bluuebunny/crossref_metadata_2025_split huggingface dataset:
AmpC hyperproduction in a Cedecea davisae implant-associated bone infection during treatment: a case report and therapeutic implications
Authors: Notter Julia , Seiffert Salome N. , Zimmermann-Kogadeeva Maria , Bösch Anja , Wenger Robert , Strahm Carol , Frischknecht Manuel , Livermore David M. , Babouee Flury Baharak 
Published: January 2022

Abstract
Background
Data on antimicrobial resistance mechanisms are scanty for Cedecea spp., with very variable antibiotic resistance patterns documented. Here we report the first in vivo resistance evolution of a C. davisae clinical isolate in a patient with a complex hand trauma and provide insight in the resistance mechanism, leading to therapeutic implications for this pathogen.

Case presentation
Cedecea davisae was isolated from a patient with hand trauma during a first surgical debridement. Six days after primary surgical treatment and under antimicrobial treatment with amoxicillin-clavulanic acid and later cefepime, follow up cultures yielded C. davisae which demonstrated a resistance development. The susceptible parental isolate and its resistant derivative were characterized by whole genome sequencing, ampC, ompC and ompF by RT- PCR. The resistant derivative demonstrated an A224G SNP in ampD, the transcriptional regulator of ampC, leading to a His75Arg change in the corresponding AmpD protein. AmpC transcription of the resistant derivative was 362-times higher than the susceptible isolate. Transcription levels of ompF and ompC were 8.5-fold and 1.3-fold lower, respectively, in the resistant derivative. Downregulation of OmpF putatively resulted from a mutation in the presumed promoter region upstream of the dusB-Fis operon, a proposed regulator for ompF.

Conclusions
This case demonstrates the in vivo resistance development of C. davisae within 7 days similar to that of the members of the Enterobacter cloacae complex. Our findings add valuable information for future therapeutic management of these opportunistic pathogens as they warrant the same empirical treatment as AmpC producers.
Association of mitochondrial respiratory chain enzymes with the risk and mortality of sepsis among Chinese children
Authors: He Danni , Li Ning , Lu Xiuxiu , Li Wei , Chen Yuanmei , Sun Zhongyuan , Zhang Lipeng , Guo Linying , Cui Xiaodai , Song Guowei , Niu Wenquan , Zhang Qi 
Published: January 2022

Abstract
Background
Sepsis is a leading cause of pediatric morbidity and mortality worldwide. The aim of this study was to explore the association of decreased mitochondrial respiratory chain enzyme activities with the risk for pediatric sepsis, and explore their association with mortality among affected children.

Methods
A total of 50 incident cases with sepsis and 49 healthy controls participated in this study. The level of serum coenzyme Q10 was measured by high-performance liquid chromatography, and selected mitochondrial respiratory chain enzymes in WBC were measured using spectrophotometric. Logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI).

Results
The levels of CoQ10, complex II, complex I + III and FoF1-ATPase were significantly higher in healthy controls than in children with sepsis (p < 0.001, = 0.004, < 0.001 and < 0.001, respectively). In children with sepsis, levels of CoQ10 and complex I + III were significantly higher in survived cases than in deceased cases (p < 0.001). Per 0.05 μmol/L, 50 nmol/min.mg and 100 nmol/min.mg increment in CoQ10, complex I + III and FoF1-ATPase were associated with significantly lowered risk of having sepsis, even after adjusting for confounding factors (OR = 0.85, 0.68 and 0.04, p = 0.001, < 0.001 and < 0.001, respectively). Per 0.05 μmol/L and 50 nmol/min.mg increment in CoQ10 and complex I + III was associated with significantly lowered risk of dying from sepsis during hospitalization, and significance retained after adjustment (OR = 0.73 and 0.76, 95% CI: 0.59 to 0.90 and 0.64 to 0.89, p = 0.004 and 0.001, respectively) in children with sepsis.

Conclusions
Our findings indicate the promising predictive contribution of low serum CoQ10 and complex I + III to the risk of pediatric sepsis and its associated mortality during hospitalization among Chinese children.
Trial registration The trial was registered with www.chictr.org.cn, number ChiCTR-IOR-15006446 on May 05, 2015. Retrospectively registered.
Primary Toxoplasma gondii infection-associated with hemophagocytic syndrome in a man with HIV infection: a case report
Authors: Zhou Ying , Liu Yongfeng , Wen Ying 
Published: January 2022

Abstract
Background
Reactivation of latent Toxoplasma gondii (T. gondii) infection is more common than primary infection in patients with human immunodeficiency virus (HIV). We report a rare case of primary T. gondii infection-associated hemophagocytic syndrome (HPS).

Case presentation
A man with HIV infection presented with fever, dyspnea and pancytopenia. He was diagnosed with primary T. gondii infection by the seroconversion from single-positive IgM antibody to double-positive IgM and IgG antibody. Metagenomic next-generation sequencing (mNGS) of a plasma sample yielded high reads of T. gondii DNA. He responded well to combined anti-Toxoplasma medicines and glucocorticoid treatment.

Conclusions
In patients with HPS and positive T. gondii IgM antibody, mNGS analysis of a peripheral blood sample is helpful in diagnosing disseminated T. gondii infection. The dynamic changes by serological detection for IgM and IgG of T. gondii further supported the inference that the patient has experienced a primary T. gondii infection.
Restricting tumor lactic acid metabolism using dichloroacetate improves T cell functions
Authors: Rostamian Hosein , Khakpoor-Koosheh Mohammad , Jafarzadeh Leila , Masoumi Elham , Fallah-Mehrjardi Keyvan , Tavassolifar Mohammad Javad , M. Pawelek John , Mirzaei Hamid Reza , Hadjati Jamshid 
Published: January 2022

Abstract
Background
Lactic acid produced by tumors has been shown to overcome immune surveillance, by suppressing the activation and function of T cells in the tumor microenvironment. The strategies employed to impair tumor cell glycolysis could improve immunosurveillance and tumor growth regulation. Dichloroacetate (DCA) limits the tumor-derived lactic acid by altering the cancer cell metabolism.
In this study, the effects of lactic acid on the activation and function of T cells, were analyzed by assessing T cell proliferation, cytokine production and the cellular redox state of T cells. We examined the redox system in T cells by analyzing the intracellular level of reactive oxygen species (ROS), superoxide and glutathione and gene expression of some proteins that have a role in the redox system. Then we co-cultured DCA-treated tumor cells with T cells to examine the effect of reduced tumor-derived lactic acid on proliferative response, cytokine secretion and viability of T cells.

Result
We found that lactic acid could dampen T cell function through suppression of T cell proliferation and cytokine production as well as restrain the redox system of T cells by decreasing the production of oxidant and antioxidant molecules. DCA decreased the concentration of tumor lactic acid by manipulating glucose metabolism in tumor cells. This led to increases in T cell proliferation and cytokine production and also rescued the T cells from apoptosis.

Conclusion
Taken together, our results suggest accumulation of lactic acid in the tumor microenvironment restricts T cell responses and could prevent the success of T cell therapy. DCA supports anti-tumor responses of T cells by metabolic reprogramming of tumor cells.
Emotion regulation-enhanced group treatment for gambling disorder: a non-randomized pilot trial
Authors: Månsson Viktor , Molander Olof , Carlbring Per , Rosendahl Ingvar , Berman Anne H. 
Published: January 2022

AbstractBackgroundDespite the association of Gambling Disorder (GD) with poor mental health, treatment options generally lack components targeting emotional difficulties. This study investigated the feasibility and acceptability of adding strategies of emotion regulation to an eight-session weekly group treatment.MethodThis non-randomized pilot study recruited 21 treatment-seeking adults with GD, (mean age = 36.3, 19% females) from addiction care. In a mixed methods design, measures of within-group changes in self-reported symptoms of GD were complemented with thematic analysis of post-treatment interviews regarding the feasibility of the treatment.ResultsWithin-group scores on the Gambling Symptoms Assessment Scale (G-SAS) showed a 47% decrease (β: -0.1599, 95% CI: − 0.2526 to − 0.0500) from pre-treatment to 12-month follow-up, with Hedges’g = 1.07 (CI: 0.57–1.60).The number of GD-symptoms according to the Structured Clinical Interview for Gambling Disorder (SCI-GD) decreased from 7.0 (SD = 1.60) at pre-treatment to 2.1 (SD = 2.36) at 12-month follow-up. Participants completed an average of 6.3 sessions and rated the intervention high in satisfaction and acceptability. Feasibility interviews showed no noticeable negative effects or ethical issues. Furthermore, helpful components in the treatment were: increased awareness of emotional processes and strategies to deal with difficult emotions.ConclusionsAdding emotion regulation strategies in the treatment of GD is feasible and acceptable and warrants further investigation in a controlled trial.Trial registrationThis study was registered with ClinicalTrials.gov (IdentifierNCT03725735).
The new frontline: exploring the links between moral distress, moral resilience and mental health in healthcare workers during the COVID-19 pandemic
Authors: Spilg Edward G. , Rushton Cynda Hylton , Phillips Jennifer L. , Kendzerska Tetyana , Saad Mysa , Gifford Wendy , Gautam Mamta , Bhatla Rajiv , Edwards Jodi D. , Quilty Lena , Leveille Chloe , Robillard Rebecca 
Published: January 2022

AbstractBackgroundGlobal health crises, such as the COVID-19 pandemic, confront healthcare workers (HCW) with increased exposure to potentially morally distressing events. The pandemic has provided an opportunity to explore the links between moral distress, moral resilience, and emergence of mental health symptoms in HCWs.MethodsA total of 962 Canadian healthcare workers (88.4% female, 44.6 + 12.8 years old) completed an online survey during the first COVID-19 wave in Canada (between April 3rd and September 3rd, 2020). Respondents completed a series of validated scales assessing moral distress, perceived stress, anxiety, and depression symptoms, and moral resilience. Respondents were grouped based on exposure to patients who tested positive for COVID-19. In addition to descriptive statistics and analyses of covariance, multiple linear regression was used to evaluate if moral resilience moderates the association between exposure to morally distressing events and moral distress. Factors associated with moral resilience were also assessed.FindingsRespondents working with patients with COVID-19 showed significantly more severe moral distress, anxiety, and depression symptoms (F > 5.5,p < .020), and a higher proportion screened positive for mental disorders (Chi-squared > 9.1,p = .002), compared to healthcare workers who were not. Moral resilience moderated the relationship between exposure to potentially morally distressing events and moral distress (p < .001); compared to those with higher moral resilience, the subgroup with the lowest moral resilience had a steeper cross-sectional worsening in moral distress as the frequency of potentially morally distressing events increased. Moral resilience also correlated with lower stress, anxiety, and depression symptoms (r > .27,p < .001). Factors independently associated with stronger moral resilience included: being male, older age, no mental disorder diagnosis, sleeping more, and higher support from employers and colleagues (B [0.02, |-0.26|].InterpretationElevated moral distress and mental health symptoms in healthcare workers facing a global crisis such as the COVID-19 pandemic call for the development of interventions promoting moral resilience as a protective measure against moral adversities.
The feasibility and acceptability of a classroom-based physical activity program for children attending specialist schools: a mixed-methods pilot study
Authors: Emonson Chloe , Papadopoulos Nicole , Rinehart Nicole , Mantilla Ana , Fuelscher Ian , Boddy Lynne M. , Pesce Caterina , McGillivray Jane 
Published: January 2022

Abstract
Background
Children with disabilities often engage in less than the recommended amount of daily physical activity (PA). Classroom-based PA breaks are a favourable method of promoting PA for children. However, evaluations of these programs in specialist schools are scarce, with even less research into their feasibility and acceptability. This may hinder effective implementation and program scalability. This pilot study investigated the feasibility and acceptability of implementing a classroom-based PA break program in Australian specialist school classrooms, using the Australian Joy of Moving (AJoM) program.

Methods
Forty primary/junior classes and their teachers across five specialist schools implemented the AJoM program for eight weeks as the intervention group within a pilot cluster randomised controlled trial. A mixed-methods design investigated classroom teachers’ (N = 22; 6 males, 16 females) perspectives of the feasibility and acceptability of the program after implementation through semi-structured telephone interviews (n = 7 teachers), qualitative survey responses (n = 18 teachers) and quantitative survey items (n = 19 teachers). Qualitative data were analysed using predominantly deductive thematic analysis. Quantitative data were analysed using descriptive statistics.

Results
Classroom-based PA breaks may be feasible for getting children with disabilities more active at school. However, considerable variation exists in teachers’ perception of the AJoM experience. While several teachers indicate that the program content could be pertinent for their class, common divergences in perceptions of feasibility and acceptability appear to relate to the age and developmental level or needs of the students in the class.

Conclusions
This study provides preliminary evidence for the feasibility and acceptability of implementing classroom-based PA breaks in specialist schools. However, results demonstrate the importance of (1) allowing a high level of flexibility in the design and implementation of programs to meet the varying needs of class groups and (2) providing a large variety of resources to cater to the heterogeneity of the children.

Trial registration
This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000193178) on 11 February 2019.
Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing
Authors: Jiang Fangfang , Xu Yuanyuan , Liu Li , Wang Kai , Wang Lu , Fu Gengfeng , Wang Liping , Li Zhongjie , Xu Junjie , Xing Hui , Wang Ning , Zhu Zhengping , Peng Zhihang 
Published: January 2022

AbstractBackgroundGreat achievements have been achieved by free antiretroviral therapy (ART). A rapid and accurate prediction of survival in people living with HIV/AIDS (PLHIV) is needed for effective management. We aimed to establish an effective prognostic model to forecast the survival of PLHIV after ART.MethodsThe participants were enrolled from a follow-up cohort over 2003-2019 in Nanjing AIDS Prevention and Control Information System. A nested case-control study was employed with HIV-related death, and a propensity-score matching (PSM) approach was applied in a ratio of 1:4 to allocate the patients. Univariable and multivariable Cox proportional hazards analyses were performed based on the training set to determine the risk factors. The discrimination was qualified using the area under the curve (AUC) and concordance index (C-Index). The nomogram was calibrated using the calibration curve. The clinical benefit of prognostic nomogram was assessed by decision curve analysis (DCA).ResultsPredictive factors including CD4 cell count (CD4), body mass index (BMI) and hemoglobin (HB) were determined and incorporated into the nomogram. In the training set, AUC and C-index (95% CI) were 0.831 and 0.798 (0.758, 0.839), respectively. The validation set revealed a good discrimination with an AUC of 0.802 and a C-index (95% CI) of 0.786 (0.681, 0.892). The calibration curve also exhibited a high consistency in the predictive power (especially in the first 3 years after ART initiation) of the nomogram. Moreover, DCA demonstrated that the nomogram was clinically beneficial.ConclusionThe nomogram is effective and accurate in forecasting the survival of PLHIV, and beneficial for medical workers in health administration.
Environmental, social, and corporate governance activities with employee psychological well-being improvement
Authors: Piao Xiangdan , Xie Jun , Managi Shunsuke 
Published: January 2022

Abstract
Background
Environmental, social, and governance (ESG) engagement is expected to benefit corporations in terms of their efficiency and sustainability. The transformative change in management practices would not only provide support for employees but also bring about additional workload, which may affect employee psychological well-being. However, the examination of the relationship between corporate ESG activities and occupational stress is scarce; hence, this study aims to fill this knowledge gap.

Methods
In total, 110,351 observations were collected from 41,998 employees regarding occupational stress to reflect employee psychological well-being. The data were derived from 11 corporations in Japan from 2017 to 2019. Data on ESG activities were collected from the MSCI ESG database from 2015 to 2017. The effect of 1-year lagged corporate ESG activities on employee psychological well-being was investigated using a lagged variable linear regression model.

Results
Positive and negative relationships were found between corporate environmental activities and occupational stress. Activities that reduce water stress during operation and adopt clean technology were found to benefit employees’ psychological well-being. On the contrary, the program for reducing toxic emissions and waste lowered employees’ occupational stress levels significantly. Regarding corporate social activities, the improvement of job satisfaction or work-life balance was associated with occupational stress. However, corporate governance activities were found to have unfavorable effects on employees’ psychological well-being.

Conclusion
The effects of corporate ESG activities on employees’ psychological well-being are found. The managerial implications suggest that caring for employees’ occupational stress during the implementation of environmental activities is necessary, and the adoption of social activities could enhance employees’ psychological well-being. Notably, corporate governance activities are a stressor for employees; top management teams should pay attention to it.
Facilitators and barriers to compliance with COVID-19 guidelines: a structural topic modelling analysis of free-text data from 17,500 UK adults
Authors: Wright Liam , Paul Elise , Steptoe Andrew , Fancourt Daisy 
Published: January 2022

Abstract
Background
During the COVID-19 pandemic, the UK government implemented a series of guidelines, rules, and restrictions to change citizens’ behaviour to tackle the spread of the virus, such as the promotion of face masks and the imposition of lockdown stay-at-home orders. The success of such measures requires active co-operation on the part of citizens, but compliance was not complete. Detailed research is required on the factors that aided or hindered compliance with these measures.

Methods
To understand the facilitators and barriers to compliance with COVID-19 guidelines, we used structural topic modelling, a text mining technique, to extract themes from over 26,000 free-text survey responses from 17,500 UK adults, collected between 17 November and 23 December 2020.

Results
The main factors facilitating compliance were desires to reduce risk to oneself and one’s family and friends and to, a lesser extent, the general public. Also of importance were a desire to return to normality, the availability of activities and technological means to contact family and friends, and the ability to work from home. Identified barriers were difficulties maintaining social distancing in public (due to the actions of other people or environmental constraints), the need to provide or receive support from family and friends, social isolation, missing loved ones, and mental health impacts, perceiving the risks as low, social pressure to not comply, and difficulties understanding and keep abreast of changing rules. Several of the barriers and facilitators raised were related to participant characteristics. Notably, women were more likely to discuss needing to provide or receive mental health support from friends and family.

Conclusion
The results demonstrated an array of factors contributed to compliance with guidelines. Of particular policy importance, the results suggest that government communication that emphasizes the potential risks of the virus and provides simple, consistent guidance on how to reduce the spread of the virus would improve compliance with preventive behaviours as COVID-19 continues and for future pandemics.
Is concern for gynaecological alarm symptoms associated with healthcare-seeking? A Danish population-based cross-sectional study
Authors: Vejlgaard Anja Schmidt , Rasmussen Sanne , Haastrup Peter Fentz , Jarbøl Dorte Ejg , Balasubramaniam Kirubakaran 
Published: January 2022

Abstract
Background
Diagnosing cancer at an early stage increases survival, and for most gynaecological cancers the diagnostic pathway is initiated, when women seek medical attention with symptoms. As many factors influence healthcare-seeking, knowledge about these factors is important. Concern can act as a barrier or a trigger for women experiencing gynaecological alarm symptoms. This study aimed to examine whether concern for the symptom or the current health was associated with healthcare-seeking among women with gynaecological alarm symptoms.

Methods
Some 100,000 randomly selected Danish citizens were invited to a national web-based survey. The questionnaire included items regarding symptom experiences, healthcare-seeking and concern for the experienced symptoms and current health. This study included 5019 women with self-reported gynaecological alarm symptoms (pelvic pain, pain during intercourse, bleeding during intercourse and postmenopausal bleeding). Concern was reported on a 5-point Likert scale from ‘not at all’ to ‘extremely’. Data were analysed using multivariate logistic regression models.

Results
Women who were ‘extremely’ concerned about a gynaecological alarm symptom had two to six times higher odds of reporting healthcare-seeking compared to women who were ‘not at all’ concerned. Symptom concern was associated with higher odds of healthcare-seeking for all four gynaecological alarm symptoms and the odds increased with increasing levels of concern. Additionally, concern for current health was associated with higher odds of healthcare-seeking. Concern for current health as expressed by others was positively associated with healthcare-seeking but had only minor influence on the association between concern for current health and healthcare-seeking.

Conclusions
Concern for a gynaecological alarm symptom and for current health was positively associated with healthcare-seeking. The results can be used for future informational health campaigns targeting individuals at risk of postponing warranted healthcare-seeking.