget preparation is needed for front-line managers. Managers have to work on the maintenance of diagnostic tools and facilitate transportation. The rural health facilities need to use another alternative power source.
“You have to make it cool”: How heterosexual Black men in Toronto, Canada, conceptualize policy and programs to address HIV and promote health
Authors: Antabe Roger , Robinson Kimberley , Husbands Winston , Miller Desmond , Harriot Andre , Johnson Kwesi , Wong Josephine Pui-Hing , Poon Maurice Kwong-Lai , Kirya John Wasikye , James Carl 
Published: December 2022

BackgroundBlack Canadian communities are disproportionately impacted by HIV. To help address this challenge, we undertook research to engage heterosexual Black men in critical dialogue about resilience and vulnerability. They articulated the necessity of making health services ‘cool’.MethodsWe draw on the analyses of focus groups and in-depth interviews with 69 self-identified heterosexual Black men and 12 service providers who took part in the 2016 Toronto arm of the weSpeak study to explore what it means to make health and HIV services ‘cool’ for heterosexual Black Canadian men.ResultsOur findings revealed four themes on making health services cool: (1) health promotion as a function of Black family systems; (2) opportunities for healthy dialogue among peers through non-judgmental interactions; (3) partnering Black men in intervention design; and (4) strengthening institutional health literacy on Black men’s health.ConclusionsWe discuss the implications of these findings for improving the health of Black Canadians.
Addressing the quality challenge of a human biospecimen biobank through the creation of a quality management system
Authors: Servais Marie-Dominique , Galtier Florence , Nouvel Agathe , Rebuffat Sandra , Laget Jonas , Géan Anne , Provost Nicolas , Lorcy Frédéric , Rigau Valérie , Couderc Guilhem , Géraud Philippe , Nocca David , Builles Nicolas , De Préville Nathalie , Lajoix Anne-Dominique 
Published: December 2022

Background
The objective of the COMET (COllection of MEtabolic Tissues) biobank project is to create a high-quality collection of insulin-sensitive tissues (liver, muscle, adipose tissues, and epiploic artery) and blood sample derivatives (plasma, serum, DNA and RNA), collected from 270 grade 2–3 obese patients undergoing bariatric surgery. Relevant data on patient such as clinical/biological characteristics and sample handling are also collected. For this, our aim was to establish a Quality Management System (QMS) to meet the reliability and quality requirements necessary for its scientific exploitation.

Materials and methods
The COMET QMS includes: (1) Quality Assurance to standardize all stages of the biobanking process, (2) Quality Controls on samples from the first patients included in order to validate the sample management process and ensure reproducible quality; and 3) “in process” Quality Controls to ensure the reliability of the storage procedures and the stability of the samples over time.

Results
For serum and plasma, several corrective actions, such as temperature handling and centrifugation conditions, were made to the protocol and led to improvement of the volume and quality of samples. Regarding DNA, all samples evaluated achieved a satisfactory level of purity and integrity and most of them yielded the required DNA quantity. All frozen tissue samples had RNAs of good purity. RNA quality was confirmed by RIN, achieving values in most cases over 7 and efficient amplification of housekeeping genes by RT-qPCR, with no significant differences among samples from the same tissue type. In the “in process” Quality Controls, DNA, RNA, and histological integrity of tissues showed no differences among samples after different preservation times.

Conclusion
Quality Control results have made it possible to validate the entire biobank process and confirm the utility of implementing QMS to guarantee the quality of a biospecimen collection.