bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Centers for Medicare & Medicaid Services SEP-1 Core Measure Implementation on Antibacterial Utilization: A Retrospective Multicenter Longitudinal Cohort Study With Interrupted Time-Series Analysis
Authors: Anderson Deverick J , Moehring Rebekah W , Parish Alice , David Michael Z , Hsueh Kevin , Cressman Leigh , Tolomeo Pam , Habrock-Bach Tracey , Hill Cherie L , Ryan Matthew , O’Brien Cara , Lokhnygina Yuliya , Dodds Ashley Elizabeth 
Published: November 2021

Abstract

Background
The impact of the US Centers for Medicare & Medicaid Services (CMS) Severe Sepsis and Septic Shock: Management Bundle (SEP-1) core measure on overall antibacterial utilization is unknown.

Methods
We performed a retrospective multicenter longitudinal cohort study with interrupted time–series analysis to determine the impact of SEP-1 implementation on antibacterial utilization and patient outcomes. All adult patients admitted to 26 hospitals between 1 October 2014 and 30 September 2015 (SEP-1 preparation period) and between 1 November 2015 and 31 October 2016 (SEP-1 implementation period) were evaluated for inclusion. The primary outcome was total antibacterial utilization, measured as days of therapy (DOT) per 1000 patient-days.

Results
The study cohort included 701 055 eligible patient admissions and 4.2 million patient-days. Overall antibacterial utilization increased 2% each month during SEP-1 preparation (relative rate [RR], 1.02 per month [95% confidence interval {CI}, 1.00–1.04]; P = .02). Cumulatively, the mean monthly DOT per 1000 patient-days increased 24.4% (95% CI, 18.0%–38.8%) over the entire study period (October 2014–October 2016). The rate of sepsis diagnosis/1000 patients increased 2% each month during SEP-1 preparation (RR, 1.02 per month [95% CI, 1.00–1.04]; P = .04). The rate of all-cause mortality rate per 1000 patients decreased during the study period (RR for SEP-1 preparation, 0.95 [95% CI, .92–.98; P = .001]; RR for SEP-1 implementation, .98 [.97–1.00; P = .01]). Cumulatively, the monthly mean all-cause mortality rate/1000 patients declined 38.5% (95% CI, 25.9%–48.0%) over the study period.

Conclusions
Announcement and implementation of the CMS SEP-1 process measure was associated with increased diagnosis of sepsis and antibacterial utilization and decreased mortality rate among hospitalized patients.
A Higher Antibody Response Is Generated With a 6- to 7-Week (vs Standard) Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccine Dosing Interval
Authors: Grunau Brian , Asamoah-Boaheng Michael , Lavoie Pascal M , Karim Mohammad Ehsanul , Kirkham Tracy L , Demers Paul A , Barakauskas Vilte , Marquez Ana Citlali , Jassem Agatha N , O’Brien Sheila F , Drews Steven J , Haig Scott , Cheskes Sheldon , Goldfarb David M 
Published: November 2021

Abstract
The optimal dosing interval for severe acute respiratory syndrome coronavirus 2 vaccines remains controversial. In this prospective study, we compared serology results of paramedics vaccinated with mRNA vaccines at the recommended short (17–28 days) vs long (42–49 days) interval. We found that a long dosing interval resulted in higher spike, receptor binding domain, and spike N terminal domain antibody concentrations.
Protein biomarkers in serum as a conservation tool to assess reproduction: a case study on brown bears (Ursus arctos)
Authors: Wilson Abbey E , Michaud Sarah A , Jackson Angela M , Stenhouse Gordon , McClelland Cameron J R , Coops Nicholas C , Janz David M 
Published: November 2021

Abstract
Monitoring the reproductive characteristics of a species can complement existing conservation strategies by understanding the mechanisms underlying demography. However, methodology to determine important aspects of female reproductive biology is often absent in monitoring programs for large mammals. Protein biomarkers may be a useful tool to detect physiological changes that are indicative of reproductive state. This study aimed to identify protein biomarkers of reproductive status in serum collected from free-ranging female brown bears (Ursus arctos) in Alberta, Canada, from 2001 to 2018. We hypothesized that the expression of proteins related to reproduction in addition to energetics and stress can be used to answer specific management-focused questions: (i) identify when a female is pregnant, (ii) detect if a female is lactating, (iii) determine age of sexual maturity (i.e. primiparity) and (iv) assess female fertility (i.e. reproduction rate). Furthermore, we investigated if silver spoon effects (favourable early life conditions provide fitness benefits through adulthood) could be determined using protein expression. A target panel of 19 proteins with established relationships to physiological function was measured by peptide-based analysis using liquid chromatography and multiple reaction monitoring mass spectrometry and their differential expression was evaluated using a Wilcoxon signed-rank test. We found biomarkers of pregnancy (apolipoprotein B-100 and afamin), lactation (apolipoprotein B-100 and alpha-2-macroglobulin) and sexual maturity (corticosteroid-binding globulin), but there were no statistically significant relationships with protein expression and fertility. The expression of proteins related to reproduction (afamin) and energetics (vitamin-D binding protein) was associated with the nutritional quality of the individual’s present habitat rather than their early life habitat. This study highlights potential biomarkers of reproductive status and provides additional methods for monitoring physiological function in wildlife to inform conservation.
What really matters: a patient-centered instrument to evaluate health-related quality of life in cardiovascular disease
Authors: Ties Daan , Singh Tajinder K , Zhang Xin , van Veghel Dennis , Schalkers Inge , Groot Hilde E , Krabbe Paul F M , van der Harst Pim 
Published: November 2021

Abstract

Aims
Patient-reported outcome measures (PROMs) to assess health-related quality of life (HRQoL) are increasingly used to guide decision-making in cardiovascular care. However, many of the existing PROMs are developed with limited patient involvement and overlook personal health preferences. We aim to develop a cardiovascular disease (CVD)-specific patient-centred preference-based PROM to assess and monitor HRQoL in CVD patients.

Methods and results
A mixed-methods study consisting of several phases was conducted to identify important health items: (i) a scoping literature review, (ii) first- and second-round expert group meetings, (iii) interviews with CVD patients, and (iv) an online survey asking CVD patients to indicate from a large set those health items that are considered the most important. The literature review, expert group meetings, and patient interviews resulted in a list of 55 items potentially important to CVD patients. In total, 666 CVD patients responded to the survey. The following nine items were considered the most important by CVD patients: mobility, activities, self-reliance, fatigue, shortness of breath, chest pain, palpitations, anxiety/worrying, and sexual limitations. An electronic preference-based PROM consisting of these nine items was developed within a cloud-based environment for clinical implementation.

Conclusion
Nine items considered the most important for health by CVD patients were identified and included in a new preference-based patient-centred PROM. This new CVD-specific PROM can be easily implemented using the electronic application and has the potential to improve quality of care for CVD patients.
Effects of ischaemic postconditioning in aortic valve replacement: a multicenter randomized controlled trial
Authors: Kaljusto Mari-Liis , Bautin Andrey , Jakobsen Øyvind , Wilimski Radoslaw , Brunborg Cathrine , Wennemo Marte , Karpova Lyudmila , Nergaard Aas Kathrine , Arendarczyk Adam , Landsverk Svein A , Galagudza Mikhail , Næsheim Torvind , Czub Pawel , Gordeev Mikhail , Vaage Jarle 
Published: November 2021

Abstract

OBJECTIVES
The effect of ischaemic postconditioning (IPost) on postcardioplegic cardiac function is not known. We hypothesized that IPost was cardioprotective in adult patients undergoing elective aortic valve replacement.

METHODS
In a multicentre, prospective, randomized trial, patients (n = 209) were randomized to either a standard operation (controls) or postconditioning. Immediately before the cross-clamp was released, patients in the postconditioning group underwent 3 cycles of flow/non-flow (2 min each) of normothermic blood via the antegrade cardioplegia line. The primary end point was cardiac index. Secondary end points included additional haemodynamic measurements, biomarkers of cardiomyocyte injury, renal function parameters, intra- and postoperative arrhythmias and use of inotropic agents.

RESULTS
There was no significant difference between the groups regarding cardiac index [mean between-group difference, 95% confidence interval (CI), 0.11 (−0.1 to 0.3), P = 0.27]. Postconditioning had no effect on other haemodynamic parametres. There was no between-group difference regarding troponin T or creatine kinase MB. Postconditioning reduced the relative risk for arrhythmias by 45% (P = 0.03) when postoperative atrial fibrillation and intraoperative ventricular fibrillation were combined. There were no differences in patients with/without diabetes, patients above/below 70 years of age or between the centres. However, after postconditioning, the cardiac index [95% CI, 0.46 (0.2–0.7), P = 0.001], cardiac output (P &lt; 0.001), mean arterial pressure (P &lt; 0.001) and left ventricular stroke work index (P &lt; 0.001) were higher in males compared to females.

CONCLUSIONS
IPost had no overall cardioprotective effects in patients undergoing aortic valve replacement but improved postoperative cardiac performance in men compared to women.
The Inventory of Physical Activity Barriers for Adults 50 Years and Older: Refinement and Validation
Authors: Wingood Mariana , Jones Salene M W , Gell Nancy M , Brach Jennifer S , Peters Denise M 
Published: November 2021

Abstract

Background and Objectives
Due to health consequences associated with insufficient physical activity (PA), particularly among aging adults, health care providers should assess and address lack of PA participation. Addressing lack of PA means developing individualized PA prescriptions that incorporate solutions to PA participation barriers. Assessing PA participation barriers can be done through the Social Ecological Model-based Inventory of Physical Activity Barriers Scale (IPAB). This study aimed to refine the initial 40-item IPAB and determine its reliability and validity.

Research Design and Methods
Five hundred and three community-dwelling adults 50 years and older completed a demographic and health questionnaire, the Physical Activity Vital Sign, the IPAB, and a feedback questionnaire. For scale refinement, half of the data were used for exploratory factor analysis and the other half for confirmatory factor analysis. The refined scale underwent reliability and validity assessment, including internal consistency, test–retest reliability, and construct validity.

Results
The refined scale contains 27 items consisting of 7 factors and 1 stand-alone item: (a) environmental, (b) physical health, (c) PA-related motivation, (d) emotional health, (e) time, (f) skills, (g) social, and (h) energy (a stand-alone item). The 27-item IPAB has good internal consistency (alpha = 0.91) and high test–retest reliability (intraclass correlation coefficient = 0.99). The IPAB’s mean scores were statistically different between those who met the recommended levels of PA and those who did not (p &lt; .001).

Discussion and Implications
The information gathered through the IPAB can guide discussions related to PA participation barriers and develop individualized PA prescriptions that incorporate solutions to the identified barriers.
Somaliland's authoritarian turn: oligarchic–corporate power and the political economy of de facto states
Authors: Elder Claire 
Published: November 2021

Abstract
Somaliland's endurance as Africa's longest de facto state has for decades preoccupied scholarship on state formation and democratization. The prevailing democratic success narrative has, however, downplayed the complex internal political dynamics and crises that have characterized Somaliland's independence since 1991. Relying on a number of robust resources, including 110 interviews and archival work conducted in Somaliland from 2015 until 2021, this article examines at close range Somaliland's political economy and provides a more cautious assessment of Somaliland's democratization trajectory. It argues that the political authority of cross-border oligarchic–corporate structures and the securitization of aid created an ‘oligopolistic state’ and ‘peaceocracy’ rather than a national, democratic government. This analysis highlights how de facto states struggle to balance political control and financial hardship generating creative and uneven governance structures. This study also raises important questions about how donors in the Gulf and in Asia provide new opportunities for recognition through Islamic finance and business that may affect de facto states' commitments to democratization. Finally, it contributes to theorizing about the ideologies of privatized governance that emerge in peripheral and developing economies and the political consequences of perennial non-recognition.
Spiritual security: an explanatory framework for conflict-related sexual violence against men
Authors: Njoku Emeka Thaddues , Dery Isaac 
Published: November 2021

Abstract
While there is a growing interest in conflict-related sexual violence (CRSV) against men, conceptual understanding and empirical knowledge are still inadequate. The notion of spiritual security is introduced in this article as an explanatory variable in CRSV, using survivors' discursive views of sexual violence victimizations in Nigeria's north-eastern region. The CRSV of males, it is argued, may also be understood as a ritual or spiritual activity carried out for bodily protection, financial prosperity, or socio-political ascendency. The survivors' impressions of CRSV's spiritual undertones are not unrelated to the heteronormative and collectively homophobic culture in their society, in which violent same-sex relations are considered so perverse and meaningful only if they are conceived as ‘evil or devilish practices’. Spiritual beliefs and practices, on the other hand, determine much of the social reality of many people in various parts of the world, and they are regarded as potent on security issues ranging from physical protection to wealth creation and socio-political advancement. This study adds to the continuing discussion on the reasons behind CRSV against men.
Counter-insurgency governance in the Sahel
Authors: Charbonneau Bruno 
Published: November 2021

Abstract
Since 2013, the multiplication of regional and international strategies and actions directed at stabilizing Mali and the Sahel, and at countering and preventing violent extremism, has not improved the situation there and, arguably, some of it has made it worse. This article analyses the type of political order and regional governance that has been and is being built after almost a decade of international interventions in the West African Sahel. It is an effort at theorizing and making sense of what is considered here to be a permanent state of intervention in the Sahel that has evolved into a form of counterinsurgency governance—a concept being proposed to point to the influence and the infusion of counterinsurgency principles into philosophies of governance. This article argues that counterinsurgency governance insists on a set of power relations and configurations that seeks to impose limits, parameters and boundaries to the purpose of and the form that Sahelian states, governments and governance ought to take. As such, counterinsurgency governance is simultaneously a mode of governance and a web of political practices and contestation whose mechanisms have failed at fully implementing its principles in the Sahel. Its fallback is the emergence of a regional strategy to manage and establish limits to Sahelian political possibilities.
Effects of maternal nutrition and rumen-protected arginine supplementation on maternal carotid artery hemodynamics and circulating amino acids of ewes and offspring
Authors: Peine Jena L , Neville Tammi L , Jia Guangquiang , Van Emon Megan L , Kirsch James D , Hammer Carolyn J , Meyer Allison M , O’Rourke Stephen T , Reynolds Lawrence P , Caton Joel S 
Published: November 2021

Abstract
Multiparous Rambouillet ewes (n = 32) were allocated in a completely randomized design to determine if rumen-protected L-arginine (RP-Arg) supplementation during mid- and late gestation would 1) alter maternal carotid artery hemodynamics and 2) affect circulating amino acids associated with arginine metabolism in dams from day 54 of gestation to parturition and in their offspring from birth to 54 d of age. Ewes were assigned to one of three treatments from day 54 ± 3.9 to parturition: control (CON; 100% nutrient requirements), restricted (RES; 60% of CON), and RES plus 180 mg RP-Arg•kg BW-1•d1 (RES-ARG). Ewes were penned individually in a temperature-controlled facility. Carotid artery hemodynamics was measured via Doppler ultrasound at day 50 and 130 of gestation. Maternal serum was collected at day 54 and 138 of gestation and at parturition. At parturition, lambs were immediately removed from their dams and reared independently. Lamb serum samples were collected at birth and 1, 3, 7, 33, and 54 d of age. Pulsatility index was the only hemodynamic measurement altered by dietary treatment, where day 130 measurements were greater (P ≤ 0.04) for RES and RES-ARG compared with CON. The change in pulsatility index was greater (P &lt; 0.01) for RES compared with CON but tended to be intermediate (P ≥ 0.12) for RES-ARG. Maternal serum Arg, Cit, and Asp at day 138 were greater (P &lt; 0.01) for CON compared with RES and RES-ARG; serum Orn at day 138 was greater (P = 0.04) for CON compared with RES. Maternal serum Cit at parturition was greater (P ≤ 0.03) for CON and RES-ARG compared with RES. Offspring serum Arg was affected by a maternal treatment by day of age interaction (P = 0.03), where at day 3, CON and RES-ARG had greater (P ≤ 0.03) serum Arg concentrations than RES, and at day 54, RES-ARG was greater than (P = 0.002) CON and RES was intermediate and did not differ from (P ≥ 0.09) CON and RES-ARG. Offspring serum Orn and Cit were less (P ≤ 0.03) for RES and RES-ARG compared with CON. Results indicate that distal tissue blood perfusion decreased due to maternal RES, and RES-ARG was able to improve perfusion but not to the level of CON ewes. Further, maternal RP-Arg altered offspring Arg and related amino acid concentrations during the postnatal period.
Doris Duke and Mary Crane: Collecting Islamic art for Shangri La, a Hawaiian hideaway home
Authors: Proctor-Tiffany Mariah 
Published: November 2021

Abstract
Doris Duke, one of the most avid twentieth-century collectors of Islamic art, spoke little about her motivation for building a remarkable collection of Islamic art for her Hawaiian home, Shangri La, and the processes whereby she did so. However, the correspondence between her and Mary Crane, a young art-history graduate student, who had travelled in the Middle East with Duke and then was her buyer in New York in 1940–41, illuminates these questions. The letters present exciting evidence, especially about the acquisition of a stunning thirteenth-century mihrab from Kashan, Iran. Moreover, mapping of the sites that Mary Crane visited in pursuit of objects reveals the network of the numerous people involved in the Islamic art market in New York. And, finally, the letters make possible an analysis of Duke’s individual manifestation of Orientalism, enabling an examination of how and why she collected works from Middle Eastern, North African and Indian cultures.
April 5, 2005—Living in Mortal Time
Authors: McQuellon Richard P. 
Published: November 2021

Abstract
The central theme of this dialogue is exploration of extended mortal time. Early in her breast cancer treatment, one of Nell’s physicians had estimated a much shorter lifespan; she expected the prediction to come true. She is prepared to die and is frustrated when she learns it is not time. Nell is finding comfort in the rituals of Catholic Church in which she was raised, even though she describes herself as “a fitfully practicing Catholic” with Buddhist leanings. She appreciates the opportunity for the Sacrament of Anointing of the Sick while at the same time questioning the many problems of the institutional church, including patriarchy. She contends with the practical problems of managing her deteriorating body as well as contemplating “pure love as the reward on the other side” when she dies. Nell is making peace with her time on earth. She is not lying passively but actively engaging her life as it comes to an end. A profound insight is finding herself feeling at home in the world for the first time in her entire life.
April 19, 2005—Leaving Gifts
Authors: McQuellon Richard P. 
Published: November 2021

Abstract
In this dialogue, Nell lets go of possessions and gifts them to friends and relatives. She was especially pleased with transferring 120,000 frequent-flyer miles to her niece’s family so they could make their annual pilgrimage to Michigan from Seattle. This is the second time she has downsized in two years. When she and Al moved from their home to this apartment, they had to place furniture in storage or sell it. A major loss with the move was her highly valued garden with its associated activities, especially digging in the good earth. Nell once again spoke of her intense fear of suffocation and likened it to “skating in the dark.” She feels the same type of fear and panic when she cannot swallow due to dry mouth. Her shortness of breath has been a continual challenge; the addition of an oxygen apparatus has helped. Unfortunately, she had difficulty getting the machine to work properly because it was delivered without an essential component, the humidifier. Consequently, her nasal passages were drying out and bleeding. She subsequently needed to increase her self-advocacy efforts with the hospice healthcare providers. We practiced a breathing exercise to help her settle herself when she feels short of breath.
Unconsciousness
Authors: Johnson L. Syd M 
Published: November 2021

Abstract
Neuroscientific knowledge about disorders of consciousness has rapidly developed in recent decades, expanding the diagnostic categories. This chapter describes the disorders and what is known about them and traces their medical and ethical history, examining how old and dogmatic certainties have given way to new and urgent uncertainties. Bioethical and philosophical discourses have not adequately kept pace with what is known and unknown about these disorders. It is argued that there is a need to reconsider outdated ethical conclusions and to revise the taxonomy of these orders, both to excise stigmatizing terms like vegetative, to more accurately reflect the changing and mercurial clinical picture, and to knock down the monoliths of conscious and unconscious.