bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Antibiotic De-escalation by Spectrum Score in Patients With Nosocomial Pneumonia: A Single-Center, Retrospective Cohort Study
Authors: Ilges Dan , Ritchie David J , Krekel Tamara , Neuner Elizabeth A , Hampton Nicholas , Kollef Marin H , Micek Scott 
Published: November 2021

AbstractBackgroundHospital-acquired and ventilator-associated pneumonia (HAP/VAP) cause significant mortality. Guidelines recommend empiric broad-spectrum antibiotics followed by de-escalation (DE). This study sought to assess the impact of DE on treatment failure.MethodsThis single-center retrospective cohort study screened all adult patients with a discharge diagnosis code for pneumonia from 2016 to 2019. Patients were enrolled if they met predefined criteria for HAP/VAP ≥48 hours after admission. Date of pneumonia diagnosis was defined as day 0. Spectrum scores were calculated, and DE was defined as a score reduction on day 3 versus day 1. Patients with DE were compared to patients with no de-escalation (NDE). The primary outcome was composite treatment failure, defined as all-cause mortality or readmission for pneumonia within 30 days of diagnosis.ResultsOf 11860 admissions screened, 1812 unique patient-admissions were included (1102 HAP, 710 VAP). Fewer patients received DE (876 DE vs 1026 NDE). Groups were well matched at baseline, although more patients receiving DE had respiratory cultures ordered (56.6% vs 50.6%, P = .011). There was no difference in composite treatment failure (35.0% DE vs 33.8% NDE, P = .604). De-escalation was not associated with treatment failure on multivariable Cox regression analysis (hazard ratio, 1.13; 95% confidence interval, 0.96–1.33). Patients receiving DE had fewer antibiotic days (median 9 vs 11, P &lt; .0001), episodes of Clostridioides difficile infection (2.2% vs 3.8%, P = .046), and hospital days (median 20 vs 22 days, P = .006).ConclusionsDe-escalation and NDE resulted in similar rates of 30-day treatment failure; however, DE was associated with fewer antibiotic days, episodes of C difficile infection, and days of hospitalization.
Coronavirus Disease 2019–Associated Invasive Fungal Infection
Authors: Baddley John W , Thompson George R , Chen Sharon C -A , White P Lewis , Johnson Melissa D , Nguyen M Hong , Schwartz Ilan S , Spec Andrej , Ostrosky-Zeichner Luis , Jackson Brendan R , Patterson Thomas F , Pappas Peter G 
Published: November 2021

Abstract
Coronavirus disease 2019 (COVID-19) can become complicated by secondary invasive fungal infections (IFIs), stemming primarily from severe lung damage and immunologic deficits associated with the virus or immunomodulatory therapy. Other risk factors include poorly controlled diabetes, structural lung disease and/or other comorbidities, and fungal colonization. Opportunistic IFI following severe respiratory viral illness has been increasingly recognized, most notably with severe influenza. There have been many reports of fungal infections associated with COVID-19, initially predominated by pulmonary aspergillosis, but with recent emergence of mucormycosis, candidiasis, and endemic mycoses. These infections can be challenging to diagnose and are associated with poor outcomes. The reported incidence of IFI has varied, often related to heterogeneity in patient populations, surveillance protocols, and definitions used for classification of fungal infections. Herein, we review IFI complicating COVID-19 and address knowledge gaps related to epidemiology, diagnosis, and management of COVID-19–associated fungal infections.
Trends and Intensity of Rhinovirus Invasions in Kilifi, Coastal Kenya, Over a 12-Year Period, 2007–2018
Authors: Mwita Morobe John , Kamau Everlyn , Murunga Nickson , Gatua Winfred , Luka Martha M , Lewa Clement , Cheruiyot Robinson , Mutunga Martin , Odundo Calleb , James Nokes D , Agoti Charles N 
Published: November 2021

Abstract

Background
Rhinoviruses (RVs) are ubiquitous pathogens and the principal etiological agents of common cold. Despite the high frequency of RV infections, data describing their long-term epidemiological patterns in a defined population remain limited.

Methods
Here, we analyzed 1070 VP4/VP2 genomic region sequences sampled at Kilifi County Hospital on the Kenya coast. The samples were collected between 2007 and 2018 from hospitalized pediatric patients (&lt;60 months of age) with acute respiratory illness.

Results
Of 7231 children enrolled, RV was detected in 1497 (20.7%) and VP4/VP2 sequences were recovered from 1070 samples (71.5%). A total of 144 different RV types were identified (67 Rhinovirus A, 18 Rhinovirus B, and 59 Rhinovirus C) and at any month, several types co-circulated with alternating predominance. Within types, multiple genetically divergent variants were observed. Ongoing RV infections through time appeared to be a combination of (1) persistent types (observed up to 7 consecutive months), (2) reintroduced genetically distinct variants, and (3) new invasions (average of 8 new types annually).

Conclusions
Sustained RV presence in the Kilifi community is mainly due to frequent invasion by new types and variants rather than continuous transmission of locally established types/variants.
Evolving a New Religious Freedom Jurisprudence: A Step Towards Ensuring Equality for Women
Authors: Jawed Maria , Jadhav Dhanaji Mukundrao 
Published: November 2021

Abstract
India is a country of religious pluralism, and cultural diversity wherein religion is one of the important social institutions. Freedom of religion in India is guaranteed as a fundamental right which comprises ‘freedom to freely profess, practice and propagate religion’ within the Constitutional boundary. The Indian constitution fosters equality to all and has a broader interpretative connotation. Often, the judiciary is posed with the delicate task of settling the sensitive disputes relating to religion. The court's intervention into such practices may lead to a conflict of existing values backed by the religion or society with newly introduced values by the court. Recently, the Supreme Court in the Sabarimala Temple Entry case declared the practice of prohibiting women in their menstruating age from entering the temples as unconstitutional. The article substantiates that the case paves the way for ensuring equality for women in every sphere, including religion. It critically appraises the existing jurisprudence of religious freedom and argues the need to establish a much coherent jurisprudence based on constitutional principles. The article correlates moral, social, and religious intricacies in determining the constitutional validity of religious practices and tries to substantiate it based on developing jurisprudence of constitutional morality.
Galaxy morphologies revealed with Subaru HSC and super-resolution techniques. I. Major merger fractions ofLUV ∼ 3–15 L*UV dropout galaxies atz∼ 4–7
Authors: Shibuya Takatoshi , Miura Noriaki , Iwadate Kenji , Fujimoto Seiji , Harikane Yuichi , Toba Yoshiki , Umayahara Takuya , Ito Yohito 
Published: November 2021

AbstractWe perform a super-resolution analysis of the Subaru Hyper Suprime-Cam (HSC) images to estimate the major merger fractions of z ∼ 4–7 dropout galaxies at the bright end of galaxy UV luminosity functions (LFs). Our super-resolution technique improves the spatial resolution of the ground-based HSC images, from ∼1″ to $\lesssim \!\!{0{^{\prime \prime }_{.}}1}$, which is comparable to that of the Hubble Space Telescope, allowing us to identify z ∼ 4–7 bright major mergers at a high completeness value of $\gtrsim \!\!90\%$. We apply the super-resolution technique to 6412, 16, 94, and 13 very bright dropout galaxies at z ∼ 4, 5, 6, and 7, respectively, in a UV luminosity range of LUV ∼ 3–$15\, L_{\rm UV}^*$ corresponding to −24 ≲ MUV ≲ −22. The major merger fractions are estimated to be $f_{\rm merger}\sim 10\%$–$20\%$ at z ∼ 4 and $\sim 50\%$–$70\%$ at z ∼ 5–7, which shows no fmerger difference compared to those of a control faint galaxy sample. Based on the fmerger estimates, we verify contributions of source blending effects and major mergers to the bright-end of double power-law (DPL) shape of z ∼ 4–7 galaxy UV LFs. While these two effects partly explain the DPL shape at LUV ∼ 3–$10\, L_{\rm UV}^*$, the DPL shape cannot be explained at the very bright end of $L_{\rm UV}\gtrsim 10\, L_{\rm UV}^*$, even after the AGN contribution is subtracted. The results support scenarios in which other additional mechanisms such as insignificant mass quenching and low dust obscuration contribute to the DPL shape of galaxy UV LFs.
Protection of photosystem I during sudden light stress depends on ferredoxin:NADP(H) reductase abundance and interactions
Authors: Rodriguez-Heredia Melvin , Saccon Francesco , Wilson Sam , Finazzi Giovanni , Ruban Alexander V , Hanke Guy T 
Published: November 2021

Abstract
Plant tolerance to high light and oxidative stress is increased by overexpression of the photosynthetic enzyme Ferredoxin:NADP(H) reductase (FNR), but the specific mechanism of FNR-mediated protection remains enigmatic. It has also been reported that the localization of this enzyme within the chloroplast is related to its role in stress tolerance. Here, we dissected the impact of FNR content and location on photoinactivation of photosystem I (PSI) and photosystem II (PSII) during high light stress of Arabidopsis (Arabidopsis thaliana). The reaction center of PSII is efficiently turned over during light stress, while damage to PSI takes much longer to repair. Our results indicate a PSI sepcific effect, where efficient oxidation of the PSI primary donor (P700) upon transition from darkness to light, depends on FNR recruitment to the thylakoid membrane tether proteins: thylakoid rhodanase-like protein (TROL) and translocon at the inner envelope of chloroplasts 62 (Tic62). When these interactions were disrupted, PSI photoinactivation occurred. In contrast, there was a moderate delay in the onset of PSII damage. Based on measurements of ΔpH formation and cyclic electron flow, we propose that FNR location influences the speed at which photosynthetic control is induced, resulting in specific impact on PSI damage. Membrane tethering of FNR therefore plays a role in alleviating high light stress, by regulating electron distribution during short-term responses to light.
A Scoping Review of the Diurnal Variation in the Intensity of Neuropathic Pain
Authors: Hu Sally , Gilron Ian , Singh Mandeep , Bhatia Anuj 
Published: November 2021

Abstract

Background
Recent studies have suggested that neuropathic pain exhibits a daily diurnal pattern, with peak levels usually occurring in the late afternoon to evening and the trough in the morning hours, although literature on this topic has been sparse. This scoping review examines current evidence on the chronobiology of neuropathic pain both in animal models and in humans with neuropathic pain.

Methods
A literature search was conducted in major medical databases for relevant articles on the chronobiology of neuropathic pain both in animal models and in humans with neuropathic pain. Data extracted included details of specific animal models or specific neuropathic pain conditions in humans, methods and timing of assessing pain severity, and specific findings of diurnal variation in pain intensity or its surrogate markers.

Results
Thirteen animal and eight human studies published between 1976 and 2020 were included in the analysis. Seven of the 13 animal studies reported specific diurnal variation in pain intensity, with five of the seven studies reporting a trend toward increased sensitivity to mechanical allodynia or thermal hyperalgesia in the late light to dark phase. All eight studies in human subjects reported a diurnal variation in the intensity of neuropathic pain, where there was an increase in pain intensity through the day with peaks in the late evening and early night hours.

Conclusions
Studies included in this review demonstrated a diurnal variation in the pattern of neuropathic pain that is distinct from the pattern for nociceptive pain. These findings have implications for potential therapeutic strategies for neuropathic pain.
Prediction of sustained biologic and targeted synthetic DMARD-free remission in rheumatoid arthritis patients
Authors: Burkard Theresa , Williams Ross D , Vallejo-Yagüe Enriqueta , Hügle Thomas , Finckh Axel , Kyburz Diego , Burden Andrea M 
Published: November 2021

Abstract

Objectives
The aim was to develop a prediction model of sustained remission after cessation of biologic or targeted synthetic DMARD (b/tsDMARD) in RA.

Methods
We conducted an explorative cohort study among b/tsDMARD RA treatment episode courses stopped owing to remission in the Swiss Clinical Quality Management registry (SCQM; 2008–2019). The outcome was sustained b/tsDMARD-free remission of ≥12 months. We applied logistic regression model selection algorithms using stepwise, forward selection, backward selection and penalized regression to identify patient characteristics predictive of sustained b/tsDMARD-free remission. We compared c-statistics corrected for optimism between models. The three models with the highest c-statistics were validated in new SCQM data until 2020 (validation dataset).

Results
We identified 302 eligible episodes, of which 177 episodes (59%) achieved sustained b/tsDMARD-free remission. Two backward and one forward selection model, with eight, four and seven variables, respectively, obtained the highest c-statistics corrected for optimism of c = 0.72, c = 0.70 and c = 0.69, respectively. In the validation dataset (47 eligible episodes), the models performed with c = 0.99, c = 0.80 and c = 0.74, respectively, and excellent calibration. The best model included the following eight variables (measured at b/tsDMARD stop): RA duration, b/tsDMARD duration, other pain/anti-inflammatory drug use, quality of life (EuroQol), DAS28-ESR score, HAQ score, education, and interactions of RA duration and other pain/anti-inflammatory drug use and of b/tsDMARD duration and HAQ score.

Conclusion
Our results suggest that models with up to eight unique variables may predict sustained b/tsDMARD-free remission with good efficiency. External validation is warranted.
Paradoxically protective effect of glucocorticoids on bone mass and fragility fracture in a large cohort: a cross-sectional study
Authors: Bukhari Marwan , Goodson Nicola , Boers Maarten 
Published: November 2021

Abstract

Objectives
Glucocorticoids (GCs) increase the risk of fracture through reduction in BMD; they may also reduce bone quality, but recent supporting data are scarce. We aimed to confirm these effects in a large population-based cohort.

Methods
We used data from patients referred for first hip and lumbar spine BMD estimation by the sole DXA scanner in the north-west of England between June 2004 and September 2016. We compared the history of fractures and BMD between patients currently on GCs and patients never exposed to GC. A logistic model adjusted for possible confounders.

Results
More than 20 000 subjects were included, 82% female, with mean age 63 (s.d. 13) years; 19% were currently on GCs. The patients on GCs were more often male, with higher BMI, but their age was similar to those not exposed to GC. Surprisingly, patients receiving GCs had ∼2% higher BMD at both sites (P &lt; 0.001) and lower prevalence of (history of) fractures (22% vs 34%; P &lt; 0.001). The corresponding odds ratio was 0.53 (95% CI: 0.49, 0.58); adjustment for age, sex, BMI and the number of indications for scanning did not alter the association.

Conclusion
In this large population-based cohort, current GC use compared with never use was associated with higher bone mass and fewer rather than more fractures after adjusting for confounders. These results might be subject to unmeasured confounding, but for now they do not lend support to a detrimental effect of GCs on bone.
Career Mathways: evaluating a novel initiative aimed at enhancing students’ attitudes towards and appreciation of mathematics
Authors: O’Meara Niamh , Fitzmaurice Olivia , Johnson Patrick 
Published: November 2021

Abstract
The power and value of mathematics cannot be underestimated in today’s society. Thus, it is pertinent that education systems worldwide help students to develop an appreciation of the subject. However, research has shown that students often lose interest in science, technology, engineering and mathematics subjects, particularly mathematics, as they cannot see the relevance of it in their lives. This, in turn, leads to the development of negative attitudes towards mathematics, which have been shown to have a knock-on effect on students’ academic performance, their participation and engagement with and motivation for the subject. The purpose of this paper is to describe and evaluate the impact of an innovative programme, known as Career Mathways, designed to improve secondary school students’ attitudes towards mathematics by highlighting the applicability and usefulness of the subject in a multitude of careers. Career Mathways was piloted in five Irish secondary schools in the 2018/2019 academic year. It involved professionals (n = 13) from a variety of industries sharing insights with students (n = 156) and teachers (n = 6) about how they use mathematics in their day-to-day working lives. Based on these insights, a suite of resources for use in the classroom was developed and implemented with students across the five schools. This paper reports on the impact that this pilot study had on students’ attitudes towards mathematics. The results from pre- and post-student surveys and teacher interviews show that Career Mathways had a moderate but positive influence on students’ appreciation of the usefulness of mathematics and this impact was more profound among lower-achieving students.
Design theories and maintenance technologies of slab tracks for high-speed railways in China: a review
Authors: Ren Juanjuan , Deng Shijie , Zhang Kaiyao , Du Wei , Wu Qinghong 
Published: November 2021

Abstract
The durability and reliability of slab track structures are essential for the long-term safety and stable operation of high-speed railways. In order to provide a solid theoretical basis and technical reference for the advancement of high-speed railway quality, this paper comprehensively discusses design theories of slab track structures, service performance evolution and maintenance technologies, and reviews the innovation happening in the industry. On top of that, the damage evolution, fatigue features and durability of slab tracks, which are highly relevant to serviceability, are summarized, and the future research trend of slab track service behaviours is pointed out. In addition, this paper summarizes the rules of establishing standards for damage maintenance, typical solutions for repairing damage and methods of evaluating the maintenance outcomes that combine field tests and numerical simulations. It also envisions a future direction where advanced testing technologies would assist the evaluation of maintenance effects.
Clinical and biological markers in disease and biologics to treat chronic rhinosinusitis
Authors: Guo Cui-Lian , Wang Chong-Shu , Liu Zheng 
Published: November 2021

Purpose of review
Chronic rhinosinusitis (CRS) is a heterogeneous disorder with diverse responses to conventional anti-inflammatory medical and surgical treatments. Even for the newly developed mAbs targeting type 2 (T2) reaction, a considerable number of patients with CRS with nasal polyps (CRSwNP) exhibited unsatisfying response. Identifying patients with a tendency to poor prognosis is critical for selecting targeted therapies to improve the treatment outcome. This review focuses on clinical and biological markers associated with prognosis of CRS patients under conventional medical and surgical treatments and provides an update summary of potential markers for T2 biologics.

Recent findings
Allergic rhinitis, asthma, prior sinus surgery, nasal polyps, tissue eosinophilia and neutrophilia, blood eosinophilia and high levels of Charcot-Leyden crystal, cystatin SN, chemokine (C-C motif) ligand 17, macrophage inflammatory protein-1β and interleukin (IL)-5 in nasal secretions have been associated with poor prognosis in CRS patients under conventional medical and surgical treatments. Blood eosinophil level might be a biomarker for anti-IL-5 (mepolizumab) and anti-IL-5R (benralizumab) biologic in patients with refractory CRSwNP.

Summary
Several clinical and biological markers have been associated with poor response to conventional treatments in CRS patients; however, majority of them should be verified by large-scale multicentre studies. More efforts are needed to identify biomarkers for biologics.
Associations Between Privacy-Related Constructs and Depression and Suicide Risk in Health Care Professionals, Trainees, and Students
Authors: Rubanovich Caryn Kseniya , Zisook Sidney , Bloss Cinnamon S. 
Published: November 2021

Purpose
The University of California, San Diego screens health care professionals, trainees, and students for depression and suicide risk. Individuals complete a voluntary, anonymous online screening tool and choose whether to provide personal demographic information. This study assessed the relationship between privacy-related constructs and self-rated depression and suicide risk.

Method
The authors analyzed responses to the screening tool collected from January 2018 to December 2019. Measures of depression, suicidal ideation and behaviors, and worry about stigma for seeking mental health services (i.e., privacy-related concern) were gathered. The number of demographic item nonresponses (i.e., age, gender, ethnicity/race, professional position) was operationalized as privacy-related behavior. Linear and logistic regression models were used to determine associations between privacy-related constructs (concern and behavior) and depression and suicide measures.

Results
A total of 1,224 respondents were included. On average, respondents reported mild depression (mean = 9.12, standard deviation = 5.94), but 43% (524/1,224) reported at least moderate depression. One in 5 respondents (248/1,224) reported worry about stigma for seeking mental health services, and more than 17% (212/1,224) skipped at least 1 demographic question. Privacy-related concern was statistically significantly and positively associated with recent depression and suicidal ideation and behaviors (odds ratios [ORs] = 3.13–7.02; 95% confidence interval [CI], 2.23–19.20; P’s < .001) and with lifetime suicide attempts (OR = 1.76; 95% CI, 1.08–2.86; P = .02). Privacy-related behavior was statistically significantly and positively associated with suicide action (OR = 2.23; 95% CI, 1.24–4.02; P = .008).

Conclusions
Privacy-related constructs may be meaningful correlates of mental health as respondents who endorsed these constructs had increased odds of worse depression and suicidal ideation and behaviors. Considering privacy-related constructs may be useful for identifying health care professionals, trainees, and students experiencing distress and in need of imminent mental health resources.