bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phenotypic and genotypic characterisation of thymine auxotrophy in Escherichia coli isolated from a patient with recurrent bloodstream infection
Authors: Jakovljev Aleksandra , Afset Jan Egil , Haugum Kjersti , Steinum Harald Otto , Gresdal Rønning Torunn , Samuelsen Ørjan , Ås Christina Gabrielsen 
Published: July 2022

Introduction
Thymine auxotrophic in vitro mutants of Escherichia coli were first reported in the mid-20th century. Later, thymine-dependent clinical strains of E. coli as well as other Enterobacterales, Enterococcus faecalis and Staphylococcus aureus have been recognized as the cause of persistent and recurrent infections.

Objectives
The aim of this study was to characterize the phenotype and investigate the molecular basis of thymine auxotrophy in ten E. coli isolates obtained at different time points from a patient with recurrent bloodstream infection (BSI) due to a chronic aortic graft infection treated with Trimethoprim/sulfamethoxazole (TMP-SMX).

Methods
Clinical data was obtained from hospital records. Growth characterization and antimicrobial susceptibility testing to TMP-SMX was performed on M9 agar and in MH broth with different thymine concentrations (0.5, 2, 5, 10 and 20 μg/mL), on Mueller-Hinton (MH) and blood agar. Whole genome sequencing (WGS) was performed on all E. coli isolates.

Results
E. coli were isolated from ten consecutive BSI episodes from a patient with chronic aortic graft infection. Six of these isolates were resistant to TMP-SMX when assayed on blood agar. Growth experiments with added thymine confirmed that these isolates were thymine-dependent (thy-), and revealed growth defects (slower growth rate and smaller colony size) in these isolates relative to thy+ isolates (n = 4). WGS indicated that all isolates were of the same clonal lineage of sequence type 7358. Genomic analysis revealed a G172C substitution in thyA in all TMP-SMX resistant isolates, while mutations affecting genes involved in the deoxyribose salvage pathway (deoB and deoC) were identified in eight isolates.

Conclusion
This case highlights the risk of resistance development to TMP-SMX, especially for long-term treatment, and the possible pitfalls in detection of growth-deficient subpopulations from chronic infections, which could lead to treatment failure.
Sedation in specialized palliative care: A cross-sectional study
Authors: Hedman Christel , Rosso Aldana , Häggström Ola , Nordén Charlotte , Fürst Carl Johan , Schelin Maria E. C. 
Published: July 2022

BackgroundPalliative sedation is used to relieve refractory symptoms and is part of clinical practice in Sweden. Yet we do not know how frequently this practice occurs, how decision-making takes place, or even which medications are preferentially used.ObjectivesTo understand the current practice of palliative sedation in Sweden.MethodsWe conducted a retrospective cross-sectional medical record-based study. For 690 consecutive deceased patients from 11 of 12 specialized palliative care units in the southernmost region of Sweden who underwent palliative sedation during 2016, we collected data on whether the patient died during sedation and, for sedated patients, the decision-making process, medication used, and depth of sedation.ResultsEight percent of patients were sedated. Almost all (94%) were given midazolam, sometimes in combination with propofol. The proportions of sedation were similar in the patient groups with and without cancer. The largest proportion of the sedated patients died in inpatient care, but 23% died at home, with specialized palliative home care. Among the patients with a decision to sedate, 42% died deeply unconscious, while for those without such a decision the corresponding figure was 16%. In only one case was there more than one physician involved in the decision to use palliative sedation.Conclusion8% of patients in specialized palliative care received palliative sedation, which is lower than international measures but much increased compared to an earlier Swedish assessment. The level of consciousness achieved often did not correspond to the planned level; this, together with indications of a scattered decision process, shows a need for clear guidelines.
Association between tocilizumab, sarilumab and all-cause mortality at 28 days in hospitalised patients with COVID-19: A network meta-analysis
Authors: Godolphin Peter J. , Fisher David J. , Berry Lindsay R. , Derde Lennie P. G. , Diaz Janet V. , Gordon Anthony C. , Lorenzi Elizabeth , Marshall John C. , Murthy Srinivas , Shankar-Hari Manu , Sterne Jonathan A. C. , Tierney Jayne F. , Vale Claire L. 
Published: July 2022

Background
A recent prospective meta-analysis demonstrated that interleukin-6 antagonists are associated with lower all-cause mortality in hospitalised patients with COVID-19, compared with usual care or placebo. However, emerging evidence suggests that clinicians are favouring the use of tocilizumab over sarilumab. A new randomised comparison of these agents from the REMAP-CAP trial shows similar effects on in-hospital mortality. Therefore, we initiated a network meta-analysis, to estimate pairwise associations between tocilizumab, sarilumab and usual care or placebo with 28-day mortality, in COVID-19 patients receiving concomitant corticosteroids and ventilation, based on all available direct and indirect evidence.

Methods
Eligible trials randomised hospitalised patients with COVID-19 that compared tocilizumab or sarilumab with usual care or placebo in the prospective meta-analysis or that directly compared tocilizumab with sarilumab. Data were restricted to patients receiving corticosteroids and either non-invasive or invasive ventilation at randomisation.
Pairwise associations between tocilizumab, sarilumab and usual care or placebo for all-cause mortality 28 days after randomisation were estimated using a frequentist contrast-based network meta-analysis of odds ratios (ORs), implementing multivariate fixed-effects models that assume consistency between the direct and indirect evidence.

Findings
One trial (REMAP-CAP) was identified that directly compared tocilizumab with sarilumab and supplied results on all-cause mortality at 28-days. This network meta-analysis was based on 898 eligible patients (278 deaths) from REMAP-CAP and 3710 eligible patients from 18 trials (1278 deaths) from the prospective meta-analysis. Summary ORs were similar for tocilizumab [0·82 [0·71–0·95, p = 0·008]] and sarilumab [0·80 [0·61–1·04, p = 0·09]] compared with usual care or placebo. The summary OR for 28-day mortality comparing tocilizumab with sarilumab was 1·03 [95%CI 0·81–1·32, p = 0·80]. The p-value for the global test of inconsistency was 0·28.

Conclusions
Administration of either tocilizumab or sarilumab was associated with lower 28-day all-cause mortality compared with usual care or placebo. The association is not dependent on the choice of interleukin-6 receptor antagonist.
Experiences and impact of living with incontinence associated stigma: A protocol for a systematic review and narrative synthesis of qualitative studies
Authors: Murphy Cathy , Avery Miriam , Macaulay Margaret , Fader Mandy 
Published: July 2022

Introduction
Incontinence is global health and social issue, with urinary incontinence alone affecting over 400 million people. Incontinence can lead to physical harms such as skin damage, but it also commonly causes social and psychological harms, including those associated with stigma. For many people, treatment to cure incontinence does not work or is not suitable and they live with the long-term consequences of incontinence. At the moment, no stigma reduction interventions (increasingly used with other conditions such as mental health problems and HIV) have been developed for people living with incontinence. As a starting point for developing such an intervention, this review will address the questions 1) What are the incontinence (urinary or faecal) associated experiences of stigma of people living with incontinence? 2) What is the impact of incontinence associated stigma on their lives?

Methods
The reviewers will search Embase, Medline, PsychINFO and the Cumulative Index to Nursing and Allied Health Literature using controlled vocabulary and relevant search terms. Articles assessed to meet inclusion criteria will be included. Once duplicates have been removed, titles and abstracts will be screened and full texts of selected research articles will be reviewed. An adapted Joanna Briggs Institute Data Extraction Form will be used to collect the data and quality will be assessed using the Joanna Briggs Institute checklist for qualitative research appraisal tool. A framework approach (using the Revised Framework for Understanding Non-communicable Disease Related Stigma) will be used to organise, integrate, interpret and summarise findings from included articles. The review will be reported in accordance with the Enhancing Transparency in reporting the synthesis of qualitative research statement. Prospero registration number CRD42021259065.

Discussion
The systematic review described in this protocol will provide the first in-depth, comprehensive understanding of people’s experiences of the stigma associated with incontinence and the impact that it has on their lives. It will identify broader influences of contextual variables such as age, sex, cause and type of incontinence, socio-economic culture and geographical location. The review aims to provide insights to support the development of incontinence associated stigma reduction interventions.
Diabetes self-management and its associated factors among patients with diabetes in central Vietnam: A cross-sectional study
Authors: Nguyen Van Bang , Thi Kim Huong Pham , Nguyen Thi Xuan , Pham Nguyen Tuyen Linh , Nguyen Van Vy Hau , Van Le Chi 
Published: July 2022

ObjectiveDiabetes self-management (DSM) enables maintenance of optimal individualized glycemic control for patients with diabetes through comprehensive lifestyle, medication adherence, and self-monitoring glucose level. This study aimed to evaluate DSM and to find associated factors among Vietnamese diabetes patients by using the Vietnamese version of Diabetes Self-Management Instrument (DSMI).MethodsA cross-sectional study was conducted at a single hospital in the central Vietnam. DSM was assessed using the DSMI. The participant’s socio-demographic and clinical features were obtained through face-to-face interviews and medical records. Multivariate linear regression was used to determine independent factors associated with total DSMI.ResultsThe mean total DSM score based on DSMI self-administered questionnaire scores was 88.4 ± 22.1, with a range of 47 to 140. The mean self-integration, self-regulation, interaction with health professionals, self-monitoring blood glucose, and adherence to the prescribed regime were 24.8, 22.3, 21.6, 10.2, and 9.5, respectively. 48.1% of DM patients had good HbA1c control. Sex, educational status, BMI, waist circumference, medical nutrition therapy, and sufficient physical activities were factors independently predictive of DSMI total score.ConclusionThis study emphasizes that the DSM situation is seen to be average among DM patients with mean DSMI score 88.4 ± 22.1 and sex, educational status, BMI, waist circumference, medical nutrition therapy, and sufficient physical activities were independently predictive factors of DSMI total score. This evidence suggests that there is a need to enhance the effectiveness of DSM education programs among diabetic patients.
Prevalence of perceived stress and coping strategies among healthcare workers during the COVID-19 outbreak at Bangkok metropolitan, Thailand
Authors: Yubonpunt Pataraporn , Kunno Jadsada , Supawattanabodee Busaba , Sumanasrethakul Chavanant , Wiriyasirivaj Budsaba 
Published: July 2022

Background
Healthcare workers (HCW), who are crucial workforce, have experienced stress during the COVID-19 pandemic. They have been learning to fight against and support patients as much as possible. Thus, this study aims to account for the psychological impact of the COVID-19 outbreaks on the healthcare workers of medical school hospitals in terms of their perceived stress and coping styles.

Method
This cross-sectional study was conducted from June to August, 2021. 517 HCWs self-administered the online survey. Perceived Stress Scale (PSS-10) in Thai-version was used to examine the perceived stress symptoms. Brief-COPE score was used to determine the coping strategies. Independent sample t-test, one-way analysis of variance (ANOVA), and multivariable regression analysis were utilized. The level of significance was set at p-value < 0.05.

Result
The prevalence of perceived stress among the HCWs was 41.97%. Coping strategies were used to deal with stress during the outbreak for problem-solving (Mean ± SD = 0.25 ± 0.60) and positive attitude (Mean ± SD = 2.85 ± 0.62). Significant difference was observed in the use of coping strategies among those who differ in marital status (F2, 514 = 7.234, p-value = 0.001), having children (t515 = -4.175, p-value < 0.001), and days off (t515 = -1.992, p-value = 0.047). Multivariable regression analysis reported who those perceived stress symptoms using social support more than those normal stress (AOR 1.54, 95% CI 1.070–2.236, p-value = 0.02). The perceived stress symptoms group used the avoidance strategy 2.03 times more than the other group (AOR 2.03, 95% CI 1.406–2.934, p-value < 0.001). Interestingly, the participants who perceived stress symptoms applied a positive attitude strategy lesser than those who experienced normal stress (57.5%) (AOR 0.42, 95% CI 0.307–0.590, p-value < 0.001).

Conclusion
The impact of the COVID-19 pandemic on mental distress remains. The findings of this study suggest further study to assess the HCWs’ stress after the pandemic. HCWs should consider merging each of the coping strategies to balance work and lifestyle in pandemic situations.
Association of hepatitis C virus infection status and genotype with kidney disease risk: A population-based cross-sectional study
Authors: Chen Yi-Chia , Wang Hung-Wei , Huang Yun-Ting , Jiang Ming-Yan 
Published: July 2022

Background
Whether there is difference in kidney disease risk between chronic hepatitis C virus (HCV) infection and resolved HCV infection remains inconclusive. Additionally, the impact of different HCV genotypes on kidney disease risk is relatively unknown. Accordingly, we conducted a population-based cross-sectional study to investigate the association of HCV infection status and genotype on kidney disease risk.

Methods
The study population were adult participants of 1999–2018 National Health and Nutrition Examination Survey in the United States. Chronic and resolved infection were defined as HCV seropositivity with and without detectable HCV RNA, respectively. HCV genotypes were classified into genotype 1, genotype 2, and other genotypes. Prevalent estimated glomerular filtration rate < 60 ml/min/1.73 m2 or urinary albumin creatinine ratio ≥ 30 mg/g was defined as kidney disease.

Results
The average age of study population (n = 44,998) was 46.7±17.0 years with 49.8% being males. Compared with individuals without HCV infection (n = 44,157), those with resolved (n = 255) or chronic HCV infection (n = 586) had higher prevalence of kidney disease: 14.8%, 23.5%, and 20.1%, respectively (p<0.001). After adjusting for potential confounders, we found that both resolved (adjusted OR: 1.40, 95% CI: 1.02–1.93) and chronic HCV infection (adjusted OR: 1.26, 95% CI: 1.01–1.57) correlated to increased kidney disease risk compared with no HCV infection. Additionally, individuals with HCV genotype 1 (adjusted OR: 1.41, 95% CI: 1.09–1.82) but not genotype 2 or other genotypes had greater kidney disease risk compared with no HCV infection. Furthermore, we observed that genotype 1 had 2-fold higher kidney disease risk (adjusted OR: 2.20, 95% CI: 1.07–4.53) compared with non-genotype 1 HCV infection.

Conclusion
Both resolved and chronic HCV infection, particularly genotype 1, were associated with higher kidney disease risk.
The associations between adherence to the Mediterranean diet and physical fitness in young, middle-aged, and older adults: A protocol for a systematic review and meta-analysis
Authors: Bizzozero-Peroni Bruno , Brazo-Sayavera Javier , Martínez-Vizcaíno Vicente , Núñez de Arenas-Arroyo Sergio , Lucerón-Lucas-Torres Maribel , Díaz-Goñi Valentina , Martínez-Ortega Isabel Antonia , Mesas Arthur Eumann 
Published: July 2022

Introduction
A healthy diet and high health-related physical fitness levels may be part of an overall healthy lifestyle. The relationship between adherence to the Mediterranean diet and physical fitness levels has been analyzed in several studies. However, no studies have synthesized evidence on this relationship throughout adulthood. Moreover, in addition to the overall Mediterranean dietary pattern, the associations of individual components of the Mediterranean diet with physical fitness indicators are also unclear.

Methods
This protocol for a systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols statement and the Cochrane Collaboration Handbook. Systematic literature searches will be performed in the MEDLINE (PubMed), Scopus, Web of Science, SPORTDiscus and Cochrane CENTRAL databases to identify studies published up to 31 January 2022. The inclusion criteria will comprise observational studies and randomized controlled trials reporting the associations between adherence to the Mediterranean diet and physical fitness levels on general healthy or unhealthy adults (≥18 years). When at least five studies addressing the same outcome are available, meta-analysis will be carried out to estimate the standardized mean difference of physical fitness according to the adherence to Mediterranean diet. Subgroup analyses will be performed according to the characteristics of the population, the individual dietary components of the Mediterranean diet and physical fitness parameters as long as there are sufficient studies.

Ethics and dissemination
This systematic review and meta-analysis protocol is designed for updating evidence on the associations between adherence to overall Mediterranean diet (and specific Mediterranean foods) and physical fitness levels in young, middle-aged, and older adults. Findings from this review may have implications for public health. The results will be disseminated through peer-reviewed publication, conference presentation, and infographics. No ethical approval will be required since only published data will be used.

PROSPERO registration number
CRD42022308259.
Scale up and strengthening of comprehensive emergency obstetric and newborn care in Tanzania
Authors: Nyamtema Angelo S. , LeBlanc John C. , Mtey Godfrey , Tomblin Murphy Gail , Kweyamba Elias , Bulemela Janet , Shayo Allan , Abel Zabron , Kilume Omary , Scott Heather , Rigby Janet 
Published: July 2022

Introduction
In Tanzania, inadequate access to comprehensive emergency obstetric and newborn care (CEmONC) services is the major bottleneck for perinatal care and results in high maternal and perinatal mortality. From 2015 to 2019, the Accessing Safe Deliveries in Tanzania project was implemented to study how to improve access to CEmONC services in underserved rural areas.

Methods
A five-year longitudinal cohort study was implemented in seven health centres (HCs) and 21 satellite dispensaries in Morogoro region. Five of the health centres received CEmONC interventions and two served as controls. Forty-two associate clinicians from the intervention HCs were trained in teams for three months in CEmONC and anaesthesia. Managers of 20 intervention facilities, members of the district and regional health management teams were trained in leadership and management. Regular supportive supervision was conducted.

Results
Interventions resulted in improved responsibility and accountability among managers. In intervention HCs, the mean monthly deliveries increased from 183 (95% CI 174–191) at baseline (July 2014 –June 2016) to 358 (95% CI 328–390) during the intervention period (July 2016 –June 2019). The referral rate to district hospitals in intervention HCs decreased from 6.0% (262/4,392) with 95% CI 5.3–6.7 at baseline to 4.0% (516/12,918) with 95% CI 3.7–4.3 during the intervention period while it increased in the control group from 0.8% (48/5,709) to 1.5% (168/11,233). The obstetric case fatality rate decreased slightly from 1.5% (95% CI 0.6–3.1) at baseline to 1.1% (95% CI 0.7–1.6) during the intervention period (not statistically significant). Active engagement strategies and training in leadership and management resulted in uptake and improvement of CEmONC and anaesthesia curricula, and contributed to scale up of CEmONC at health centre level in the country.

Conclusions
Integration of leadership and managerial capacity building, with CEmONC-specific interventions was associated with health systems strengthening and improved quality of services.
John Dewey – Écrits sur les religions et le naturalisme
Authors: Mahieddin Emir 
Published: July 2022

Recensé : John Dewey, Écrits sur les religions et le naturalisme. Recueil de textes traduits et introduits par Joan Stavo-Debauge, Genève, IES éditions, 2019, 344 p. (« Le geste social »).
Enhancement of shoot proliferation and evaluation of biotic elicitation effects on anatomical changes of pseudo stem and anti-lipid peroxidation activity of Curcuma mangga Val.
Authors: ABRAHAM Fariz , CHAN Lai-Keng , INDRAYANTO Gunawan , BOEY Peng Lim 
Published: July 2022

Mango turmeric (Curcuma mangga Val.) contains many bioactive compounds that are used for traditional treatment of various health problems and ailments. Slow propagation nature of C. mangga have resulted in short supply to meet the market demand. The longitudinally incised half shoot explants promote 100 % increased of shoot number compared with non-incised shoots with the formation of average 6.6 shoots/explant when they were cultured either vertically or horizontally on MS medium supplemented with 2.0 mg l-1 BA and 0.5 mg l-1 NAA. Biotic elicitation with 3.5 mg l-1 or 5.0 mg l-1 yeast extract or combination of 150 mg l-1 chitosan and 3.5 mg l-1 yeast extract did not promote shoot proliferation but exhibited anti-lipid peroxidation activity slightly lower than quercetin, a potent plant antioxidant flavonoid and butyl hydroxyl toluene (BHT), a commercial preservative agent which is used as a positive control. While absolute ethanol which served as a negative control did not show any anti-lipid peroxidation activity. Biotic elicitation of C. mangga plantlets using similar elicitors resulted in anatomical changes of its pseudostem with reduced number of thin lignified xylem cells and the presence of druse suspected to be oxalate crystals inside the cortex cells with delicate cell wall.
Magdalena Jaszczyk-Grzyb. Mowa nienawiści ze względu na przynależność etniczną i narodową w komunikacji internetowej. Analiza porównawcza języka polskiego i niemieckiego. Poznań: Wydawnictwo Naukowe UAM. 2021. Pp. 375
Authors: Stawnicka Jadwiga 
Published: July 2022

Book review:
Magdalena Jaszczyk-Grzyb. Mowa nienawiści ze względu na przynależność etniczną i narodową w komunikacji internetowej. Analiza porównawcza języka polskiego i niemieckiego. Poznań: Wydawnictwo Naukowe UAM. 2021. Pp. 375