bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carbapenem-Resistant Enterobacteriaceae Infections in Patients on Renal Replacement Therapy
Authors: Eilertson Brandon , Cober Eric , Richter Sandra S , Perez Federico , Salata Robert A , Kalayjian Robert C , Watkins Richard R , Doi Yohei , Kaye Keith S , Evans Scott , Fowler Vance G , Bonomo Robert A , DeHovitz Jack , Kreiswirth Barry , van Duin David ,   Antibacterial Resistance Leadership Group
Published: August 2020

AbstractBackgroundPatients on chronic intermittent renal replacement therapy (RRT) are at risk for infection with carbapenem-resistant Enterobacteriaceae (CRE). However, the impact of RRT on outcomes after CRE infections remains to be defined. Here we perform a comparison of outcomes for CRE-infected patients with preserved renal function compared with CRE-infected patients on RRT.MethodsCases and controls were defined from a prospective cohort of CRE-infected patients from the Consortium on Resistance against Carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE). Cases were defined as CRE-infected patients on RRT at hospital admission, while controls were defined as CRE-infected patients with serum creatinine &lt;2 mg/dL and not receiving RRT at admission. Risk factors for 28-day in-hospital mortality were assessed using multivariable logistic regression. An ordinal ranking of outcomes by desirability analysis was performed.ResultsPatients on RRT were more likely to have diabetes mellitus and cardiac disease than controls. Urinary sources of infection were less common in the RRT group. In RRT patients, 28-day in-hospital mortality was increased as compared with controls: 22/71 (31%) vs 33/295 (11%). RRT remained significantly associated with 28-day in-hospital mortality after adjustment for source of infection, prehospitalization origin, and severity of illness (adjusted odds ratio, 2.27; 95% confidence interval [CI], 1.09–4.68; P = .03). Using univariable desirability of outcome ranking analysis, RRT status was associated with a 68% (95% CI, 61%–74%) chance of a worse disposition outcome.ConclusionsChronic RRT in CRE-infected patients is associated with increased in-hospital mortality and worse disposition outcomes at 28 days.
HIV and Chagas Disease Coinfection, a Tractable Disease?
Authors: Guidetto Betiana , Tatta Melisa , Latini Veronica , Gonzales Milene , Riarte Adelina , Tavella Silvina , Warley Eduardo , Altclas Javier 
Published: August 2020

Abstract
We present 2 patients born in Argentina who were newly diagnosed with advanced HIV disease and Chagas disease reactivation with central nervous system involvement. The patients received concurrent benznidazole treatment and antiretroviral therapy, showing good response. Improvement in morbidity and mortality due to early treatment makes this treatment appropriate for coinfected patients.
Infection of a prosthetic knee joint with Clostridium bifermentans
Authors: Barrett Lisa F , Saragadam Sailaja Devi , DiMaria Christina N , Delgado-Daza Alejandro 
Published: August 2020

ABSTRACT
We present the first reported case of prosthetic joint infection caused by Clostridium bifermentans, which was treated with total joint washout and debridement allowing for the patient to retain his prosthesis and achieve full recovery. Clostridium bifermentans is a gram-positive, anaerobic, spore-forming bacterium. This organism was once considered to be non-pathogenic, but has recently been associated with cases of septic arthritis, empyema, osteomyelitis, soft tissue infection, brain abscess, bacteremia and endocarditis.
Vaping-induced lung injury: brief report for the practicing clinician
Authors: Khiatah Bashar , Murdoch Alex , Hubeny Charles , Constantine Carl , Frugoli Amanda 
Published: August 2020

ABSTRACT
The USA is witnessing an outbreak of vaping-induced lung injuries associated with the drastic rise in e-cigarette use, especially among teenagers and young adults. Our understanding of the harmful effects of these products is expanding as an increasing amount of consumers seek medical care for lung-related illnesses. The knowledge of the long-term sequelae of e-cigarette use is limited due to their novelty, but a growing association exists between use and acute lung injury. We describe a case vignette of vaping-induced lung injury to increase physician awareness and discuss the applicability of preliminary diagnostic criteria.
A successful treatment of severe lupoid cutaneous leishmaniasis in an elderly man: a case report
Authors: Ahmad Sulafa , Suleiman Hamid , Al-Shehabi Zuheir 
Published: August 2020

ABSTRACT
Lupoid cutaneous leishmaniasis (LCL) is a rare, atypical presentation of cutaneous leishmaniasis (CL). In this report, the authors present the case of a severe LCL in an elderly patient who presented to our dermatology department with severe, painful ulcerated lesion on his midface with cosmetic deformity to his nose. He had a history of CL 3 years ago at the same place. Histopathologic examination showed epidermal and dermal changes with chronic inflammatory infiltrate and no leishmaniasis bodies were detected. He was admitted and treated with systemic glucantime (60 mg/kg) for a month followed by hydroxychloroquine (200 mg twice a day) for another month with favorable outcome. Countries with endemic CL should consider LCL in patients with a history of leishmaniasis and a similar clinical presentation, especially that it could be misdiagnosed with other granulomatous cutaneous conditions, thus leading to cosmetic deformities that can be avoided with early adequate treatment.
Implications of household-level evidence for policy models: the case of macro-financial linkages
Authors: Muellbauer John 
Published: August 2020

AbstractMacroeconomic policy models should track the different channels of monetary transmission, providing a framework for Monetary Policy Committees. They should also be useful for assessing risks to financial stability, including for designing macroprudential stress tests and instrument settings in the new macroprudential toolkits. Current policy models, including the ‘semi-structural’ non-DSGE econometric models such as FRB-US, are seriously deficient in these respects, failing to capture the credit channel and the role of real estate in the financial accelerator that operated in the global financial crisis, and in key transmission channels in the recovery. Furthermore, developments in economic theory, greatly encouraged by new evidence, have rendered redundant the previously accepted micro-foundations for household behaviour in these policy models.A multi-purpose policy model needs to include a household-housing sub-system. This should contain a consumption function broadly consistent with the micro-evidence with equations for permanent income, for the balance sheet drivers, and for residential investment. To capture the credit channel, this block of the model needs to embed common credit conditions in the equations. Sub-system estimation is required to impose the cross-equation restrictions implied by these common factors.
Radiation of waves by a thin cap submerged in ice-covered ocean
Authors: Das Arijit , De Soumen , Mandal B N 
Published: August 2020

SummaryThe present article is concerned with the radiation of flexural gravity waves due to a thin cap submerged in the ice-covered ocean. The problem is reduced to a system of hypersingular integral equations using the boundary perturbation method. The first-order approximation has only been considered. The effects of the rigidity of the ice sheet and depth of submergence on the added mass and damping coefficient have been analysed. Two types of caps (for example, concave upwards and concave downwards) have been considered for the numerical results. The effect of the concavity on added mass and damping coefficient has also been studied. The present study should be helpful to understand the nature of waves generated by a heaving submerged body in an ice-covered ocean.
Speed or Accuracy Instructions During Skill Learning do not Affect the Acquired Knowledge
Authors: Vékony Teodóra , Marossy Hanna , Must Anita , Vécsei László , Janacsek Karolina , Nemeth Dezso 
Published: August 2020

Abstract
A crucial question in skill learning research is how instruction affects the performance or the underlying representations. Little is known about the effects of instructions on one critical aspect of skill learning, namely, picking-up statistical regularities. More specifically, the present study tests how prelearning speed or accuracy instructions affect the acquisition of non-adjacent second-order dependencies. We trained 2 groups of participants on an implicit probabilistic sequence learning task: one group focused on being fast and the other on being accurate. As expected, we detected a strong instruction effect: accuracy instruction resulted in a nearly errorless performance, and speed instruction caused short reaction times (RTs). Despite the differences in the average RTs and accuracy scores, we found a similar level of statistical learning performance in the training phase. After the training phase, we tested the 2 groups under the same instruction (focusing on both speed and accuracy), and they showed comparable performance, suggesting a similar level of underlying statistical representations. Our findings support that skill learning can result in robust representations, and they highlight that this form of knowledge may appear with almost errorless performance. Moreover, multiple sessions with different instructions enabled the separation of competence from performance.
A Giant Squamous Cell Carcinoma Arising in a Patient with Hidradenitis Suppurativa
Authors: Özkur Ezgi , Altunay İlknur Kivanç , Celayir Mustafa Fevzi , Çerman Asli Aksu , Uçak Ramazan 
Published: August 2020

ABSTRACT
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease of follicular pilosebaceous units. Chronic, active, and poorly controlled disease may lead to squamous cell carcinoma (SCC). The diagnosis and treatment of SCC in HS is particularly challenging because SCC lesions may be easily mistaken for HS lesions. Current medical literature recommends aggressive surgical excision with at least 2-cm margins. In this article, the authors describe a giant perianal SCC arising in a patient with HS who was treated with surgical resection and radiotherapy.
Sexual and Reproductive Health Service Utilization and Sexuality for Teens on the Autism Spectrum
Authors: Graham Holmes Laura , Shattuck Paul T. , Nilssen A. Renee , Strassberg Donald S. , Himle Michael B. 
Published: August 2020

ABSTRACT:

Objectives:
Health care providers and educators play critical roles in supporting healthy sexuality development for youth with autism spectrum disorder. There is limited information about the sexual behavior of these youth, especially girls, and about their access to sexuality education or health care services.

Methods:
This study addressed these gaps by surveying parents of youth with autism aged 12–18 years (N = 298, 52.7% boys) with a range of intellectual functioning.

Results:
According to parent report, most youth experienced sexual attraction and were interested in relationships, including same-sex attraction or relationships (13.2%). Girls were more likely than boys to have had a romantic relationship and less likely to have experienced school or legal consequences for sexual behavior. Around one-fifth of youth had engaged in a socially inappropriate sexual behavior, whereas 6.4% had a known sexual abuse history and 14.5% were bullied by peers for lack of sexual knowledge. Almost 40% received no sex education in school or in the community, including 60.9% of youth with parent-reported intelligence quotient under 70. Some parents consulted with school personnel (36.4%) or health care providers (55.9%) about sexuality issues, whereas 19.5% reported taking no action aside from talking to their child about sexuality. Utilization models including predisposing, enabling, and needs-related factors were applied to parent consultation with providers and use of school-based sexuality education programming.

Conclusion:
The results suggest unmet needs for sexual and reproductive health services, particularly among youth who are younger, those who have co-occurring intellectual disability, or those who are homeschooled or who attend private, charter, or therapeutic versus public schools.
A Large, Open-Label, Phase 3 Safety Study of DaxibotulinumtoxinA for Injection in Glabellar Lines: A Focus on Safety From the SAKURA 3 Study
Authors: Green Jeremy B. , Mariwalla Kavita , Coleman Kyle , Ablon Glynis , Weinkle Susan H. , Gallagher Conor J. , Vitarella Domenico , Rubio Roman G. 
Published: August 2020

BACKGROUND
SAKURA 3 was a Phase 3, open-label, repeat-dose safety study of DaxibotulinumtoxinA for Injection (DAXI); a component of the largest Phase 3 clinical development program of an aesthetic neuromodulator in glabellar lines.

OBJECTIVE
To evaluate the use of DAXI (40U) up to 3 treatments for moderate or severe glabellar lines.

METHODS
Eligible subjects rolled over from the placebo-controlled trials (n = 477) or were de novo (n = 2,214) and received 1 to 3 treatments over a maximum of 84 weeks. Safety and efficacy were evaluated at least every 4 weeks up to Week 36 (Treatments 1 and 2) and Week 12 (Treatment 3). Select subjects could be retreated after Week 12 if glabellar lines returned to baseline.

RESULTS
Safety results are reported for 2,691 subjects, of which 882 received a second treatment and 568 a third. Treatment-related adverse events (AEs) occurred in 17.8% of subjects, which were generally mild and resolved. No serious AEs were treatment-related. Eyelid ptosis occurred in 0.9% of treatments. Adverse events were consistent across treatments and no new safety signals were observed.

CONCLUSION
The safety of DAXI in this large open-label safety study confirms the findings from the pivotal Phase 3 trials, providing reassurance in its overall safety profile.
A Survey on National Pediatric Antibiotic Stewardship Programs, Networks and Guidelines in 23 European Countries
Authors: Kopsidas Ioannis , Vergnano Stefania , Spyridis Nikos , Zaoutis Theoklis , Patel Sanjay 
Published: August 2020

Background:
Misuse, overuse of antimicrobials and increasing rates of antimicrobial resistance are well-recognized problems throughout Europe. The aim of this survey was to describe the current pediatric antibiotic stewardship (PAS) landscape across Europe and identify gaps, in terms of national programs, networks and guidelines.

Methods:
A survey of 17 questions was circulated in July 2019 among 24 European pediatric infectious disease researchers and clinicians, professors and heads of department on the existence of PAS programs, national networks and meetings, established competencies, metrics and guidelines.

Results:
We received responses from 23 countries. National guidelines on the management of children with common infections treated in hospital settings exist in 15 of 23 (70%); only 8 of 15 (53%) had been updated within the previous 4 years. Most provide guidance on antibiotic initiation and duration (14 of 15, 93%), but few on when to transition from intravenous to oral antibiotics (7 of 15, 47%). National PAS competencies have only been developed in 4 countries; only 1 addressed both community and hospital prescribing. Organized national PAS networks are only established in the United Kingdom and Germany; 21 of 23, 91% countries had no agreed metric for antibiotic prescribing in children; 2 of 23 were based on daily defined doses.

Conclusions:
Fragmented implementation of PAS programs, no agreed metrics, lack of established PAS competencies and national PAS networks along with inexistent funding is alarming in view of existing high rates of antimicrobial resistance in Europe.
Arterial stiffness late after Kawasaki disease in children: Assessment by performing brachial–ankle pulse wave velocity
Authors: Chien Kuang-Jen , Huang Hurng-Wern , Weng Ken-Pen , Huang Shih-Hui , Li Sung-Chou , Lin Chu-Chuan , Hsieh Kai-Sheng 
Published: August 2020

Background:
Whether low-risk Kawasaki disease (KD) patients are at increased risk of cardiovascular disease later in life remains controversial. The purpose of this study is to examine the arterial stiffness and exercise performance of KD patients in chronic stage.

Methods:
This study included 158 subjects. They were divided into three groups: 37 KD patients with regressed coronary artery lesions (CALs) (M/F 23/14, 13.6 ± 6.5 years) (group I), 43 KD patients without CALs (M/F 26/17, 13.9 ± 6.2 years) (group II), and 78 age- and gender-matched normal controls (M/F 44/34, 13.2 ± 6.9 years) (group III). They all underwent brachial–ankle pulse wave velocity (baPWV), an exercise test, and blood sampling to measure the levels of high-sensitivity C-reactive protein (hs-CRP), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and total cholesterol (TC). The differences among the groups were compared.

Results:
There were significant differences among the three groups in terms of right and left baPWV (p < 0.01 respectively), HDL level (p < 0.05), TC/HDL ratio (p < 0.05), and oxygen consumption (VO2) peak (p < 0.05). Moreover, group I subjects had significantly higher right and left baPWV (p < 0.05 respectively), lower HDL level (p < 0.05), and lower VO2 peak (p < 0.05) than group II subjects. Furthermore, baPWV was significantly correlated with TG level (r = 0.326, p < 0.05), TC/HDL ratio (r = 0.483, p < 0.01), LDL level (r = 0.386, p < 0.01), and VO2 peak (r = −0.385, p < 0.05) in group I subjects. Only the TC/HDL ratio was found to be a significant correlating factor for an increase of baPWV (beta = 0.68, p < 0.05) in KD patients after multiple linear regression.

Conclusion:
Our results suggest that arterial stiffness is present late after KD and may adversely affect exercise performance, especially in patients with regressed CALs. Regular measurement of baPWV may be indicated in the long-term follow-up of KD patients.
Smartphone frailty screening: Development of a quantitative early detection method for the frailty syndrome
Authors: Chen Hung-Ju , Chen Po-Yin , Kao Chung-Lan , Sung Wen-Hsu 
Published: August 2020

Background:
Frailty syndrome in older population generates formidable social cost. The early detection of “prefrail” stage is essential so that interventions could be performed to prevent deterioration. The purpose of this study was to organize appropriate physical performance tests into a computerized early frailty screening platform, called frailty assessment tools (FAT) system, to detect individuals who are in the prefrail stage.

Methods:
Four switches, one distance meter, and one power measure were adopted to build the FAT system that could perform six physical performance tests including single leg standing (SLS), repeated chair rise, timed up and go, self-selected walking speed, functional reach, and grip power. Participants over 65 years old were recruited and classified into three groups according to Fried criteria. The differences in variables between prefrail and robust groups were compared by the χ2 test, independent samples t test, and Mann-Whitney U test, for nominal variables, normal, and non-normal distributive continuous variables, respectively. The statistically significant level was set at 0.05 (α = 0.05).

Results:
Only SLS did not reach significance to distinguish prefrail from robust. Among 35 participants (73.23 ± 5.70 years old), the FAT score predicted that 90.73 ± 19.95% of pre-frail subjects and 15.01 ± 25.25% of robust subjects were in the prefrail stage.

Conclusion:
The FAT system, which provides results immediately, is an advantageous alternative to traditional manual measurements. The use of the FAT score for predicting the prefrail stage will help to provide early intervention to prevent individuals from progressing into frailty. The FAT system provides a more convenient and comprehensive frailty screening. Using this computerized automatic screening platform, it may be possible to expand the scope of frailty prevention.
Cancer incidence and mortality following treatment of hyperthyroidism with radioactive iodine
Authors: Evron Josh M. , Esfandiari Nazanene H. , Papaleontiou Maria 
Published: August 2020

Purpose of review
Hyperthyroidism is a commonly encountered clinical issue. Radioactive iodine is one of the treatment modalities employed over the last 80 years. Prior studies are conflicting as to whether radioactive iodine is associated with an increased risk of subsequent malignancy and associated mortality. The present article reviews recent publications on this subject.

Recent findings
Two recent studies make meaningful contributions to the existing literature; however, data remain inconsistent. The first, conducted using the Clalit Health Services database, evaluated solid tumor incidence after radioactive iodine and found no association with increased risk of solid tumor malignancy. The second, which is an updated analysis of the Cooperative Thyrotoxicosis Therapy Follow-up Study, concluded that there is a dose-dependent increased risk of solid tumor mortality using a novel method of estimating organ-specific radiation exposure.

Summary
In patients with hyperthyroidism, radioactive iodine is a popular and effective treatment option. Prior studies reach conflicting conclusions on the potential relationship between radioactive iodine and both subsequent cancer incidence and mortality. We review recent publications that add to our understanding of this important clinical question.
The problem of vaccination refusal: a review with guidance for pediatricians
Authors: Tokish Hannah , Solanto Mary V. 
Published: August 2020

Purpose of review
In the wake of multiple recent outbreaks of the measles and other vaccine-preventable diseases, it is crucial to understand and address parental concerns about vaccination. The purposes of this review are: to identify the causes of vaccine resistance, to elucidate the variables that have led to the success or failure of interventions to date, and to consider implications for pediatricians treating children whose parents are vaccination-resistant.

Recent findings
Recent research draws on insights from cognitive science to understand vaccine resistance and to develop more effective interventions. Studies show that vaccine resistors are more likely to value lifestyle liberty, to favor individualistic over hierarchical worldviews, and to believe in conspiracy theories. Interventions that seek primarily to correct erroneous beliefs about the dangers of vaccination are likely to fail or even backfire. On the other hand, intervention strategies, such as motivational interviewing, in which the provider elicits and shows respect for parents’ values and concerns while empowering them to make well informed and well reasoned decisions, are more likely to be successful. Parents cite a trusting relationship with their pediatrician as the most important factor influencing their decision to vaccinate.

Summary
Pediatricians are in the best position to successfully apply insights from cognitive science and intervention research to overcome vaccination-hesitancy.