pinecone/core-2020-05-10-deduplication huggingface dataset:
Respiratory infection by Corynebacterium striatum: epidemiological and clinical determinants

AbstractThe increasing prevalence of advanced chronic respiratory disease, with frequent exposure to broad-spectrum antibiotics for repeated and prolonged hospitalizations, favours the emergence of nosocomial respiratory infection by Gram-positive bacteria, such as outbreaks of Corynebacterium striatum. There is little evidence about patterns of respiratory infection, transmission and adaptive ability of this pathogen. Seventy-two C. striatum isolates from 51 advanced respiratory patients, mainly chronic obstructive pulmonary disease, were studied during 38 months. Patients were 74.8 ± 8.6 years old and 81.9% were men, who had required an average of 2.2 hospitalizations and 63.5 days in the hospital in the previous year. Of 49 isolates from 42 patients we were able to identify 12 clones by multilocus sequence analysis (MLSA), nine phenotypic variants and 22 antibiotic susceptibility patterns, and we determined their clinical and epidemiological determinants. MLSA allows identification of the existence of nosocomial outbreaks by transmission of the same or different clones, the persistence of the same clone in the environment or in patient airways for months. The study showed the high variability and adaptive capacity of the isolates, the antibiotic multidrug-resistance in all of them, and their contribution to a high morbidity and mortality (41%) during the study period
Haemolytic-uraemic syndrome with bacteraemia caused by a new hybrid Escherichia coli pathotype

AbstractWe describe a new atypical Shiga-toxin-producing Escherichia coli (STEC) responsible for a severe episode of haemolytic–uraemic syndrome in an adult with a relapse associated with bacteraemia. This STECs train of serotype O80:H2 harboured stx2c and stx2d gene subtypes, the rare eae ɛ variant and a ColV plasmid with a conserved virulence plasmidic region involved in virulence of human and avian extraintestinal pathogenic E. coli. This atypical hybrid pathotype, which represents a new threat, is a further demonstration that STEC may be a recipient for extraintestinal virulence factors and raises again the question of antibiotic therapy during STEC infection
In vitro characterization of representative clinical South African Staphylococcus aureus isolates from various clonal lineages

AbstractData concerning the virulence and pathogenesis of South African strains of Staphylococcus aureus are limited. We investigated host–pathogen interactions of randomly selected clinical S. aureus isolates representing various clones. We characterized the ability of isolates to adhere to fibronectin, fibrinogen, collagens IV and VI, to invade host cells and to induce cell death in vitro. We analysed the possible association of these results with characteristics such as methicillin resistance, Panton–Valentine leucocidin (PVL) positivity and clonality. The S. aureus isolates displayed diversity in their abilities to adhere to various human ligands. All isolates were highly invasive except for ST121. PVL-negative isolates were significantly more invasive than the PVL-positive isolates (p 0.004). Isolates of CC5, CC30 and CC121 were non-cytotoxic, whereas isolates of CC22, CC8, CC15, CC45 and CC88 were very cytotoxic. No statistical association was identified between cell death and methicillin resistance, bacterial PVL status, clonality or patient HIV status. The vast majority of isolates were invasive and induced significant cell death. PVL-negative isolates were more invasive than PVL-positive isolates, while methicillin-resistant isolates were not found to be more invasive or cytotoxic than methicillin-susceptible isolates
Emergence of Klebsiella pneumoniae clinical isolates producing KPC-2 carbapenemase in Cuba

AbstractThe emergence of Klebsiella pneumoniae producing carbapenemase (KPC) has now become a global concern. As a part of a nationwide multicentre surveillance study in Cuba, three K. pneumoniae clinical isolates resistant to carbapenems were detected for a 1-month period (September to October 2011). PCR and sequence analysis revealed that the three strains harboured blaKPC-2. They showed resistance or intermediate susceptibility to expanded-spectrum cephalosporins, other ß-lactams, a ß-lactam/ß-lactamase inhibitor combination, and gentamicin. Two strains were susceptible only to colistin, whereas the other strain showing colistin resistance was susceptible to fluoroquinolones. These blaKPC-2-positive K. pneumoniae strains were classified into ST1271 (CC29), a novel clone harbouring blaKPC-2, and were revealed to be genetically identical by PCR-based DNA fingerprinting. The three patients infected with the KPC-producing K. pneumoniae had common risk factors, and had no overseas travel experience outside Cuba, suggesting local acquisition of the resistant pathogen. This is the first report of a KPC-producing K. pneumoniae in Cuba. Although detection of KPC in Enterobacteriaceae is still rare in Cuba, our finding indicated that KPC-producing bacteria are a global concern and highlighted the need to identify these microorganisms in clinical laboratories
First antimicrobial resistance data and genetic characteristics of Neisseria gonorrhoeae isolates from Estonia, 2009–2013

AbstractGonorrhoea is a sexually transmitted infection with major public health implications and Neisseria gonorrhoeae has developed resistance to all antimicrobials introduced for treatment. Enhanced surveillance of antimicrobial resistance in N. gonorrhoeae is crucial globally. This is the first internationally reported antimicrobial resistance data for N. gonorrhoeae from Estonia (44 isolates cultured in 2009–2013). A high prevalence of resistance was observed for azithromycin, ciprofloxacin and tetracycline. One and two isolates with resistance and decreased susceptibility to the last remaining first-line treatment option ceftriaxone, respectively, were identified. It is crucial to implement surveillance of gonococcal antimicrobial resistance (ideally also treatment failures) in Estonia
Enteroaggregative Shiga toxin-producing Escherichia coli of serotype O104:H4 in Belgium and Luxembourg

AbstractIn 2011, a large outbreak of infections caused by Shiga toxin-producing Escherichia coli (STEC) O104:H4 occurred in Germany. This exceptionally virulent strain combined virulence factors of enteroaggregative E. coli (EAggEC) and STEC. After the outbreak only a few sporadic cases of infection with this rare serotype were reported, most of which were related to travel to the Middle East or North Africa. Here we describe two cases of enteroaggregative STEC (Agg-STEC) O104:H4 infection that occurred in Belgium in 2012 and 2013 respectively. In both cases travel in a Mediterranean country preceded the infection. The first strain was isolated from the stool of a 42-year-old woman presenting bloody diarrhoea, who had travelled to Tunisia the week before. The second case involves a 14-year-old girl who, upon her return from Turkey to Belgium, suffered from an episode of bloody diarrhoea and haemolytic uraemic syndrome. Extended typing of the isolates with pulsed field gel electrophoresis revealed that the strains were closely related, though not exactly the same as the 2011 outbreak strain. This report supports the previously made hypothesis that Agg-STEC has a human reservoir and might be imported by travellers coming from an area where the pathogen is endemic. Furthermore, it emphasizes the concern that these bacteria may cause future outbreaks as evenly virulent O104:H4 isolates seem to be widespread
High seroprevalence of Borrelia miyamotoi antibodies in forestry workers and individuals suspected of human granulocytic anaplasmosis in the Netherlands

AbstractSubstantial exposure to Borrelia miyamotoi occurs through bites from Ixodes ricinus ticks in the Netherlands, which also transmit Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum. Direct evidence for B. miyamotoi infection in European populations is scarce. A flu-like illness with high fever, resembling human granulocytic anaplasmosis, has been attributed to B. miyamotoi infections in relatively small groups. Borrelia miyamotoi infections associated with chronic meningoencephalitis have also been described in case reports. Assuming that an IgG antibody response against B. miyamotoi antigens reflects (endured) infection, the seroprevalence in different risk groups was examined. Sera from nine out of ten confirmed B. miyamotoi infections from Russia were found to be positive with the recombinant antigen used, and no significant cross-reactivity was observed in secondary syphilis patients. The seroprevalence in blood donors was set at 2.0% (95% CI 0.4–5.7%). Elevated seroprevalences in individuals with serologically confirmed, 7.4% (2.0–17.9%), or unconfirmed, 8.6% (1.8–23%), Lyme neuroborreliosis were not significantly different from those in blood donors. The prevalence of anti-B. miyamotoi antibodies among forestry workers was 10% (5.3–16.8%) and in patients with serologically unconfirmed but suspected human granulocytic anaplasmosis was 14.6% (9.0–21.8%); these were significantly higher compared with the seroprevalence in blood donors. Our findings indicate that infections with B. miyamotoi occur in tick-exposed individuals in the Netherlands. In addition, B. miyamotoi infections should be considered in patients reporting tick bites and febrile illness with unresolved aetiology in the Netherlands, and other countries where I. ricinus ticks are endemic
Identification of OXA-23 carbapenemases: novel variant OXA-239 in Acinetobacter baumannii ST758 clinical isolates in Mexico

AbstractA collection of 15 carbapenem-resistance Acinetobacter baumannii clinical isolates was analysed on two tertiary hospitals in Mexico. The OXA-51 was identified in all isolates, followed by OXA-239 and OXA-58; OXA-239 is described as a new OXA-23-like allele. These carbapenemases were identified on four clonal groups, distributed between two neighbouring hospitals. Acinetobacter baumannii is poorly studied in Mexico; this situation urges the implementation of strategies to prevent its dissemination
Protothecal peritonitis in child after bone marrow transplantation: case report and literature review of paediatric cases

AbstractThe case presented here illustrates a protothecal infection caused by Prototheca wickerhamii in a paediatric haematopoietic stem cell recipient followed by a review of the literature of all 13 paediatric cases published since 1980. Protothecosis is a rare disease caused by algae, not described in this setting before. Infection was proven additionally post‐mortem from peritoneal dialysis fluid. Even though no death of a paediatric patient due to this infection has been reported and the mortality rate associated with protothecosis is low, our patient died from multiorgan failure as a result of numerous post‐transplant complications and a strain of cultivated alga that was highly resistant to antifungal agents. Prototheca spp. show various susceptibility profiles, and there is no direct correlation between in vitro activity and clinical response. There are different treatment regimens described but there are no clear published guidelines of specific therapy of protothecosis. Paediatric cases were successfully treated mostly with amphotericin B and azoles. As the number of immunocompromised patients increases, it is necessary to think more about unusual pathogens such as Prototheca
Genomic analysis of three African strains of Bacillus anthracis demonstrates that they are part of the clonal expansion of an exclusively pathogenic bacterium

AbstractBacillus anthracis is the causative agent of anthrax and is classified as a ‘Category A’ biological weapon. Six complete genomes of B. anthracis (A0248, Ames, Ames Ancestor, CDC684, H0491, and Sterne) are currently available. In this report, we add three African strain genomes: Sen2Col2, Sen3 and Gmb1. To study the pan‐genome of B. anthracis, we used bioinformatics tools, such as Cluster of Orthologous Groups, and performed phylogenetic analysis. We found that the three African strains contained the pX01 and pX02 plasmids, the nonsense mutation in the plcR gene and the four known prophages. These strains are most similar to the CDC684 strain and belong to the A cluster. We estimated that the B. anthracis pan‐genome has 2893 core genes (99% of the genome size) and 85 accessory genes. We validated the hypothesis that B. anthracis has a closed pan‐genome and found that the three African strains carry the two plasmids associated with bacterial virulence. The pan‐genome nature of B. anthracis confirms its lack of exchange (similar to Clostridium tetani) and supports its exclusively pathogenic role, despite its survival in the environment. Moreover, thanks to the study of the core content single nucleotide polymorphisms, we can see that our three African strains diverged very recently from the other B. anthracis strains
First isolation and genomic characterization of enterovirus A71 and coxsackievirus A16 from hand foot and mouth disease patients in the Lao PDR

AbstractEnterovirus A71 (EV‐A71) and coxsackievirus A16 (CV‐A16) are major aetiological agents of hand, foot and mouth disease in Asia. We established the first genomic characterization of strains isolated in 2011 from Lao patients. Isolates were related to EV‐A71 genotype C4 and CV‐A16 genotype B1a that circulated in neighbouring countries during the same period. This confirms the regional character of hand, foot and mouth disease epidemiology and makes plausible the occurrence of severe disease in the Lao population
The nonprofit board as a team : pilot results and initial insights

There is a growing desire for boards of nonprofits to deliver better governance to the organizations they control. Consequently, self-evaluation has become an important tool for nonprofit boards to meet these expectations and demonstrate that they are discharging their responsibilities effectively. This article describes initial results aimed at developing a psychometrically sound, survey-based board evaluation instrument, based on the Team Development Survey (TDS), that assesses the team attributes of an organization’s board.  Our results indicate that while constructs applicable to teams generally appear to apply to boards, there are also important differences. We highlight how a perception of board objective clarity, appropriate skills mix, resource availability, and psychological safety were positively and significantly associated with measures of board, management and organizational performance
Winning the Baldrige Award: How the Henry Ford Health System Undertook a Five‐Year Improvement Process

Henry Ford Health Systems (HFHS) won the 2011 Baldrige Award, a major accomplishment. This achievement resulted from a systemwide focus on minimizing and controlling medical errors, a cultural shift to stimulate innovation and creative problem solving, and service excellence at every level. The five‐year effort centered on meeting Baldrige Award criteria, typically utilized in the for‐profit setting. When applied to the nonprofit sector, HFHS managed to reduce costs, reduce medication and treatment errors, introduce multiple creative clinical programs, and launch a new Ritz Carlton‐quality, hotel‐style service
Managing organizational social capital through value configurations

Nonprofits are said to serve as places for the reproduction of social capital. However, little is known about how to manage social capital in a nonprofit. This article presents a theory-based perspective on how to plan, execute, and measure social capital production in a nonprofit organization. By using the concept of value configurations as a method to analyze and describe the creation of organizational social capital, bonding and bridging social capital can be managed in alternative ways. In a value shop framework, the participants are more homogeneous, and growth is heavily based on referrals and reputation as well as the quality of the members. Organizations managed as value shops will foster bonding social capital. In contrast, a value network framework incorporates more likely heterogeneous, multilevel participants that add legitimacy to the network. Organizations in this framework will strengthen the evolution of bridging social capital
Social Return on Investment Analysis: A Case Study of a Job and Skills Training Program Offered by a Social Enterprise

This article uses a social return on investment (SROI) methodology to analyze the social impact of a social enterprise offering a job and skills training program to an unemployed, largely female population. The social enterprise is based in Toronto (Canada) and run by a nonprofit agency dedicated to the advancement and empowerment of women, primarily immigrants, through access to employment. We focus our analysis on a job and skills training program that provides clients with the skills and tools that they need to successfully seek employment in their efforts to (re-)enter the Canadian labor market. Our goal is to determine the tangible and intangible program outcomes by applying and testing the SROI methodology
Decision‐Making Fairness and Consensus Building in Multisector Community Health Alliances: A Mixed‐Methods Analysis

Given their inherently diverse composition and potentially competing interests, a foundational activity of community health alliances is establishing consensus on the vision and strategies for achieving its goals. Using an organizational justice framework, we examined whether member perceptions of fairness in alliances' decision‐making processes are associated with the perceived level of consensus among members regarding the alliance vision and strategies. We used a mixed‐methods design to examine the relationship between perceptions of fairness and consensus within fourteen multisector community health alliances. Quantitative analysis found the perceived level of consensus to be positively associated with decision‐making transparency (procedural fairness), inclusiveness (procedural fairness), and benefits relative to costs (distributive fairness). Qualitative analysis indicated that the consensus‐building process is facilitated by using formal decision‐making frameworks and engaging alliance members in decision‐making processes early. Alliance leaders may be more successful at building consensus when they recognize the need to appeal to a member's sense of procedural and distributive fairness, and, perhaps equally important, recognize when one rather than the other is called for and draw upon decision‐making processes that most clearly evoke that sense of fairness. Our findings reinforce the importance of fairness in building and sustaining capacity for improving community health
Patterns of governance structures in trade associations and unions

Most research on the governance of nonprofit organizations concentrates on welfare-oriented organizations and disregards other types of nonprofits. This article examines the governance structures of trade associations and unions as a special type of nonprofit organization. Analysis is based on a qualitative case study survey of thirty Swiss trade associations. The results distinguish four categories of governance: satellite governance, delegate governance, executive governance, and inner-circle governance
A prospective observational study of machine translation software to overcome the challenge of including ethnic diversity in healthcare research

Aim This study investigates whether machine translation could help with the challenge of enabling the inclusion of ethnic diversity in healthcare research. Design A two phase, prospective observational study. Methods Two machine translators, Google Translate and Babylon 9, were tested. Translation of the Strengths and Difﬁculties Questionnaire (SDQ) from 24 languages into English and translation of an English information sheet into Spanish and Chinese were quality scored. Quality was assessed using the Translation Assessment Quality Tool. Results Only six of the 48 translations of the SDQ were rated as acceptable, all from Google Translate. The mean number of acceptably translated sentences was higher (P = 0001) for Google Translate 171(SD 7 2) than for Babylon 9 11 (SD79). Translation by Google Translate was better for Spanish and Chinese,although no score was in the acceptable range. Machine translation is not currently sufﬁciently accurate without editing to provide translation of materials for use in healthcare research
The repositioning of hospitalised patients with reduced mobility: a prospective study

Aim: 

To determine the frequency of patient repositioning across three consecutive nursing shifts (day, evening and night) and to identify predictors of repositioning frequency.
Background: 

Patient repositioning is a frequently implemented pressure injury prevention strategy. Yet, little is known about how often it should be implemented, or the frequency of movement among hospitalized patients with reduced mobility.
Design: 

An observational prospective study.
Methods: 

Chart audits were used to gather clinical and demographic data. Semi-structured observations were conducted every 30 minutes for a continuous 24-hour period. Observational data included the patient's body position, the frequency of repositioning, assistance require to reposition and the use of support surfaces.
Results: 

Patients were repositioned frequently during the day and evening and least at night time. Elevation of the head of the bed (1–45°) was the most frequently adopted position. The independent predictors of repositioning frequency were age and gender, with older patients and males repositioned less frequently.Griffith Health, School of Nursing and MidwiferyFull Tex
A qualitative study of professional caregivers’ perceptions of processes contributing to mealtime agitation in persons with dementia in nursing home wards and strategies toattain calmness

Professional caregivers perceived agitation during mealtime as resulting from
negative feelings in residents triggered by a lack of or negative social interaction,
too much or ambiguous stimuli or demands exceeding residents’ capacity.
Strategies for attaining calm mealtimes involved thorough planning beforehand.
During mealtime, professional caregivers focused on establishing a positive
community around the table, helping residents focus on eating and continuously
observing residents for subtle signals indicating that agitation was about
to develop. The prerequisites to succeed with the strategies were knowledge of
the residents’ preferences and abilities, knowledge sharing within the team and
awareness of one’s own communication style. Thus, the professional caregivers
operationalized person-centred care in a mealtime context
Patient perceptions of nurse mentors facilitating the Aussie Heart Guide: A home-based cardiac rehabilitation programme for rural patients

Aim: 

To explore and describe long-term thoughts and perceptions of the Aussie Heart Guide Programme including the role of the mentor, held by patients recovering from myocardial infarction.
Design: 

A qualitative design.
Methods: 

Thirteen patients recovering from myocardial infarction who were unable to attend a hospital-based or affiliated outpatient cardiac rehabilitation programme were interviewed by telephone at the completion of the programme and asked to describe the relationship with their assigned nurse mentor and their perception of the audiovisual used in the programme.
Results: 

Three themes emerged; assisting me to cope, supporting me and my family and tailoring the programme to my needs. Patients were satisfied with the programme and appreciative of the supportive and caring relationships provided by mentors during their hospitalization through to their discharge from the programme.Full Tex