bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computational and Human Intelligence Methods for Constructing Practical Risk Prediction Models: An Application to Cardio-Renal Outcomes in Non-Diabetic CKD Patients
Authors: Bauer Chris , Schuchhardt Johannes , Vaitsiakhovich Tatsiana , Kleinjung Frank 
Published: November 2024

AbstractThe current investigation aimed to develop a novel approach for risk prediction modeling of clinical outcomes in common diseases based on computational and human intelligence techniques with no a priori input on risk factors using real-world individual patient-level data from administrative claims. Bootstrapping multivariable Cox regression and ant colony optimization were employed to develop time-to-first-event risk prediction models of cardio-renal outcomes in patients with non-diabetic chronic kidney disease (CKD) as a demonstration case. A cohort of 504,924 non-diabetic CKD stage 3 or 4 patients enrolled from 2008 to 2018 were identified in the US administrative de-identified claims database, Optum Clinformatics® Data Mart. Initial set of potential risk factors was derived from patient-level data at baseline and included more than 540,000 variables. Risk prediction models of hospitalization for heart failure, worsening of CKD stage from baseline and a renal composite outcome of end-stage kidney disease, kidney failure or need for dialysis in non-diabetic CKD stage 3 or 4 were built. Final model optimization was conducted using human intelligence to combine clinically similar features and build equivalence classes to ensure that risk factors included in the final model were routinely collected and easily interpretable by healthcare providers. Demonstrated validity of our approach in non-diabetic CKD offers opportunities for application in other therapeutic areas, with the potential to improve overall prognosis and decrease the clinical and economic burden of common diseases. The approach enables developing practical prediction models for risk estimation in routine clinical practice.
Sustainable mitigation method for earthquake-induced liquefaction using gravel-tire chips mixture: an integrated approach
Authors: Hu Yutao , Hazarika Hemanta , Madabhushi Gopal Santana Phani , Haigh Stuart Kenneth 
Published: November 2024

AbstractThis study investigates the potential of using Gravel-Tire Chips Mixture (GTCM) drains to mitigate soil liquefaction during earthquakes through an integrated experimental and numerical approach. The experiments involved a controlled setup with three distinct scenarios, evaluating the effectiveness of GTCM drain configurations in controlling excess pore water pressure in foundation soils, thereby reducing liquefaction and building settlement under seismic loading. Numerical simulations were performed to complement the physical tests and provide deeper insights into soil-drain interactions during dynamic events. The experimental results showed that GTCM drains significantly reduced settlement, with a reduction of up to 40 times in cases where GTCM drains were used compared to unmitigated conditions. Additionally, the presence of GTCM drains was effective in dissipating excess pore water pressure, which is a primary cause of liquefaction. Numerical simulations confirmed the experimental findings, indicating minimal pore water pressure buildup and reduced deformation in soils reinforced with GTCM drains. This research demonstrates that GTCM drains provide a sustainable and effective method to mitigate liquefaction and reduce earthquake-induced structural damage. The findings emphasize the importance of strategic drain placement and highlight the environmental benefits of repurposing waste materials such as tires for geotechnical applications, offering a cost-effective solution for enhancing infrastructure resilience in earthquake-prone regions.
Modeling and analysis of nonlinear dynamics of axisymmetric vector nozzle based on deep neural network
Authors: Wang X. , Hu H. , Chen Z. , Wang H. , Ye L. , Ye G. 
Published: November 2024

Abstract
The axisymmetric nozzle mechanism is the core part for thrust vectoring of aero engine, which contains complex rigid-flexible coupled multibody system with joints clearance and significantly reduces the efficiency in modeling and calculation, therefore the kinematics and dynamics analysis of axisymmetric vectoring nozzle mechanism based on deep neural network is proposed. The deep neural network model of the axisymmetric vector nozzle is established according to the limited training data from the physical dynamic model and then used to predict the kinematics and dynamics response of the axisymmetric vector nozzle. This study analyses the effects of joint clearance on the kinematics and dynamics of the axisymmetric vector nozzle mechanism by a data-driven model. It is found that the angular acceleration of the expanding blade and the driving force are mostly affected by joint clearance followed by the angle, angular velocity and position of the expanding blade. Larger joint clearance results in more pronounced fluctuations of the dynamic response of the mechanism, which is due to the greater relative velocity and contact force between the bushing and the pin. Since axisymmetric vector nozzles are highly complex nonlinear systems, traditional numerical methods of dynamics are extremely time-consuming. Our work indicates that the data-driven approach greatly reduces the computational cost while maintaining accuracy, and can be used for rapid evaluation and iterative computation of complex multibody dynamics of engine nozzle mechanism.
Provider & nursing perspectives on the “panculture”: opportunities for innovative diagnostic stewardship interventions
Authors: Gibas Kevin M. , Mermel Leonard A. 
Published: November 2024

Abstract

Objective:
To examine practices of providers and nursing staff in evaluating febrile patients and identify drivers of excessive diagnostic testing.

Design:
Prospective multiple-choice surveys.

Setting:
Inpatient areas and the Emergency Department at Rhode Island Hospital (RIH) in Providence, RI.

Participants & Methods:
We conducted two surveys focused on the evaluation of febrile inpatients at RIH. One survey was of providers trained in internal medicine, surgery, pediatrics, emergency medicine, and neurology; the other survey was of nursing staff (registered nurses and certified nursing assistants), in inpatient areas and the emergency department.

Results:
70 providers (9%) and 178 nursing staff (12%) completed the surveys. 64% of providers (n = 43) reported “always” or “often” ordering full fever workups and 67% of providers (n = 47) reported “always” or “often” physically evaluating febrile patients. Nurses were less likely than providers to report that providers “always” or “often” physically evaluate febrile patients (n = 80, 45%; P < 0.01) and more likely to report providers “always” or “often” order full fever workups (n = 135, 76%; P = 0.04). 71% of providers (n = 50) reported “always” or “often” receiving written handoffs. 86% of providers (n = 60) reported handoffs are “always” or “often” accurate; however, only 17% of providers responded these were “always” accurate. 77% of providers (n = 54) reported “always” or “often” following handoff instructions to obtain a full fever workup for febrile patients, regardless of clinical status. Responses differed significantly by unit type and provider specialty and position.

Conclusions:
This study elucidates drivers of inefficient and excessive utilization of diagnostic studies and identifies targets for diagnostic stewardship interventions.
Can risk factors and risk scores help predict colonization and infection in multidrug-resistant gram-negative bacteria?
Authors: Restrepo-Arbeláez Natalia , García-Betancur Juan Carlos , Pallares Christian José , El Ayoubi L’Emir Wassim , Kiratisin Pattarachai , Kanj Souha S. , Villegas María Virginia 
Published: November 2024

Abstract
Antimicrobial resistance (AMR) is positioning as one of the most relevant threats to global public health and threatens the effective treatment of an ever-growing number of bacterial infections in various healthcare settings, particularly in acute care and surgical units, as well as in the community. Among multidrug-resistant (MDR) gram-negative bacteria (MDRGNB), Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii require special attention, since they account for most of the mortality associated with bacterial infections and are often MDR. It is clear that there is an important global variation in antibiotic resistance profiles among MDRGNB species. Extended-spectrum β-lactamase-producing Enterobacterales, carbapenem-resistant Enterobacterales, DTR-P. aeruginosa, and MDR-A. baumannii are the focus of this review. Here, we summarize a series of relevant studies on risk factors associated with colonization and infection with these MDRGNB. Likewise, we offer a comparative overview of those studies providing scoring systems to predict the risk of infection with these MDR pathogens, and their pros and cons. Despite the variable accuracy of published risk factors for predicting colonization or infection with MDRGNB, these scores are valuable tools that may help anticipate colonization and infection among those colonized. More importantly, they may help reduce unnecessary use of broad-spectrum antimicrobials and guiding the selection of an optimal treatment.
Environmental tobacco smoke exposure in a multi-city cohort of children with asthma: Analyzing true exposure and the validity of caregiver survey
Authors: McKeon Katherine , Werthmann Derek , Straubing Rebecca , Rodriguez Anna , Sosnoff Connie , Blount Benjamin C. , Chew Ginger L. , Reponen Tiina , Adamkiewicz Gary , Hsu Joy , Rabito Felicia A. 
Published: November 2024

Abstract

Introduction:
The avoidance of asthma triggers, like tobacco smoke, facilitates asthma management. Reliance upon caregiver report of their child’s environmental tobacco smoke (ETS) exposure may result in information bias and impaired asthma management. This analysis aimed to characterize the chronicity of ETS exposure, assess the validity of caregiver report of ETS exposure, and investigate the relationship between ETS exposure and asthma attack.

Methods:
A secondary data analysis was performed on data from a longitudinal study of 162 children aged 7–12 years with asthma living in federally subsidized housing in three US cities (Boston, Cincinnati, and New Orleans). Data were collected at three time points over 1 year.

Results:
Over 90% of children were exposed to ETS (≥0.25 ng/ml of urine cotinine (UC)). Exposure was consistent over 1 year. Questionnaire data had a sensitivity of 28–34% using UC ≥0.25 ng/ml as the gold standard. High ETS exposure (UC ≥ 30 ng/ml) was significantly associated with asthma attack (aOR 2.97, 0.93–9.52, p = 0.07). Lower levels (UC 0.25–30 ng/ml) were not statistically significant (aOR 1.76, 0.71– 4.38, p = 0.22). No association was found using caregiver-reported ETS exposure.

Conclusion:
Relying on questionnaire data to assess children’s exposure to tobacco smoke may lead to substantial information bias. For children with asthma, incorrect characterization may substantially impact asthma morbidity.
Health impacts of a remotely delivered prolonged nightly fasting intervention in stressed adults with memory decline and obesity: A nationwide randomized controlled pilot trial
Authors: James Dara L. , Mun Chung Jung , Larkey Linda K. , Ofori Edward , Hawley Nanako A. , Alperin Kate , Vance David E. , Sears Dorothy D. 
Published: November 2024

Abstract

Objective/Goals:
Cognitive decline is intricately linked to various factors such as obesity, stress, poor sleep, and circadian rhythm misalignment, which are interrelated in their impact on cognitive health. Irregular food-intake timing further compounds these issues. The practice of prolonged nightly fasting (PNF) may help synchronize food intake with circadian rhythms, potentially mitigating adverse effects of cognitive decline and associated factors.

Methods:
A pilot nationwide, remotely delivered, 2-arm randomized controlled trial was conducted to assess the 8-week outcomes of cognition, stress, and sleep, after a PNF intervention (14-hr nightly fast, 6 nights/week, no calories after 8 pm) compared to a health education (HED) control condition. Participants were living with memory decline, stress, and obesity and had weekly check-in calls to report fasting times (PNF) or content feedback (HED).

Results:
Participants were enrolled from 37 states in the US; N = 58, 86% women, 71% white, 93% non-Latinx, mean (SD) age 50.1 (5.1) years and BMI 35.6 (3.6) kg/m2. No group differences existed at baseline. Linear mixed-effects models were used to compare outcome change differences between groups. Compared to the HED control, the PNF intervention was associated with improved sleep quality (B = −2.52; SE = 0.90; 95% CI −4.30–−0.74; p = 0.006). Perceived stress and everyday cognition significantly changed over time (p < 0.02), without significant difference by group.

Discussion:
Changing food intake timing to exclude nighttime eating and promote a fasting period may help individuals living with obesity, memory decline, and stress to improve their sleep. Improved sleep quality may lead to additional health benefits.
A survey of individuals’ willingness to share real-world data postmortem with researchers
Authors: Hendricks-Sturrup Rachele M. , Lu Christine Y. 
Published: November 2024

Abstract

Objective:
As posthumous data use policy within the broader scope of navigating postmortem data privacy is a procedurally complex landscape, our study addresses this by exploring patterns in individuals’ willingness to donate data with health researchers after death and developing practical recommendations.

Methods:
An electronic survey was conducted in April 2021 among adults (≥18 years of age) registered in ResearchMatch (www.researchmatch.org), a national health research registry. Descriptive statistics were used to observe trends in, and multinomial logistic regression analyses were conducted at a 95% confidence interval to determine the association between, willingness to donate some, all, or no data after death with researchers based on the participants’ demographics (education level, age range, duration of using online medical websites, and annual frequency of getting ill).

Results:
Of 399 responses, most participants were willing to donate health data (electronic medical record data [67%], prescription history data [63%], genetic data [54%], and fitness tracker data [53%]) after death. Among 397 respondents, we identified that individuals were more likely to donate some data after death (vs. no data) if they had longer duration of using online medical websites (adjusted relative risk ratio = 1.22, p= 0.04, 95% CI: 1.01 to 1.48). No additional significant findings were observed between willingness to donate all, some, or none of their data after death and other demographic factors.

Conclusions:
Engaging patients in online medical websites may be one potential mechanism to encourage or inspire individuals to participate in posthumous data donation for health research purposes.
Medical Access and Care Continuity: Qualitative Assessments of Patients with Breast Cancer and Family Members’ Experiences Following the 2011 Triple Disaster in Fukushima, Japan
Authors: Singh Priya , Montesino Stephanie , Ozaki Akihiko , Murakami Michio , Kaneda Yudai , Abe Toshiki , Zhao Tianchen , Yamamoto Chika , Ito Naomi , Amir Isamu , Yamashita Erika , Saito Hiroaki , Sawano Toyoaki , Gonda Kenji , Ohira Hiromichi , Yanagisawa Robert , Katz Craig , Tsubokura Masaharu 
Published: November 2024

Abstract

Objectives
While studies have examined the effects of large-scale disasters on disaster-vulnerable individuals, these analyses may not capture the full impact. This study qualitatively explored the impacts of the March 2011 Fukushima triple disaster on patients with breast cancer and their families, aiming to highlight the importance of incorporating family narratives to grasp the full effect of large-scale disasters.

Methods
Utilizing the medical records from two hospitals, deceased patients with breast cancer from the disaster period were identified. Relatives were interviewed using a semi-structured approach. Thematic analysis was conducted via the Braun and Clarke method and Taguette transcription software.

Results
Interviews with seven family members of six patients revealed three main themes: the family’s caregiving burden and their deepened bonds with the patient, the patients’ extensive medical challenges and their physical and mental decline, and the shared confusion during the disaster due to resource shortages and evacuation dilemmas.

Conclusions
This study uncovered significant infrastructural issues such as reduced medical support and the heavy caregiving load on families, amidst some strengthened relationships during a time of crisis. Future research should investigate these issues across various disaster contexts, and proactive measures should be implemented to prevent exacerbation of these challenges.
Transmission of MRSA, ESBL E. coli, and C. difficile within a tertiary care hospital and across surrounding facilities in Japan: a molecular epidemiological study with the PCR-based Open-reading frame typing
Authors: Saito Hiroki , Miike Satoshi , Ohno Tatsuya , Anzai Momoko , Kasai Fumimasa , Hosoyama Akiko , Takakura Tomomi , Tanaka Yosuke , Fujitani Shigeki 
Published: November 2024

AbstractObjective:To determine the regional impact of transmission of multidrug-resistant organisms (MRDOs) and Clostridioides difficile (C. difficile) among a tertiary care hospital and surrounding facilities including long-term care facilities (LTCFs).Design:Retrospective cohort study.Methods:Patients admitted to a tertiary care hospital from July 2019 to July 2021 were recruited if their clinically collected cultures grew the following pathogens: Methicillin-resistant Staphylococcus aureus (MRSA), Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacterales, Pseudomonas aeruginosa with difficult-to-treat resistance, Carbapenem-resistant Enterobaterales, Vancomycin-resistant Enterococci, and C. difficile. Patient characteristics including admission and discharge pathway were collected. For the isolates of MRSA, ESBL-producing Escherichia coli (E. coli), and C. difficile, a molecular epidemiological analysis was conducted, utilizing the PCR-based Open-Reading Frame Typing (POT) method.Results:Three hundred-five patients were identified with a total of 332 culture specimens of the target pathogens. The top three were 132 MRSA isolates (43.3%, out of 305), 97 ESBL E. coli (31.8%), and 32 ESBL Enterobacterales (non-E. coli) (10.5%). The target pathogens were more detectable within 3 days among patients admitted from LTCFs or other hospitals than those admitted from home (Odds Ratio 4.6, 95% confidence interval 2.8-7.6, p-value < 0.001). The molecular epidemiological analysis suggested the transmissions of MRSA, ESBL E. coli and C. difficile occurred 52 out of 111 patients within the in-hospital environment, and 7 out of 128 within the prehospital environment, respectively.Conclusions:MDROs/C. difficile transmission is prevalent within a tertiary care hospital and further complicated by its inter-facility transmission across surrounding LTCFs and hospitals in Japan.
“A Place of Refuge to Republicans and Royalists”: The French Revolution in British Dominica
Authors: Freund Heather 
Published: November 2024

AbstractDuring the French Revolution, thousands of revolutionaries and royalists fled the turmoil in French islands. Many went to nearby islands, from which they could observe events. Situated between Martinique and Guadeloupe, Dominica had a majority French population and a long history of connection with its French neighbors. This article uses the case of Dominica to explore the effects of the French Revolution on a non-French island in the Eastern Caribbean. From the start, its proximity to the French islands led to its entanglement in revolutionary politics. It was the first British island to receive refugees, and the influx of people of all racial, social, and political backgrounds into Dominica posed challenges for island officials. Officials had to determine on what terms to admit emigrants, whether they posed a threat to the colony, and how to feed and house them. They also worried about the influences of foreigners and revolutionary ideas on their own disaffected free and enslaved populations. This article argues that Dominica's location, heterogeneous population, and internal instability allowed it to become a node for regional migration and information networks that embroiled it in the turmoil that engulfed its neighbors and ultimately threatened British control of the island.
The use of experimental designs to examine causality in authentic leadership: A scoping review
Authors: Dadich Ann , Abbott Ling , Lux Andrei A. , Lowe Kevin B. 
Published: November 2024

AbstractAuthentic leadership studies are often criticised for the limited use of causally defined research designs. To advance scholarship is this area, this article presents a scoping review on the use of experimental designs to examine causality in authentic leadership. Eleven publications were identified, which presented 16 experiments that met the inclusion criteria. Generally, these experiments tested authentic leadership as an antecedent; were conducted online; used a one-factor design; involved large samples, typically of working adults or residents; involved a manipulation check; involved the use of written vignettes to manipulate levels of authentic leadership; included counterfactual conditions; culminated with outcomes pertaining to followers; and established the causal effects of authentic leadership on the outcome(s) of interest. These findings suggest the value of: written vignettes; multi-method approaches; and online experiments. They also highlight opportunities to advance authentic leadership research through the use of sequential experiments and immersive technologies.
Business Courts as Loci of Privilege: The Business Judgment Rule Abroad
Authors: Hofri-Winogradow Adam , Maimon-Blau Inbal 
Published: November 2024

Abstract
Business courts can function as loci of privilege, both institutional and substantive, expressing a clear privileging of business as a sphere of social action. Using an original case study, we show how the establishment of a new business court privileged businesspersons in two ways: by providing them with expert judicial services and by receiving into law a rule that gives them unique protection from liability—the Delaware Business Judgment Rule. We did not find that this reception reflected court capture by businesspersons. It did reflect a conviction that Delaware law is best, inculcated by US-educated academics, and inter-jurisdictional competitive aspirations. Our case study demonstrates how business courts express the structured power of business and businesspersons.