bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraperitoneal vancomycin treatment of multifocal methicillin-resistant Staphylococcus aureus osteomyelitis in a patient on peritoneal dialysis
Authors: Abid Qassim , Asmar Basim , Kim Edward , Molloy Leah , Gregory Melissa , Valentini Rudolph P 
Published: September 2020

Abstract

Purpose
We report the case of a 2-year-old girl with end-stage renal disease managed by peritoneal dialysis (PD) who developed methicillin-resistant staphylococcal osteomyelitis of the left shoulder and was successfully treated with intraperitoneal (IP) administration of vancomycin for 2 weeks followed by oral clindamycin therapy.

Summary
The patient was hospitalized with tactile fever and a 3-day history of worsening fussiness. Radiography of the left shoulder showed findings indicative of osteomyelitis. Vancomycin was administered via central venous line for 3 days, during which time the patient underwent PD 24 hours a day. After magnetic resonance imaging revealed proximal humeral osteomyelitis, septic arthritis of the shoulder joint, and osteomyelitis of the scapula, the patient underwent incision and drainage of the left shoulder joint. Both blood and joint drainage cultures grew methicillin-resistant Staphylococcus aureus that was sensitive to vancomycin. The patient’s central venous catheter was removed on hospital day 4; due to difficulties with peripheral i.v. access and a desire to avoid placing a peripherally inserted central venous catheter, vancomycin administration was changed to the IP route, with vancomycin added to the PD fluid. During IP treatment, serum vancomycin levels were maintained at 13.5 to 18.5 mg/L, and the calculated ratio of vancomycin area under the curve to minimum inhibitory concentration was maintained above 400. After completing a 14-day course of IP vancomycin therapy, the patient was switched to oral clindamycin, with subsequent complete resolution of osteomyelitis.

Conclusion
IP vancomycin was effective for treatment of invasive S. aureus infection in this case. This approach should be considered in patients undergoing PD for whom peripheral i.v. access options are limited and/or not preferred.
Cross-cultural neuropsychological assessment in the European Union: a Delphi expert study
Authors: Franzen Sanne , Papma Janne M , van den Berg Esther , Nielsen T Rune 
Published: September 2020

Abstract

Objective
The increasing ethnic diversity in the European Union (EU) calls for adaptations to neuropsychological assessment practices. The aims of this study were to examine the current state of cross-cultural neuropsychological assessment in EU-15 countries and to provide recommendations for researchers and policy makers.

Method
Twelve experts from nine EU-15 countries participated in a Delphi consensus study involving two sequential rounds of web-based questionnaires and an in-person consensus meeting. The experts individually rated Delphi topics on the basis of importance (scale 1–10). The degree of consensus was determined by assessing first and third quartiles (Q1 and Q3) and medians.

Results
Consensus outcomes showed the following priorities: (a) the development of tests (median importance rating 10, Q1-Q3: 9–10), (b) the collection of normative data (median importance rating 9, Q1-Q3: 8–10), and (c) more training, awareness, and knowledge regarding cross-cultural assessment among neuropsychologists in the EU (median importance rating 9, Q1-Q3: 8–10). Whereas memory tests were often available, tests measuring social cognition (median 9, Q1-Q3: 8–10) and language (median 9, Q1-Q3: 7–10) are particularly lacking. Recommendations were made regarding essential skills and knowledge necessary for cross-cultural neuropsychological assessment.

Conclusions
This study in a small group of experts suggests that the development and availability of cross-cultural tests and normative data should be prioritized, as well as the development and implementation of training initiatives. Furthermore, EU guidelines could be established for working with interpreters during neuropsychological assessment. Before implementing these recommendations, follow-up studies are recommended that include more minority neuropsychologists and community stakeholders.
Biological network analysis with deep learning
Authors: Muzio Giulia , O’Bray Leslie , Borgwardt Karsten 
Published: September 2020

AbstractRecent advancements in experimental high-throughput technologies have expanded the availability and quantity of molecular data in biology. Given the importance of interactions in biological processes, such as the interactions between proteins or the bonds within a chemical compound, this data is often represented in the form of a biological network. The rise of this data has created a need for new computational tools to analyze networks. One major trend in the field is to use deep learning for this goal and, more specifically, to use methods that work with networks, the so-called graph neural networks (GNNs). In this article, we describe biological networks and review the principles and underlying algorithms of GNNs. We then discuss domains in bioinformatics in which graph neural networks are frequently being applied at the moment, such as protein function prediction, protein–protein interaction prediction and in silico drug discovery and development. Finally, we highlight application areas such as gene regulatory networks and disease diagnosis where deep learning is emerging as a new tool to answer classic questions like gene interaction prediction and automatic disease prediction from data.
MicrobiomeExplorer: an R package for the analysis and visualization of microbial communities
Authors: Reeder Janina , Huang Mo , Kaminker Joshua S , Paulson Joseph N 
Published: September 2020

Abstract

Summary
We developed the MicrobiomeExplorer R package to facilitate the analysis and visualization of microbial communities. The MicrobiomeExplorer R package allows a user to perform typical microbiome analytic workflows and visualize their results, either through the command line or an interactive Shiny application included with the package. In addition to applying common analytical workflows, the application enables automated analysis report generation.

Availability and implementation
Available at https://github.com/zoecastillo/microbiomeExplorer.

Supplementary information
Supplementary data are available at Bioinformatics online.
The Speed of Development of Adolescent Brain Age Depends on Sex and Is Genetically Determined
Authors: Brouwer Rachel M , Schutte Jelle , Janssen Ronald , Boomsma Dorret I , Hulshoff Pol Hilleke E , Schnack Hugo G 
Published: September 2020

Abstract
Children and adolescents show high variability in brain development. Brain age—the estimated biological age of an individual brain—can be used to index developmental stage. In a longitudinal sample of adolescents (age 9–23 years), including monozygotic and dizygotic twins and their siblings, structural magnetic resonance imaging scans (N = 673) at 3 time points were acquired. Using brain morphology data of different types and at different spatial scales, brain age predictors were trained and validated. Differences in brain age between males and females were assessed and the heritability of individual variation in brain age gaps was calculated. On average, females were ahead of males by at most 1 year, but similar aging patterns were found for both sexes. The difference between brain age and chronological age was heritable, as was the change in brain age gap over time. In conclusion, females and males show similar developmental (“aging”) patterns but, on average, females pass through this development earlier. Reliable brain age predictors may be used to detect (extreme) deviations in developmental state of the brain early, possibly indicating aberrant development as a sign of risk of neurodevelopmental disorders.
Primary Care Guidance for Persons With Human Immunodeficiency Virus: 2020 Update by the HIV Medicine Association of the Infectious Diseases Society of America
Authors: Thompson Melanie A , Horberg Michael A , Agwu Allison L , Colasanti Jonathan A , Jain Mamta K , Short William R , Singh Tulika , Aberg Judith A 
Published: September 2020

AbstractAdvances in antiretroviral therapy (ART) have made it possible for persons with human immunodeficiency virus (HIV) to live a near expected life span, without progressing to AIDS or transmitting HIV to sexual partners or infants. There is, therefore, increasing emphasis on maintaining health throughout the life span. To receive optimal medical care and achieve desired outcomes, persons with HIV must be consistently engaged in care and able to access uninterrupted treatment, including ART. Comprehensive evidence-based HIV primary care guidance is, therefore, more important than ever. Creating a patient-centered, stigma-free care environment is essential for care engagement. Barriers to care must be decreased at the societal, health system, clinic, and individual levels. As the population ages and noncommunicable diseases arise, providing comprehensive healthcare for persons with HIV becomes increasingly complex, including management of multiple comorbidities and the associated challenges of polypharmacy, while not neglecting HIV-related health concerns. Clinicians must address issues specific to persons of childbearing potential, including care during preconception and pregnancy, and to children, adolescents, and transgender and gender-diverse individuals. This guidance from an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America updates previous 2013 primary care guidelines.
Enteropathogenic Escherichia coli Infection in Cancer and Immunosuppressed Patients
Authors: Olvera Adilene , Carter Hannah , Rajan Anubama , Carlin Lily G , Yu Xiaomin , Zeng Xi-Lei , Shelburne Samuel , Bhatti Micah , Blutt Sarah E , Shroyer Noah F , Jenq Robert , Estes Mary K , Maresso Anthony , Okhuysen Pablo C 
Published: September 2020

Abstract

Background
The role of enteropathogenic Escherichia coli (EPEC) as a cause of diarrhea in cancer and immunocompromised patients is controversial. Quantitation of fecal bacterial loads has been proposed as a method to differentiate colonized from truly infected patients.

Methods
We studied 77 adult cancer and immunosuppressed patients with diarrhea and EPEC identified in stools by FilmArray, 25 patients with pathogen-negative diarrhea, and 21 healthy adults without diarrhea. Stools were studied by quantitative polymerase chain reaction (qRT-PCR) for EPEC genes eaeA and lifA/efa-1 and strains characterized for virulence factors and adherence to human intestinal enteroids (HIEs).

Results
Patients with EPEC were more likely to have community-acquired diarrhea (odds ratio, 3.82 [95% confidence interval, 1.5–10.0]; P = .008) compared with pathogen-negative cases. Although EPEC was identified in 3 of 21 (14%) healthy subjects by qPCR, the bacterial burden was low compared to patients with diarrhea (≤55 vs median, 6 × 104 bacteria/mg stool; P &lt; .001). Among EPEC patients, the bacterial burden was higher in those who were immunosuppressed (median, 6.7 × 103 vs 55 bacteria/mg; P &lt; .001) and those with fecal lifA/ifa-1 (median, 5 × 104 vs 120 bacteria/mg; P = .015). Response to antimicrobial therapy was seen in 44 of 48 (92%) patients with EPEC as the sole pathogen. Antimicrobial resistance was common and strains exhibited distinct patterns of adherence with variable cytotoxicity when studied in HIEs. Cancer care was delayed in 13% of patients.

Conclusions
Immunosuppressed cancer patients with EPEC-associated diarrhea carry high burden of EPEC with strains that are resistant to antibiotics, exhibit novel patterns of adherence when studied in HIEs, and interfere with cancer care.
Using Prior Culture Results to Improve Initial Empiric Antibiotic Prescribing: An Evaluation of a Simple Clinical Heuristic
Authors: Elligsen Marion , Pinto Ruxandra , Leis Jerome A , Walker Sandra A N , MacFadden Derek R , Daneman Nick 
Published: September 2020

Abstract

Background
A patient’s prior cultures can inform the subsequent risk of infection from resistant organisms, yet prescribers often fail to incorporate these results into their empiric antibiotic selection. Given that timely initiation of adequate antibiotics has been associated with improved outcomes, there is an urgent need to address this gap.

Methods
In order to better incorporate prior culture results in the selection of empiric antibiotics, we performed a pragmatic, prospective, hospital-wide intervention: (1) empiric antibiotic prescriptions were assessed for clinically significant discordance with the most recent methicillin-resistant Staphylococcus aureus (MRSA) surveillance swab, previous cultures for extended-spectrum beta-lactamases (ESBLs), and the most recent culture for a Gram-negative (GN) organism; and (2) if discordant, an antimicrobial stewardship pharmacist provided recommendations for alternative therapy. The impact was analyzed using a quasi-experimental design comparing two 9-month periods (pre- and postintervention) at a large academic, tertiary care institution.

Results
Clinically significant discordance was identified 99 times in the preintervention period and 86 times in the intervention period. The proportion of patients that received concordant therapy increased from 73% (72/99) in the control group to 88% (76/86) in the intervention group (P = .01). The median time to concordant therapy was shorter in the intervention group than the control group (25 vs 55 hrs, respectively; P &lt; .001; adjusted hazard ratio = 1.95 [95% confidence interval {CI}, 1.37–2.77; P &lt; .001]). The median duration of unnecessary vancomycin therapy was reduced by 1.1 days (95% CI, .5–1.6 days; P &lt; .001).

Conclusions
This intervention improved prescribing, with a shorter time to concordant therapy and an increased proportion of patients receiving empiric therapy concordant with prior culture results. The use of unnecessary vancomycin was also reduced.
Infliximab, Immunomodulators and Treatment Failures in Paediatric and Adolescent Patients with Crohn’s Disease: a Nationwide Cohort Study
Authors: Lund Ken , Larsen Michael Due , Knudsen Torben , Kjeldsen Jens , Nielsen Rasmus Gaardskær , Mertz Nørgård Bente 
Published: September 2020

Abstract

Background and Aims
In paediatric patients with Crohn’s disease, the role of combination therapy, infliximab plus immunomodulators [thiopurine or methotrexate], is debated and data are sparse. We examined whether infliximab plus immunomodulators, compared to infliximab therapy alone, reduces the risk of treatment failure measured by intestinal surgery or switching type of anti-tumour necrosis factor [TNF] α agent within 24 months.

Design
Using Danish registries, we identified patients with Crohn’s disease, aged ≤ 20 years at the time of the first infliximab treatment, and retrieved data on their co-medications. We used Cox regression models to examine surgery or switching type of anti-TNFα agent from January 1, 2003 to December 31, 2015.

Results
We included 581 patients. The 2-year cumulative percentage of surgery was 8.5% among patients receiving combination therapy and 14.5% in those receiving infliximab alone. The adjusted 2-year hazard ratio [HR] of surgeries was 0.53 (95% confidence interval [CI] 0.32–0.88) in patients receiving combination therapy, compared to patients receiving infliximab alone. When examining a switch of anti-TNFα we included 536 patients. Within 2 years, 18.3% experienced a switch among patients receiving combination therapy and 24.8% in patients treated with infliximab alone, corresponding to an adjusted HR of 0.66 [95% CI 0.45–0.97] in patients receiving combination therapy.

Conclusions
The HR of intestinal surgeries and the risk of a switch to another anti-TNFα was reduced in paediatric and adolescent patients receiving combination therapy, compared to patients receiving only infliximab. These results suggest a benefit for infliximab therapy combined with immunomodulators, but these need to be confirmed in data with additional clinical information.
Buying Informed Voters: New Effects of Information on Voters and Candidates
Authors: Cruz Cesi , Keefer Philip , Labonne Julien 
Published: September 2020

AbstractDespite the prominence of information in theories of electoral accountability, providing voters with information often fails to improve politician performance. Using two experiments in the Philippines, we show that when voters are unfamiliar with basic government capabilities, merely informing them of what politicians could do is sufficient to decrease support for incumbents. However, politicians can counteract this decrease in support by increasing clientelistic practices such as vote buying. Our work shows how even neutral information campaigns can improve the leverage of voters vis-à-vis their politicians, offering guidance for the design of interventions to change the electoral equilibrium in clientelistic countries.
Making a Dent in Dent Disease
Authors: Shipman Katherine E , Weisz Ora A 
Published: September 2020

AbstractDent disease (DD) is a rare kidney disorder caused by mutations in the Cl−/H+ exchanger ClC-5. Extensive physiologic characterization of the transporter has begun to illuminate its role in endosomal ion homeostasis. Nevertheless, we have yet to understand how loss of ClC-5 function in the kidney proximal tubule impairs membrane traffic of megalin and cubilin receptors to cause the low molecular weight proteinuria characteristic of DD. This review identifies open questions that remain to be answered, evaluates the current literature addressing these questions, and suggests new testable models that may link loss of ClC-5 function to tubular proteinuria in DD.
The Relationship Between Career Success and Sense of Purpose: Examining Linkages and Changes
Authors: Weston Sara J , Cardador M Teresa , Hill Patrick L , Schwaba Ted , Lodi-Smith Jennifer , Whitbourne Susan K 
Published: September 2020

AbstractObjectivesAlthough researchers have linked sense of purpose to working status, there are few studies examining how specific characteristics of work may correlate with sense of purpose. The aim of the current study is to extend prior research by assessing the degree to which objective and subjective forms of career success—occupational prestige and work satisfaction—are associated with levels of and changes in sense of purpose.MethodsParticipants were part of the Rochester Adult Longitudinal Study (N = 307), which contains multiple cohorts of participants each assessed at multiple waves (full age range: 42–71). We used cross-lagged modeling to test the relationships in our model.ResultsOccupational prestige was not associated with sense of purpose levels and change. However, work satisfaction was positively associated with higher levels of sense of purpose initially, and there was evidence that changes in the 2 constructs were positively correlated.DiscussionThese findings suggest that subjective career success may be more important for sense of purpose than more objective indicators. Findings are discussed with respect to study limitations and guidance for future researchers using secondary data.
Within-Couple Personality Concordance Over Time: The Importance of Personality Synchrony for Perceived Spousal Support
Authors: Lewis Nathan A , Yoneda Tomiko 
Published: September 2020

AbstractObjectivesWithin-couple similarities in personality traits tend to be positively associated with relationship well-being. However, research in this area is typically based on cross-sectional designs, thereby limiting examination of longitudinal personality concordance. Given that life experiences shape within-person change in personality, and that partners within a couple often experience similar life events, investigation of within-couple personality synchrony and associations with marital outcomes is warranted.MethodsUsing data from 3,988 couples (mean age at baseline = 67.0 years, SD = 9.6), multilevel dyadic growth models estimated within-couple similarity in baseline levels, change, and occasion-to-occasion variability for each of the Big Five personality traits over an 8-year follow-up. Bivariate growth models examined the effect of within-couple similarity on perceived spousal support, accounting for dependency within couples.ResultsAdjusting for baseline age, education, functional ability, and relationship length, analyses revealed within-couple concordance between baseline levels of all 5 personality traits, as well as correlated within-couple fluctuations in neuroticism, extraversion, and openness over time. Similarity in openness, agreeableness, and neuroticism trajectories predicted spousal support. Couples were most similar in openness, showing correlated intercepts, change, and variability, and this longitudinal synchrony was particularly important for perceived spousal support in women.DiscussionThese findings provide evidence for longitudinal personality synchrony over time within older adult couples. Further, concordance in neuroticism, extraversion, and openness predicted perceived spousal support, though there may be some gender differences in personality dynamics and relationship well-being. Effects of similarity were relatively small compared to actor and partner effects of these traits.
Creating Affirmative and Inclusive Practices When Providing Genetic and Genomic Diagnostic and Research Services to Gender-Expansive and Transgender Patients
Authors: Theisen J Graham , Amarillo Ina E 
Published: September 2020

Abstract

Background
Gender expansive and transgender (GET) healthcare extends beyond gender-affirming therapies, reaching every medical specialty and subspecialty. As the number of GET patients seeking health services has increased, so has the need for standards of care regarding GET-affirmative practices throughout the healthcare system. As such, the number of publications surrounding GET-affirmative practices has steadily risen. However, even as such research has gained ground in other areas, one realm in which there has been a relative lag is genetics and genomics (GG).

Content
In this article, we track the GET patient and their laboratory sample from the clinic to the GG laboratory and back. Throughout the preanalytical, analytical, and postanalytical phases, we identify publications, recommendations, and guidelines relevant to the care of the GET community. We also identity knowledge gaps in each area and provide recommendations for affirmative and inclusive processes for addressing those gaps.

Summary
We have identified the practices involved in GG services that would benefit from GET-affirmative process improvement, reviewing relevant affirmative guidelines. Where guidelines could not be found, we identified those knowledge gaps and suggested potential solutions and future directions for implementing GET-affirmative practices.