bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China
Authors: Huang Wan , Zhang Jisheng , Zeng Lingyi , Yang Chengru , Yin Lining , Wang Jianmin , Li Jie , Li Xinhui , Hu Kewang , Zhang Xiaoli , Liu Beizhong 
Published: January 2022

BackgroundThis study aimed to determine the molecular characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in a hospital in western Chongqing, southwestern China.MethodsA total of 127 unique CRKP isolates were collected from the Yongchuan Hospital of Chongqing Medical University, identified using a VITEK-2 compact system, and subjected to microbroth dilution to determine the minimal inhibitory concentration. Enterobacteriaceae intergenic repeat consensus polymerase chain reaction and multilocus sequence typing were used to analyze the homology among the isolates. Genetic information, including resistance and virulence genes, was assessed using polymerase chain reaction. The genomic features of the CRKP carrying gene blaKPC-2 were detected using whole-genome sequencing.ResultsST11 was the dominant sequence type in the homology comparison. The resistance rate to ceftazidime-avibactam in children was much higher than that in adults as was the detection rate of the resistance gene blaNDM (p &lt; 0.0001). Virulence genes such as mrkD (97.6%), uge (96.9%), kpn (96.9%), and fim-H (84.3%) had high detection rates. IncF (57.5%) was the major replicon plasmid detected, and sequencing showed that the CRKP063 genome contained two plasmids. The plasmid carrying blaKPC-2, which mediates carbapenem resistance, was located on the 359,625 base pair plasmid IncFII, together with virulence factors, plasmid replication protein (rep B), stabilizing protein (par A), and type IV secretion system (T4SS) proteins that mediate plasmid conjugation transfer.ConclusionOur study aids in understanding the prevalence of CRKP in this hospital and the significant differences between children and adults, thus providing new ideas for clinical empirical use of antibiotics.
Enhanced Proinflammatory Cytokine Production and Immunometabolic Impairment of NK Cells Exposed to Mycobacterium tuberculosis and Cigarette Smoke
Authors: Rao Yafei , Gai Xiaoyan , Le Yanqing , Xiong Jing , Liu Yujia , Zhang Xueyang , Wang Jundong , Cao Wenli , Sun Yongchang 
Published: January 2022

AimSmoker COPD patients with chest radiological signs of prior tuberculosis (TB) showed more severe lung damage, but the mechanisms remain unclear. Emerging evidence has implicated NK cells in the pathogenesis of both COPD and TB. The purpose of this study was to delineate the profile and cytokine production of NK-cell subpopulations and their immunometabolic changes after exposure to both cigarette smoke (CS) and Mycobacterium tuberculosis(MTB).MethodsWe profiled NK-cell subpopulations in terms of percentage and cytokine production by flow cytometry in smoker patients with pulmonary TB (PTB). In an in vitro coexposure model, we investigated proinflammatory cytokine production, glycolytic influx, and oxidative phosphorylation of NK cells under CS extract (CSE) and PPD costimulation.ResultsPeripheral blood NK cells in smoker patients with active PTB (CS+PTB group) showed altered proportion of subpopulations and excessive proinflammatory cytokine expressions. In vitro, CSE- and PPD-coexposed NK-92 cells displayed enhanced proinflammatory cytokine production, concurrent with decreased glycolytic influx and oxidative phosphorylation.ConclusionSmoker patients with active PTB showed enhanced proinflammatory cytokine expression within altered NK cell subpopulations. CSE and PPD coexposure induced heightened cytokine production concurrent with impaired cell metabolism in NK cells. These novel data suggest a potential role of NK cells in the pathogenesis of lung injury in subjects with coexposure to CS and TB.
Optimal Threshold of Homeostasis Model Assessment of Insulin Resistance to Identify Metabolic Syndrome in a Chinese Population Aged 45 Years or Younger
Authors: Lin Szu-Yu , Li Wen-Cheng , Yang Ting-An , Chen Yi-Chuan , Yu Wei , Huang Hsiung-Ying , Xiong Xue-Jie , Chen Jau-Yuan 
Published: January 2022

BackgroundMetabolic syndrome (MetS) is regarded as a major risk factor for diabetes mellitus and cardiovascular disease (CVD). The optimal threshold of the homeostasis model assessment of insulin resistance (HOMA-IR) has been established for predicting MetS in diverse populations and for different ages. This study assessed the serum HOMA-IR level in a healthy Chinese population aged ≤45 years to determine its relationship with metabolic abnormalities.MethodsCross-sectional study data were collected from health checkup records of Chinese adults aged ≥18 years between 2013 and 2016 at Xiamen Chang Gung Hospital. Participants completed a standardized questionnaire, which was followed by a health examination and blood sample collection. Exclusion criteria were as follows: history of known CVDs; liver, kidney, or endocrine diseases or recent acute illness; hypertension; hyperlipidemia; and pregnancy or lactation.ResultsThe clinical and laboratory characteristics of 5954 men and 4185 women were analyzed. Significant differences were observed in all assessed variables (all P &lt; 0.05). The optimal cutoff point of HOMA-IR for predicting MetS was 1.7 in men and 1.78 in women.ConclusionsWe aimed to determine the optimal cutoff point of HOMA-IR for predicting MetS in a healthy Chinese population aged ≤45 years. The findings of this study would provide an evidence-based threshold for evaluating metabolic syndromes and further implementing primary prevention programs, such as lifestyle changes in the target population.
Pregnancy in Women With Monogenic Diabetes due to Pathogenic Variants of the Glucokinase Gene: Lessons and Challenges
Authors: Timsit José , Ciangura Cécile , Dubois-Laforgue Danièle , Saint-Martin Cécile , Bellanne-Chantelot Christine 
Published: January 2022

Heterozygous loss-of-function variants of the glucokinase (GCK) gene are responsible for a subtype of maturity-onset diabetes of the young (MODY). GCK-MODY is characterized by a mild hyperglycemia, mainly due to a higher blood glucose threshold for insulin secretion, and an up-regulated glucose counterregulation. GCK-MODY patients are asymptomatic, are not exposed to diabetes long-term complications, and do not require treatment. The diagnosis of GCK-MODY is made on the discovery of hyperglycemia by systematic screening, or by family screening. The situation is peculiar in GCK-MODY women during pregnancy for three reasons: 1. the degree of maternal hyperglycemia is sufficient to induce pregnancy adverse outcomes, as in pregestational or gestational diabetes; 2. the probability that a fetus inherits the maternal mutation is 50% and; 3. fetal insulin secretion is a major stimulus of fetal growth. Consequently, when the fetus has not inherited the maternal mutation, maternal hyperglycemia will trigger increased fetal insulin secretion and growth, with a high risk of macrosomia. By contrast, when the fetus has inherited the maternal mutation, its insulin secretion is set at the same threshold as the mother’s, and no fetal growth excess will occur. Thus, treatment of maternal hyperglycemia is necessary only in the former situation, and will lead to a risk of fetal growth restriction in the latter. It has been recommended that the management of diabetes in GCK-MODY pregnant women should be guided by assessment of fetal growth by serial ultrasounds, and institution of insulin therapy when the abdominal circumference is ≥ 75th percentile, considered as a surrogate for the fetal genotype. This strategy has not been validated in women with in GCK-MODY. Recently, the feasibility of non-invasive fetal genotyping has been demonstrated, that will improve the care of these women. Several challenges persist, including the identification of women with GCK-MODY before or early in pregnancy, and the modalities of insulin therapy. Yet, retrospective observational studies have shown that fetal genotype, not maternal treatment with insulin, is the main determinant of fetal growth and of the risk of macrosomia. Thus, further studies are needed to specify the management of GCK-MODY pregnant women during pregnancy.
Decision-Making Process for the Management of Acute Stroke in Patients on Oral Anticoagulant: From Guidelines to Clinical Routine
Authors: Sibon Igor , Mazighi Mikael , Smadja Didier 
Published: January 2022

Background: The occurrence of both ischaemic (IS) and haemorrhagic stroke in patients on anticoagulation is a major issue due to the frequency of their prescriptions in westernised countries and the expected impact of anticoagulant activity on recanalization during an IS or on the outcomes associated with intracerebral haemorrhage (ICH). Several guidelines are available but sometimes differ in their conclusions or regarding specific issues, and their application in routine emergency settings may be limited by particular individual issues or heterogeneous local specificities.Methods: Based on the current guidelines and additional published data, the algorithms proposed in this paper aim to help the decision-making process regarding stroke management in the setting of concurrent anticoagulants by addressing specific clinical situations based on clinical variables commonly encountered in real-world practise.Results: For patients on non–vitamin K oral anticoagulants, reversion can be achieved with specific antidotes, but only idarucizumab, the specific dabigatran antidote, is indicated in both IS and ICH. Due to the low risk of a prothrombotic effect, idarucizumab can be immediately used in IS patients eligible for thrombolysis before the dabigatran concentration is known. To optimise ICH management, the time since symptom onset, with thresholds proposed at 6 and 9 hours based on the expected timing of haematoma expansion, could also to be taken into account.Conclusions: Anticoagulant reversal in patients presenting with a stroke remains a major issue, and algorithms based on a step-by-step approach may be useful for clinical practise. Real-life studies strongly support the benefits of idarucizumab availability in stroke units and emergency departments.
Association of Hypokalemia Incidence and Better Treatment Response in NSCLC Patients: A Meta-Analysis and Systematic Review on Anti-EGFR Targeted Therapy Clinical Trials
Authors: Zhou Jiawei , Bai Jianling , Yue Yuanping , Chen Xin , Lange Theis , You Dongfang , Zhao Yang 
Published: January 2022

BackgroundThis meta-analysis was designed to explore the relationship between the level of serum potassium and the treatment effect of epidermal growth factor receptor (EGFR) antagonist in advanced non-small cell lung cancer (aNSCLC).MethodsWe searched phase II/III prospective clinical trials on treatment with EGFR antagonists for aNSCLC patients. The objective response rate (ORR) and/or the disease control rate (DCR) and the incidence of hypokalemia of high grade (equal to or greater than grade 3) were summarized from all eligible trials. Heterogeneity, which was evaluated by Cochran’s Q-test and the I2 statistics, was used to determine whether a random effects model or a fixed effects model will be used to calculate pooled proportions. Subgroup analysis was performed on different interventions, line types, phases, and drug numbers.ResultsFrom 666 potentially relevant articles, 36 clinical trials with a total of 9,761 participants were included in this meta-analysis. The pooled ORR was 16.25% (95%CI = 12.45–21.19) when the incidence of hypokalemia was 0%–5%, and it increased to 34.58% (95%CI = 24.09–45.07) when the incidence of hypokalemia was greater than 5%. The pooled DCR were 56.03% (95%CI = 45.03–67.03) and 64.38% (95%CI = 48.60–80.17) when the incidence rates of hypokalemia were 0%–5% and greater than 5%, respectively. The results of the subgroup analysis were consistent with the results of the whole population, except for not first-line treatment, which may have been confounded by malnutrition or poor quality of life in long-term survival.ConclusionThe efficacy of anti-EGFR targeted therapy was positively associated with the hypokalemia incidence rate. Treatment effects on the different serum potassium strata need to be considered in future clinical trials with targeted therapy.
The Pharmacogenetics of Statin Therapy on Clinical Events: No Evidence that Genetic Variation Affects Statin Response on Myocardial Infarction
Authors: Trompet Stella , Postmus Iris , Warren Helen R. , Noordam Raymond , Smit Roelof A. J. , Theusch Elizabeth , Li Xiaohui , Arsenault Benoit , Chasman Daniel I. , Hitman Graham A. , Munroe Patricia B. , Rotter Jerome I. , Psaty Bruce M. , Caulfield Mark J. , Krauss Ron M. , Cupples Adrienne L. , Jukema Wouter J. 
Published: January 2022

Background: The pharmacogenetic effect on cardiovascular disease reduction in response to statin treatment has only been assessed in small studies. In a pharmacogenetic genome wide association study (GWAS) analysis within the Genomic Investigation of Statin Therapy (GIST) consortium, we investigated whether genetic variation was associated with the response of statins on cardiovascular disease risk reduction.Methods: The investigated endpoint was incident myocardial infarction (MI) defined as coronary heart disease death and definite and suspect non-fatal MI. For imputed single nucleotide polymorphisms (SNPs), regression analysis was performed on expected allelic dosage and meta-analysed with a fixed-effects model, inverse variance weighted meta-analysis. All SNPs with p-values &lt;5.0 × 10−4 in stage 1 GWAS meta-analysis were selected for further investigation in stage-2. As a secondary analysis, we extracted SNPs from the Stage-1 GWAS meta-analysis results based on predefined hypotheses to possibly modifying the effect of statin therapy on MI.Results: In stage-1 meta-analysis (eight studies, n = 10,769, 4,212 cases), we observed no genome-wide significant results (p &lt; 5.0 × 10−8). A total of 144 genetic variants were followed-up in the second stage (three studies, n = 1,525, 180 cases). In the combined meta-analysis, no genome-wide significant hits were identified. Moreover, none of the look-ups of SNPs known to be associated with either CHD or with statin response to cholesterol levels reached Bonferroni level of significance within our stage-1 meta-analysis.Conclusion: This GWAS analysis did not provide evidence that genetic variation affects statin response on cardiovascular risk reduction. It does not appear likely that genetic testing for predicting effects of statins on clinical events will become a useful tool in clinical practice.
Heavy Metals and Probabilistic Risk Assessment via Pheretima (a Traditional Chinese Medicine) Consumption in China
Authors: Xu Xiaohui , Li Limin , Zhou Heng , Hu Qing , Wang Lingling , Cai Qiang , Zhu Yin , Ji Shen 
Published: January 2022

Earthworms are known to accumulate inorganic contaminants from the soil; they are also used as a traditional Chinese medicine (TCM) called Pheretima, which might cause safety problems with long-term exposure. Here, this study was conducted to determine and analyze the level of heavy metal contamination such as arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), manganese (Mn), nickel (Ni), and lead (Pb) in Pheretima and then explore the probabilistic health risks caused by 8 heavy metals in 98 batches of Pheretima using Monte Carlo simulation. A risk assessment strategy was conducted to assess heavy metal–associated health risk of Pheretima based on consumption data. For random consumption sampling, the results found that the non-carcinogenic risk of As is higher than the acceptable level, and the carcinogenic risk levels of As and Cr exceeded the acceptable risk recommended by the USEPA. Cr and As were regarded as the priority metals for risk control in the present study. Finally, it was recommended that the dosing frequency should be less than 24 d/y. In general, this study conducted a probabilistic risk assessment of heavy metals in Pheretima, which would be of significance for policy makers to take effective strategies to improve the quality and safety of Pheretima.
Initial Home Dialysis Is Increased for Rural Patients by Accessing Urban Facilities
Authors: Adler Joel T. , Husain S. Ali , Xiang Lingwei , Rodrigue James R. , Waikar Sushrut S. 
Published: January 2022

Key Points

Despite having access to fewer facilities that offer home dialysis, rural patients with ESKD are more likely to be on home dialysis.There remains a significant mortality gap between urban and rural patients with ESKD, even when accessing home dialysis.

Background
The 240,000 rural patients with end stage kidney disease in the United States have less access to nephrology care and higher mortality than those in urban settings. The Advancing American Kidney Health initiative aims to increase the use of home renal replacement therapy. Little is known about how rural patients access home dialysis and the availability and quality of rural dialysis facilities.

Methods
Incident dialysis patients in 2017 and their facilities were identified in the United States Renal Data System. Facility quality and service availability were analyzed with descriptive statistics. We assessed the availability of home dialysis methods, depending on rural versus urban counties, and then we used multivariate logistic regression to identify the likelihood of rural patients with home dialysis as their initial modality and the likelihood of rural patients changing to home dialysis within 90 days. Finally, we assessed mortality after dialysis initiation on the basis of patient home location.

Results
Of the 97,930 dialysis initiates, 15,310 (16%) were rural. Rural dialysis facilities were less likely to offer home dialysis (51% versus 54%, P<0.001). Although a greater proportion of rural patients (9% versus 8%, P<0.001) were on home dialysis, this was achieved by traveling to urban facilities to obtain home dialysis (OR=2.74, P<0.001). After adjusting for patient and facility factors, rural patients had a higher risk of mortality (HR=1.06, P=0.004).

Conclusions
Despite having fewer facilities that offer home dialysis, rural patients were more often on home dialysis methods because they traveled to urban facilities, representing an access gap. Even if rural patients accessed home dialysis at urban facilities, rural patients still suffered worse mortality. Future dialysis policy should address this access gap to improve care and overall mortality for rural patients.
EDITORIAL
Authors: Colacrai Miryam , Lechini Gladys 
Published: January 2022

Esta nueva entrega de los Cuadernos de Política Exterior Argentina (CUPEA), correspondiente al segundo semestre 2021, nos encuentra aún desafiando al COVID y sus consecuencias locales, regionales y globales, en un contexto internacional signado por la incertidumbre y la disputa por la hegemonía.
En esta oportunidad, los Cuadernos de Política Exterior Argentina (Nueva época) -en tanto espacio de actualización académica y de promoción de debates en el campo disciplinar de las Relaciones Internacionales- no podían dejar de abordar cuestiones referidas a la política exterior argentina y latinoamericana.
تسويق متعدد المستويات التجاري في منظور الفقهاء
Authors: Wadud Abdul , Faiz Fauzinudin 
Published: January 2022

تسويق متعدد المستويات التجاري هو تركيب التسويق الذي استخدمته بعض الشركات كتخطيط كلي لتسويق منتاجاتها. وهذا التركيب تم تصميمه لتكوين رجال التسويق القائمين ببيع منتجات الشركة على أن يكافأ المروِّجون لهذه المنتاجات على بيعهم لها أفرادا، بل يكافأون على بيوع المروجين الآخرين الذين قاموا بتعريفهم هذه الشركةَ فيكوّن الخط التحتي من الناشرين المروجين وهيئة من المستويات المتعددة لمكافآت مختلفة في صورة الهرم وان الناس في تردد بين القبول والرفض، فمنهم من يقبل بدون شرط ولا نظر إلى عين المعاملة، ومنهم من يرفض بدون التعمق في أي وجه كان الخطر وهل هو حقيقي أم خيالي
EFFECTS OF COUNTERFEITS ON BRANDED PRODUCTS IN GARMENTS INDUSTRY: A PERSPECTIVE ON CONSUMER BEHAVIOUR
Authors: Gul Arbab , Muhammad Ali  , Muhammad Ahmad Khan Qazi  , Nuzulul Fatimah  
Published: January 2022

Counterfeit products are fake replicas of the real products. Deceptive counterfeits buying (consumer is well-aware about counterfeits) and non-deceptive counterfeits buying (consumer is not aware of counterfeits) are two dimensions of counterfeits buying. In Pakistan counterfeiting is an embryonic issue for many markets i.e., cosmetics, cellular, electronics, home appliances, and medicines. Furthermore, in last decade counterfeiting predominantly affect the garment’s market of branded products in Pakistan. This study aims to investigate the counterfeit effects on consumer buying perception of branded garments products. The various determinants used in this research for counterfeit brands’ purchase intentions and attitude towards counterfeits in Pakistani context have not been used in the way as they are used in the current research. After the data analysis it has been found that Purchase Intention of branded products and Attitude towards the branded products have positive significant impact on Counterfeits Products. Perceived quality of branded products has negative significant impact on counterfeits products while Status consumption has no significant impact on counterfeits Products.
Pengaruh Tehnik Relaksasi Genggam Jari Terhadap Penurunan Nyeri Pasien Post Sectio Caesarea Di Rsu Undata Palu Provinsi Sulawesi Tengah
Authors: Silfia Niluh Nita , Lisnawati Lisnawati , Arlina Ni Made 
Published: January 2022

Latar Belakang: Persalinan Sectio Caesarea di RSU Undata Palu pada tahun 2017 sebanyak 128 orang, tahun 2018 berjumlah 135 orang. Pasien post Sectio Caesarea yang diberikan terapi farmakologi sebanyak 45 orang karena mengalami nyeri akibat insisi pembedahan sehingga peneliti tertarik untuk melakukan penelitian tentang Tehnik relaksasi genggam jari. Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui pengaruh tehnik relaksasi genggam jari terhadap penurunan nyeri pasien post Sectio Caesarea di RSU Undata Palu Provinsi Sulawesi Tengah. Metedologi: Desain penelitian menggunakan Pre-Experimental one group Pretest-posttest design. Variabel dalam penelitian ini yaitu Variabel dependent (relaksasi genggam jari) dan variabel independent (penurunan nyeri). Pengambilan sampel dilakukan dengan tehnik Purposive sampling. Populasi dalam penelitian ini adalah semua ibu post Sectio Caesarea yang dirawat di Ruang Paviliun Matahari di RSU Undata Palu Provinsi Sulawesi Tengah. Jumlah sampel yang diambil sebanyak 30 orang. Pengumpulan data menggunakan skala Numerical Ranting Scale (NRS). Hasil: Hasil dari penelitian ini menunjukan bahwa sebelum pemberian relaksasi genggam jari mengalami nyeri ringan sebanyak 2 responden (6,7%), nyeri sedang sebanyak 27 responden (90%) dan nyeri berat terkontrol sebanyak 1 responden (3,3%). Setelah pemberian tehnik relaksasi genggam jari sebagian besar mengalami nyeri ringan seanyak 13 responden (43,3%), nyeri sedang sebanyak 16 responden (53,3%) dan tidak nyeri sebanyak 1 responden (3,3%). Didapatkan p value = 0,001 ≤ α = 0,05. Kesimpulan: Kesimpulan pada penelitian ini bahwa ada Pengaruh Relaksasi Genggam Jari Terhadap Penurunan Nyeri Pasien Post Sectio Caesarea di RSU Undata Palu Provinsi Sulawesi Tengah. Hasil dari penelitian ini diharapkan dapat diaplikasikan difasilitas kesehatan seperti di rumah sakit.