bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation of drug resistance pattern with Lipase Production in clinical isolates of Klebsiella pneumoniae
Authors: Devanathan Kanimozhi , Sivaraman Umadevi , Subramaniam Pramodhini , Easow Joshy 
Published: April 2022

Abstract
AimThe aim of our study is to correlate drug resistance patterns with Lipase production in clinical isolates of Klebsiella pneumoniae. Materials and MethodsA total of 150 clinical isolates of Klebsiella pneumoniae from various clinical samples collected during the period from July 2020 to December 2020 was included in this study. Lipase production was detected by tween 80 agar and an antibiotic susceptibility test has been performed by Kirby-Bauer disk diffusion method as per CLSI guidelines [10]. Extended Spectrum Beta-lactamase (ESBL) producers were detected by combined disc diffusion method and Carbapenemase production was detected by using the E-test strip method.Results and DiscussionOut of 150 consecutive non-duplicate isolates of Klebsiella pneumoniae, 74 isolates from Exudate, 7 from Blood, and 69 were from urine. Among 150 isolates, 85(56.6%) isolates produced Lipase production, 43(57.3%) were ESBL producers and 20(32.25%) isolates were positive for Carbapenemase production.ConclusionShowing virulence in clinical isolates of Klebsiella pneumoniae, and the antibiotic susceptibility pattern with lipase production in Klebsiella pneumoniae were noticed. If the virulence is increased in Klebsiella pneumoniae, a drug-resistant pattern also shows more resistance in number. And finally, to correlate the ESBL and Carbapenemase producer with lipase production, in that also the ESBL and Carbapenemase producer shows more number with lipase production. And also noted, when compared with outpatients, inpatients show more lipase production. And hence ampicillin is an intrinsic resistance to Klebsiella pneumoniae. In this study, to correlate the drug-resistant pattern, ESBL, and Carbapenemase producer with lipase production in clinical isolates of Klebsiella pneumoniae.
Evaluation of Nursing Competences in the Licensure Exam: an Italian Observational Study
Authors: Pantaleo Flavia , D'Angelo Daniela , Stievano Alessandro , Albanesi Beatrice , Petrizzo Antonello , Notarnicola Ippolito , Pulimeno Ausilia Maria Lucia , De Marinis Maria Grazia , Marchetti Anna 
Published: April 2022

Abstract
BackgroundIn recent years, the licensure exam in nursing has focused on the range of curricula and teaching methods used in international universities. ‘Tuning’ was the first document that sought to harmonise training purposes in terms of competences and learning outcomes in Europe. Nursing has 47 specific competences divided into 5 domains.MethodsA multicentric observational perspective study was conducted in four universities in the Lazio region for to describe which of 47 Tuning competences are evaluated during the licensure exam in Italian nursing degree courses, at what level of performance, in which clinical area and setting are contextualised, and what types of tests are used for their evaluation. The commissioners of the Professional Order of Rome – OPI – collected data via tests in the licensure exams for the academic years 2017–2019 using 2 grids, one for cognitive and one for psychomotor assessments.ResultsThe Tuning competences were requested 7522 times, 5130 for the cognitive trials and 2392 for the psychomotor trials. The most frequently requested competences were those associated with domain 2, and the level of performance most required in cognitive tests was autonomy of judgement (52.30%). In both tests, the most-investigated competences concerned the area of non-communicable diseases and the hospitalised adult patient. ConclusionsThe competences assessed most often were associated with nursing practice and clinical decision-making. These areas coincided with those deemed essential for the first cycle of studies and are contextualised for the priority health problems of hospitalised adult patients. This indicates that nursing education still focuses on the preparation of nursing students for hospital settings. Moreover, there is still a high degree of discrepancy in the types of tests used in different schools. Their choices are influenced by the number of students and the structural resources available.
CCM signaling complex (CSC) couples both classic and non-classic progesterone receptor signaling
Authors: Abou-Fadel Johnathan , Jiang Xiaoting , Grajeda Brian , Padarti Akhil , Ellis Cameron , Flores Esmeralda , O Alyssa-Marie Cailing-De La , Zhang Jun 
Published: April 2022

Abstract
Background
Breast cancer, the most commonly diagnosed cancer, remains the second leading cause of cancer death in the United States, and excessive Progesterone (PRG) or Mifepristone (MIF) exposure, including females under Hormone Replacement Therapy or taking hormonal contraceptives during their reproductive ages, may be at an increased risk for developing breast cancer. PRG exerts its cellular responses through signaling cascades involving classic, non-classic, or combined responses by binding to either classic nuclear PRG receptors (nPRs) or non-classic membrane PRG receptors (mPRs). Currently, the intricate balance and switch mechanisms between these two signaling cascades remain elusive. Three genes, CCM1-3, form the CCM signaling complex (CSC) which mediates multiple signaling cascades.
Methods
Utilizing molecular cellular biology, Omics, and systems biology approaches, we analyzed the relationship among CSC, PRG, and nPRs/mPRs.
Results
We discover that the CSC plays an essential role in coupling both classic and non-classic PRG signaling pathways by mediating crosstalk between them, forming the CmPn (CSC-mPRs-PRG-nPRs) signaling network. We found that mPR-specific PRG actions (PRG + Mifepristone) play an essential role in this CmPn network during breast cancer tumorigenesis; identified 4 categories of candidate biomarkers (9 intrinsic, 2 PRG-inducible, 1 PRG-repressive, 1 mPR-specific PRG-repressive, and 2 mPR-responsive) for Luminal-A breast cancers during tumorigenesis; and confirmed prognostic application of RPL13 and RPL38 as intrinsic biomarkers in Luminal-A breast cancers using a dual validation method.
Conclusions
We discover that the CSC plays an essential role in the CmPn signaling network.
Intraocular Pressure Screening During High-Volume Cataract Surgery Outreach in Ethiopia
Authors: McClain Ian J. , Rooney David M. , Tabin Geoffrey C. 
Published: April 2022

Abstract
Introduction: Glaucoma is the leading cause of irreversible blindness worldwide and is often undetected in resource-limited settings. Early screening and treatment of elevated intraocular pressure (IOP) reduces both the development and progression of visual field defects. IOP screening in developing countries is limited by access to ophthalmic equipment, trained ophthalmic staff, and follow up. High-volume cataract surgery outreaches in resource-limited countries provide ample opportunity for glaucoma screening, intervention and follow up. Methods: This prospective cross-sectional study took place during a cataract outreach campaign sponsored by the Himalayan Cataract Project (HCP) in partnership with Felege Hiwot Hospital in Bahir Dar, Ethiopia, during April 5th – April 10th 2021. IOP was measured on the surgical eye of patients before undergoing small incision cataract surgery (SICS) using rebound tonometry with an iCare tonometer model IC100.Results: Intraocular pressure (IOP) was measured in 604 eyes of 595 patients who received SICS. Mean IOP was 12.1 mmHg (SD = 5.0 mmHg). A total of 29 patients had an IOP greater than 21 mmHg representing 4.8% of total IOP measurements. A total of 17 patients received oral acetazolamide prior to surgery to acutely lower IOP. Six of these patients had their surgery delayed due to elevated IOP and 9 patients received excisional goniotomy at the time of SICS. A temporal approach during SCIS was taken for all patients with elevated IOP to allow for possible trabeculectomy at a future date.Discussion: IOP screening during high-volume cataract outreach campaigns can be performed safely, accurately and on a large scale with minimal resources and supplemental training. Pre-operative IOP measurement can improve surgical care at the time of cataract surgery as well as help establish long-term follow up for patients with glaucoma.
Exploring HIV Testing Service Models for Enhanced Positivity Yield in Southern Africa, 2022: A Systematic Review
Authors: Mugauri Hamufare D. , Karakadzai Mujinga , Mugurungi Owen , Chirenda Joconiah , Takarinda Kudakwashe , Tshimanga Mufuta 
Published: April 2022

Abstract
Background: In 2015, the World Health Organization issued HIV testing guidelines that shifted the global focus on HIV testing, from testing for coverage to targeted testing. This was done to enhance positivity yield and increase efficiency in the utilization of finite resources. In response, various nations developed varied models of implementation, which has exposed varied implementation of the targeted testing mantra. Because of the varied interpretations as shown by the many models that were developed in response to the guidelines, the success of the strategies remains unknown. Targeted testing is particularly important for Southern Africa, which, until this day, bears a disproportionate burden of HIV. Methods: We, therefore, intend to conduct a systematic review of all studies on targeted testing models that were developed and are being implemented in Southern Africa. Further, we will examine each identified model and its documented contribution to the identification of HIV positive clientsDiscussion: In Southern Africa, HIV/AIDS caused 336,175 deaths and more than 20 million Disability Adjusted Life Years (DALYs) in 2017 alone (9,10). Southern Africa remains the epicentre of HIV/AIDS with the top 10 high burdened countries all being within the Southern Africa Development Community (SADC). This study will therefore recommend the most effective Targeted HIV testing models for utilization in resource-limited settings.Conclusion: This review will provide insights into the models for targeted testing being implemented in Southern Africa. Further, it will demonstrate high-yield innovations that can be adopted to expedite HIV epidemic control through enhanced case detection
Practical counting of substitutive paths on a planar infrastructure network
Authors: Hayashi Yukio , Tanaka Atsushi 
Published: April 2022

Abstract
When there are many non-intersecting paths between two vertices on a network, the connectivity is fault-tolerant. Because of no common vertices on these paths, they can be emergently used in avoiding destroyed parts on the usual paths by any disasters or attacks. It gives a tolerance index whether the combination of non-intersecting paths is many or few. However, to enumerate such paths is an intractable combinatorial problem, no practical algorithm has been known. On the other hand, many socio-technological infrastructure networks are embedded on the surface of Earth. Thus, as an approximate solution, we extendedly apply the counting method based on a path matrix with our proposed mapping to directed acyclic graphs from a planar network according to each pair of source and terminal vertices. The tendency of many or few combinations of the paths is clearly investigated through computer simulations for real networks. This approach will be useful for evaluating the existence of substitutive paths to improve the tolerance in risk management.
How to avoid the posterosuperior femoral neck screw in-out-in intraoperatively: The application of the 150° oblique tangential fluoroscopic view
Authors: Zhang Jian , Tang Xin 
Published: April 2022

Abstract
Objective: This study investigates the application of the 150° tangential fluoroscopic projection as a novel fluoroscopic view to detect the posterosuperior screw in-out-in (IOI) in the inverted triangle cannulated screws fixation of femoral neck fractures.Methods: A retrospective analysis was conducted including 33 patients with femoral neck fractures enrolled from April to November 2021. All patients underwent closed reduction and internal fixation with inverted triangular cannulated screws under intra-operative C-arm fluoroscopy. The posterosuperior femoral neck screw position (whether in-out-in and the distance to the femoral neck cortex) was evaluated from the standard anteroposterior (AP), lateral view, and tangential view images. Postoperative computed tomography (CT) scan results are considered the gold standard for detecting the femoral neck screw locations.Results: Of 33 patients, no femoral neck screws were found to be placed IOI under the standard AP and lateral views. The tangential view revealed the posterosuperior screw was IOI in 8 patients, whereas the average distance between the posterosuperior screw and the posterior femoral neck cortex was 2.73±1.06 mm under the standard lateral view. Postoperative CT verified that posterosuperior screw was placed IOI in these 8 patients. In the other 25 patients, the average distance between the posterosuperior screw and the posterior femoral neck cortex was 5.48±1.26 mm under the standard lateral view and 2.76±1.08 mm under the tangential view, with a statistically significant difference between the two groups (p<0.05). Post-operative CT demonstrated that the femoral neck screws were completely contained in the femoral neck in these 25 patients.Conclusions: Intra-operative tangential view of 150° can effectively identify the posterosuperior screw IOI in the inverted triangle cannulated screws fixation of femoral neck fractures. Based on our study, we highly recommend the tangential view as a routine intraoperative fluoroscopic angle to avoid the posterosuperior screw IOI.
Chinese herbal formula comprehensively and significantly ameliorated a range of autonomic symptoms accompanying Parkinson’s disease: a case report
Authors: Zhang Yong , Xiao Zheman , Lu Zuneng 
Published: April 2022

Abstract
We reported a Parkinson’s disease (PD) patient with a range of severe forms of autonomic dysfunction, who achieved notable and comprehensive improvements in autonomic dysfunction, including orthostatic hypotension, anorexia, constipation, sexual dysfunction, intolerance to cold and heat, and hyperhidrosis, after taking a Chinese herbal formula (CHF). Furthermore, this CHF significantly reduced the total dose of antiparkinsonian drugs taken by the patient. Furthermore, the case report provides some clues about the pathogenesis of PD-related autonomic symptoms; that is, hypothalamic–pituitary–adrenal (HPA) axis hypofunction or kidney-yang deficiency may be the key mechanism for autonomic dysfunction in PD patients.
Geochemistry of the Paleocene saline lake in the southwestern Jianghan Basin, Central China: implications for provenance, tectonic setting, and palaeoclimate
Authors: Yan Kai , Wang Chunlian , Wang Jiuyi , Yu Xiaocan , Teng Xiaohua , Li Ruiqin , Liu Lihong 
Published: April 2022

Abstract
As an important sedimentary area of mineral resources in central and eastern China, the Jianghan Basin has received more and more attention. In recent years, thick evaporites and potassium and lithium-rich brine ores have been discovered in the Paleocene strata in the southern Jianghan Basin, which provides a material basis for studying the genesis of evaporites in central and eastern China. This paper aims to further understand the provenance, tectonic setting and paleoenvironment of the Paleocene Shashi Formation in the south of Jianghan Basin through the study of whole-rock geochemistry, so as to provide theoretical basis for the formation of evaporite. The chondrite-normalized REE distribution pattern of the Shashi Formation’s siltstones are characterized by enriched LREE and flat HREE similar to those of UCC with negative Eu anomalies. Combined with the geochemical element ratio discriminant diagram, such as Al2O3-TiO2, Zr/Sc-Th/Sc, Hf-La/Th, and La/Sc-Co/Th, these samples were sourced from felsic source rocks. Moreover, the discriminant diagrams of K2O/Na2O-SiO2/Al2O3, La-Th-Sc, and Th-Co-Zr/10 suggest that the samples were formed under the tectonic settings of active continental margin and continental island arc. The discriminant diagrams of Zr/Sc-Th/Sc and Al2O3-Zr-TiO2 show that all samples were not affected by recycling and hydraulic sorting. The weathering indices (CIA, CIW, PIA, and ICV) and the diagram of Al2O3-(CaO + Na2O)-K2O suggest that mild chemical weathering in the source area under arid climatic condition. And the palaeoclimatic indicators of Sr/Cu, Ga/Rb, and C-value indicate that the climate was cool and arid. According to the geochemical data and previous studies, the Paleocene sediments in the southwest of the Jianghan Basin were from felsic source rocks, and formed in the tectonic background of active continental margin and continental island arc, and the climate was mainly arid and cold.
Multicomponent exercises to prevent and reduce back pain in elderly care nurses: A randomized controlled trial
Authors: Otto Ann-Kathrin , Wollesen Bettina 
Published: April 2022

Abstract
Background
Sports science is making an important contribution to health services research and supports the development of tailored interventions, e.g., in nursing settings. Working in elderly care is associated with a high prevalence of low back pain (LBP). Due to the diverse requirements and high strains, multicomponent programs are essential to address all relevant factors. This randomized controlled trial investigated the effects of a tailored ten-week ergonomics and twelve-week strength training on lifting behavior (Progressive Isoinertial Lifting Evaluation (PILE-Test)), strength endurance (Biering-Sørensen-Test), LBP (Visual Analog Scale, VAS), functional impairment (Oswestry Disability Index (ODI)) and adherence (self-developed questionnaire).
Methods
n = 42 nurses were randomly assigned to the intervention (n = 20) or control group (n = 22). The data were collected at baseline, at ten weeks (after ergonomics training), at 22 weeks (after strength training), and at 34 weeks (follow-up). Group differences were analyzed by Chi2-Tests, ANOVA, and Linear Mixed Models.
Results
The intervention group showed an improved lifting performance (PILE-Test; 95% CI, 1.378–7.810, p = .006) and a reduced LBP compared to the control group (VAS; 95% CI, -1.987-0.034, p = .043) after ergonomics training (PILE-Test, F (1,34) = 21.070, p < .001; VAS, F (1,34) = 5.021, p = .032). The results showed no differences concerning the Biering-Sørensen-Test and the ODI. Positive adherence rates were observed.
Conclusions
This approach and the positive results are essential to derive specific recommendations for effective prevention. The study results can be completed in future research with additional strategies to reduce nurses’ burden further.
Trial registration:
The trial was registered at DRKS.de (DRKS00015249, registration date: 05/09/2018).
DOCNN: Double Optimized Convolution Neural Network for Brain Abnormalities Segmentation via MRI
Authors: V Nehru , V Prabhu 
Published: April 2022

Abstract
Brain Image segmentation is the predominate approach used to conquer an isolated anomaly portion of MRI image through proper thresholding strategy adapted in the deep learning model. Hence, it can converge to desire fitness value and thereby, finds optimistic solution to best threshold effectively. However, it may face high computational complexity because of meta-heuristic search of multi-level thresholding in order to console accuracy as well as efficiency. In this paper, an effective segmentation of abnormalities on magnetic resonance imaging (MRI) images using Double Optimized Convolution Neural Network (DOCNN) is proposed. In this method, first, Ant Bee Colony (ABC) algorithm along with Sugeno Fuzzy (SF) logic set is used to extract the salient features by knowing depth of penetration into tissues textures. Thereby, a cell infectious radius and spreading ratio is easily calculated. Second, a best optimistic threshold value is identified without creating any additional complexity by using back widow spider algorithm. When compared to other existing approaches such as Equilibrium optimization (EO), Particle swarm optimization (PSO), Slap swarm optimization (SSO), Genetic algorithm (GA), Firefly algorithm (FA), and Gray wolf optimization (GWO), With Other Deep Learning Models (CNN, RNN, LSTM) the proposed algorithm takes less computational complexity and high accuracy in terms of infectious portion detection. It has proved by estimated parameters such as specificity, precision, and sensitivity, Jaccard index and Dice coefficient index.
Anaplastic Thyroid Carcinoma With Ilium and Cervical Lymph Nodes Metastases: A Case Report and Literature Review
Authors: Gong Yi , Tan Wanlin , Liao Liyan , Xu Yan , Li Xiaodu , Zhang Qi , Niu Chengcheng 
Published: April 2022

Abstract
IntroductionAnaplastic thyroid carcinoma (ATC) is a rare and clinically aggressive thyroid carcinoma with highly mortality. However, no matter the diagnosis or therapy of this disease was still a dilemma.Case reportWe present a 79-year-old female patient with progressively enlarged thyroid nodules and diagnosed as tracheal stenosis. Two years ago, the patient had presented in our hospital with right ilium pain and diagnosed as poorly differentiated squamous cell carcinoma of lung with right ilium and cervical lymph nodes metastases. Then, the patient received intensity-modulated radiotherapy (IMRT) and cancer immunotherapy with pembrolizumab. Twenty months later, a total thyroidectomy and cervical lymph nodes dissection were undertaken, the histopathologic and immunohistochemical evaluations confirmed the diagnosis of ATC with local squamous cell carcinoma differentiation. Postoperatively, the patient received a cancer immunotherapy with anlotinib and envafolimab, but the patient died 6 weeks after surgery.ConclusionWe have reported a case of ATC with local squamous cell carcinoma differentiation, which was misdiagnosed as lung squamous cell carcinoma with extensive metastases and treated by cancer immunotherapy, the overall survival of this patient was more than 24 months.
Efficacy of pancreatic duct stenting prior to laparoscopic pancreatic tumor enucleation
Authors: Jiang Guixing , Zhou Xinyang , Wang Meng , Lin Tianyu , Chen Jionghuang , Ding Guoping , Wu Zhengrong , Lou Songmei , Liang Xiao , Cao Liping 
Published: April 2022

Abstract
Background
Laparoscopic pancreatic tumor enucleation (LPE) is a viable option for the removal of non-malignant pancreatic masses leading to maximally preservation of organ function. However, postoperative pancreatic fistula (POPF) is a concern, particularly when the mass is close to the main pancreatic duct (MPD). Pancreatic duct stents are used to treat refractory pancreatic leakage, Preoperative stenting of the MPD might prevent its injury when performing LPE.
Aimas
To explore the application value of pancreatic duct stents in laparoscopic pancreatic tumor enucleation.
Methods
We reviewed the clinical data of patients who underwent either Laparoscopic pancreatic enucleation with pancreatic stenting (LPE + PS) or LPE from January 2016 to December 2019. The patients were divided into two groups as LPE + PS and LPE.
Results
Twenty (9 LPE and 11 LPE + PS) were included in the final analysis. The 2 groups were equivalent in baseline characteristics and pathologic variables. LPE + PS group showed shorter hospital stay (p = 0.045), lower Grade B/C postoperative pancreatic fistula rates than the LPE group (p = 0.047). Intraoperative and postoperative outcomes, including operating time (p = 0.124), estimated blood loss (p = 0.258), were similar in the two groups. No local recurrence and no patients presented exocrine or endocrine insufficiency was detected in either group.
Conclusion
This procedure is associated with acceptable morbidity and it is safe. The preoperative stenting of the MPD may facilitates to identify the main pancreatic duct intraoperatively, might avoid the occurrence of Grade B/C POPF.