bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opportunities for Stewardship in the Transition From Intravenous to Enteral Antibiotics in Hospitalized Pediatric Patients
Authors: Cotter Jillian M , Hall Matt , Girdwood Sonya Tang , Stephens John R , Markham Jessica L , Gay James C , Shah Samir S 
Published: February 2021

BACKGROUND/OBJECTIVEPediatric patients hospitalized with bacterial infections often receive intravenous (IV) antibiotics. Early transition to enteral antibiotics can reduce hospital duration, cost, and complications. We aimed to identify opportunities to transition from IV to enteral antibiotics, describe variation of transition among hospitals, and evaluate feasibility of novel stewardship metrics.METHODSThis multisite retrospective cohort study used the Pediatric Health Information System to identify pediatric patients hospitalized with pneumonia, neck infection, orbital infection, urinary tract infection (UTI), osteomyelitis, septic arthritis, or skin and soft tissue infection (SSTI) between 2017 and 2018. Opportunity days were defined as days on which patients received both IV antibiotics and enteral medications, suggesting enteral tolerance. Percent opportunity was defined as opportunity days divided by days on any antibiotics. Both outcomes excluded IV antibiotics that have no alternative oral formulation. We evaluated outcomes per infection and antibiotic and assessed across‐hospital variation.RESULTSWe identified 88,522 aggregate opportunity days in 100,103 hospitalizations. On 57% of the antibiotic days, there was an opportunity to switch patients to enteral therapy, with greatest opportunity days in SSTI, neck infection, and pneumonia encounters, and with clindamycin, ceftriaxone, and ampicillin‐sulbactam. Percent opportunity varied by infection (73% in septic arthritis to 40% in pneumonia). There was significant across‐hospital variation in percent opportunity for all infections.CONCLUSIONThis multicenter study demonstrated the potential opportunity to transition from IV to enteral therapy in over half of antibiotic days. Opportunity varied by infection, antibiotic, and hospital. Across‐hospital variation demonstrated likely missed opportunities for earlier transition and the need to define optimal transition times. Stewardship efforts promoting earlier transition for highly bioavailable antibiotics could reduce healthcare utilization and promote high‐value care. We identified feasible stewardship metrics.
Clinical Guideline Highlights for the Hospitalist: Anaphylaxis Management in Adults and Children
Authors: Burroughs‐Ray Desirée C , Wells Daniel R , Dennis Mallie M , Jackson Christopher D 
Published: February 2021

GUIDELINE TITLEAnaphylaxis—A 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysisRELEASE DATEApril 2020PRIOR VERSIONAnaphylaxis – a 2019 practice parameter and GRADE analysisDEVELOPERAmerican Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma, and Immunology (ACAAI)FUNDING SOURCENoneTARGET POPULATIONAdult and pediatric patients with anaphylaxis
Performance Pay and Prior Learning—Evidence from a Retail Chain
Authors: Manthei Kathrin , Sliwka Dirk , Vogelsang Timo 
Published: February 2021

We report the results of two field experiments in a retail chain and show that the effectiveness of performance pay crucially hinges on prior job experience. Introducing sales-based performance pay first for district managers and later for store managers, we find negligible average treatment effects. From surveys and interviews, we develop a formal model demonstrating that the effect of performance pay decreases with experience and may even vanish in the limit. We provide empirical evidence in line with this hypothesis—for instance, finding positive treatment effects (only) in stores with low job experience. This paper was accepted by Yan Chen, decision analysis.
Sonographic bridging callus at six weeks following displaced midshaft clavicle fracture can accurately predict healing
Authors: Nicholson Jamie A. , Oliver William M. , MacGillivray Tom J. , Robinson C. Michael , Simpson A. Hamish R. W. 
Published: February 2021

Aims To evaluate if union of clavicle fractures can be predicted at six weeks post-injury by the presence of bridging callus on ultrasound. Methods Adult patients managed nonoperatively with a displaced mid-shaft clavicle were recruited prospectively. Ultrasound evaluation of the fracture was undertaken to determine if sonographic bridging callus was present. Clinical risk factors at six weeks were used to stratify patients at high risk of nonunion with a combination of Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) ≥ 40, fracture movement on examination, or absence of callus on radiograph. Results A total of 112 patients completed follow-up at six months with a nonunion incidence of 16.7% (n = 18/112). Sonographic bridging callus was detected in 62.5% (n = 70/112) of the cohort at six weeks post-injury. If present, union occurred in 98.6% of the fractures (n = 69/70). If absent, nonunion developed in 40.5% of cases (n = 17/42). The sensitivity to predict union with sonographic bridging callus at six weeks was 73.4% and the specificity was 94.4%. Regression analysis found that failure to detect sonographic bridging callus at six weeks was associated with older age, female sex, simple fracture pattern, smoking, and greater fracture displacement (Nagelkerke R2 = 0.48). Of the cohort, 30.4% (n = 34/112) had absent sonographic bridging callus in addition to one or more of the clinical risk factors at six weeks that predispose to nonunion. If one was present the nonunion rate was 35%, 60% with two, and 100% when combined with all three. Conclusion Ultrasound combined with clinical risk factors can accurately predict fracture healing at six weeks following a displaced midshaft clavicle fracture. Cite this article: Bone Joint Res 2021;10(2):113–121.
High-resolution sequential thermal fringe projection technique for fast and accurate 3D shape measurement of transparent objects
Authors: Landmann Martin , Speck Henri , Dietrich Patrick , Heist Stefan , Kühmstedt Peter , Tünnermann Andreas , Notni Gunther 
Published: February 2021

Three-dimensional (3D) shape measurement systems based on diffuse reflection of projected structured light do not deliver reliable data when measuring glossy, transparent, absorbent, or translucent objects. In recent years, we have developed a method based on stereo recording with infrared cameras and projection of areal aperiodic sinusoidal thermal patterns to detect such objects. However, the measurements took longer than 10 s, up to minutes; moreover, the measurement accuracy was improvable. Now, we have succeeded in both drastically reducing measurement time and significantly increasing measurement quality. This finally provides a technique for reliably measuring transparent objects, e.g., in series production. We demonstrate measurement examples achieved within 1 s and with 3D standard deviations less than 10 µm.
Real-time IBFD transmission system based on adaptive optical self-interference cancellation using the hybrid criteria regular triangle algorithm
Authors: Zhang Zhiyi , Zheng Lizhuo , Xiao Shilin , Liu Zhiyang , Fang Jiafei , Hu Weisheng 
Published: February 2021

In this Letter, we first propose and demonstrate a real-time in-band full duplex (IBFD) transmission system based on adaptive optical self-interference cancellation (OSIC). The field programmable gate array (FPGA) is used for high-speed and real-time orthogonal frequency-division multiplexing (OFDM) transmission. The hybrid criteria regular triangle (RT) algorithm is first proposed to combine signal power and the bit error rate (BER) together as the objective function to realize the adaptive control process. With this algorithm, the real-time adaptive OSIC system is able to converge and fully recover the signal of interest (SOI) within 12 sampling times, which is by far the fastest, to the best of our knowledge, convergence under the real-time transmission scenario. Experiments show that the system can achieve 28 dB cancellation depth across 0–1.45 GHz wideband, and 40 dB cancellation depth at 900 MHz, 2.4 GHz, and 5 GHz, which is the best cancellation performance in current real-time adaptive OSIC schemes and shows the potential of our system in different commercial applications.
Concordance of SVR12, SVR24 and SVR durability in Taiwanese chronic hepatitis C patients with direct-acting antivirals
Authors: Lin Chuan-Pin , Liang Po-Cheng , Huang Ching-I , Yeh Ming-Lun , Hsu Po-Yao , Hsu Cheng-Ting , Wei Yu-Ju , Liu Ta-Wei , Hsieh Ming-Yen , Hou Nai-Jen , Jang Tyng-Yuang , Lin Yi-Hung , Wang Chih-Wen , Lin Zu-Yau , Chen Shinn-Cherng , Huang Chung-Feng , Huang Jee-Fu , Dai Chia-Yen , Chuang Wan-Long , Yu Ming-Lung 
Published: February 2021

Background/Aims
Undetectable HCV RNA 12 weeks after the end of treatment (SVR12) has been the valid efficacy endpoint in the era of direct-acting antivirals (DAAs). Its concordance with SVR4 and SVR24 and long-term durability is unknown in Taiwanese chronic hepatitis C (CHC) patients.

Methods
A total of 1080 CHC patients who received all-oral DAAs and an achieved end-of-treatment virological response (EOTVR), defined as undetectable HCV RNA at the end of therapy, were consecutively enrolled. HCV RNA was monitored 4, 12, and 24 weeks after EOT. Patients who achieved SVR24, defined as undetectable HCV RNA 24 weeks after EOT, were followed annually for assessing SVR durability.

Results
Eleven (1.02%) patients experienced HCV RNA reappearance after EOT. The most frequent timing of RNA reappearance was observed at SVR4 (n = 7), followed by SVR12 (n = 3) and SVR 24 (n = 1). The positive predictive value (PPV) and negative predictive value (NPV) of SVR4 in predicting SVR12 were 99.7% and 100%, respectively, whereas the PPV and NPV of SVR12 in predicting SVR24 were 99.9% and 100%, respectively. Pyrosequencing confirmed delayed relapse rather than reinfection for the patient who had detectable HCV RNA at SVR24. Among 978 patients who achieved SVR24, after a median follow-up period of 17.3±8.2 months, the SVR durability is 100% up to a 4-year follow-up.

Conclusion
Achievement of SVR12 provides excellent durability of HCV seroclearance after DAA therapy. On-demand HCV RNA beyond SVR12 should be recommended for patients with unexplainable abnormal liver function or high-risk behaviors.
Heterogeneity of multiple sclerosis lesions in fast diffusional kurtosis imaging
Authors: Thaler Christian , Kyselyova Anna A. , Faizy Tobias D. , Nawka Marie T. , Jespersen Sune , Hansen Brian , Stellmann Jan-Patrick , Heesen Christoph , Stürner Klarissa H. , Stark Maria , Fiehler Jens , Bester Maxim , Gellißen Susanne 
Published: February 2021

Background
Mean kurtosis (MK), one of the parameters derived from diffusion kurtosis imaging (DKI), has shown increased sensitivity to tissue microstructure damage in several neurological disorders.

Methods
Thirty-seven patients with relapsing-remitting MS and eleven healthy controls (HC) received brain imaging on a 3T MR scanner, including a fast DKI sequence. MK and mean diffusivity (MD) were measured in the white matter of HC, normal-appearing white matter (NAWM) of MS patients, contrast-enhancing lesions (CE-L), FLAIR lesions (FLAIR-L) and black holes (BH).

Results
Overall 1529 lesions were analyzed, including 30 CE-L, 832 FLAIR-L and 667 BH. Highest MK values were obtained in the white matter of HC (0.814 ± 0.129), followed by NAWM (0.724 ± 0.137), CE-L (0.619 ± 0.096), FLAIR-L (0.565 ± 0.123) and BH (0.549 ± 0.12). Lowest MD values were obtained in the white matter of HC (0.747 ± 0.068 10−3mm2/sec), followed by NAWM (0.808 ± 0.163 10−3mm2/sec), CE-L (0.853 ± 0.211 10−3mm2/sec), BH (0.957 ± 0.304 10−3mm2/sec) and FLAIR-L (0.976 ± 0.35 10−3mm2/sec). While MK differed significantly between CE-L and non-enhancing lesions, MD did not.

Conclusion
MK adds predictive value to differentiate between MS lesions and might provide further information about diffuse white matter injury and lesion microstructure.
Higher plasma drug levels in elderly people living with HIV treated with darunavir
Authors: Tyrberg Erika , Edén Arvid , Eriksen Jaran , Nilsson Staffan , Treutiger Carl Johan , Thalme Anders , Mellgren Åsa , Gisslén Magnus , Andersson Lars-Magnus 
Published: February 2021

Background
The proportion of elderly people living with HIV-1 (PLHIV) is rising. In older patients, comorbidities and concomitant medications are more frequent, increasing the risk of potential drug-drug interactions (PDDIs). Data on the pharmacokinetics of ART in individuals aged ≥ 65 years of age are scarce. We compared plasma drug levels of ART, PDDIs, and side-effects in PLHIV aged ≥ 65 years of age, with controls ≤ 49 years of age.

Methods
Patients ≥ 65 years of age and controls ≤ 49 years of age, all of whom were on stable treatment with atazanavir (ATV), darunavir (DRV), or efavirenz (EFV) were included cross-sectionally. Plasma drug levels of ART were analyzed, comorbidities, concomitant medication, adherence, and side-effects recorded, and PDDIs analyzed using drug interactions databases.

Results
Between 2013 and 2015, we included 100 individuals ≥ 65 years of age (study group) and 99 controls (≤ 49 years of age). Steady-state DRV concentrations were significantly higher in the study group than in the control group (p = 0.047). In the ATV group there was a trend towards a significant difference (p = 0.056). No significant differences were found in the EFV arm. The DRV arm had a higher frequency of reported side-effects than the ATV and EFV arms in the study group (36.7% vs. 0% and 23.8% respectively (p = 0.014), with significant differences between DRV vs. ATV, and EFV vs. ATV).

Conclusions
Higher steady-state plasma levels of DRV and ATV (but not EFV) were found in PLHIV aged ≥ 65 years of age, compared to controls ≤ 49 years of age.
Evaluating equality in prescribing Novel Oral Anticoagulants (NOACs) in England: The protocol of a Bayesian small area analysis
Authors: Rezaei-Darzi Ehsan , Mehdipour Parinaz , Di Cesare Mariachiara , Farzadfar Farshad , Rahimzadeh Shadi , Nissen Lisa , Ahmadvand Alireza 
Published: February 2021

BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia, affecting about 1.6% of the population in England. Novel oral anticoagulants (NOACs) are approved AF treatments that reduce stroke risk. In this study, we estimate the equality in individual NOAC prescriptions with high spatial resolution in Clinical Commissioning Groups (CCGs) across England from 2014 to 2019.MethodsA Bayesian spatio-temporal model will be used to estimate and predict the individual NOAC prescription trend on ‘prescription data’ as an indicator of health services utilisation, using a small area analysis methodology. The main dataset in this study is the “Practice Level Prescribing in England,” which contains four individual NOACs prescribed by all registered GP practices in England. We will use the defined daily dose (DDD) equivalent methodology, as recommended by the World Health Organization (WHO), to compare across space and time. Four licensed NOACs datasets will be summed per 1,000 patients at the CCG-level over time. We will also adjust for CCG-level covariates, such as demographic data, Multiple Deprivation Index, and rural-urban classification. We aim to employ the extended BYM2 model (space-time model) using the RStan package.DiscussionThis study suggests a new statistical modelling approach to link prescription and socioeconomic data to model pharmacoepidemiologic data. Quantifying space and time differences will allow for the evaluation of inequalities in the prescription of NOACs. The methodology will help develop geographically targeted public health interventions, campaigns, audits, or guidelines to improve areas of low prescription. This approach can be used for other medications, especially those used for chronic diseases that must be monitored over time.
Hypersensitivity reactions to multiple anti-tuberculosis drugs
Authors: Shin Hong-Joon , Chang Jin-Sun , Kim Min-Suk , Koh Bo-Gun , Park Ha-Young , Kim Tae-Ok , Park Chul-Kyu , Oh In-Jae , Kim Yu-Il , Lim Sung-Chul , Kim Young-Chul , Koh Young-Il , Kwon Yong-Soo 
Published: February 2021

ObjectiveThis study aimed to evaluate hypersensitivity reactions to anti-tuberculosis (TB) drugs.MethodsWe retrospectively compared the clinical manifestations and treatment outcomes of single and multiple drug hypersensitivity reactions (DHRs).ResultsTwenty-eight patients were diagnosed with anti-TB DHRs using oral drug provocation tests. Of these 28 patients, 17 patients (60.7%) had DHRs to a single drug and 11 (39.3%) had multiple DHRs. The median age of patients was 57.5 years (interquartile range [IQR], 39.2–73.2). Of the total patients, 18 patients (64.3%) were men. The median number of anti-TB drugs causing multiple DHRs was 2.0 (IQR 2.0–3.0). Rifampin was the most common drug that caused DHRs in both the single and multiple DHR groups (n = 8 [47.1%] and n = 9 [52.9%], respectively). The treatment success rate was lower in the multiple DHR group than in the single DHR group; however, the difference was not statistically significant (81.8% vs. 94.1%; P = 0.543).ConclusionsMultiple anti-TB DHRs were common in all patients who experienced DHRs, and rifampin was the most common causative drug. The treatment outcomes appeared to be poorer in patients with multiple DHRs than in those with single DHRs.
Disciplinary practices among orphaned children in Sub-Saharan Africa
Authors: Lee Mark , Boyle Elizabeth Heger 
Published: February 2021

ObjectivesThis study considers whether orphans’ experiences with physically and psychologically violent discipline differ from non-orphans in sub-Saharan Africa, and to what extent national, community, household, caretaker, and child characteristics explain those differences.MethodsWe use cross-sectional Multiple Indicator Cluster Surveys (MICS) administered between 2010–2017 in 14 sub-Saharan African countries. The sample included 125,197 children, of which 2,937 were maternal orphans, 9,113 were paternal orphans, and 1,858 were double orphans. We estimate the difference between orphans and non-orphans experience of harsh discipline using multivariable logistic regressions with country fixed effects and clustered standard errors.ResultsFindings show that orphaned children experiencelessharsh discipline in the home. With the exception of double orphans’ experience with physically violent discipline, these differences persisted even after controlling for a rich set of child, household, and caretaker characteristics.ConclusionsWe propose two alternative explanations for our surprising findings and provide a supplementary analysis to help arbitrate between them. The evidence suggests that orphaned children (especially those with a deceased mother) are less likely to experience harsh discipline because of lower caretaker investment in their upbringing. We encourage future research to draw on in-depth interviews or household surveys with discipline data from multiple children in a home to further unpack why orphans tend to experience less harsh punishment than other children.
Long term pronostic value of suPAR in chronic heart failure: reclassification of patients with low MAGGIC score
Authors: Dupuy Anne Marie , Kuster Nils , Bargnoux Anne Sophie , Aguilhon Sylvain , Huet Fabien , Leclercq Florence , Pasquié Jean-Luc , Roubille François , Cristol Jean Paul 
Published: February 2021

Abstract

Objectives
Inflammation is a hallmark of heart failure (HF) and among inflammatory biomarkers, the most studied remains the C-reactive protein (CRP). In recent years several biomarkers have emerged, such as sST2 and soluble urokinase–type plasminogen activator receptor (suPAR). This study set out to examine the relative importance of long-time prognostic strength of suPAR and the potential additive information on patient risk with chronic HF in comparison with pronostic value of CRP and sST2.

Methods
Demographics, clinical and biological variables were assessed in a total of 182 patients with chronic HF over median follow-up period of 80 months. Inflammatory biomarkers (i.e., CRP, sST2, and suPAR) were performed.

Results
In univariate Cox regression analysis age, NYHA class, MAGGIC score and the five biomarkers (N-terminal pro brain natriuretic peptide [NT-proBNP], high-sensitive cardiac troponin T [hs-cTnT], CRP, sST2, and suPAR) were associated with both all-cause and cardiovascular mortality. In the multivariate model, only NT-proBNP, suPAR, and MAGGIC score remained independent predictors of all-cause mortality as well as of cardiovascular mortality. Risk classification analysis was significantly improved with the addition of suPAR particularly for all-cause short- and long-term mortality. Using a classification tree approach, the same three variables could be considered as significant classifier variables to predict all-cause or cardiovascular mortality and an algorithm were reported. We demonstrated the favorable outcome associated with patients with a low MAGGIC score and a low suPAR level by comparison to patients with low MAGGIC score but high suPAR values.

Conclusions
The main findings of our study are (1) that among the three inflammatory biomarkers, only suPAR levels were independently associated with 96-month mortality for patients with chronic HF and (2) that an algorithm based on clinical score, a cardiomyocyte stress biomarker and an inflammatory biomarker could help to a more reliable long term risk stratification in heart failure.
Academic, cultural and social growth through the language of websites: A challenge for European University Language Centres
Authors: Argondizzo Carmen , De Bartolo Anna Maria , Fazio Alessandra , Jimenez Jean M. , Ruffolo Ida 
Published: February 2021

Abstract
At the start of 2000 a new scenario emerged in Europe thanks to the Council of Europe and the European Commission who, in support of the Bologna Process (1999), laid the foundations for disseminating the value of multilingualism and multiculturalism. The aim was to create a framework of actions to make citizens more aware of respecting diversity in languages and cultures and pave the way for integrating the varied geographical realities present in Europe. Language instruction was a priority identified as a tool for developing socio-cultural awareness and, within this scenario, universities played a key role. In particular, University Language Laboratories, previously regarded as language learning resources for small numbers of students, became University Language Centres, gaining status as fully-fledged academic places for the dissemination of multilingualism and multiculturalism, where intercultural communication, learning by doing, autonomous language learning, self-assessment and European Language Portfolios, communicative strategies and social inclusion, creativity and knowledge-sharing became key concepts to be internalised and implemented in academic communities. Indeed, the enhancement of cultural and democratic growth among young learners and citizens, in general, assumed paramount importance. The impact of the Lifelong Learning and Erasmus programs, strongly encouraged by the Bologna Accords, and later the internationalization process of European universities, further strengthened the need to promote linguistic, social and cultural growth in academic societies. Based on these premises, the purpose of this paper is twofold. First, it will discuss the importance of investigating how University Language Centres present the aforementioned concepts through their actions, focussing principally on the language used on their websites. Secondly, it will propose a potential project framework in which the CercleS community will be invited to share ideas and experiential knowledge in representing itself and its mission to potential users.