bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Group B Streptococcus in pregnant women in Kerala and relation to neonatal outcomes: a prospective cross-sectional study
Authors: Gurudas Girija , Arjun Rajalakshmi , Jain Naveen , Ranganayaki Vidyalekshmy , Sasikumar Chinnu , Mohan Viji , Hussain Febeena , Pournami Femitha 
Published: October 2022

SUMMARY

Background and objectives
Early onset sepsis (EOS) in neonates is a scourge that contributes to morbidity and mortality. Prominent stakeholders recommend universal screening of antenatal women for Group B Streptococcus (GBS) and intrapartum antibiotic prophylaxis (IAP) for those who are carriers. However, there are controversies. Other guidelines allow region-specific protocols due to sociodemographic, geographical and ethnic differences. We planned to analyze the prevalence of GBS rectovaginal carriage at 36–37 weeks gestation and its effect on early neonatal status.

Methods
This prospective multidisciplinary study (Obstetrics, Perinatology, Neonatology, Microbiology and Infectious diseases) was conducted in our tertiary care center between February 2020 and May 2021.

Results
In our study group which included 966 mothers who delivered at the hospital, 4.8% of mothers who were screened by genito-rectal swabs were positive for GBS at 36–37 weeks gestation. All these mothers were given IAP as per protocol. Other organisms detected on screening mothers were Candida and Gram-negative bacteria. None of the neonates born to these mothers required any intensive care unit admission or therapy for systemic illness. There was no difference in clinically relevant outcomes between neonates who were born to GBS-positive mothers as compared to those born to negative screen result mothers.

Conclusions
GBS prevalence in our cohort was lower than most scientific reports. The neonates born to carrier mothers did not present with signs of early-onset sepsis.
Every treasured drop! Blood transfusion requirements in very preterm neonates after implementation of blood conservation strategies: an observational analytical study
Authors: Anand Vishnu , Pournami Femitha , Prithvi Ajai Kumar , Nandakumar Anand , Prabhakar Jyothi , Jain Naveen 
Published: October 2022

Abstract

Background
Certain morbidities are inevitable in preterm infants; the challenge lies in minimizing them. Anemia of prematurity is multifactorial. Therapy largely depends on adult red blood cell transfusions (RBCT); which inherently, are not without problems. Most literature in this respect are retrospective or evaluate individual stratagems to reduce RBCT.

Methods
This observational analytical study was planned to compare need for RBCT, before and after institution of blood conservation strategies (BCS). All those ≤30 weeks gestation at birth during two-time epochs were included (Before BCS: retrospective; After BCS: prospective). BCS constituted of delayed cord clamping (DCC), strict sampling indications, micro-sampling with point-of-care testing (MS-POCT) and adherence to RBCT thresholds.

Results
Of 45 enrolled neonates in each group, proportion of those requiring even 1 RBCT was significantly reduced after BCS [51.1% vs. 26.7%, p = 0.02, OR 0.35, 95%CI (0.14, 0.84)]. Calculated cumulative blood volume losses (35.3 ml vs. 21.9 ml) and loss per kilogram birth weight (35.3 ml/kg vs. 20.12 ml/kg) were significantly lower after BCS (p = 0.0036). Need for &gt;1 RBCT, mean lowest Hb, mean maximum-hemoglobin drop, need for arterial lines were reduced. Adherence to RBCT thresholds were acceptably good in both time epochs. However, the compliance to DCC was low in both groups, identifying one area of focus with scope for massive improvement.

Conclusions
Need for RBCT transfusions largely attributable to reduced blood losses for lab analysis were reduced after BCS. Installation of in-house MS-POCT seemed to be the pivotal factor. Units that care for very preterm infants must make attempts to procure MS-POCT equipment.
How Health Experiences in Tanzania Foster Change in Nursing Student Perceptions of Diversity and Self
Authors: Herron Elizabeth K. , Knopp Andrea 
Published: October 2022

Abstract
International study abroad programs offered by American universities provide opportunities to experience global health care disparities. This qualitative phenomenological research using a hermeneutic approach was conducted to explore how clinical experience in Tanzania influenced the knowledge and attitudes of prelicensure baccalaureate nursing students toward culture, health care disparities, and health care outcomes. Two main themes emerged from the research: thinking as another and carrying it forward.
Learning Impact of Armed Forces Medical Background on Military Nursing Students in an Accelerated Bachelor of Science in Nursing Program
Authors: Wiersma Gretchen Michele , Cox Catherine Wilson , McNelis Angela M. , Tebbenhoff Billinda , Schumann Mary Jean , Maring Joyce 
Published: October 2022

Abstract
The study examined differences between military students enrolled in an accelerated bachelor of science in nursing (BSN) program with and without medical experience and/or a previous bachelor’s degree on graduation grade point average (GPA) and NCLEX®-RN first-time pass rates. Significant differences were found between groups with/without military medical experience on NCLEX-RN, but not graduation GPA. Significant differences were found between groups with/without prior degree on GPA, but not on NCLEX-RN. Having both medical experience and a prior degree did not make a difference on GPA or NCLEX-RN. Findings offer guidance on admission criteria to accelerated programs for this unique group of students.
Understanding COVID-19’s Impact on Nursing Students’ Education, Professional Perceptions, Stress, and Coping
Authors: Overbaugh Kristen J. , Monforto Kathleen , DiGiacomo Pat , Maloney Courtney 
Published: October 2022

Abstract
This descriptive mixed-methods study was conducted to understand the impact of COVID-19 on undergraduate nursing students’ education, perceptions of nursing, stress, and coping. A convenience sample (N = 150) reported high levels of stress with higher stress levels significantly associated with lower coping. The essence of nursing, emotions surrounding the transition to nursing, educational barriers, and faculty-student relationships emerged as themes. The findings can be used to revise curricula and better support nursing students in future disasters and transitions to practice during unpredictable times.
Do bacterial vaccines/adjuvants prevent wheezing episodes in children?
Authors: Nieto Antonio , Nieto María , Conejero Laura , Subiza José Luis 
Published: October 2022

Purpose of review
To discuss recently discovered mechanisms of action of some bacterial vaccines that may account for their clinical benefit in the prevention of recurrent wheezing and asthma exacerbations in infants and early childhood.

Recent findings
Trained immunity has been shown to confer innate immune cells with a quite long-term nonspecific protection against a broad spectrum of pathogens. Inducers of trained immunity include some bacterial vaccines. Trained immunity-based vaccines (TIbV) of bacterial origin have the capability to induce nonspecific responses to a variety of pathogens, including respiratory viruses, in addition to their nominal bacterial antigens. Clinical data, from epidemiological surveys to well designed randomized clinical trials, indicate that TIbV formulated with bacteria prevent respiratory tract infections of viral cause, such as those associated with recurrent wheezing or asthma exacerbation, in children. Administration of these vaccines by the mucosal route may be important for their outcome in respiratory infections.

Summary
Mucosal bacterial immunotherapy, including certain TIbV, confer protection against a broad spectrum of pathogens, such as viruses, through a mechanism mediated by trained immunity. Clinical studies on the use of these preparations against recurrent wheezing reflect these mechanistic effects. These findings open a new avenue for the development of new strategies for this condition.
Transformed Cell Ratio (TCR): A Novel Parameter for Radiation Dose Estimation in Rapid Premature Chromosome Condensation (PCC) Assay Induced by 0–40 Gy Co-60 Gamma Rays
Authors: Gao Ling , Lu Xue , Liu Meng-Meng , Li Shuang , Liu Qing-Jie 
Published: October 2022

Abstract
Calyculin A-induced premature chromosome condensation (PCC) assay is considered a method for estimating radiation dose. In this study, a novel parameter, the transformed cell ratio (TCR), which is the ratio of irradiated and unirradiated lymphocyte transformation rates in the PCC assay, was suggested for dose estimation since it may be correlated with ionizing radiation dose. Human peripheral lymphocytes were irradiated in vitro with 60Co gamma ray doses of 0, 10, 20, 30, and 40 Gy, stimulated with phytohemagglutinin, and incubated for 3, 6, 12, or 48 h, division-blocked with colcemid, and PCC-induced by calyculin A or addition of extra cyclin-dependent kinase 1/cyclin B (CDK1/cyclinB). Results showed that G1-, S-, G2-, and M-PCC cells appeared in human lymphocyte culture, dose-response curves between the absorbed dose and lymphocyte transformation rate or TCR was fitted. TCR presented the best goodness-of-fit to a linear model (y = 0.0097 X +0.9952, R2 = 0.971, P < 0.05) within 0 to 40 Gy. Observations also suggested that TCR is a potential biological dosimeter for assessing received radiation doses ranging from 0 to 40 Gy during radiation exposure.
Outcomes of very delayed onset chronic postoperative endophthalmitis caused by Cutibacterium acnes including treatment with endolaser photocoagulation
Authors: Mammo Danny A. , Le Phuoc-Hanh , Arepalli Sruthi , Srivastava Sunil K. , Sharma Sumit 
Published: October 2022

Introduction:
To the authors' knowledge, these are 2 of the longest reported time periods between cataract surgery and diagnosis of chronic postoperative endophthalmitis. The clinical course and outcomes are discussed.

Patient and Clinical Findings:
2 patients underwent uneventful cataract surgery and presented with recurrent anterior segment inflammation years after the surgery. In the first case, an 88-year-old man presented with granulomatous uveitis in the left eye 4 years after intracapsular cataract extraction and posterior chamber intraocular lens (CE/PC IOL) placement. In the second case, a 79-year-old woman presented with iritis 7 years after CE/PC IOL.

Diagnosis, Intervention, and Outcomes:
Both patients were treated for presumed idiopathic uveitis for years before the diagnosis of chronic endophthalmitis caused by Cutibacterium acnes. 1 case required endolaser photocoagulation to an infectious nidus.

Conclusions:
Chronic postoperative endophthalmitis can present many years after uneventful cataract surgery.
Tachygastria in Preterm Infants
Authors: Ortigoza Eric Brum , Cagle Jackson , Brown Larry Steven , Mansi Sherief , Gosser Sandra Peralez , Montgomery Ashley D. , Foresman Zeri , Boren Monica L. , Pettit Pamela S. , Thompson Tami D. , Vasil Diana M. , Chien Jui‐Hong , Neu Josef , Koh Andrew Young , Sanghavi Rinarani , Mirpuri Julie 
Published: October 2022

Objectives:Tachygastria is a gastric dysrhythmia (>4 to ≤9 cycles per minute, cpm) associated with gastric hypomotility and gastrointestinal disorders. Healthy preterm infants spend more time in tachygastria than adults; however, normative values are not defined. We sought to determine the percent of time preterm infants spend in tachygastria.Methods:We conducted a longitudinal, prospective cohort study with weekly electrogastrography (EGG) recordings in 51 preterm <34 weeks’ gestation and 5 term (reference) infants. We calculated percentage recording time in tachygastria (% tachygastria) and determined the mean ± standard deviation (SD) across EGG sessions. Mixed effects model was performed to test weekly variance in % tachygastria and gestational age effect. Successive pre‐ and post‐prandial measurements were obtained to assess reproducibility of % tachygastria. We compared time to achieve full feeds between subjects with % tachygastria within 1 SD from the mean versus % tachygastria >1 SD from mean.Results:Three hundred seventy‐six EGG sessions were completed (N = 56). Mean % tachygastria was 40% with SD ±5%. We demonstrated no change in % tachygastria across 9 postnatal weeks (P = 0.70) and no gestational age effect. No difference was demonstrated between successive pre‐ (P = 0.91) and post‐prandial (P = 0.96) % tachygastria. Infants with 35%–45% tachygastria (within 1 SD from mean) had higher gestational age and less time to achieve full feeds than infants with <35% or >45% tachygastria.Conclusions:EGG is a reproducible tool to assess % tachygastria in preterm infants. Clinical significance of increased or decreased % tachygastria needs further investigation to validate if 35%–45% tachygastria is safe for feeding.
Budesonide and the Gluten Containing Elimination Diet as Treatments for Non‐responsive Celiac Disease in Children
Authors: Ali Ibrahim Awab , Kenyon Victoria , Fasano Alessio , Leonard Maureen M. 
Published: October 2022

Objectives:Non‐responsive celiac disease (NRCD) is defined as patients having persistent symptoms and enteropathy (Marsh 3 histology) suggestive of active celiac disease (CeD), after following a gluten‐free diet (GFD) for at least 12 months. NRCD is suggested to affect 15% of children with CeD but data are limited and there is no research to date describing treatment of children with this condition. The aim of this study was to describe our center’s approach to identifying and treating NRCD with budesonide and the Gluten Containing Elimination Diet (GCED).Methods:We performed a retrospective, single center analysis over a 5‐year period of patients with CD less than 18 years of age (inclusive) who underwent treatment for persistent symptoms and enteropathy despite following a GFD.Results:We identified 22 patients with NRCD. Thirteen were treated with the GCED for 3 months with 46% achieving both histological and symptomatic resolution. Nine patients were treated with budesonide (6–9 mg), with 89% achieving both symptomatic and histologic resolution after a median 3‐month treatment course. Further, 67% of patients who responded to the GCED and 100% of patients who responded to budesonide remained in remission for at least 6 months following treatment transition back to exclusive GFD.Conclusions:The GCED and budesonide can provide benefit for NRCD. Most patients with NRCD can return to a GFD after 3 months of treatment.
Impact of Dose Reduction of Topical Steroids to Manage Adrenal Insufficiency in Pediatric Eosinophilic Esophagitis
Authors: Nistel Mason , Furuta Glenn T. , Pan Zhaoxing , Hsu Stephanie 
Published: October 2022

Objective:
To evaluate the impact of type and dose of swallowed topical steroids (STS) and concurrent steroid therapy on the development and resolution of adrenal insufficiency (AI) in pediatric eosinophilic esophagitis (EoE).

Methods:
We performed a retrospective case-control study of pediatric EoE subjects in a single tertiary care center, who were treated with STS for at least 3 months and diagnosed with AI based on a peak stimulated cortisol level of <18 µg/dL (500 nmol/L). Steroid forms and doses, and endoscopy data were collected at the time of AI diagnosis and AI resolution or the last known evaluation. Steroid formulations were converted to a fluticasone-equivalent dose for analysis.

Results:
Thirty-two EoE subjects with AI were identified, and 20 had AI resolution, including 12 who remained on lower dose STS. Eight of the 32 patients were also treated with extended-release budesonide (ER budesonide), which resulted in a 7-fold higher total daily steroid dose, and thus were analyzed separately. When the 24 cases that were not on ER budesonide were compared to the 81 controls, no difference was found in the STS dose nor total daily steroid dose, although the inhaled steroid dose had marginal significance. Peak eosinophil counts tended to increase when STS doses were decreased, except in subjects on ER budesonide at AI diagnosis.

Conclusion:
Altering the total daily steroid regimen can lead to resolution of AI in patients with EoE, though this may come at the expense of disease control.
Prevalence and predictors of psychological distress in women diagnosed with breast cancer and women without breast cancer: a prospective study of psychological risk and resilience factors
Authors: Van Noyen Lotte , Markovitz Sabine , Broers Nick J. , Peters Madelon L. 
Published: October 2022

Abstract

Background:
There is some controversy whether psychological distress after breast cancer diagnosis and treatment remains elevated at the long-term follow-up. This study compares the prevalence of psychological distress and anxiety and depressive disorders between patients with breast cancer and women without cancer in a prospective longitudinal design. Moreover, risk and protective factors for psychological distress and anxiety and depressive disorders were compared between the 2 groups.

Methods:
Two hundred fifty-three patients with breast cancer who underwent surgery completed a series of self-report questionnaires immediately after surgery and 18 months later. In addition, 211 female participants without being diagnosed with cancer were assessed at the same time points. Outcomes are psychological distress as measured with the Hospital Anxiety and Depression Scale and possible presence of anxiety and depressive disorders measured with the Patient Health Questionnaire. Trait resilience, optimism, and neuroticism were investigated as protective or risk factors for the development of psychological distress, anxiety, and depression.

Results:
We found that the levels of psychological distress and the prevalence of anxiety and depressive disorders are higher in the breast cancer group both at baseline and at 18 months of follow-up. Trait resilience and optimism were observed to be protective factors, and neuroticism was found to be a risk factor in both the breast cancer group and the comparison group.

Conclusions:
Psychological distress, depression, and anxiety remain elevated in patients with breast cancer over a period of one-and-a-half year. The identified protective and risk factors for these conditions are not unique for patients with breast cancer.
Impact and cost-effectiveness of non-governmental organizations on the HIV epidemic in Ukraine among MSM
Authors: Trickey Adam , Walker Josephine G. , Bivegete Sandra , Semchuk Nadiya , Saliuk Tetiana , Varetska Olga , Stone Jack , Vickerman Peter 
Published: October 2022

Objective:
Non-governmental organizations (NGOs) in Ukraine have provided HIV testing, treatment, and condom distribution for MSM. HIV prevalence among MSM in Ukraine is 5.6%. We estimated the impact and cost-effectiveness of MSM-targeted NGO activities in Ukraine.

Design:
A mathematical model of HIV transmission among MSM was calibrated to data from Ukraine (2011–2018).

Methods:
The model, designed before the 2022 Russian invasion of Ukraine, evaluated the impact of 2018 status quo coverage levels of 28% of MSM being NGO clients over 2016–2020 and 2021–2030 compared with no NGO activities over these time periods. Impact was measured in HIV incidence and infections averted. We compared the costs and disability adjusted life years (DALYs) for the status quo and a counterfactual scenario (no NGOs 2016–2020, but with NGOs thereafter) until 2030 to estimate the mean incremental cost-effectiveness ratio (cost per DALY averted).

Results:
Without NGO activity over 2016–2020, the HIV incidence in 2021 would have been 44% (95% credibility interval: 36–59%) higher than with status quo levels of NGO activity, with 25% (21–30%) more incident infections occurring over 2016–2020. Continuing with status quo NGO coverage levels will decrease HIV incidence by 41% over 2021–2030, whereas it will increase by 79% (60–120%) with no NGOs over this period and 37% (30–51%) more HIV infections will occur. Compared with if NGO activities had ceased over 2016–2020 (but continued thereafter), the status quo scenario averts 14 918 DALYs over 2016–2030 with a mean incremental cost-effectiveness ratio of US$600.15 per DALY averted.

Conclusion:
MSM-targeted NGOs in Ukraine have prevented considerable HIV infections and are highly cost-effective compared with a willingness-to-pay threshold of 50% of Ukraine's 2018 GDP (US$1548).
An International Multicenter Prospective Study Evaluating the Long-term Oncological Impact of Adjuvant Chemotherapy in ypN+ Rectal Cancer
Authors: Denost Quentin , Fleming Christina A. , Burghgraef Thijs , Celerier Bertrand , Geitenbeek Ritchie , Rullier Eric , Tuynman Jurriaan , Consten Esther , Hompes Roel ,   Dutch MIRECA Collaborative Group (Pubmed Citable)
Published: October 2022

Objective:
To assess the oncological benefit of adjuvant chemotherapy (AC) in node positive (ypN+) rectal cancer after neoadjuvant chemoradiotherapy and radical surgery.

Background:
The evidence for AC after total mesorectal excision for locally advanced rectal cancer is conflicting and the net survival benefit is debated.

Methods:
An international multicenter comparative cohort study was performed comparing oncological outcomes in tertiary rectal cancer centers from the Netherlands and France. Patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by total mesorectal excision surgery and with positive lymph nodes on histologic examination (ypN+) were included for analysis. Kaplan-Meier curves were generated to compare disease-free (DFS) and overall survival in AC and non-AC groups.

Results:
Of 1265 patients screened, a total of 239 rectal cancer patients with ypN+ disease were included. Demographic and clinical characteristics were similar in both groups. Higher systemic recurrence rates were observed in the non-AC group compared with those who received AC [32.0% (n=40) vs 17.5% (n=11), respectively, P=0.034]. DFS at 1 and 5 years postoperatively were significantly better in the AC group (92% vs 80% at 1 year; 72% vs 51% at 5 years, P=0.024), whereas no difference in overall survival was observed.

Conclusions:
In this multicenter comparative cohort study, we identified an oncological benefit of AC in both systemic recurrence and DFS in ypN+ rectal cancer patients. From this data, systemic chemotherapy continues to confer oncological benefit in locally advanced ypN+ rectal cancer.