bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial Etiology and Antibiotic Sensitivity Patterns in Late-Onset Neonatal Blood Infection
Authors: Elkadry Ihab Hussein , Ibrahim Ponnambath Chokkiyil Hafis 
Published: April 2022

Introduction:
The incidence and etiology of neonatal bloodstream infections vary globally. Early appropriate antibiotic therapy is crucial. An empiric antibiotic choice should be driven by accurate knowledge of the local spectrum of pathogens and susceptibilities.

Methodology:
A retrospective observational study was conducted on neonates born at local tertiary center from January 1, 2013, to December 31, 2018, with late-onset bloodstream infection (LBSI). Trends of causative organisms and antibiotic susceptibilities were analyzed.

Results:
A total of 696 LBSI occurred in 469 neonates. Overall incidence over the 6 years was 122/1000 admissions. The median time to LBSI was 13 days of life. Majority of infections occurred in infants <32 weeks. About 75.9% were caused by Gram-positive and the rest by Gram-negative bacteria. The most common organism was coagulase-negative staphylococcus (CoNS) which showed an increase in resistance to amikacin over time, but with stable sensitivity patterns to teicoplanin. Klebsiella and Escherichia coli were the most common Gram-negative organisms. There was improving sensitivity to cephalosporin in Klebsiella species. Sixteen percent of Gram-negative isolates were extended spectrum beta-lactamase (ESBL) producing. Majority of the Gram-negative bacteria including ESBL-producing strains remained sensitive to amikacin. An empiric antibiotic combination of teicoplanin and amikacin was appropriate to cover the majority of LBSIs.

Conclusions:
The majority of late-onset neonatal bloodstream infections in this study cohort were caused by Gram-positive organisms of which CoNS was the most common. The empiric antibiotic choices for LBSI on our unit seem appropriate based on the data. In units where the organism and susceptibility patterns are similar, the same antibiotic choices may be justified.
Combined Peripheral Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Predictive Biomarker for Pathological Complete Response after Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer Patients
Authors: Babbar Pooja , Rudresha A. H. , Dasappa Lokanatha , Abraham Linu Jacob , Babu M. C. Suresh , Lokesh K. N. , Rajeev L. K. , Saldanha Smitha C. , Abhilash GH , Pandey Amit 
Published: April 2022

Background:
Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently been used as prognostic markers in several tumors particularly more studied in gastrointestinal cancers. Impact of these markers on breast cancer is less studied. We evaluated the correlation of pretreatment NLR and PLR with pathological complete response (pCR) rate to neoadjuvant chemotherapy (NACT) treatment in triple-negative breast cancer (TNBC) patients in addition to analyze the association of these parameters with other clinicopathological parameters.

Materials and Methods:
Seventy-four early or locally advanced TNBC patients who received NACT and subsequent breast surgery from January 2018 to December 2020 were analyzed. Complete blood profiles done within 1 week of start of NACT were recorded and NLR and PLR were calculated. Pathological responses to NACT after surgery were recorded. The correlation of NLR and PLR with pCR rate and other clinicopathological parameters were evaluated.

Results:
The median age of presentation was 47 years. Eighteen patients (24.3%) had achieved pCR in this study. The pCR rate was higher in patients with low pre-treatment NLR (≤2.2) versus high NLR (>2.2) (P = 0.038) and low pre-treatment PLR (≤195.8) versus high PLR (>195.8) (P = 0.039). Both the pretreatment NLR and PLR values had no significant association with other clinicopathological profiles such as age, menopausal status, histopathological types and grade of differentiation, and initial clinical stage whereas there is an increase trend of ≤50 years of age group presentation in low NLR/PLR patients. On multivariate analysis, pre-NACT NLR and PLR were found to be independent predictive biomarker for pCR in TNBC patients.

Conclusion:
The study observed that the pre-NACT NLR and PLR are an indicator of pCR to NACT in TNBC unfolding its potential in future as a cost-effective prognostic and predictive biomarker.
Effectiveness of Posters in Enhancement of Knowledge about Cancer among Outpatients and Caregivers
Authors: Kulkarni Sadhana Sudhir , Joshi Bhavna Pramod , Nayak Prabha Pandurang , Kelkar Vasanti Prabhakar 
Published: April 2022

Introduction:
Noncommunicable diseases are posing serious public health threats in developed as well as developing countries. Cancer has become one of the leading health problems. The lack of knowledge about cancer in the general public is a major hurdle in its prevention, early detection, and treatment. Out of various media, display of posters is a simple and cost-effective way of mass education. Hence, the effectiveness of posters in imparting knowledge regarding cancer needs to be evaluated.

Materials and Methods:
After ethical clearance, a quasi-experimental study was undertaken among 314 outpatients and caregivers in waiting area of outpatient department of a tertiary health-care institute. Individuals aged 18 years and above, who could read, write, and understand Marathi language, participated in the study. Written informed consent was obtained. Each of the participants was asked to fill a pretested, structured questionnaire before their entry into display area of posters. Self-paced observation of posters was allowed, after which posttest questionnaire was administered. Totally 255 completely filled forms were considered for analysis. Data were analyzed using SPSS v25.0, and Chi-square values were calculated.

Results:
Of the 255 participants, 175 (68.6%) were males and 80 (31.3%) were females. The number of correct responses marked increased in posttest as compared to pretest for all 13 items. The difference was found to be statistically highly significant (P ≤ 0.0001) for 9 and significant (P = 0.012, 0.005) for 2 of the total 13 items in the questionnaire.

Conclusions:
This study provides evidence that posters can be used as an effective tool for health communication regarding cancer among outpatients and caregivers in outpatient department.
Use of amniotic membrane ameliorating postoperative discomfort in pterygium surgery
Authors: Mejía Luis F. , Gil Juan C. 
Published: April 2022

Purpose:
To report the results of using human amniotic membrane (AM) as a bandage at the end of pterygium surgery to diminish its uncomfortable postoperative symptoms.

Materials and Methods:
Observational, descriptive retrospective study in which patients with bilateral primary nasal pterygia were operated on with a conjunctival-limbal autograft with conventional suturing, one eye receiving an AM bandage at the end of surgery and the other not.

Results:
There were 20 eyes of 10 patients, five men, and five women, with a mean age of 28.7 ± 6.4 years; general postoperative symptoms (pain, burning sensation, and tearing) and foreign body sensation were statistically lower in the AM group at the 4th, 8th, and 12th postoperative day (P < 0.05).

Conclusions:
AM as a bandage at the end of pterygium surgery reduces the uncomfortable postoperative symptoms typical of such surgery.
INFLUENCE OF POLYOXIDONIUM, Poly(I:C), DALARGIN ON THE PROTECTIVE EFFICACY OF YERSINIA PESTIS VACCINE STRAIN EV LINE NIIEG IN EXPERIMENTAL PLAGUE
Authors: Shchukovskaya T. N. , Kurylina A. F. , Shavina N. Yu. , Bugorkova S. A. 
Published: April 2022

In this study, the use of immunoadjuvants polyoxidonium (azoximer bromide), Poly (I:C) as a synthetic analog of double-stranded RNA (TLR3 ligand), and synthetic analog of leu-enkephalin dalargin (DA) was experimentally investigated for their potential to minimize ImD50 Yersinia pestis vaccine strain EV line NIIEG co-administrated via invasive (subcutaneous) and noninvasive (intranasal) routes in lethal bubonic and pneumonic models of plague followed by challenge with virulent Y. pestis strains of the main and non-main subspecies from various natural plague foci. The data showed that in all cases immunoadjuvants significantly increased protective efficacy of Y. pestis vaccine strain EV line NIIEG co-administrated to BALB/c inbreed mice in case of lethal challenge with virulent Y. pestis strains in spite of varying magnitude of humoral immune response. Y. pestis vaccine strain EV line NIIEG formulated with polyoxidonium provided more effective protection against lethal challenge with wild-type high virulent strain Y. pestis in pneumonic model of plague. Polyoxidonium introduced into vaccine formula resulted in four-fold rise in total survival in animals with pneumonic plaque. Feasibility of using immunoadjuvants for regimen of specific and urgent plaque prevention is justified.
ANTIBODIES SPECIFIC TO CHEMICAL CARCINOGENS AND SEX STEROIDS AS WELL AS SERUM ESTRADIOL AND PROGESTERONE LEVELS IN FEMALES WITH BREAST CANCER AND LUNG CANCER MALES
Authors: Glushkov A. N. , Polenok E. G. , Mun S. A. , Gordeeva L. A. , Kostyanko M. V. , Kolpinsky G. I. , Lutsenko V. A. , Antonov A V. , Titov V. A. , Vafin I. A. 
Published: April 2022

Previous studies found some associations between immunoglobulin class A antibodies specific to benzo[a]pyrene (IgA-Bp), estradiol (IgA-Es) and progesterone (IgA-Pg) as well as breast cancer (BC) in females and lung cancer (LC) in males. It was suggested that such antibodies affect serum Es and Pg levels.Our study was aimed at revealing putative features of mutual effects of IgA-Bp, IgA-Es and IgA-Pg on serum Es and Pg level both in healthy and BC females as well as healthy and LC males.Serum levels of Es and Pg and IgA-Bp, IgA-Es and IgA-Pg were measured by ELISA in 190 nonsmoking healthy and 518 BC females as well as 312 smoking healthy and 196 LC males.It was found that healthy subjects vs cancer patients prominently differed by assessing individual Pg/Es ratios: healthy vs BC females had it set at 6.6 vs 2.9 (p 0.0001), respectively, whereas in healthy vs LC males it was at 5.2 vs 10.1 (p 0.0001), respectively.Individual Pg/Es ratio paralleled in healthy females with high vs low IgA-Bp/IgA-Pg 1.5 and IgA-Es/IgA-Pg 1.5 ratios (3.5 vs 9.7, p 0.0001). No T such associations were observed in BC patients. In addition, the lowest individual Pg/Es ratio in healthy males was found together with IgA-Es/ IgA-Pg 1.5 ratios accompanied with IgA-Bp/IgA-Pg ≤ 1.5 (2.9) and peaked in case of concurrently low IgA-Bp/IgA-Pg ≤ 1.5 and IgA-Es/IgA-Pg ≤ 1.5 (5.2, p = 0.005) or high IgA-Bp/IgA-Pg 1.5 and IgA-Es/IgA-Pg 1.5 (6.5, p = 0.002). In contrast, the lowest Pg/Es ratio (7.4) was revealed in LC patients simultaneously bearing high IgA-Bp/IgA-Pg 1.5 and low IgA-Es/IgA-Pg ≤ 1.5 ratios compared to simultaneously low ratios (11.3, p = 0.002).In conclusion, individual Pg/Es ratios depended on individual IgA-Bp/IgA-Pg and IgA-Es/IgA-Pg ratios. A cooperative influence of serum antibodies specific to environmental chemical carcinogens and endogenous steroids on hormone balance was featured both in healthy subjects as well as BC females and LC males.The data obtained may be useful while developing new strategies to cancer prevention: by using selective modulators of estrogen receptors and aromatase inhibitors as well as for development of anticancer vaccines.
Visualization of B10 regulatory cells in peripheral blood in physiological pregnancy
Authors: Ziganshina M. M. , Khaidukov S. V. 
Published: April 2022

The current trend in studies of the B-cell immunity is the study of small subpopulations of cells. It was found that a minor subpopulation of IL-10 producing B-cells (B10-reg cells) has the properties of limiting excessive reactions of the innate and adaptive immune response. Their regulatory and pathogenetic effect has been shown in various physiological and pathophysiological conditions, in particular in the pathological pregnancies.Due to the low content of B10-reg cells in the blood (up to 1%) and the difficulties of visualizing flow cytometry data, a previously developed method based on prolonged stimulation of peripheral blood cells with a combination of factors ((CD40L+CpG) and PMA) causing cell activation, proliferation and maturation, allows visualization of the enriched fraction of B10-reg cells (B10 cells + pro-B10 cells), the content of which exceeds 5%. The aim of this study was to obtain a stimulated ex vivo population of B10 cells + pro-B10 cells from the peripheral blood of patients with physiological pregnancy and to develop an optimal strategy for gating B10-reg cells for their visualization.Materials and methods: in patients with physiological pregnancy in the third trimester, peripheral blood was taken. The cells were stimulated according to two protocols. First protocol: short (5 hours) stimulation of whole blood cells under sterile conditions with mixture of PMA + ionomycin + brefeldin A. The second protocol: long-term (48 hours) stimulation of the isolated mononuclear fraction under sterile conditions with a mixture (CD40L + CpG) with the addition of PMA + ionomycin + brefeldin A during the last 5 hours. Cells were stained for surface markers (CD45, CD19, CD24, CD27, CD38) and the intracellular content of IL-10. Sample analysis was performed on a Navios™ flow cytometer.Results: a five-color cytometric analysis was performed and a sequential gating strategy was developed based on the isolation of the gate by lymphocytes (marker CD45); restriction of B-lymphocytes (marker CD19); isolating a subpopulation of B cells expressing the CD24 marker; limiting the two required subpopulations of B10-reg cells for CD27 and CD38: CD19+CD24hiCD27+IL-10+ and CD19+CD24hiCD38hiIL-10+. Stimulation of cells based on the first protocol allows visualizing up to 1% of both subpopulations, and based on the second protocol - about 10%. The method opens up prospects for fundamental research of B10-reg cells during pregnancy. The detectable amounts of an enriched population of B10-reg cells can be of diagnostic and prognostic value in the clinic for idiopathic obstetric complications.
Intervensi Edukasi Tentang Pengasuhan Anak pada 1000 Hari Pertama Kehidupan (HPK) Di Wilayah Puskesmas Takalalla Kabupaten Soppeng
Authors: Mappamadeng Andi Anggreany , Kurnaesih Een , Idris Fairus Prihatin 
Published: April 2022

Seorang anak membutuhkan asuh, asih, dan asah sebagai kebutuhan dasar untuk mencapai tumbuh kembang yang optimal. Tidak memenuhi nutrisi yang optimal pada 1000 HPK anak bisa berdampak buruk terhadap pertumbuhan otak yang optimal. Jika pertumbuhan otak tidak optimal, perkembangan kognitif anak pun terhambat. Ini dapat berakibat berkurangnya kecerdasan buah hati. Tujuan dari Penelitian ini adalah untuk menganalisis pengaruh Intervensi Edukasi tentang Pengasuhan Anak pada 1000 Hari Pertama Kehidupan di Wilayah Puskesmas Takalalla Kab. Soppeng. Jenis Penelitian yang digunakan adalah Quasi Eksperimen dengan pendekatan two group pretest and posttest design. Sampel dalam penelitian ini adalah ibu yang memiliki anak usia 0-24 bulan yang berjumlah 32 orang kelompok intervensi dan 32 orang kelompok kontrol. Pengumpulan data melalui Kuesioner. Data dianalisis dengan menggunakan uji T paired test dengan convidence interval (CI) 95% dan ? < 0.05. Hasil Penelitian menunjukkan bahwa Intervensi Edukasi terhadap Pengetahuan (p= 0.001), Sikap (p=0.000), Tindakan (p=0.002), dan kepercayaan (p=0.000) berpengaruh secara significan terhadap Pengasuhan Anak pada 1000 Hari Pertama Kehidupan di wilayah Puskesmas Takalalla Kab. Soppeng. Diharapkan agar dilakukan pemberian informasi yang lebih practical kepada masyarakat khususnya ibu, terutama calon ibu dalam mempersiapkan generasi penerus yang berkualitas terutama pada 1000 Hari Pertama Kehidupan Serta lebih mengoptimalkan Pelayanan Posyandu, dan melibatkan peran serta keluarga seperti suami dan orang tua ketika sosialisasi dan pemberian informasi dilakukan.
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Mortality and Conversion Rates to Below-Knee or Above-Knee Amputation After Transmetatarsal Amputation
Authors: Barcel D. Anthony , Odum Susan , Rowe Taylor , Sabatini J. Bradley , Ford Samuel E. , Davis W. Hodges , Irwin Todd A. 
Published: April 2022

Introduction:
The purpose of this study was to identify associated risk factors for complications, need for a higher level of amputation such as below-knee amputation (BKA) or above-knee amputation (AKA), and mortality after transmetatarsal amputation (TMA).

Methods:
We identified 265 patients who underwent 286 TMA procedures between June 2002 and July 2016. Medical records were reviewed for revision surgery and amputation. Mortality was verified using the National Death Index. We identified and documented potential risk factors including diabetes, hemoglobin A1c level, end-stage renal disease, cardiovascular disease, peripheral vascular disease, history of revascularization, contralateral amputation, and neuropathy. Sixty-eight percent were male, the mean age was 56.9 years (SD 12.8; range 24.1 to 92.1), and the median body mass index was 28.6 (interquartile range, 24.5 to 33.1).

Results:
Twenty-seven percent of the patients required a subsequent BKA or AKA after the index TMA surgery. The results of a multivariable model indicated that women (odds ratio [OR], 3.63; 95% confidence interval [CI], 1.716 to 7.672), patients aged 57 to 64 years (OR, 0.17; 95% CI, 0.06 to 0.51), and patients with a history of revascularization (OR, 7.06, 95% CI, 2.86 to 17.44) had markedly higher odds than the relevant comparison groups. Forty percent of the patients died after the index TMA at a median of 27 months. After adjusting for all patient factors, history of end-stage renal disease (OR, 2.2; 95% CI, 1.206 to 4.014) and cardiovascular disease (OR, 2.879; 95% CI, 1.615 to 5.131) remained markedly associated with mortality after TMA.

Discussion:
There are high rates of additional amputation after nontraumatic TMA and a high mortality rate. Surgeons should set realistic expectations with patients considered for TMA and identify risk factors, which may guide treatment. Treatment is multidisciplinary, requiring attention to surgical details, correction of vascular deficiency or contracture when present, and perioperative medical optimization.

Level of Evidence:
IV
The Effect of Obstructive Sleep Apnea on Venous Thromboembolism Risk in Patients Undergoing Total Joint Arthroplasty
Authors: Tang Alex , Aggarwal Vinay K. , Yoon Richard S. , Liporace Frank A. , Schwarzkopf Ran 
Published: April 2022

Introduction:
Obstructive sleep apnea (OSA) is a known risk factor for venous thromboembolism (VTE), defined as pulmonary embolism (PE) or deep vein thrombosis (DVT); however, little is known about its effect on VTE rates after total joint arthroplasty (TJA). This study sought to determine whether patients with OSA who undergo TJA are at greater risk for developing VTE versus those without OSA.

Methods:
A retrospective analysis was conducted on 12,963 consecutive primary TJA patients at a single institution from 2016 to 2019. Patient demographic data were collected through query of the electronic medical record, and patients with a previous history of OSA and VTE within a 90-day postoperative period were captured using the International Classification of Disease, 10th revision diagnosis and procedure codes.

Results:
Nine hundred thirty-five patients with OSA were identified. PE (0.6% versus 0.24%, P = 0.023) and DVT (0.1% versus 0.04%, P = 0.37) rates were greater for patients with OSA. A multivariate logistic regression revealed that patients with OSA had a higher odds of PE (odds ratio [OR] 3.821, P = 0.023), but not DVT (OR 1.971, P = 0.563) when accounting for significant demographic differences. Female sex and total knee arthroplasty were also associated with a higher odds of PE (OR 3.453 for sex, P = 0.05; OR 3.243 for surgery type, P = 0.041), but not DVT (OR 2.042 for sex, P = 0.534; OR 1.941 for surgery type, P = 0.565).

Conclusion:
Female patients with OSA may be at greater risk for VTE, specifically PE, after total knee arthroplasty. More attention toward screening procedures, perioperative monitoring protocols, and VTE prophylaxis may be warranted in populations at risk.
ANALISIS FAKTOR-FAKTOR YANG MEMPENGARUHI OPINI AUDIT GOING CONCERN
Authors: Dharma Dias Adi 
Published: April 2022

Tujuan penelitian ini untuk menganalisis pengaruh dari likuiditas, opini audit tahun sebelumnya dan reputasi auditor terhadap opini audit going concern. Populasi yang digunakan adalah perusahaan manufaktur yang terdaftar di Bursa Efek Indoneia (BEI) tahun 2015-2017. Pengambilan sampel menggunakan metode purposive sampling diperoleh sampel sebanyak 38 perusahaan. Uji hipotesis dalam penelitian ini menggunakan analisis regresi logistik. Hasil analisis penelitian menunjukan bahwa likuiditas dan reputasi auditor tidak berpengaruh terhadap opini audit going concern. Sedangkan opini audit tahun sebelumnya berpengaruh positif secara signifikan terhadap opini audit going concern. Secara simultan hasil penelitian ini menunjukan bahwa keseluruhan variabel (likuiditas, opini audit tahun sebelumnya dan reputasi auditor) berpengaruh terhadap opini audit going concern.
Measurements of Air Quality in Kindergartens and Schools in the Republic of Slovenia before the COVID-19 Epidemic
Authors: Muhič Simon , Muhič Tatjana 
Published: April 2022

This article presents measurements of air quality in school and kindergarten facilities, which were carried out in 311 spaces throughout the Republic of Slovenia, before taking measures to improve energy efficiency of measured buildings. During the measurements, the internal dimensions of the spaces were also measured, as well as data on the energy efficiency of buildings and weather data at the time of the measurements. The measurements focused on indoor carbon dioxide concentration levels and air temperature and relative humidity of indoor air. The performed statistical analysis of measurements shows a large dispersion of measured parameters in buildings, which cannot be statistically significantly related to the analyzed quantities. During the occupancy of the spaces, a statistically significant difference in the concentration of carbon dioxide in the indoor air between the spaces of schools and kindergartens was found. The results of the measurements were also evaluated from the point of view of the COVID-19 pandemic. The average value of measured carbon dioxide value during occupancy of the spaces was compared with the results of a model that predicts an airborne transmission risk. The measured average value of relative humidity in kindergartens shows that relative humidity was 37 %, where is the highest infection risk according to recent studies. The measured average carbon dioxide concentration in classrooms and playrooms significantly exceeds the safe concentration, predicted by the model, to prevent COVID-19 spread at the expected six-hour exposure.