bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripherally inserted central catheters have a protective role and the effect of fluctuation curve feature in the risk of bloodstream infection compared with central venous catheters: a propensity-adjusted analysis
Authors: Lv Yu , Huang Xiaobo , Lan Yunping , Xia Qi , Chen Fuli , Wu Jiayu , Li Wei , Cao Hongrong , Xie Caixia , Li Luting , Han Hukui , Wang Hui , Xiang Qian 
Published: March 2022

Abstract
Background
The prevention of peripherally inserted central catheters (PICC)-associated BSI and central venous catheters (CVC)-associated BSI have been a topic of national importance in China. Therefore, we aimed to explore the epidemiological characteristics of central line-associated bloodstream infection (CLABSI), and to evaluate whether PICCs were associated with a protective effect for CLABSI.

Methods
A retrospective cohort study was conducted in teaching hospital in Western China. All adult patients received a CVC or PICC during their hospital stay were included from January 2017 to December 2020. Primary endpoint was CLABSI up to 30 days after CVC or PICC placement. Propensity scores with a 2:1 match was used to account for potential confounders, and restricted cubic spline was used to visualize the risk of CLABSI at different time points during the catheterization.

Results
A total of 224687 devices (180522 PICCs and 45965 CVCs) in 24879 patients were included. The overall incidence was 1.8 CLABSIs per 1000 catheter-days. The odds ratio (OR) value increased day by day after PICC insertion, reached a relatively high point on the 4th day, and decreased from days 5 through 8. From the 9th day of intubation the OR value began to gradually increase day by day again. After covariate adjustment using propensity scores, CVCs were associated with higher risk of CLABSI (adjHR = 3.27, 95% CI 2.38–4.49) compared with PICCs.

Conclusions
PICCs have a protective role and the effect of fluctuation curve feature in CLABSI when compared to CVCs, and the first 8 calendar days after CVC insertion are the acute stage of CVC-associated BSI.
The challenge of antibiotic selection in prosthetic joint infections due to Corynebacterium striatum: a case report
Authors: Streifel Amber C. , Varley Cara D. , Ham YoungYoon , Sikka Monica K. , Lewis James S. 
Published: March 2022

Abstract
Background
Corynebacterium striatum is a gram-positive facultative anaerobe found in the environment and human flora that has historically been considered a contaminant. More recently, Corynebacterium striatum has been implicated in human infections, including respiratory infections, endocarditis, and bone and joint infections, particularly those involving hardware or implanted devices.

Case presentation
A 65-year-old man presented for washout of his left total knee arthroplasty following a revision 20 days prior. The patient underwent debridement of his left total knee and revision of the left total femur arthroplasty. Daptomycin was initiated empirically due to a previous rash from vancomycin. Operative tissue cultures grew Staphylococcus haemolyticus, Staphylococcus epidermidis and Corynebacterium striatum. Given concern for daptomycin resistance and the reliability of vancomycin susceptibility, daptomycin was discontinued and vancomycin initiated following a graded challenge. Within a few days, the patient developed a diffuse, blanching, erythematous, maculopapular rash and daptomycin was restarted. Over the next 72 h, his rash progressed and he met criteria for drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Daptomycin was stopped and oral linezolid initiated; rash improved. C. striatum returned with susceptibility to gentamicin, linezolid, vancomycin and daptomycin. Due to concern for adverse effects on long-term linezolid, daptomycin was restarted and was tolerated for 20 days, at which point purulent drainage from incision increased. The patient underwent another arthroplasty revision and washout. Operative cultures from this surgery were again positive for C. striatum. Repeat C. striatum susceptibilities revealed resistance to daptomycin but retained susceptibility to linezolid. Daptomycin was again changed to linezolid. He completed six weeks of linezolid followed by linezolid 600 mg daily for suppression and ultimately opted for disarticulation.

Conclusions
C. striatum has historically been regarded as a contaminant, particularly when grown in tissue culture in the setting of prosthetic joint infection. Based on the available literature and susceptibility patterns, the most appropriate first-line therapy is vancomycin or linezolid. Treatment with daptomycin should be avoided, even when isolates appear susceptible, due to the risk of development of high-level resistance (MIC > 256 µg/mL) and clinical failure.
Childbirth Readiness Scale (CRS): instrument development and psychometric properties
Authors: Mengmei Yuan , Meizhen Zhao , Tieying Zeng , Meiliyang Wu , Ye Chen , Ke Zhang , AiQing Tu 
Published: March 2022

Abstract
Background
Childbirth preparation plays an important role in reducing maternal mortality and improving women’s childbirth experience. Evaluating childbirth readiness levels before and after interventions provides a basis for formulating more targeted and effective interventions. However, existing tools only assess partial childbirth preparation or have limited evidence of reliability and validity. The aim of this study was thus to develop a new instrument for use during the third trimester to comprehensively assess the readiness level of pregnant women, and test the scale’s psychometric properties.

Methods
The scale was developed through exploratory mixed methods including qualitative and quantitative phases. A literature review and in-depth semi-structured interviews were utilized to identify the scale items. A Delphi expert consultation evaluated the content validity. Psychometric testing was conducted in a convenience sample of 731 pregnant women in the third trimester (recruited from 3 tertiary hospitals in Hubei province in China). Item analysis was used to screen items; exploratory factor analysis was performed to extract factors; confirmatory factor analysis was performed to evaluate fit on the factor structures.

Results
The final scale consisted of four dimensions and 18 items that explained 65.8% of the total variance. Confirmative factor analysis (CFA) model showed that the 4-factor model fits the data well. The total Cronbach alpha coefficient of the total scale and 4 factors was 0.935 and 0.853–0.914. The split-half reliability was 0.880. The dimensions comprised “Self-management”, “Information literacy”, “Birth confidence” and “Birth plan”.

Conclusions
The childbirth readiness scale we developed has good reliability and validity, and can be used to comprehensively assess the readiness level of pregnant women. In addition to understanding the overall level of women’s childbirth readiness, using subscale scores, improvements can be targeted to specific areas of the preparation for childbirth, to improve the efficiency of the intervention.
Associations of antenatal care visit with utilization of institutional delivery care services in Afghanistan: intersections of education, wealth, and household decision-making autonomy
Authors: Rahman Mostafizur , Saha Priom , Uddin Jalal 
Published: March 2022

Abstract
Background
The importance of antenatal care (ANC) visits in safe motherhood and childbirth is well-documented. However, less is known how social determinants of health interact with ANC visits in shaping the uptake of professional delivery care services in low-income countries. This study examines the associations of ANC visits with institutional delivery care utilization outcomes in Afghanistan. Further, we assess the extent to which ANC visits intersect with education, wealth, and household decision-making autonomy in predicting two outcomes of delivery care utilization- delivery at a health facility and delivery assisted by a skilled birth attendant.

Methods
We used data from the Afghanistan Demographic and Health Survey (AfDHS) 2015. The analytic sample included 15,590 women of reproductive age (15–49). We assessed the associations using logistic regression models, estimated the predicted probability of delivery care outcomes using statistical interactions, and presented estimates in margins plot.

Results
Multivariable adjusted analyses suggest that women who had 4 or more ANC visits were 5.7 times (95% CI = 4.78, 7.11; P < 0.05) more likely to use delivery care at a health facility and 6.5 times (95% CI = 5.23, 8.03; P < 0.05) more likely to have a delivery assisted by a skilled birth attendant compared to women who had no ANC visit. Estimates from models with statistical interactions of ANC visits with education, wealth, and decision-making autonomy suggest that women with higher social status were more advantageous in utilizing institutional delivery care services compared to women with lower levels of social status.

Conclusion
Our findings suggest that the associations of ANC visits with institutional delivery care services are stronger among women with higher social status. The results have implications for promoting safe motherhood and childbirth through improving women’s social status.
First observation of intraocular extranodal natural killer/T-cell lymphoma secondary to a retroperitoneal tumour: a case report and comparative review
Authors: Chen Binyao , Yang Shizhao , Su Wenru 
Published: March 2022

AbstractBackgroundVitreoretinal lymphomas are difficult to diagnose due to their insidious onset and inaccessible focal points. Natural killer/T-cell derived malignancies are rare as intraocular lymphomas and usually have a rapid progression and a poor prognosis. Therefore, it is essential to make a definite diagnosis, especially differentially with B-cell-derived lymphomas, which account for most cases of vitreoretinal lymphomas.Case presentationThis case report describes a 55-year-old female reporting a 10-month history of painless decline in her vision of the right eye. Optical coherence tomography of the patient revealed hyperreflective nodules and irregular humps in the retinal pigment epithelium layer. The right vitreous was aspirated for diagnostic assessment, revealing an interleukin-10 level of 39.4 pg/mL and an interleukin-10/interleukin-6 ratio of 1.05. The right vitreous humor was positive for Epstein–Barr virus DNA. Upon a systemic examination, a high metabolic nodule was found in the retroperitoneal area and proven to be positive for Epstein–Barr virus-encoded mRNA, CD2, CD3ε, TIA-1, and Ki-67. Considering the homology of the two lesions, the patient was diagnosed with metastatic vitreoretinal lymphoma secondary to retroperitoneal extranodal natural killer/T-cell derived lymphoma. The patient received systemic chemotherapy and regular intravitreal injections of methotrexate. Her visual acuity of the right eye had improved from 20/125 to 20/32 at the latest follow-up. No new lesions were found.ConclusionsA definitive diagnosis of vitreoretinal lymphoma is challenging. On some occasions in which pathological evidence is missing, the available examination results and clinical observations must be comprehensively considered. This study herein summarized pertinent pieces of literature and reports and reviewed available practicable methods to make a definitive diagnosis of intraocular extranodal natural killer/T-cell lymphoma, which was particularly distinct from the common diffuse large B-cell lymphomas.
EEG monitoring during anesthesia in children aged 0 to 18 months: amplitude-integrated EEG and age effects
Authors: Schultz Barbara , Schultz Michael , Boehne Martin , Dennhardt Nils 
Published: March 2022

AbstractBackgroundThe amplitude-integrated EEG (aEEG) is a widely used monitoring tool in neonatology / pediatric intensive care. It takes into account the amplitudes, but not the frequency composition, of the EEG. Advantages of the aEEG are clear criteria for interpretation and time compression. During the first year of life, the electroencephalogram (EEG) during sedation / anesthesia changes from a low-differentiated to a differentiated EEG; higher-frequency waves develop increasingly. There are few studies on the use of aEEG during pediatric anesthesia. A systematic evaluation of the aEEG in defined EEG stages during anesthesia / sedation is not yet available. Parameters of pediatric EEGs (power, median frequency, spectral edge frequency) recorded during anesthesia and of the corresponding aEEGs (upper and lower value of the aEEG trace) should be examined for age-related changes. Furthermore, it should be examined whether the aEEG can distinguish EEG stages of sedation / anesthesia in differentiated EEGs.MethodsIn a secondary analysis of a prospective observational study EEGs and aEEGs (1-channel recordings, electrode positions on forehead) of 50 children (age: 0–18 months) were evaluated. EEG stages: A (awake), Slow EEG, E2, F0, and F1in low-differentiated EEGs and A (awake), B0–2, C0–2, D0–2, E0–2, F0–1in differentiated EEGs.ResultsMedian and spectral edge frequency increased significantly with age (p < 0.001 each). In low-differentiated EEGs, the power of the Slow EEG increased significantly with age (p < 0.001). In differentiated EEGs, the power increased significantly with age in each of the EEG stages B1to E1(p = 0.04, or less), and the upper and lower values of the aEEG trace increased with age (p < 0.001). A discriminant analysis using the upper and lower values of the aEEG showed that EEG epochs from the stages B1to E1were assigned to the original EEG stage in only 19.3% of the cases. When age was added as the third variable, the rate of correct reclassifications was 28.5%.ConclusionsThe aEEG was not suitable for distinguishing EEG stages above the burst suppression range. For this purpose, the frequency composition of the EEG should be taken into account.
Determinants of multimorbidity of infectious diseases among under-five children in Bangladesh: role of community context
Authors: Rashmi Rashmi , Paul Ronak 
Published: March 2022

Abstract
Background
The presence of more than one morbid condition among children has become a global public health concern. Studies carried out in Bangladesh have primarily focused on diarrhoea and acute respiratory tract infections independently without considering their co-occurrence effect. The present study examines the multimorbid conditions of infectious diseases in under-five Bangladeshi children. It explores multimorbidity determinants and the role of community context, which are often overlooked in previous literature.

Methods
Utilizing the most recent Demographic and Health Survey of Bangladesh (2017–18), we used mixed-effects random-intercept Poisson regression models to understand the determinants of multimorbidity of infectious diseases in under-five Bangladeshi children considering the community-level characteristics.

Results
The present study found that 28% of the children experienced multimorbidity two weeks prior to the survey. Community-level variability across all the statistical models was statistically significant at the 5% level. On average, the incidence rate of multimorbidity was 1.34 times higher among children from high-risk communities than children from low-risk communities. Moreover, children residing in rural areas and other urban areas involved 1.29 [CI: 1.11, 1.51] and 1.28 [CI: 1.11, 1.47] times greater risk of multimorbidity respectively compared to children from city corporations. Additionally, the multimorbidity incidence was 1.16 times [CI: 1.03, 1.30] higher among children from high-altitude communities than children living in low-altitude communities.

Conclusion
The significant effect of public handwashing places suggests community-based interventions among individuals to learn hygiene habits among themselves, thus, the severity of coexistence nature of infectious diseases. A higher incidence of coexistence of such infectious diseases in the poor and semi-urban populace further recommends a targeted awareness of a clean environment and primary healthcare programmes.
Neutrophil side fluorescence: a new indicator for predicting the severity of patients with bronchiectasis
Authors: Li Shiqi , Yu Chunxiao , Jie Hongyu , Han Xinai , Zou Shujing , Tan Quanguang , Luo Shugeng , Chen Youming , Wang Jinhong 
Published: March 2022

Abstract
Background
Neutrophilic inflammation in the airway is a hallmark of bronchiectasis. Neutrophil extracellular traps (NETs) have been reported to play an important role in the occurrence and development of bronchiectasis. Neutrophil side fluorescence is one of the characteristics of neutrophils that can reflect the activation of neutrophils and the formation of NETs.

Objective
To explore the relationship between the values of neutrophil side fluorescence (NEUT-SFL) in the peripheral blood of bronchiectasis patients, and the severity of the disease.

Methods
82 patients with bronchiectasis from the Department of Respiratory and Critical Medicine, at the Third Affiliated Hospital of Southern Medical University and were scored with Bronchiectasis Severity Index (BSI) (2019–2021). The clinical data such as the value of NEUT-SFL, neutrophil count, C-reactive protein, and procalcitonin levels were collected and retrospectively analyzed. NEUT-SFL values neutrophil count from 28 healthy subjects were also used to ascertain cut-off values.

Results
Based on the BSI scores, patients were divided into three categories as mild (32%), moderate (29%), and severe (39%). Our results showed that the values of NEUT-SFL were higher in bronchiectasis patients compared to healthy controls. The levels of NEUT-SFL positively correlated with the high BSI scores in patients (P = 0.037, r = 0.23) and negatively correlated with the lung function in these patients (r = − 0.35, P = 0.001). The area under the ROC curve was 0.813, the best cut-off was 42.145, indicating that NEUT-SFL values > 42.145 can potentially predict the severity of bronchiectasis.

Conclusions
The values of NEUT-SFL in the peripheral blood can be used for predicting the severity of bronchiectasis.
Platelet is the early predictor of bronchopulmonary dysplasia in very premature infants: an observational cohort study
Authors: Wang Xiaoling , Ma Yan , Wang Shenghui , Dong Wenbin , Lei Xiaoping 
Published: March 2022

Abstract
Background
A previous study showed that the lungs are involved in the biogenesis of platelets (PLTs). Thus, the present study aimed to investigate the association between bronchopulmonary dysplasia (BPD), a chronic lung disease, and PLT parameters in very premature infants.

Methods
The study subjects were premature infants with a gestational age of ≤ 30 weeks and birth weight of ≤ 1500 g in a preterm birth cohort study recruited between January 1, 2015, and August 31, 2019. BPD was defined as the need for oxygen supplementation more than 28 days after birth. The PLT count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) level were compared between BPD and non-BPD infants. A generalized estimating equation model was used to adjust for confounding factors. A forward stepwise logistic regression model was used to calculate the adjusted odds ratio (OR) for thrombocytopenia in the BPD group. Receiver operating characteristic curve analysis was performed to assess the predictive value of PLT count combined with gestational age (GA) and birth weight (BW) for BPD.

Results
The final study subjects were 134 very premature infants, namely, 64 infants with BPD and 70 infants without BPD. The BPD infants had lower PLT counts (F = 4.44, P = 0.03) and PCT levels (F = 12.54, P = 0.00) than the non-BPD infants. However, the MPV (F = 14.25, P = 0.00) and PDW (F = 15.04, P = 0.00) were higher in the BPD group. After adjusting for potential confounding factors, the BPD infants had a higher risk of thrombocytopenia than the non-BPD infants (adjusted aOR 2.88, 95% CI 1.01–8.15), and the risk of BPD was increased in very premature infants with a PLT count ≤ 177*109/L (OR 4.74, 95% CI 1.93–11.62) at the end of the second week. In the multivariate predictive model, it was showed that the AUC area (0.85), sensitivity (0.88), specificity (0.70) and Youden index (0.58) are improved using PLT counts ≤ 177*109/L combined with GA and BW.

Conclusions
Abnormal PLT parameters were observed in BPD infants, and a PLT count ≤ 177*109/L was a potential risk factor for the development of BPD in very premature infants.
Disrupted knee – disrupted me: a strenuous process of regaining balance in the aftermath of an anterior cruciate ligament injury
Authors: Karlström Josefin , Wiklund Maria , Tengman Eva 
Published: March 2022

Abstract
Background
Individuals describe both short and long term consequences after an anterior cruciate ligament (ACL) injury. Functional impairments are well documented while psychological, social and contextual factors need to be further investigated. By the use of a qualitative method incorporating a biopsychosocial lens, we aimed to explore individuals’ experiences of living and coping with an ACL rupture with a specific focus on experiences significant to overall life, activity in daily living and physical activity more than one year after injury.

Methods
Twelve participants were chosen strategically by a purposive sampling. Four men and eight women (19–41 years) with an ACL rupture 2–25 years ago, were included. Semi-structured interviews were used and analysed with qualitative content analysis.

Results
The results consisted of one overarching theme: ‘A strenuous process towards regaining balance’ which built on three categories ‘Disrupted knee’, ‘Disrupted me’ and ‘Moving forward with new insights’. The overarching theme captures the participants’ experiences of a strenuous process towards regaining both physical and mental balance in the aftermath of an ACL injury. The results illuminate how participants were forced to cope with a physically ‘disrupted knee’, as well as facing mental challenges, identity challenges and a ‘disrupted me’. By gradual acceptance and re-orientation they were moving forward with new insights – although still struggling with the consequences of the injury.

Conclusions
Individuals with an ACL injury experience both physical, psychological, and social challenges several years after injury. In addition to the functional impairments, diverse psychological, social and contextual ‘disruptions’ and struggles may also be present and influence the rehabilitation process. It is important that physiotherapists identify individuals who face such challenges and individually tailor the rehabilitation and support. A biopsychosocial approach is recommended in the clinical practice and future studies focusing on psychosocial processes in the context of ACL rehabilitation are warranted.