bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing an Emergency Department–specific Antibiogram Versus Hospital-wide Antibiogram and Therapeutic Dilemmas for Uncomplicated Cystitis
Authors: Peyko Vincent , Daves Alexander , Eggleston Matthew 
Published: April 2019

Background
The emergency department (ED) lies between the inpatient and outpatient worlds. Varying rates of antimicrobial resistance along with the volume of patients presenting to the ED with potential urinary tract infections make empiric antibiotic selection difficult but vital. However, simply referring to the guidelines may neither optimize therapy nor mitigate resistance.

Methods
This was a retrospective cohort study comparing antimicrobial sensitivities of women from home, diagnosed with uncomplicated cystitis and discharged home, versus sensitivities of an institution-wide antibiogram between September 1, 2016, and February 28, 2017. The primary outcome was determining whether there was a difference between Escherichia coli sensitivities in nonpregnant women older than 14 years, from home, being discharged home and diagnosed with uncomplicated cystitis versus an institution-specific antibiogram.

Results
Over the study period, 258 patients were evaluated for uncomplicated cystitis with 128 patients included in the final analysis as the retrospective cohort after 130 patients were excluded. Statistically significant differences between the retrospective cohort and institution-wide antibiogram were 80.5% versus 57% (P < 0.001) for amoxicillin/clavulanic acid, 85.9% versus 75% (P = 0.007) for cefazolin, 94.5% versus 86% (P = 0.008) for ceftriaxone, 96.1% versus 87% (P = 0.003) for cefepime, 97.5% versus 66% (P < 0.001) for levofloxacin, and 99.2% versus 95% (P = 0.032) for nitrofurantoin, respectively.

Conclusions
Our study shows differences between an ED-specific antibiogram and institution-wide antibiogram. Many common and guideline-recommended antimicrobials used to treat acute uncomplicated cystitis may not be appropriate. Compiling ED-specific antibiograms at all institutions may help to optimally guide therapy.
Disseminated Cryptococcal Infection in a Patient Receiving Acalabrutinib for Chronic Lymphocytic Leukemia
Authors: Wilson Paul A. , Melville Kathleen 
Published: April 2019

Abstract
A 61-year-old man with chronic lymphocytic leukemia (CLL) developed disseminated cryptococcal infection, diagnosed 7 months after commencement of acalabrutinib, a Bruton's tyrosine kinase inhibitor. To our knowledge, this is the first reported case of cryptococcal infection occurring in a patient being treated with acalabrutinib (with approximately 10 cryptococcal infections previously related to ibrutinib). Other unusual features included the development of mild hypercalcemia, which has been a rare complication of cryptococcal infection, and a probable immune reconstitution inflammatory syndrome–like response to extensive pulmonary cryptococcal infection. The case further emphasizes the need for vigilance for possible invasive fungal infection (particularly Cryptococcus) in patients treated with Bruton's tyrosine kinase inhibitors.
A Decision Algorithm Is Not Superior to Clinician Judgment to Determine Need for Peripheral vs Central Venous Catheterization
Authors: Panter Melissa , Olson DaiWai M. , Stutzman Sonja E. , Aiyagari Venkatesh 
Published: April 2019

ABSTRACT

Background: Venous access, via a midline peripheral catheter (midline) or a peripherally inserted central catheter, is used regularly in the neurointensive care unit as a means for prolonged infusion of drugs or medications. There is little research on how to choose the appropriate access device to use in this setting. The aim of this study is to trial an algorithm to assist clinicians in determining which device to use, as a way to reduce patient complications such as central line–associated bloodstream infection and deep vein thrombosis. Methods: This quality improvement initiative included both retrospective and prospective data. A retrospective chart review was performed, and data were analyzed for variables associated with decision making between the 2 access devices. An algorithm was developed to assist clinicians with deciding between midline access and peripherally inserted central catheter access. Results: A total of 325 charts were reviewed (126 retrospective and 109 prospective). Results show no significant differences in the demographic characteristics of either group. Before intervention, clinicians chose the correct access device 86% of the time, whereas after the intervention, clinicians chose the correct device 78% of the time (P = .06). Conclusion: The results of this study indicate that the quality improvement intervention and algorithm decision-making tool did not improve accuracy of use of access devices.
Clinical Characteristics of Acute Vestibular Neuritis According to Involvement Site
Authors: Lee Jung-Yup , Park Jin Su , Kim Min-Beom 
Published: April 2019

Objective:
To analyze the clinical characteristics of acute vestibular neuritis (AVN) according to involvement site.

Study Design:
Retrospective chart analysis.

Setting:
Tertiary referral hospital.

Patients/Interventions:
Over a period of 3 years, we reviewed 133 cases of AVN. Patients were classified into three groups: 1) total vestibular neuritis (superior and inferior vestibular nerve involvement [TVN]); 2) superior vestibular neuritis (superior vestibular nerve involvement [SVN]); and 3) inferior vestibular neuritis (inferior vestibular nerve involvement [IVN]).

Main Outcome Measure:
We analyzed the clinical course and results of vestibular function tests (video-nystagmography, video head impulse test [vHIT], caloric test, and cervical vestibular evoked myogenic potential).

Results:
In the study, there were 39.9% TVN cases, 48.1% SVN cases, and 12% IVN cases. The number of days to spontaneous nystagmus remission, hospital duration, and follow-up period were shorter in the IVN group than in the SVN and TVN groups. The symptom onset period was longer in the IVN group than in the SVN and TVN groups. Spontaneous nystagmus and head shaking nystagmus amplitude were smaller in the IVN group than in the SVN and TVN groups. Concordance of results between the caloric test, cervical vestibular evoked myogenic potential, and vHIT was relatively low in the IVN group.

Conclusion:
The IVN group had a shorter clinical course and weaker nystagmus in comparison with the TVN and SVN groups. The use of additional vHIT in the diagnosis of AVN can help provide a more accurate diagnosis of the rare subtype of IVN, which can be confused with various central lesions.
When to intervene for donor-specific antibody after heart transplantation
Authors: Njue Faith , Chih Sharon 
Published: April 2019

Purpose of review
Posttransplant donor-specific human leukocyte antigen (HLA) antibodies (DSA) represent a complex area in heart transplantation with nonstandardized practice and paucity of clinical data to guide optimal management.

Recent findings
De novo DSA after heart transplantation is common and associated with rejection, cardiac allograft vasculopathy, allograft failure, and mortality. Advances in methods for HLA antibody detection have enabled identification of DSA with high precision and sensitivity. The detection of HLA antibodies must, however, be interpreted within appropriate laboratory and clinical contexts; it remains unclear which DSA are associated with greatest clinical risk. Increased antibody and clinical surveillance as well as optimization of maintenance immunosuppression are required for all patients with DSA. Antibody-directed therapies are reserved for patients with allograft dysfunction or rejection. Treatment of DSA may also be considered in asymptomatic high-risk patients including those in whom DSA arise de novo posttransplant, is persistent, high titer, or complement activating. The impact of DSA reduction and removal on long-term clinical outcomes remains unknown.

Summary
Despite improvements in DSA detection, identification, and characterization, best therapeutic strategies are unclear. Prospective multicenter studies are needed to develop effective standardized approaches for DSA management in heart transplantation.
Current practices in deceased organ donor management
Authors: Patel Madhukar S. , Abt Peter L. 
Published: April 2019

Purpose of review
Optimizing the management of deceased organ donors focuses on providing critical care that prevents, mitigates, or repairs the pathophysiologic sequelae of brain death. This review discusses protocol-based care; approaches to monitoring, resuscitation, hormone replacement therapy, and respiratory management; and the potential of various additional donor therapies.

Recent findings
Protocol-based critical care after the determination of brain death has the potential to substantially increase the quantity and improve the quality of organs available for transplantation. Close hemodynamic monitoring with timely resuscitation using isotonic fluid replacement as well as adjunctive vasoactive and hormone replacement therapy in the persistently hemodynamically unstable donor is recommended. Convincing evidence suggests that mild therapeutic hypothermia of the donor can be adopted to reduce delayed graft function in the renal transplant recipient.

Summary
There continues to be a limited number of current published reports pertaining to deceased organ donor management, with many practices still based on consensus statements. Recent endorsement and recommendations for conducting donor intervention research have provided a framework for future studies, which have potential to lead to the publication of quality results so that more evidence-based guidelines can be developed.
HIV-Related Deaths in Nairobi, Kenya: Results From a HIV Mortuary Surveillance Study, 2015
Authors: Nyagah Lilly M. , Young Peter W. , Kim Andrea A. , Wamicwe Joyce , Kimani Maureen , Waruiru Wanjiru , Rogena Emily , Oduor Johansen , Walong Edwin , Waruru Anthony , Oyugi Julius , Downer Marie , De Cock Kevin M. , Sirengo Martin 
Published: April 2019

Background:
Death is an important but often unmeasured endpoint in public health HIV surveillance. We sought to describe HIV among deaths using a novel mortuary-based approach in Nairobi, Kenya.

Methods:
Cadavers aged 15 years and older at death at Kenyatta National Hospital (KNH) and City Mortuaries were screened consecutively from January 29 to March 3, 2015. Cause of death was abstracted from medical files and death notification forms. Cardiac blood was drawn and tested for HIV infection using the national HIV testing algorithm followed by viral load testing of HIV-positive samples.

Results:
Of 807 eligible cadavers, 610 (75.6%) had an HIV test result available. Cadavers from KNH had significantly higher HIV positivity at 23.2% (95% CI: 19.3 to 27.7) compared with City Mortuary at 12.6% (95% CI: 8.8 to 17.8), P < 0.001. HIV prevalence was significantly higher among women than men at both City (33.3% vs. 9.2%, P = 0.008) and KNH Mortuary (28.8% vs. 19.0%, P = 0.025). Half (53.3%) of HIV-infected cadavers had no diagnosis before death, and an additional 22.2% were only diagnosed during hospitalization leading to death. Although not statistically significant, 61.9% of males had no previous diagnosis compared with 45.8% of females (P = 0.144). Half (52.3%) of 44 cadavers at KNH with HIV diagnosis before death were on treatment, and 1 in 5 (22.7%) with a previous diagnosis had achieved viral suppression.

Conclusions:
HIV prevalence was high among deaths in Nairobi, especially among women, and previous diagnosis among cadavers was low. Establishing routine mortuary surveillance can contribute to monitoring HIV-associated deaths among cadavers sent to mortuaries.
Changes in Disparities in Estimated HIV Incidence Rates Among Black, Hispanic/Latino, and White Men Who Have Sex With Men (MSM) in the United States, 2010–2015
Authors: McCree Donna Hubbard , Williams Austin M. , Chesson Harrell W. , Beer Linda , Jeffries William L. , Lemons Ansley , Prather Cynthia , Sutton Madeline Y. , McCray Eugene 
Published: April 2019

Background:
During 2008–2015, the estimated annual HIV incidence rate in the United States decreased for each transmission risk category, except for men who have sex with men (MSM). Racial/ethnic disparities exist, with higher incidence rates for Black and Hispanic/Latino MSM.

Setting:
This analysis examines changes, 2010–2015, in disparities of HIV incidence among Black, Hispanic/Latino and White MSM.

Methods:
We compared results from the rate ratio, rate difference, weighted and unweighted index of disparity, and population attributable proportion. We calculated incidence rates for MSM using HIV surveillance data and published estimates of the MSM population in the United States. We generated 95% confidence intervals for each measure and used the Z statistic and associated P values to assess statistical significance.

Findings:
Results from all but one measure, Black-to-White rate difference, indicate that racial/ethnic disparities increased during 2010–2015; not all results were statistically significant. There were statistically significant increases in the Hispanic/Latino-to-White MSM incidence rate ratio (29%, P < 0.05), weighted index of disparity with the rate for White MSM as the referent group (9%, P < 0.05), and the population attributable proportion index (10%, P < 0.05). If racial/ethnic disparities among MSM had been eliminated, a range of 55%–61% decrease in overall MSM HIV incidence would have been achieved during 2010–2015.

Conclusions:
A large reduction in overall annual HIV incidence among MSM can be achieved by eliminating racial/ethnic disparities among MSM. Removing social and structural causes of racial/ethnic disparities among MSM can be effective in reducing overall annual HIV incidence among MSM.
Long-term Outcome of Renal Transplantation in Patients with Congenital Lower Urinary Tract Malformations: A Multicenter Study
Authors: Marchal Stéphane , Kalfa Nicolas , Iborra François , Badet Lionel , Karam Georges , Broudeur Lucas , Branchereau Julien , Abdo Nicolas , Thuret Rodolphe 
Published: April 2019

Background.
Renal insufficiency can occur in patients with congenital lower urinary tract malformations (LUTM) even when managed during infancy. Data in the current literature concerning this subject remain sparse. The aim of this study was to report the feasibility and long-term results of renal transplantation during adulthood in patients with a congenital LUTM.

Methods.
A retrospective multicenter study from 3 French renal transplant centers was conducted, including 123 transplantations on 112 patients with LUTM (1996–2016). Graft survival, patient survival, and complications were analyzed. Results were stratified according to the underlying uropathy and the type of initial management during childhood or before transplantation.

Results.
In this study, patients suffering from posterior urethral valves (n = 49), spina bifida (n = 21), central neurogenic bladder (n = 13), bladder exstrophy (n = 14), prune belly syndrome (n = 12), Hinman syndrome (n = 6), urogenital sinus (n = 4), and other pathologies (n = 4) were included. The mean age at transplantation was 32.1 years old (±11.2). The mean follow-up period was 7.2 years. Patient survival at 1, 5, 10, and 15 years was 97.4%, 93.0%, 89.4%, and 80.0%, respectively. Graft survival at 1, 5, 10, 15, and 20 years was 96.6%, 87.6%, 77.3%, 60.6%, and 36.4%, respectively. Enterocystoplasty and continent urinary diversions exposed grafts to more frequent acute pyelonephritis (P = 0.02). There was no difference in graft survival when transplantation was performed on an enterocystoplasty or urinary diversions compared with a native bladder, provided a well-conducted bladder management.

Conclusions.
Even though enterocystoplasty and continent urinary diversions exposed grafts to more frequent acute graft pyelonephritis, patient and graft survival rates in LUTM at 10 years were similar to other kidney transplantations on native bladders.
Cross-talk of cutaneous beta human papillomaviruses and the immune system: determinants of disease penetrance
Authors: Venuti Assunta , Lohse Stefan , Tommasino Massimo , Smola Sigrun 
Published: April 2019

Human papillomaviruses (HPVs) infect the epithelia of skin or mucosa, where they can induce hyperproliferative lesions. More than 220 different HPV types have been characterized and classified into five different genera. Mucosal high-risk HPVs are causative for cancers of the anogenital region and oropharynx. Clinical data from patients with the rare genetic disorder epidermodysplasia verruciformis (EV) indicate that genus beta-HPVs cooperate with ultraviolet (UV) radiation in the development of cutaneous squamous cell carcinoma. In addition, epidemiological and biological findings indicate that beta-HPV types play a role in UV-mediated skin carcinogenesis also in non-EV individuals. However, the mechanisms used by these cutaneous viruses to promote epithelial carcinogenesis differ significantly from those of mucosal HPVs. Recent studies point to a delicate cross-talk of beta-HPVs with the cell-autonomous immunity of the host keratinocytes and the local immune microenvironment that eventually determines the fate of cutaneous HPV infection and the penetrance of disease. This review gives an overview of the critical interactions of genus beta-HPVs with the local immune system that allow the virus to complete its life cycle, to escape from extrinsic immunity, and eventually to cause chronic inflammation contributing to skin carcinogenesis.
This article is part of the theme issue ‘Silent cancer agents: multi-disciplinary modelling of human DNA oncoviruses’.
Capturing multiple-type interactions into practical predictors of type replacement following human papillomavirus vaccination
Authors: Man Irene , Auranen Kari , Wallinga Jacco , Bogaards Johannes A. 
Published: April 2019

Current HPV vaccines target a subset of the oncogenic human papillomavirus (HPV) types. If HPV types compete during infection, vaccination may trigger replacement by the non-targeted types. Existing approaches to assess the risk of type replacement have focused on detecting competitive interactions between pairs of vaccine and non-vaccine types. However, methods to translate any inferred pairwise interactions into predictors of replacement have been lacking. In this paper, we develop practical predictors of type replacement in a multi-type setting, readily estimable from pre-vaccination longitudinal or cross-sectional prevalence data. The predictors we propose for replacement by individual non-targeted types take the form of weighted cross-hazard ratios of acquisition versus clearance, or aggregate odds ratios of coinfection with the vaccine types. We elucidate how the hazard-based predictors incorporate potentially heterogeneous direct and indirect type interactions by appropriately weighting type-specific hazards and show when they are equivalent to the odds-based predictors. Additionally, pooling type-specific predictors proves to be useful for predicting increase in the overall non-vaccine-type prevalence. Using simulations, we demonstrate good performance of the predictors under different interaction structures. We discuss potential applications and limitations of the proposed methodology in predicting type replacement, as compared to existing approaches.
This article is part of the theme issue ‘Silent cancer agents: multi-disciplinary modelling of human DNA oncoviruses’.
Modelling the evolution of viral oncogenesis
Authors: Murall Carmen Lía , Alizon Samuel 
Published: April 2019

Most human oncogenic viruses share several characteristics, such as being DNA viruses, having long (co)evolutionary histories with their hosts and causing either latent or chronic infections. They can reach high prevalences while causing relatively low case mortality, which makes them quite fit according to virulence evolution theory. After analysing the life histories of DNA oncoviruses, we use a mathematical modelling approach to investigate how the virus life cycle may generate selective pressures favouring or acting against oncogenesis at the within-host or at the between-host level. In particular, we focus on two oncoprotein activities, namely extending cell life expectancy and increasing cell proliferation rate. These have immediate benefits (increasing viral population size) but can be associated with fitness costs at the epidemiological level (increasing recovery rate or risk of cancer) thus creating evolutionary trade-offs. We interpret the results of our nested model in light of the biological features and identify future perspectives for modelling oncovirus dynamics and evolution.This article is part of the theme issue ‘Silent cancer agents: multi-disciplinary modelling of human DNA oncoviruses’.
Function and clinical relevance of RHAMM isoforms in pancreatic tumor progression
Authors: Choi Soyoung , Wang Dunrui , Chen Xiang , Tang Laura H. , Verma Akanksha , Chen Zhengming , Kim Bu Jung , Selesner Leigh , Robzyk Kenneth , Zhang George , Pang Sharon , Han Teng , Chan Chang S. , Fahey Thomas J. , Elemento Olivier , Du Yi-Chieh Nancy 
Published: April 2019

AbstractThe receptor for hyaluronic acid-mediated motility (RHAMM) is upregulated in various cancers. We previously screened genes upregulated in human hepatocellular carcinomas for their metastatic function in a mouse model of pancreatic neuroendocrine tumor (PNET) and identified that humanRHAMMBpromoted liver metastasis. It was unknown whetherRHAMMBis upregulated in pancreatic cancer or contributes to its progression. In this study, we found that RHAMM protein was frequently upregulated in human PNETs. We investigated alternative splicing isoforms,RHAMMAandRHAMMB, by RNA-Seq analysis of primary PNETs and liver metastases.RHAMMB, but notRHAMMA, was significantly upregulated in liver metastases. RHAMMBwas crucial forin vivometastatic capacity of mouse and human PNETs. RHAMMA, carrying an extra 15-amino acid-stretch, did not promote metastasis in spontaneous and experimental metastasis mouse models. Moreover,RHAMMBwas substantially higher thanRHAMMAin pancreatic ductal adenocarcinoma (PDAC).RHAMMB, but notRHAMMA, correlated with both higherEGFRexpression and poorer survival of PDAC patients. Knockdown of EGFR abolished RHAMMB-driven PNET metastasis. Altogether, our findings suggest a clinically relevant function ofRHAMMB, but notRHAMMA, in promoting PNET metastasis in part through EGFR signaling.RHAMMBcan thus serve as a prognostic factor for pancreatic cancer.