bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular characterization of multidrug-resistant ESKAPEE pathogens from clinical samples in Chonburi, Thailand (2017–2018)
Authors: Ruekit Sirigade , Srijan Apichai , Serichantalergs Oralak , Margulieux Katie R. , Mc Gann Patrick , Mills Emma G. , Stribling William C. , Pimsawat Theerasak , Kormanee Rosarin , Nakornchai Suthisak , Sakdinava Chaiwat , Sukhchat Prawet , Wojnarski Mariusz , Demons Samandra T. , Crawford John M. , Lertsethtakarn Paphavee , Swierczewski Brett E. 
Published: August 2022

Abstract
Background
ESKAPEE pathogens Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp. and Escherichia coli are multi-drug resistant (MDR) bacteria that present increasing treatment challenges for healthcare institutions and public health worldwide.

Methods
431 MDR ESKAPEE pathogens were collected from Queen Sirikit Naval Hospital, Chonburi, Thailand between 2017 and 2018. Species identification and antimicrobial resistance (AMR) phenotype were determined following CLSI and EUCAST guidelines on the BD Phoenix System. Molecular identification of antibiotic resistant genes was performed by polymerase chain reaction (PCR), real-time PCR assays, and whole genome sequencing (WGS).

Results
Of the 431 MDR isolates collected, 1.2% were E. faecium, 5.8% were S. aureus, 23.7% were K. pneumoniae, 22.5% were A. baumannii, 4.6% were P. aeruginosa, 0.9% were Enterobacter spp., and 41.3% were E. coli. Of the 401 Gram-negative MDR isolates, 51% were carbapenem resistant, 45% were ESBL producers only, 2% were colistin resistance and ESBLs producers (2%), and 2% were non-ESBLs producers. The most prevalent carbapenemase genes were blaOXA-23 (23%), which was only identified in A. baumannii, followed by blaNDM (17%), and blaOXA-48-like (13%). Beta-lactamase genes detected included blaTEM,blaSHV, blaOXA, blaCTX-M, blaDHA, blaCMY, blaPER and blaVEB. Seven E. coli and K. pneumoniae isolates showed resistance to colistin and carried mcr-1 or mcr-3, with 2 E. coli strains carrying both genes. Among 30 Gram-positive MDR ESKAPEE, all VRE isolates carried the vanA gene (100%) and 84% S. aureus isolates carried the mecA gene.

Conclusions
This report highlights the prevalence of AMR among clinical ESKAPEE pathogens in eastern Thailand. E. coli was the most common MDR pathogen collected, followed by K. pneumoniae, and A. baumannii. Carbapenem-resistant Enterobacteriaceae (CRE) and extended spectrum beta-lactamases (ESBLs) producers were the most common resistance profiles. The co-occurrence of mcr-1 and mcr-3 in 2 E. coli strains, which did not affect the level of colistin resistance, is also reported. The participation of global stakeholders and surveillance of MDR remain essential for the control and management of MDR ESKAPEE pathogens.
Preoperative anxiety and its associated factors among women undergoing elective caesarean delivery: a cross-sectional study
Authors: Fentie Yewlsew , Yetneberk Tikuneh , Gelaw Moges 
Published: August 2022

Abstract
Background
Anxiety is a behavioral expression of tension and unpleasant emotion that arises from multifactorial dimensions that might increase the mortality of patients during anesthesia and surgery. This study aimed to verify the prevalence and associated factors of preoperative anxiety among women undergoing elective cesarean delivery.

Method
A cross-sectional study design was conducted on a total of 392 patients who underwent elective cesarean delivery in Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia from October 15, 2020, to September 15, 2021. Data was collected using a validated Amsterdam questionnaire, after translating to the local language (Amharic). Descriptive statistics were expressed in percentages and presented in tables. Bivariable and multivariable logistic analyses were done to identify factors associated with preoperative anxiety. The statistical significance level was set at P < 0.05 with 95% CI.

Results
The overall prevalence of preoperative anxiety in women undergoing elective cesarean delivery was 67.9 [95% CI = (63.0–72.7)]. Participants who came from rural areas [AOR = 2.65; 95%CI: 1.27–5.53], farmers [AOR = 2.35; 95%CI: 1.02–5.40], participants with no previous surgical and anesthesia history [AOR = 2.91; 95%CI: 1.69–5.01], and primiparous women [AOR = 1.69; 95%CI: 1.01–2.83] were more significantly associated with preoperative anxiety.

Conclusion
The prevalence of preoperative anxiety among elective cesarean deliveries was found to be high. So, preoperative maternal counseling and anxiety reduction services should therefore be given top priority, particularly for those women who came from rural areas, are farmers, have no prior surgical or anesthetic experience, and are primiparous.
Quality of life and its influencing factors among breast cancer patients at Tikur Anbessa specialised hospital, Addis Ababa, Ethiopia
Authors: Getu Mikiyas Amare , Chen Changying , Wang Panpan , Kantelhardt Eva Johanna , Addissie Adamu 
Published: August 2022

Abstract
Background
Quality of life (QoL) has become an important measure for evaluating cancer patients’ treatment and prognosis. Breast cancer patients are at an increased risk of experiencing poor QoL during active treatment of cancer. This study aimed to assess QoL and it’s influencing factors among breast cancer patients using the newly updated breast cancer specific tool of the European Organisation for Research and Treatment of Cancer EORTC Breast Cancer Specific Quality of Life Questionnaire QLQ-BR45.

Methods
An institutional based crossectional study was conducted with 248 breast cancer patients at Tikur Anbessa Specialized Hospital (TASH). Descriptive statistics, one-way analysis of variance (ANOVA), and linear regression were used to describe and analyze the data.

Results
The participant’s Global health status/QoL mean score was 65.6. Among the functional scales, future perspective scored the lowest (57.1, SD ± 37.3). The highest mean score on the symptom scales/items were financial difficulties (50, SD ± 38.6), followed by appetite loss (37.4, SD ± 36.4) and fatigue (34.3, SD ± 27.1) while the lowest symptom score was diarrhoea (6.4 ± 18.4). EORTC QLQ-BR45, future perspective (mean = 57.1, SD ± 37.3) and upset by hair loss (41.8, SD ± 34.6) were the most affected functioning and symptoms scales respectively. An increased stage of tumor was associated with more pain (P = 0.041), appetite loss (P = 0.042), and arm symptoms (P = 0.003). Patients who had no comorbidity had better physical (P < 0.001), cognitive (P = 0.013), and social (P = 0.009) function.

Conclusion
These specific functional scales and symptoms should be assessed individually to address unmet needs. Clinicians could design psychosocial interventions to improve these function and to reduce symptoms.
Communicating the Spinal Muscular Atrophy diagnosis to children and the principle of autonomy
Authors: Fernandes Isabella Araujo Mota , Menezes Renata Oliveira Almeida , Rego Guilhermina 
Published: August 2022

Abstract
Introduction
The trinomial relationship between physicians/children/guardians is essential in the process of communicating a disease and its prognosis.

Objective
Analyzing the exercise of autonomy by this trinomial relationship in communicating the diagnosis of spinal muscular atrophy (SMA).

Methodology
Caregivers of SMA patients answered a questionnaire containing a structured interview and the Event Impact Scale – Revised.

Results
The sample comprised 50 volunteers, 94% of whom were female caregivers. Psychological trauma was predominantly reported when caregivers communicated the diagnosis to children. 22% have a high risk of post-traumatic stress, relating the feeling of unpreparedness in communicating this to the child.

Conclusions
It was identified that the failure in communication is the main factor for negative repercussions on the autonomy of children and their guardians, with self-reported psychological trauma, besides the high risk for post-traumatic stress syndrome.
miR-215-5p regulates osteoporosis development and osteogenic differentiation by targeting XIAP
Authors: Yin Zilong , Shen Jian , Wang Qiang , Wen Liangyuan , Qu Wenjing , Zhang Yaonan 
Published: August 2022

Abstract
Background
Osteoporosis (OP) is a metabolic disease that involves microstructure destruction and fracture damage. The present study probed into the significance of miR-215-5p in OP progression.

Methods
Serum samples were collected from surgical patients and healthy controls. qRT-PCR analysis was utilized to determine the miR-215-5p level in clinical samples and human bone mesenchymal stem cells (hBMSCs) induced by β-glycerol phosphate. A dual luciferase reporter assay was exploited to examine the targeted relationship between miR-215-5p and XIAP. The mineralization and calcium deposition of hBMSCs were assessed by detection of ALP activity, Alizarin red staining, and osteoblast marker expression. Protein expression was determined by western blot analysis.

Results
MiR-215-5p was significantly reduced in patients with OP and increased in hBMSCs treated with β-glycerophosphate. Enhanced miR-215-5p level triggered augment in osteoblast markers (Alkaline phosphatase/ ALP, Osteocalcin/ OCN, and Runt-Related Transcription Factor 2/ Runx2), which was accompanied by the increase of ALP activity in hBMSCs and accumulation of Calcium. Functional experiments show that XIAP was a target of miR-215-5p and negatively modulated by miR-215-5p. XIAP expression levels were increased in OP samples, and decreased XIAP in β-glycerophosphate-treated hBMSCs inhibited its’ osteogenic differentiation. Functional loss and acquisition experiments depicted that miR-215-5p promoted the differentiation of hBMSCs by inhibiting the XIAP level, playing a protective role in the pathogenesis of OP.

Conclusions
β-glycerophosphate promoted the osteogenic differentiation of hBMSCs, increased miR-215-5p level, and decreased XIAP. miR-215-5p stimulated osteogenic differentiation of hBMSCs by targeting XIAP, shedding new insights for the detection and therapy of OP.
Sexual dysfunction among men with diabetes; a cross-sectional study at a specialised diabetes clinic in Sri Lanka
Authors: de Silva Nipun Lakshitha , Athukorala Tharaka , Gamage Jayathra Liyana , Katulanda Gaya , de Silva Prasad , Sumanatilleke Manilka , Somasundaram Noel 
Published: August 2022

Abstract
Background
Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many publications report the prevalence, there is limited data on its associations, impact, and health-seeking behaviour. The objectives were to assess the prevalence of male sexual dysfunction, its associations, impact and treatment-seeking among men with diabetes in a selected tertiary care Diabetes Clinic.

Methods
A cross-sectional study was conducted at the Diabetes Clinic, National Hospital of Sri Lanka, from January to September 2020. Men with diabetes aged 18 to 70 years undergoing annual assessment were recruited consecutively. Socio-demographic and clinical information were collected using an interviewer-administered questionnaire. Erectile dysfunction (ED), premature ejaculation, mental health and quality of life were assessed using validated self-administered questionnaires. Cardiovascular autonomic reflex tests and total testosterone levels were performed. Penile colour Doppler ultrasonography was performed on consenting participants with erectile dysfunction. Associations were assessed using the chi-square test or Fisher’s exact for dichotomous variables and independent sample t-test for continuous variables.

Results
Two hundred and twelve participants were recruited with a mean age of 54.1 (SD = 10.1) years. Erectile dysfunction was present in 168 (79.2%), (mild: 45, mild-moderate: 56, moderate: 26, severe: 41). Premature ejaculation was present in 26 (18.7%). Libido was low among 16%. Sexual dysfunction was not revealed to a health provider by 85.6% despite 60.5% experiencing psychological and/or relationship effects. Out of 18 who sought treatment, only 4 achieved a good response. Mean age (55.4 ± 9.5 vs 48.7 ± 10.6 years, p < 0.001) and duration of diabetes (10.9 ± 7.6 vs 5.8 ± 4.6 years, p < 0.001) were higher while eGFR was lower (73.9 ± 27.7 vs 100.51 ± 28.08 years, p < 0.008) among those with ED compared to those without. Diabetic retinopathy (4% vs 42%, p < 0.001), peripheral neuropathy (17.9% vs 38.4%, p = 0.041) and lower limb arterial disease (0% vs 12.2%, p = 0.04) were associated with ED. Arterial insufficiency was seen among 50% of the participants who underwent penile colour Doppler ultrasonography.

Conclusions
Male sexual dysfunction is a pervasive yet underappreciated problem in diabetes care despite its effect on the individual. Patient and disease characteristics would guide the identification of high-risk individuals for targeted screening in clinical practice.
Fetuin-A mediates the difference in adipose tissue insulin resistance between young adult pakistani and norwegian patients with type 2 diabetes
Authors: Lee-Ødegård Sindre , Ueland Thor , Thorsby Per M. , Aukrust Pål , Michelsen Annika E. , Halvorsen Bente , Drevon Christian A. , Birkeland Kåre I. 
Published: August 2022

Abstract
Background
South-Asian immigrants to Western countries have a high prevalence of type 2 diabetes mellitus (T2DM) and increased adipose tissue insulin resistance (AT-IR), as compared to their Western counterparts. Fetuin-A is a hepatokine known to influence AT-IR.

Aim
Can plasma fetuin-A concentrations explain an ethnic difference in adipose tissue insulin resistance?

Methods
We performed a two-step euglycemic-hyperinsulinaemic clamp and measured plasma concentrations of fetuin-A and non-esterified fatty acids (NEFA), in 18 Pakistani and 21 Norwegians with T2DM (age 29–45y) in Norway. AT-IR was calculated as NEFA-suppression during the clamp. The adipokines/cytokines leptin, adiponectin, visfatin, PTX3, IL-1β, INF-γ, and IL-4 were measured in fasting plasma. Liver fat was estimated by CT-scans.

Results
Despite a lower BMI, Pakistani patients displayed higher AT-IR than Norwegians. NEFA-suppression during clamp was lower in Pakistani than Norwegians (mean=-20.6%, 95%CI=[-40.8, -0.01] and p = 0.046). Plasma fetuin-A concentration was higher in Pakistani than Norwegians (43.4 ng/mL[12.7,74.0], p = 0.007) and correlated negatively to %NEFA-suppression during clamp (rho=-0.39, p = 0.039). Plasma fetuin-A concentration explained 22% of the ethnic difference in NEFA-suppression during the clamp. Pakistani patients exhibited higher plasma leptin and lower PTX3 levels than Norwegian, and plasma visfatin correlated positively to plasma fetuin-A levels in the Pakistani patients. We observed no correlation between plasma fetuin-A and liver fat, but fetuin-A correlated negatively with plasma IL-1β, INF-γ, and IL-4 concentrations. Plasma IL-4 concentration was lower in Pakistani than in Norwegian patients.

Conclusion
Fetuin-A may contribute to explain the discrepancy in T2DM prevalence between Pakistani and Norwegians patients by influencing AT-IR.
Patterns of adult and youth inpatient admissions before and after the COVID-19 pandemic in a psychiatric ward: an observational study
Authors: Rodrigues Carolina Alves , Rodrigues Nuno , Nascimento Miguel , Oliveira-Silva Joana 
Published: August 2022

Abstract
Background
The current pandemic situation led to deep changes not only in social relationships, but also on clinical care and access to healthcare facilities. The authors aimed to understand whether this context affected the main characteristics of psychiatric hospitalizations, measured by admissions in a portuguese acute psychiatric ward.

Methods
Retrospective data collection of all patients admitted in Centro Hospitalar Psiquiátrico de Lisboa, in two different time periods: pre-COVID-19 (march 11th, 2019 to march 10th, 2020, n = 1845) and COVID-19 (march 11th, 2020 to march 10th, 2021, n = 1278); comparing the number of total admissions, compulsory ones, age, sex, median days of admission, median days to readmission and diagnosis at discharge. Distribution of disorders in both groups, as well as in compulsory admissions were also evaluated. The same comparisons were evaluated in the 15–25-year-old patient group.

Results
Statistical significance was found regarding total number of admissions (reduction of around 30.7%), as well as compulsory ones (reduction of 14%, although the relative frequency had increased), days of admission and distribution between admissions (with lower reductions regarding dementias, schizophrenia and affective disorders, while substance use disorders and intellectual disabilities presented reductions of over 50%), with no differences between gender, median age, previous admissions or readmissions. Distribution between compulsory admissions did not present differences before and during COVID periods.
For patients between 15 and 25 years of age, statistical significance was found regarding total number of compulsory ones (94 versus 44, p-value = 0.01), and in all groups of diagnoses (all with p-value = 0.001).

Conclusions
While there was a general reduction in the overall number of patients admitted, in the most severe conditions (compulsory admissions and schizophrenia diagnosis) did not present such a reduction. Difficulties in social, clinical and family networks can explain the reduction of the time to readmission. Future research could show whether there is a rebound increase number of admissions in the other diagnoses.

Trial Registration
The current study was approved by the hospital’s scientific and ethics committees (CCP number 0060/2021 and CES 09/2021).
Real-time video communication between ambulance paramedic and scene – a simulation-based study
Authors: Sonkin Roman , Jaffe Eli , Wacht Oren , Morse Helena , Bitan Yuval 
Published: August 2022

Abstract
Introduction
Telemedicine has been widely used in various medical settings including in Emergency Medical Services (EMS). The goal of this study was to assess the possible roles of real-time video communication between paramedics and bystanders at scenes of emergency, in the analysis and treatment of patients.

Methods
44 experienced paramedics participated in a simulation. Participants communicated with the experimenter presenting video clips showing patients that simulated three emergency scenarios: trauma, an unresponsive patient with cardiac arrest, and an opiate overdose. The simulation sessions were conducted through Zoom™, recorded, and then analyzed to document participants’ questions, requests, instructions, and their timings during each scenario.

Results
The trauma scenario was assessed most promptly, with instructions to handle the bleeding provided by all paramedics. In the unresponsive patient with cardiac arrest scenario, most of the participants achieved a correct initial diagnosis, and in the opiate overdose scenario over half of paramedics sought visual clinical clues for the differential diagnoses of loss of consciousness and their causes. Additional results show the type of assessment, treatment and diagnosis participants provided in each scenario, and their confidence about situation.

Conclusions
The findings show that direct video communication between paramedic and scene may facilitate correct diagnosis, provision of instructions for treatment, and early preparation of medications or equipment. These may decrease time to correct diagnosis and lifesaving treatment and impact patient morbidity and mortality. Moreover, the findings highlight the difference between incidents with higher visual clarity, such as trauma, and conditions that require an extended diagnosis to reveal, such as unresponsive patients. This may also increase the paramedics’ mental preparedness for what is expected at the scene.
Effect of formic acid treatment on colostrum quality, and on absorption and function of immunoglobulins: a randomized controlled trial in Holstein dairy calves
Authors: Smith Billy I. , Cady Sarah V. , Aceto Helen W. 
Published: August 2022

AbstractBackgroundGood quality colostrum is characterized by high immunoglobulin concentration and low pathogen load. Some methods of pathogen reduction can decrease immunoglobulin concentration and potentially affect their function. Objectives were to determine the effect of formic acid treatment on colostral bacterial and immunoglobulin (IgG) levels before feeding, and serum immunoglobulin concentration and neutralizing capabilities after feeding. Fifteen female Holstein calf pairs born < 12 h apart from different dams were randomly assigned to receive four liters of either untreated pooled (both dams) colostrum (MC) or colostrum acidified to pH 4.0–4.5 (AC). Colostrum characteristics estimated; pH, bacterial load, IgG concentration, and neutralization of Infectious Bovine Rhinotracheitis (IBRV/BoHV-1), Bovine Viral Diarrhea (BVDV) Types 1 and 2. Blood samples were collected on days 1, 3 and monthly for 6 months and were analyzed for IgG, and both viral plus leptospiral neutralization, and total protein (day 3 only).ResultsCompared to MC (mean 6.7, SD 0.4; median 6.8, range 6.0–7.3), AC pH was significantly reduced (mean 4.3, SD 0.2; median 4.3, range 4.0–4.5;P < 0.001). Total coliform count (cfu/mL) was also reduced (MC mean 149, SD 444; median 1, range 0–1,700; AC mean 8, SD 31; median 0, range 0–120;P = 0.02). Colostrum IgG concentration was not significantly different between MC (mean 93.3, SD 39.7; median 92.8, range 36.7–164.4 g/L) and AC (mean 101.9, SD 36.7; median 108.3, range 33.8–164.4 g/L;P = 0.54). In calves, serum IgG peaked on day 3 (MC mean 26.1, SD 34.9; median 169.2, range 8.3–151.0 g/L; AC mean 30.2, SD 48.7; median 188.8, range 3.1–204.4 g/L;P = 0.77), and apparent efficiency of IgG absorption was not different between groups (MC mean 24.3, SD 11.4, median 25.3, range 8.6–51.3%; AC mean 22.6, SD 21.7, median 21.6, range 4.1–58.9%;P = 0.65). Thereafter, IgG levels declined but did not differ between groups. MC and AC serum neutralizing titers for IBRV, BVDV Types 1 and 2, orLeptospira interrogansserovars Canicola, and Pomona andL. borgpeterseniiserovar Hardjo were not different.ConclusionsColostrum acidification significantly decreased bacterial load fed to newborn calves without affecting colostral IgG concentration or virus neutralization. In addition, acid treatment did not affect serum IgG concentration in calves or its activity against common pathogens.