bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of urine flow cytometry and urine test strip in predicting relevant bacteriuria in different patient populations
Authors: Gehringer Christian , Regeniter Axel , Rentsch Katharina , Tschudin-Sutter Sarah , Bassetti Stefano , Egli Adrian 
Published: February 2021

Abstract
Background
Urinary tract infection (UTI) is diagnosed combining urinary symptoms with demonstration of urine culture growth above a given threshold. Our aim was to compare the diagnostic accuracy of Urine Flow Cytometry (UFC) with urine test strip in predicting bacterial growth and in identifying contaminated urine samples, and to derive an algorithm to identify relevant bacterial growth for clinical use.

Methods
Species identification and colony-forming unit (CFU/ml) quantification from bacterial cultures were matched to corresponding cellular (leucocytes/epithelial cells) and bacteria counts per μl. Results comprise samples analysed between 2013 and 2015 for which urine culture (reference standard) and UFC and urine test strip data (index tests, Sysmex UX-2000) were available.

Results
47,572 urine samples of 26,256 patients were analysed. Bacteria counts used to predict bacterial growth of ≥105 CFU/ml showed an accuracy with an area under the receiver operating characteristic curve of > 93% compared to 82% using leukocyte counts. The relevant bacteriuria rule-out cut-off of 50 bacteria/μl reached a negative predictive value of 98, 91 and 89% and the rule-in cut-off of 250 bacteria/μl identified relevant bacteriuria with an overall positive predictive value of 67, 72 and 73% for microbiologically defined bacteriuria thresholds of 105, 104 or 103 CFU/ml, respectively. Measured epithelial cell counts by UFC could not identify contaminated urine.

Conclusions
Prediction of a relevant bacterial growth by bacteria counts was most accurate and was a better predictor than leucocyte counts independently of the source of the urine and the medical specialty ordering the test (medical, surgical or others).
Adenovirus viremia may predict adenovirus pneumonia severity in immunocompetent children
Authors: Zhang Ruimu , Wang Hongmei , Tian Shufeng , Deng Jikui 
Published: February 2021

Abstract
Background
Previous studies have demonstrated an association between adenovirus viremia and disease severity in immunocompromised children. However, few studies have focused on this association in immunocompetent children. This study explored the association between adenovirus viremia and adenovirus pneumonia severity in immunocompetent children.

Methods
We performed a retrospective, observational study of immunocompetent children with adenovirus pneumonia admitted to Shenzhen Children’s Hospital in Shenzhen, China. Pneumonia was classified as severe or mild based on the Chinese guideline for the classification of pneumonia severity. Serum samples from all the children included in the study were tested for adenovirus DNA with a quantitative polymerase chain reaction. Clinical manifestations, laboratory examinations, and disease severity were compared between children with severe and mild pneumonia.

Results
A total of 111 immunocompetent children with adenovirus pneumonia (60 severe, 51 mild) were included. The median age was 40 months, and 64 patients were male. Five patients were admitted to the intensive care unit, and two underwent endotracheal intubation. All patients were discharged after recovery or improvement. Univariate analysis and binary logistic regression analysis showed that leukocytosis (OR = 1.1; 95% CI: 1.0 to 1.2; P = 0.033), co-infection with Mycoplasma pneumoniae (OR = 5.0; 95% CI: 2.1 to 12.3; P <  0.001), and high blood viral load (OR = 1.5; 95% CI: 1.2 to 2.0; P = 0.001) may be risk factors for severe adenovirus pneumonia.

Conclusions
Leukocytosis, co-infection with Mycoplasma pneumoniae, and high blood viral load may be risk factors for severe adenovirus pneumonia in immunocompetent children. Blood viral load may predict pneumonia severity.
Case series of acute appendicitis association with SARS-CoV-2 infection
Authors: Prichard Charlsea , Canning Matthew , McWilliam-Ross Kindra , Birbari John , Parker William , Wasson Lori , Hollingsworth John W. 
Published: February 2021

Abstract
Background
Describe the indications for surgical interventions in asymptomatic patients with SARS-CoV-2. We are unaware of previous reports of an association between SARS-CoV-2 and acute appendicitis.

Methods
We performed a single institution retrospective review of SARS-CoV-2 pre-procedure testing and indications for surgical intervention. Statistical comparisons were performed using Chi Square analysis or two-tailed Student T test.

Results
We report a high prevalence of SARS-CoV-2 in both all testing and pre-procedure testing during the enrollment period. We observe a high prevalence of acute appendicitis among patients identified to be SARS-CoV-2 positive during pre-procedure testing and without recognized symptoms of COVID19.

Conclusion
We report a previously unrecognized association between SARS-CoV-2 and acute appendicitis.
Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya
Authors: Gersh Jill K. , Barnabas Ruanne V. , Matemo Daniel , Kinuthia John , Feldman Zachary , Lacourse Sylvia M. , Mecha Jerphason , Warr Alex J. , Kamene Maureen , Horne David J. 
Published: February 2021

Abstract
Background
People living with HIV (PLHIV) who reside in high tuberculosis burden settings remain at risk for tuberculosis disease despite treatment with anti-retroviral therapy and isoniazid preventive therapy (IPT). The performance of the World Health Organization (WHO) symptom screen for tuberculosis in PLHIV receiving anti-retroviral therapy is sub-optimal and alternative screening strategies are needed.

Methods
We enrolled HIV-positive adults into a prospective study in western Kenya. Individuals who were IPT-naïve or had completed IPT > 6 months prior to enrollment were eligible. We evaluated tuberculosis prevalence overall and by IPT status. We assessed the accuracy of the WHO symptom screen, GeneXpert MTB/RIF (Xpert), and candidate biomarkers including C-reactive protein (CRP), hemoglobin, erythrocyte sedimentation rate (ESR), and monocyte-to-lymphocyte ratio for identifying pulmonary tuberculosis. Some participants were evaluated at 6 months post-enrollment for tuberculosis.

Results
The study included 383 PLHIV, of whom > 99% were on antiretrovirals and 88% had received IPT, completed a median of 1.1 years (IQR 0.8–1.55) prior to enrollment. The prevalence of pulmonary tuberculosis at enrollment was 1.3% (n = 5, 95% CI 0.4–3.0%): 4.3% (0.5–14.5%) among IPT-naïve and 0.9% (0.2–2.6%) among IPT-treated participants. The sensitivity of the WHO symptom screen was 0% (0–52%) and specificity 87% (83–90%). Xpert and candidate biomarkers had poor to moderate sensitivity; the most accurate biomarker was CRP ≥ 3.3 mg/L (sensitivity 80% (28–100) and specificity 72% (67–77)). Six months after enrollment, the incidence rate of pulmonary tuberculosis following IPT completion was 0.84 per 100 person-years (95% CI, 0.31–2.23).

Conclusions
In Kenyan PLHIV treated with IPT, tuberculosis prevalence was low at a median of 1.4 years after IPT completion. WHO symptoms screening, Xpert, and candidate biomarkers were insensitive for identifying pulmonary tuberculosis in antiretroviral-treated PLHIV.
Distorted chemosensory perception and female sex associate with persistent smell and/or taste loss in people with SARS-CoV-2 antibodies: a community based cohort study investigating clinical course and resolution of acute smell and/or taste loss in people with and without SARS-CoV-2 antibodies in London, UK
Authors: Makaronidis Janine , Firman Chloe , Magee Cormac G. , Mok Jessica , Balogun Nyaladzi , Lechner Matt , Carnemolla Alisia , Batterham Rachel L. 
Published: February 2021

Abstract
Background
Loss of smell and/or taste are cardinal symptoms of COVID-19. ‘Long-COVID’, persistence of symptoms, affects around one fifth of people. However, data regarding the clinical resolution of loss of smell and/or taste are lacking. In this study we assess smell and taste loss resolution at 4–6 week follow-up, aim to identify risk factors for persistent smell loss and describe smell loss as a feature of long-COVID in a community cohort in London with known SARS-CoV-2 IgG/IgM antibody status. We also compare subjective and objective smell assessments in a subset of participants.

Methods
Four hundred sixty-seven participants with acute loss of smell and/or taste who had undergone SARS-CoV-2 IgG/IgM antibody testing 4–6 weeks earlier completed a follow-up questionnaire about resolution of their symptoms. A subsample of 50 participants completed an objective olfactory test and results were compared to subjective smell evaluations.

Results
People with SARS-CoV-2 antibodies with an acute loss of sense of smell and taste were significantly less likely to recover their sense of smell/taste than people who were seronegative (smell recovery: 57.7% vs. 72.1%, p = 0.027. taste recovery 66.2% vs. 80.3%, p = 0.017). In SARS-CoV-2 positive participants, a higher percentage of male participants reported full resolution of smell loss (72.8% vs. 51.4%; p < 0.001) compared to female participants, who were almost 2.5-times more likely to have ongoing smell loss after 4–6 weeks (OR 2.46, 95%CI 1.47–4.13, p = 0.001). Female participants with SARS-CoV-2 antibodies and unresolved smell loss and unresolved taste loss were significantly older (> 40 years) than those who reported full resolution. Participants who experienced parosmia reported lower smell recovery rates and participants with distorted taste perception lower taste recovery rates. Parosmia had a significant association to unresolved smell loss (OR 2.47, 95%CI 1.54–4.00, p < 0.001).

Conclusion
Although smell and/or taste loss are often transient manifestations of COVID-19, 42% of participants had ongoing loss of smell, 34% loss of taste and 36% loss of smell and taste at 4–6 weeks follow-up, which constitute symptoms of ‘long-COVID’. Females (particularly > 40 years) and people with a distorted perception of their sense of smell/taste are likely to benefit from prioritised early therapeutic interventions.

Trials registration
ClinicalTrials.govNCT04377815 Date of registration: 23/04/2020.
The probability of receiving a kidney transplantation in end-stage kidney disease patients who are treated with haemodiafiltration or haemodialysis: a pooled individual participant data from four randomised controlled trials
Authors:   on behalf of the HDF Pooling project investigators, Vernooij Robin W. M. , Law Way , Peters Sanne A. E. , Canaud Bernard , Davenport Andrew , Grooteman Muriel P. C. , Kircelli Fatih , Locatelli Francesco , Maduell Francisco , Morena Marion , Nubé Menso J. , Ok Ercan , Torres Ferran , Woodward Mark , Blankestijn Peter J. , Bots Michiel L. 
Published: February 2021

AbstractBackgroundDue to a critical shortage of available kidney grafts, most patients with Stage 5 Chronic Kidney Disease (CKD5) require bridging dialysis support. It remains unclear whether treatment by different dialysis modalities changes the selection and/or preparation of a potential transplant candidate. Therefore, we assessed whether the likelihood of receiving kidney transplant (both living or deceased kidney donors) differs between haemodialysis (HD) and online haemodiafiltration (HDF) in patients with CKD5D.MethodsIndividual participant data from four randomised controlled trials comparing online HDF with HD were used. Information on kidney transplant was obtained during follow-up. The likelihood of receiving a kidney transplant was compared between HD and HDF, and evaluated across different subgroups: age, sex, diabetes, history of cardiovascular disease, albumin, dialysis vintage, fistula, and level of convection volume standardized to body surface area. Hazard ratios (HRs), with corresponding 95% confidence intervals (95% CI), comparing the effect of online HDF versus HD on the likelihood of receiving a kidney transplant, were estimated using Cox proportional hazards models with a random effect for study.ResultsAfter a median follow-up of 2.5 years (Q1 to Q3: 1.9–3.0), 331 of the 1620 (20.4%) patients with CKD5D received a kidney transplant. This concerned 22% (n = 179) of patients who were treated with online HDF compared with 19% (n = 152) of patients who were treated with HD. No differences in the likelihood of undergoing a kidney transplant were found between the two dialysis modalities in both the crude analyse (HR: 1.07, 95% CI: 0.86–1.33) and adjusted analysis for age, sex, diabetes, cardiovascular history, albumin, and creatinine (HR: 1.15, 95%-CI: 0.92–1.44). There was no evidence for a differential effect across subgroups based on patient- and disease-characteristics nor in different categories of convection volumes.ConclusionsTreatment with HD and HDF does not affect the selection and/or preparation of CKD5D patients for kidney transplant given that the likelihood of receiving a kidney transplant does not differ between the dialysis modalities. These finding persisted across a variety of subgroups differing in patient and disease characteristics and is not affected by the level of convection volume delivered during HDF treatment sessions.
Comprehensive molecular profiling of Taiwanese breast cancers revealed potential therapeutic targets: prevalence of actionable mutations among 380 targeted sequencing analyses
Authors: Huang Chi-Cheng , Tsai Yi-Fang , Liu Chun-Yu , Chao Ta-Chung , Lien Pei-Ju , Lin Yen-Shu , Feng Chin-Jung , Chiu Jen-Hwey , Hsu Chih-Yi , Tseng Ling-Ming 
Published: February 2021

Abstract
Background
Breast cancer is one of the leading causes of cancer-related deaths in women, and there is a demand in developing an Asian-based genetic profiling database for breast cancer in improving the treatment response. This study aimed to determine molecular alternations and identify potential therapeutic targets by analyzing the genetic profiling from a cohort of Taiwanese breast cancers using a commercialized next-generation sequencing (NGS) targeted panel.

Methods
The study population comprised a broad spectrum of breast cancer patients in Taiwan, including Group 1: planned to receive first-line surgery and followed by adjuvant therapy, or early relapse within three years, Group 2: planned to receive first-line neoadjuvant therapy and followed by surgery, and Group 3: de novo stage IV, or stage IV with recurrence beyond three years. Molecular profiles were determined using Thermo Fisher™ Oncomine™ Comprehensive Assay version 3 (TMO comprehensive assay) from Formalin-Fixed Paraffin-Embedded (FFPE) tissues. Level of actionability was evaluated with the ESMO Scale of clinical actionability of molecular targets (ESCAT).

Results
A total of 380 TMO comprehensive assays were conducted on 372 patients, and we presented targeted sequencing analyses of Tier I: alteration-drug match associated with improved outcome in clinical trials including ERBB2 amplification, BRCA1/2 germline mutation, PIK3CA mutation, and NTRK translocation, and Tier II: antitumor activity associated with the matched alteration-drug but lack of prospective outcome data including PTEN loss, ESR1 mutation, AKT1 mutation, and ERBB2 mutation, and Tier III: matched drug-alteration that led to clinical benefit in another tumor type including MDM2 amplification, and ERBB3 mutation. Among them, 249 (66%) showed at least one actionable alternation based on the ESCAT criteria. The most frequent impacted genes (all variants combined within each sample) were PIK3CA (38%), followed by ERBB2 (23%), ESR1 (10%), AKT1 (6%), and BRCA2 (5%), and the remaining rare variants (less than 5% of assayed cohort) were BRCA1 (3%), MDM2 (2.2%), and ERBB3 (1.1%).

Conclusion
Targeted sequencing of actionable genes is believed to provide clinical applicability and substantial benefits for Taiwanese breast cancer patients. A valid scale of clinical actionability should be adopted for precision medicine practice under multidisciplinary molecular tumor board.
Diabetes mellitus hospitalization and mortality rate according to a national database in Brazil: a longitudinal study
Authors: Florêncio Rêncio Bento , de Araújo Fonseca Luiza Gabriela , da Silva Vivian Fernanda Dantas , Lima Íllia Nadinne Dantas Florentino , Gualdi Lucien Peroni 
Published: February 2021

Abstract
Background
Diabetes mellitus (DM) is an important public health problem worldwide. In addition to the impairment in functionality, the large number of complications which lead to hospitalizations results in high treatment costs. The aim of this study was to analyze the incidence of hospitalizations, mortality rate and hospital costs, as well as to observe the temporal trend of hospitalizations and length of hospital stay due to DM between 2008 and 2019 in Brazil.

Methods
This is a longitudinal descriptive study in which all data regarding hospital admissions registered in the Brazilian system of Hospital Information of “Sistema Único de Saúde” (SIH/SUS; http://datasus.saude.gov.br) due to DM (ICD-10) were included. Comparisons among the groups were performed by an unpaired Student’s t-test, two-way ANOVA with a Tukey post hoc test (p < 0.05).

Results
An increased hospitalization of 1.83% due to DM was observed between 2008 and 2019 in Brazil. The Southeastern region had the highest incidence (34.6%) and mortality rate when compared to the other regions (p < 0.05). We also found that females were more likely to be hospitalized in comparison to males, without a statistically significant difference. Finally, a progressive increase of hospitalizations and mortality rate were observed according to age groups, as well as increased spending due to DM hospitalizations over the years.

Conclusion
Hospitalizations due to DM in Brazil showed an expressive increase over the last 12 years, and there is a need for primary healthcare interventions to help reduce this situation.
Sociocultural barriers to hepatitis B health literacy in an immigrant population: a focus group study in Korean Americans
Authors: Hyun Sarah , Ko Okhyun , Kim Soonsik , Ventura William R. 
Published: February 2021

Abstract
Background
Chronic hepatitis B (CHB) is a major global health issue disproportionately affecting Asian Americans and other immigrant populations in the United States. Despite the high risk of morbid complications from CHB, the majority of individuals with CHB do not access healthcare due to a complex of barriers. These barriers influence health literacy which may affect behaviors linked to hepatitis B care. We aimed to identify and evaluate various sociocultural factors and how they interact with health literacy to impact CHB care and health seeking in a Korean American population.

Methods
A total of 28 Korean American individuals with CHB were divided into 5 different focus discussion groups. This study investigated the participants’ sociocultural backgrounds as well as their awareness and utilization of the healthcare system that could influence their health literacy and behaviors in accessing care.

Results
Our analysis identified and concentrated on three themes that emerged from these discussions: low risk perception and knowledge of CHB and its complications; language, immigrant status, and stigma; and financial and institutional barriers. The participants’ overall awareness of the disease and prevention methods demonstrated poor understanding of important characteristics and potential outcomes of the disease. Additionally, differences in cultural expectations and a lack of understanding and utilization of healthcare systems affected health literacy in further limiting participants’ motivation to seek care.

Conclusions
The present study suggests that there are culture-specific barriers to health literacy governing individuals’ health behavior in accessing hepatitis B care. These findings may inform strategies for developing culturally tailored resources and programs and for facilitating the implementation of community-wide hepatitis B education and screening initiatives in immigrant communities.
Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys
Authors: Leight Jessica , Wilson Nicholas 
Published: February 2021

Abstract
Background
High rates of maternal mortality and intimate partner violence (IPV) are both major worldwide health challenges. Evidence from single-country samples suggests that IPV may be an important risk factor for low utilization of maternal health services, but there is little large-scale evidence on this association. This paper evaluates whether IPV is a risk factor for low utilization of maternal health services in a large cross-country sample, and also compiles evidence on the relative effects of different forms of IPV.

Methods
We analyze the association between intimate partner violence and utilization of maternal health care, using a dataset compiling all Demographic and Health Surveys that report data on intimate partner violence. Using data on 166,685 women observed in 36 countries between 2005 and 2016, we estimate logistic regression models to analyze the relationship between lifetime experience of IPV and utilization of antenatal care (ANC), facility delivery care, and postnatal care. We estimate both unadjusted models and models adjusted for geographic and sociodemographic characteristics that are generally correlated with utilization of maternal health care (including age, education, number of children, wealth status, marital status, and urbanity).

Results
Lifetime experience of any IPV is associated with decreased use of maternal health services in a broad sample of births observed in lower and middle-income countries: in particular, the utilization of four or more ANC visits, the number of ANC visits, and the utilization of facility care at birth. This association remains statistically significant even after adjusting for country of residence, subnational region of residence, and additional individual-level covariates; however, there is no statistically significant association between experience of any IPV and postnatal care. The only form of IPV significantly associated with care utilization is physical IPV.

Conclusions
Women experiencing physical intimate partner violence show lower levels of utilization of maternal health services in a large sample of developing and middle-income countries. Given that reduced utilization of maternal health services is correlated with maternal and neonatal health outcomes, this pattern suggests that IPV prevention may be an important component of interventions targeting enhanced maternal and neonatal health.