bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ampicillin-Ceftriaxone vs Ampicillin-Gentamicin for Definitive Therapy of Enterococcus faecalis Infective Endocarditis: A Propensity Score–Matched, Retrospective Cohort Analysis
Authors: Shah Niyati H , Shutt Kathleen A , Doi Yohei 
Published: March 2021

Abstract

Background
Ampicillin-ceftriaxone (AC) has emerged as an alternative antibiotic regimen for enterococcal infective endocarditis (EIE) with reduced toxicity compared with ampicillin-gentamicin (AG), but evidence regarding its success in reducing EIE-associated death in the United States is limited.

Methods
We conducted a retrospective, propensity score–matched cohort analysis of EIE patients treated with AC or AG between 2010 and 2017 at 3 hospitals in Pittsburgh, Pennsylvania. We assessed all-cause 90-day mortality as the primary outcome and in-hospital mortality, length of hospital stay, hospital readmissions, adverse events, and relapse of bacteremia as the secondary outcomes.

Results
A total of 190 patients with EIE (100 treated with AC and 90 with AG) were included. Ninety-day mortality was significantly higher with AC than AG (21% vs 8%; P = .02). After propensity score matching, 56 patients in each group remained for the outcomes analysis. Documented aminoglycoside resistance, presence of annular or aortic abscess, and complete pacemaker removal were the significantly different variables between the 2 matched cohorts. We observed no statistically significant difference in 90-day mortality between the 2 treatment groups (11% vs 7%; P = .55). Adverse events were more common in patients treated with AG (25 vs 39; P = .0091), and more patients in the propensity score–matched AG cohort switched antibiotic regimens than in the AC group (10% vs 49%; P &lt; .0001).

Conclusions
Patients treated with AC demonstrate no significant differences in mortality, treatment failure, or bacteremia relapse compared with AG in a propensity score–matched EIE cohort.
Nucleoside Reverse-Transcriptase Inhibitor Resistance Mutations Predict Virological Failure in Human Immunodeficiency Virus-Positive Patients During Lamivudine Plus Dolutegravir Maintenance Therapy in Clinical Practice
Authors: Borghetti Alberto , Giacomelli Andrea , Borghi Vanni , Ciccullo Arturo , Dusina Alex , Fabbiani Massimiliano , Rusconi Stefano , Zazzi Maurizio , Mussini Cristina , Di Giambenedetto Simona 
Published: March 2021

Abstract
The TANGO trial demonstrated the efficacy of lamivudine plus dolutegravir in virologically suppressed patients without previous virological failures (VFs). In this dataset from clinical practice investigating the impact of past nucleoside reverse-transcriptase inhibitor resistance on this strategy, the combination of M184V/I plus at least 1 thymidine analog-associated mutation significantly increased the risk of VF.
Metagenomic Next-Generation Sequencing for Pathogen Detection and Transcriptomic Analysis in Pediatric Central Nervous System Infections
Authors: Ramchandar Nanda , Coufal Nicole G , Warden Anna S , Briggs Benjamin , Schwarz Toni , Stinnett Rita , Xie Heng , Schlaberg Robert , Foley Jennifer , Clarke Christina , Waldeman Bryce , Enriquez Claudia , Osborne Stephanie , Arrieta Antonio , Salyakina Daria , Janvier Michelin , Sendi Prithvi , Totapally Balagangadhar R , Dimmock David , Farnaes Lauge 
Published: March 2021

AbstractBackgroundPediatric central nervous system (CNS) infections are potentially life-threatening and may incur significant morbidity. Identifying a pathogen is important, both in terms of guiding therapeutic management and in characterizing prognosis. Usual care testing by culture and polymerase chain reaction is often unable to identify a pathogen. We examined the systematic application of metagenomic next-generation sequencing (mNGS) for detecting organisms and transcriptomic analysis of cerebrospinal fluid (CSF) in children with central nervous system (CNS) infections.MethodsWe conducted a prospective multisite study that aimed to enroll all children with a CSF pleocytosis and suspected CNS infection admitted to 1 of 3 tertiary pediatric hospitals during the study timeframe. After usual care testing had been performed, the remaining CSF was sent for mNGS and transcriptomic analysis.ResultsWe screened 221 and enrolled 70 subjects over a 12-month recruitment period. A putative organism was isolated from CSF in 25 (35.7%) subjects by any diagnostic modality. Metagenomic next-generation sequencing of the CSF samples identified a pathogen in 20 (28.6%) subjects, which were also all identified by usual care testing. The median time to result was 38 hours.ConclusionsMetagenomic sequencing of CSF has the potential to rapidly identify pathogens in children with CNS infections.
Detection of Environmental Spread of SARS-CoV-2 and Associated Patient Characteristics
Authors: Semelka Charles T , Ornelles David A , O’Connell Nathaniel S , Parsons Emma C , Blevins Maria W , Ivey Lauren E , Bischoff Werner E 
Published: March 2021

Abstract
Understanding transmission of severe acute respiratory syndrome coronavirus 2 informs infection prevention practices. Air sampling devices were placed in patient hospital rooms for consecutive collections with and without masks. With patient mask use, no virus was detected in the room. High viral load and fewer days from symptom onset were associated with viral particulate dispersion.
Circulating β-d-Glucan as a Marker of Subclinical Coronary Plaque in Antiretroviral Therapy-Treated People With Human Immunodeficiency Virus
Authors: Isnard Stéphane , Fombuena Brandon , Sadouni Manel , Lin John , Richard Corentin , Routy Bertrand , Ouyang Jing , Ramendra Rayoun , Peng Xiaorong , Zhang Yonglong , Finkelman Malcolm , Tremblay-Sher Daniel , Tremblay Cecile , Chartrand-Lefebvre Carl , Durand Madeleine , Routy Jean-Pierre 
Published: March 2021

Abstract

Background
Despite antiretroviral therapy (ART), people with human immunodeficiency virus (PWH) have increased risk of inflammatory comorbidities, including cardiovascular diseases. Gut epithelial damage, and translocation of bacterial lipopolysaccharide (LPS) or fungal β-d-glucan (BDG) drive inflammation in ART-treated PWH. In this study, we investigated whether markers of gut damage and microbial translocation were associated with cardiovascular risk in asymptomatic ART-treated PWH.

Methods
We cross-sectionally analyzed plasma from 93 ART-treated PWH and 52 uninfected controls older than 40 years of age from the Canadian HIV and Aging Cohort. Participants were cardiovascular disease free and underwent a cardiac computed tomography (CT) to measure total coronary atherosclerotic plaque volume (TPV). Levels of bacterial LPS and gut damage markers REG3α and I-FABP were measured by enzyme-linked immunosorbent assay. Fungal BDG levels were analyzed using the Fungitell assay.

Results
β-d-glucan levels but not LPS were significantly elevated in ART-treated PWH with coronary artery plaque (P = .0007). Moreover, BDG but not LPS levels correlated with TPV (r = 0.26, P = .01). Intestinal fatty acid binding protein (I-FABP) but not REG3α levels correlated with TPV (r = 0.23, P = .03). However, BDG and LPS levels were not elevated in uninfected controls with plaque. In multivariable models, elevated BDG levels were independently associated with the presence of coronary atherosclerosis in PWH but not in uninfected controls.

Conclusions
Translocation of fungal BDG was associated with coronary atherosclerosis assessed by CT-scan imaging in ART-treated PWH, suggesting a human immunodeficiency virus-specific pathway leading to cardiovascular disease. Further investigation is needed to appraise causality of this association. Translocation of fungal products may represent a therapeutic target to prevent cardiovascular disease in ART-treated PWH.
Plasma levels of the fungal product β-D-Glucan, but not the bacterial product lipopolysaccharide, are associated with the presence and the size of subclinical coronary atherosclerosis plaque in people living with HIV taking antiretroviral therapy, independently of classical cardiovascular risk factors.
When Azoles Cannot Be Used: The Clinical Effectiveness of Intermittent Liposomal Amphotericin Prophylaxis in Hematology Patients
Authors: Batchelor R , Thomas C , Gardiner B J , Lee S J , Fleming S , Wei A , Coutsouvelis J , Ananda-Rajah M 
Published: March 2021

AbstractBackgroundPatients unable to take azoles are a neglected group lacking a standardized approach to antifungal prophylaxis. We evaluated the effectiveness and safety of intermittent liposomal amphotericin B (L-AMB) prophylaxis in a heterogenous group of hematology patients.MethodsA retrospective cohort of all hematology patients who received a course of intravenous L-AMB, defined as 1 mg/kg thrice weekly from July 1, 2013 to June 30, 2018, were identified from pharmacy records. Outcomes included breakthrough-invasive fungal disease (BIFD), reasons for premature discontinuation, and acute kidney injury.ResultsThere were 198 patients who received 273 courses of L-AMB prophylaxis. Using a conservative definition, the BIFD rate was 9.6% (n = 19 of 198) occurring either during L-AMB prophylaxis or up to 7 days from cessation in patients who received a course. Probable/proven BIFD occurred in 13 patients (6.6%, 13 of 198), including molds in 54% (n = 7) and non-albicans Candidemia in 46% (n = 6). Cumulative incidence of BIFD was highest in patients with acute myeloid leukemia (6.8%) followed by acute lymphoblastic leukemia (2.7%) and allogeneic stem cell transplantation (2.5%). The most common indication for L-AMB was chemotherapy, or anticancer drug-azole interactions (75% of courses) dominated by vincristine, or acute myeloid leukemia clinical trials, followed by gut absorption concerns (13%) and liver function abnormalities (8.8%). Acute kidney injury, using a modified international definition, complicated 27% of courses but was not clinically significant, accounting for only 3.3% (9 of 273) of discontinuations.ConclusionsOur findings demonstrate a high rate of BIFD among patients receiving L-AMB prophylaxis. Pragmatic trials will help researchers find the optimal regimen of L-AMB prophylaxis for the many clinical scenarios in which azoles are unsuitable, especially as targeted anticancer drugs increase in use.
A case report of dyshidrotic bullous pemphigoid developing after partial anterior circulation ischaemic stroke
Authors: Fanelli D , Miller J , Setty R , Husain E , McNeil M 
Published: March 2021

ABSTRACT
Dyshidrotic bullous pemphigoid is a rare form of bullous pemphigoid that affects predominantly a patient’s hands and feet. It has been associated in the literature with neurologic, psychiatric and cerebrovascular disorders. We present an interesting case of this rare skin condition developing in a patient following a diagnosis of partial anterior circulation stroke.
Cardiac arrest in anti-mitochondrial antibody associated inflammatory myopathy
Authors: Højgaard Pil , Witting Nanna , Rossing Kasper , Pecini Redi , Hartvig Lindkær Jensen Thomas , Hasbak Philip , Diederichsen Louise P 
Published: March 2021

Abstract
Insight into predictors of cardiac involvement in inflammatory myopathies is sparse. A negative prognostic role of anti-mitochondrial antibodies (AMA) has been noticed and is supported by the current case. We describe a male patient who at the age 40 suffered a cardiac arrest and over the following months experienced progressive heart failure, arrhythmias and proximal muscle weakness. Clinical, genetic and serologic testing and repeated imaging- and histopathological investigations resulted in a diagnosis of AMA-associated, necrotizing, inflammatory myositis with cardiac involvement. Besides a cardiac resynchronization therapy defibrillator, heart failure and antiarrhythmic drugs the patient received successive immunosuppressants, which improved skeletal muscle strength but not cardiac disease progression. At age 45 he died from end-stage heart failure. Clinicians must be aware of AMA-associated myositis as a cause of unclarified heart disease, even in patients with initially sparse extra-cardiac manifestations. Further knowledge of treatment strategies is highly needed for this disease entity.
Ischaemic stroke as the presenting feature of COVID-19: a series of three cases from Qatar
Authors: Iqbal Yousaf , Haddad Peter M , Latoo Javed , Alhatou Mohammed Ibrahim , Alabdulla Majid 
Published: March 2021

Abstract
Most cases of stroke associated with coronavirus disease 2019 (COVID-19) occur during the course of a characteristic COVID-19 respiratory illness. We report three patients where the presenting feature of COVID-19 was stroke. Two patients had no respiratory symptoms throughout their clinical course. In each case, COVID-19 was confirmed by a reverse transcription polymerase chain reaction (RT-PCR) test and the diagnosis of ischaemic stroke by brain imaging. The patients were relatively young (40, 45 and 50 years). None had a prior history of cerebrovascular events. Stroke risk factors were absent in one, limited to overweight and smoking in another but more prominent in the third patient. Two patients had large vessel occlusion and elevated D-dimer levels. Multiple infarcts were seen in two patients. Clinicians should consider the possibility of COVID-19 in patients presenting with stroke and conversely consider investigating for stroke if a patient with COVID-19, even if mildly ill, develops acute neurological symptoms.
The World Management Survey at 18: lessons and the way forward
Authors: Scur Daniela , Sadun Raffaella , Van Reenen John , Lemos Renata , Bloom Nicholas 
Published: March 2021

AbstractUnderstanding how differences in management ‘best practices’ affect organizational outcomes has been a focus of both theoretical and empirical work in the fields of management, sociology, economics, and public policy. The World Management Survey (WMS) project was born almost two decades ago with the main goal of developing a new systematic measure of management practices being used in organizations. The WMS has contributed to a body of knowledge around how managerial structures, not just managerial talent, relate to organizational performance. Over 18 years of research, a set of consistent patterns have emerged and spurred new questions. We present a brief overview of what we have learned in terms of measuring and understanding management practices and condense the implications of these findings for policy. We end with an outline of what we see as the path forward for both research and policy implications of this research programme.
Breakthroughs in computational design methods open up new frontiers for de novo protein engineering
Authors: Meinen Ben A , Bahl Christopher D 
Published: March 2021

Abstract
Proteins catalyze the majority of chemical reactions in organisms, and harnessing this power has long been the focus of the protein engineering field. Computational protein design aims to create new proteins and functions in silico, and in doing so, accelerate the process, reduce costs and enable more sophisticated engineering goals to be accomplished. Challenges that very recently seemed impossible are now within reach thanks to several landmark advances in computational protein design methods. Here, we summarize these new methods, with a particular emphasis on de novo protein design advancements occurring within the past 5 years.
The role of pubertal status and sleep satisfaction in emotion reactivity and regulation in children and adolescents
Authors: Lustig Kari A , Cote Kimberly A , Willoughby Teena 
Published: March 2021

AbstractStudy ObjectivesThis study investigated the role of pubertal status and hormones in the association between sleep satisfaction and self-reported emotion functioning in 256 children and adolescents aged 8–15.MethodsSelf-report data was provided on sleep duration, sleep satisfaction, and emotion reactivity and regulation, and a saliva sample was obtained for hormone measures. A subset of children also wore an Actigraph watch to measure sleep for a week.ResultsLatent-class analysis revealed three classes of sleepers: Satisfied, Moderately Satisfied, and Dissatisfied. Dissatisfied sleepers reported more difficulties with emotion regulation and greater emotion reactivity than Satisfied sleepers. High difficulties with emotion regulation was associated with shorter objective sleep duration, and high emotion reactivity was associated with lower sleep efficiency. For girls, Dissatisfied sleepers reported being further through pubertal development than Satisfied sleepers. There were also significant correlations between pubertal development and shorter sleep duration and longer sleep latency in girls, and shorter and more irregular sleep in boys. Finally, pubertal development in girls was a significant moderator in the relationship between sleep satisfaction and difficulties with emotion regulation in Dissatisfied sleepers, such that being further through puberty and having unsatisfactory sleep resulted in the highest emotion regulation difficulties.ConclusionsThis study expands on previous literature by considering the role of sleep satisfaction and the interaction with puberty development on emotion function. Specifically, a role for pubertal development was identified in the association between unsatisfactory sleep and emotion regulation in girls.
Medication Abortion With Pharmacist Dispensing of Mifepristone
Authors: Grossman Daniel , Baba C. Finley , Kaller Shelly , Biggs M. Antonia , Raifman Sarah , Gurazada Tanvi , Rafie Sally , Averbach Sarah , Meckstroth Karen R. , Micks Elizabeth A. , Berry Erin , Raine-Bennett Tina R. , Creinin Mitchell D. 
Published: March 2021

OBJECTIVE:
To estimate effectiveness and acceptability of medication abortion with mifepristone dispensed by pharmacists.

METHODS:
We conducted a prospective cohort study at eight clinical sites and pharmacies in California and Washington State from July 2018 to March 2020. Pharmacists at participating pharmacies underwent a 1-hour training on medication abortion. We approached patients who had already been evaluated, counseled, and consented for medication abortion per standard of care. Patients interested in study participation gave consent, and the clinician electronically sent a prescription to the pharmacy for mifepristone 200 mg orally, followed 24–48 hours later by misoprostol 800 micrograms buccally. Participants were sent web-based surveys about their experience and outcomes on days 2 and 14 after enrollment and had routine follow-up with study sites. We extracted demographic and clinical data, including abortion outcome and adverse events, from medical records. We performed multivariable logistic regression to assess the association of pharmacy experience and other covariates with satisfaction.

RESULTS:
We enrolled 266 participants and obtained clinical outcome information for 262 (98.5%), of whom two reported not taking either medication. Of the 260 participants with abortion outcome information, 252 (96.9%) and 237 (91.2%) completed day 2 and 14 surveys, respectively. Complete medication abortion (primary outcome) occurred for 243 participants (93.5%, 95% CI 89.7–96.1%). Four participants (1.5%, 95% CI 0.4–3.9%) had an adverse event, none of which was serious or related to pharmacist dispensing. In the day 2 survey, 91.3% (95% CI 87.1–94.4%) of participants reported satisfaction with the pharmacy experience. In the day 14 survey, 84.4% (95% CI 79.1–88.8%) reported satisfaction with the medication abortion experience. Those reporting being very satisfied with the pharmacy experience had higher odds of reporting overall satisfaction with medication abortion (adjusted odds ratio 2.96, 95% CI 1.38–6.32).

CONCLUSION:
Pharmacist dispensing of mifepristone for medication abortion is effective and acceptable to patients, with a low prevalence of adverse events.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03320057.
Contraception Choice Among Those Seeking Abortion for Fetal Indication or Management of Pregnancy Loss
Authors: Meurice Marielle E. , Lovio Marissa , Chang Jenny J. , Perry Rachel 
Published: March 2021

OBJECTIVE:
To compare contraception choices of those who are undergoing abortion procedures for fetal indications or surgical management of pregnancy loss with those who are having abortions for another indication.

METHODS:
We conducted a cross-sectional study at University of California, Irvine, from December 1, 2017, through December 31, 2018, and included gestational ages up to 24 0/7 weeks. We abstracted data from electronic medical records and analyzed them using descriptive statistics, χ2, Fisher exact tests, and a multivariate logistic regression model for primary outcome (whether a contraception method was chosen) and secondary outcome (whether a long-active reversible contraception was chosen).

RESULTS:
Those with fetal indication were less likely to choose contraception than those with other indication (68/134, 50.7% vs 142/158, 89.9%, P<.001), and among those choosing contraception those with fetal indication were less likely to choose long-acting reversible contraception (LARC) (19/68, 27.9% vs 94/142, 66.2%, P<.001). Differences remained significant in multivariable analysis that controlled for age, gestational age in weeks, race, parity, procedure type, and comorbidities (among those with fetal indication for choosing any contraception: adjusted odds ratio [aOR] 0.11, 95% CI 0.05–0.23; choosing LARC: aOR 0.17, 95% CI 0.07–0.39).

CONCLUSION:
Only half of those seeking abortion for a fetal indication or surgical management of pregnancy loss were interested in contraception.
Sex differences in brain development in fetuses and infants who are at low or high likelihood for autism
Authors: Villa L. M. , Hampton S. , Aydin E. , Tait R. , Leming M. J. , Tsompanidis A. , Patterson I. , Allison C. , Austin T. , Suckling J. , Baron-Cohen S. , Holt R. J. 
Published: March 2021

AbstractBackgroundIt is unknown whether the neural underpinnings of autism are presentin utero. In addition, it is unclear whether typical neural sexual differentiation, which is associated with the development of autism, is evidentin utero. We longitudinally investigated fetal and infant sex differences in brain structure and function, and differences in brain development in those at low and high likelihood for autism. Here, we use the term ‘typical’ interchangeably with the term ‘low-autism likelihood’.MethodsParticipants were longitudinally studiedin uterofirst at 30-33 weeks of gestation, and then as infants 8-12 weeks after birth. We compared total brain volumes and resting-state functional connectivity between 15 female and 15 male low-autism likelihood fetuses (defined as having no first degree autistic relative). We also compared the brain structure and function of these 30 fetuses to a rare group of 11 fetuses (5 females and 6 males) who had an autistic mother or sibling, and therefore a higher likelihood of developing autism. Although a small sample, the high-autism likelihood group are reported as they are challenging to recruit. Additionally, we correlated sex differences in functional connectivity with autism likelihood group differences across the fetal and infant brains.ResultsThere was a group-by-sex interaction in fetal total brain volume. Typical males, on average, showed faster total brain volume growth in the perinatal period than typical females. The high-autism likelihood group showed lower resting-state functional connectivity at both time-points compared to the typical group, and regions indicating sex differences overlapped with those associated with high-autism likelihood group differences in functional connectivity.ConclusionsIn uterosexual differentiation of brain structure was more pronounced in fetuses with a high likelihood for autism. Moreover, sexual differentiation of the fetal and infant brain may overlap with the neural development of autism.