bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful Treatment of Recurrent Extensively Drug-Resistant Elizabethkingia anophelis Bacteremia Secondary to Ventricular Assist Device–Associated Infection
Authors: Vessely Madeleine B , Siddiqui Marrium , Kling Kendall , Guenette Alexis , Bachta Kelly E R 
Published: October 2024

Abstract
Elizabethkingia anophelis is an emerging pathogen increasingly implicated in health care–associated infections. Here, we report a case of recurrent ventricular assist device–associated infection caused by multidrug-resistant Elizabethkingia anophelis and describe the clinical course, treatment challenges, and ultimate case resolution. Our results demonstrate that standard clinical methodologies for determining trimethoprim-sulfamethoxazole minimum inhibitory concentration, including VITEK2 and gradient diffusion tests, may be unsuitable for Elizabethkingia anophelis as they result in false-negative susceptibility results. The discrepancy between antimicrobial susceptibility testing reported here highlights the importance of investigating and validating the applicability of standard clinical antimicrobial susceptibility testing and interpretation when treating emerging pathogens such as Elizabethkingia anophelis.
Modeling human activity comprehension at human scale: Prediction, segmentation, and categorization
Authors: Nguyen Tan T , Bezdek Matthew A , Gershman Samuel J , Bobick Aaron F , Braver Todd S , Zacks Jeffrey M 
Published: October 2024

Abstract
Humans form sequences of event models—representations of the current situation—to predict how activity will unfold. Multiple mechanisms have been proposed for how the cognitive system determines when to segment the stream of behavior and switch from one active event model to another. Here, we constructed a computational model that learns knowledge about event classes (event schemas), by combining recurrent neural networks for short-term dynamics with Bayesian inference over event classes for event-to-event transitions. This architecture represents event schemas and uses them to construct a series of event models. This architecture was trained on one pass through 18 h of naturalistic human activities. Another 3.5 h of activities were used to test each variant for agreement with human segmentation and categorization. The architecture was able to learn to predict human activity, and it developed segmentation and categorization approaching human-like performance. We then compared two variants of this architecture designed to better emulate human event segmentation: one transitioned when the active event model produced high uncertainty in its prediction and the other transitioned when the active event model produced a large prediction error. The two variants learned to segment and categorize events, and the prediction uncertainty variant provided a somewhat closer match to human segmentation and categorization—despite being given no feedback about segmentation or categorization. These results suggest that event model transitioning based on prediction uncertainty or prediction error can reproduce two important features of human event comprehension.
BOWIE-ALIGN: A JWST comparative survey of aligned versus misaligned hot Jupiters to test the dependence of atmospheric composition on migration history
Authors: Kirk James , Ahrer Eva-Maria , Penzlin Anna B T , Owen James E , Booth Richard A , Alderson Lili , Christie Duncan A , Claringbold Alastair B , Esparza-Borges Emma , Fisher Chloe E , López-Morales Mercedes , Mayne N J , McCormack Mason , Meech Annabella , Panwar Vatsal , Powell Diana , Sergeev Denis E , Taylor Jake , Tsai Shang-Min , Valentine Daniel , Wakeford Hannah R , Wheatley Peter J , Zamyatina Maria 
Published: October 2024

ABSTRACT
A primary objective of exoplanet atmosphere characterization is to learn about planet formation and evolution, however, this is challenged by degeneracies. To determine whether differences in atmospheric composition can be reliably traced to differences in evolution, we are undertaking a transmission spectroscopy survey with JWST to compare the compositions of a sample of hot Jupiters that have different orbital alignments around F stars above the Kraft break. Under the assumption that aligned planets migrate through the inner disc, while misaligned planets migrate after disc dispersal, the act of migrating through the inner disc should cause a measurable difference in the C/O between aligned and misaligned planets. We expect the amplitude and sign of this difference to depend on the amount of planetesimal accretion and whether silicates accreted from the inner disc release their oxygen. Here, we identify all known exoplanets that are suitable for testing this hypothesis, describe our JWST survey, and use noise simulations and atmospheric retrievals to estimate our survey’s sensitivity. With the selected sample of four aligned and four misaligned hot Jupiters, we will be sensitive to the predicted differences in C/O between aligned and misaligned hot Jupiters for a wide range of model scenarios.
Moving the Goalposts? Mutual Fund Benchmark Changes and Relative Performance Manipulation
Authors: Mullally Kevin , Rossi Andrea 
Published: October 2024

Abstract
We analyze changes to mutual funds’ self-declared benchmarks using hand-collected data from funds’ prospectuses. Under existing rules, funds can freely change their benchmark indexes and, implicitly, the historical returns to which they compare their past performance. Funds exploit this loophole by adding (dropping) indexes with lower (higher) past returns, thereby materially improving the appearance of their benchmark-adjusted returns. High-fee funds, broker-sold funds, and funds experiencing poor performance and outflows are more likely to engage in this behavior. These funds subsequently attract additional flows despite continuing to underperform their peers.
Changes in Diaphragm Intrusion and Thoracic Dimensions After Posterior Spinal Fusion in Patients With Neuromuscular Scoliosis
Authors: Benes Gregory , Gabos Peter G. , Redding Gregory J. , Hunsberger Joann , Cahill Patrick ,   Harms Study Group, Sponseller Paul D. 
Published: October 2024

Background:
Cerebral palsy (CP) can cause scoliosis with large thoracolumbar or lumbar curves. Such curves may impair pulmonary function by causing the abdomen and diaphragm to encroach on the thorax. Our purpose was to investigate changes in diaphragm position and other thoracic radiographic measurements at 2 years after posterior spinal fusion (PSF).

Methods:
Retrospective review of data from 56 pediatric patients (Gross Motor Function Classification System >3) who underwent PSF for CP–related (neuromuscular) scoliosis at one US academic hospital from 2010 to 2018. In this study, we used radiographs taken preoperatively and 2 years after PSF to measure lung volume, diaphragm intrusion index (DII), diaphragm vertebral level (DVL), space available for the lung (SAL), and T1-S1 height.

Results:
Lung volume had increased by a mean 902 cm3 (range, –735 to 2697 cm3) at 2-year follow-up. DII improved from a mean (and SD) of 61%±12% to 71%±11% on the left side and 58%±14% to 68%±11% on the right (P<0.001). DVL increased caudally by a mean 1.2 vertebral levels bilaterally, with a mean postoperative position between T8 and T9. Lung space became more symmetrical as the SAL increased from 0.76 to 0.91 (P<0.001). T1-S1 height increased by a mean 7.5±4.3 cm.

Conclusions:
These findings suggest a new way to understand changes in thoracic volume and redistribution of thoracic and lumbar balance when correcting the collapsing spinal deformity in CP. A more caudal postoperative diaphragm position with less diaphragm intrusion into the thorax may reflect an improved length-tension configuration, which could in turn produce greater diaphragmatic strength and endurance.

Level of Evidence:
Level III
Development and Validation of a Machine Learning Model for Early Detection of Untreated Infection
Authors: Buell Kevin G. , Carey Kyle A. , Dussault Nicole , Parker William F. , Dumanian Jay , Bhavani Sivasubramanium V. , Gilbert Emily R. , Winslow Christopher J. , Shah Nirav S. , Afshar Majid , Edelson Dana P. , Churpek Matthew M. 
Published: October 2024

BACKGROUND:
Early diagnostic uncertainty for infection causes delays in antibiotic administration in infected patients and unnecessary antibiotic administration in noninfected patients.

OBJECTIVE:
To develop a machine learning model for the early detection of untreated infection (eDENTIFI), with the presence of infection determined by clinician chart review.

DERIVATION COHORT:
Three thousand three hundred fifty-seven adult patients hospitalized between 2006 and 2018 at two health systems in Illinois, United States.

VALIDATION COHORT:
We validated in 1632 patients in a third Illinois health system using area under the receiver operating characteristic curve (AUC).

PREDICTION MODEL:
Using a longitudinal discrete-time format, we trained a gradient boosted machine model to predict untreated infection in the next 6 hours using routinely available patient demographics, vital signs, and laboratory results.

RESULTS:
eDENTIFI had an AUC of 0.80 (95% CI, 0.79–0.81) in the validation cohort and outperformed the systemic inflammatory response syndrome criteria with an AUC of 0.64 (95% CI, 0.64–0.65; p < 0.001). The most important features were body mass index, age, temperature, and heart rate. Using a threshold with a 47.6% sensitivity, eDENTIFI detected infection a median 2.0 hours (interquartile range, 0.9–5.2 hr) before antimicrobial administration, with a negative predictive value of 93.6%. Antibiotic administration guided by eDENTIFI could have decreased unnecessary IV antibiotic administration in noninfected patients by 10.8% absolute or 46.4% relative percentage points compared with clinicians.

CONCLUSION:
eDENTIFI could both decrease the time to antimicrobial administration in infected patients and unnecessary antibiotic administration in noninfected patients. Further prospective validation is needed.
Serum levels of total bile acids are associated with an increased risk of HCC in patients with cirrhosis
Authors: El-Serag Hashem B. , Thrift Aaron P. , Duong Hao , Ning Jing , Khaderi Saira , Singal Amit G. , Asrani Sumeet K. , Marrero Jorge A. , Powell Hannah , Rizwan Kinza , Najjar Omar , Amos Christopher I. , Luster Michelle , Al-Sarraj Abeer , Salem Emad , Scheurer Michael E. , Chhatwal Jagpreet , Kaochar Salma , Kanwal Fasiha 
Published: October 2024

Background:
Previous studies have reported higher circulating bile acid levels in patients with HCC compared to healthy controls. However, the association between prediagnostic bile acid levels and HCC risk among patients with cirrhosis is unclear.

Methods:
We measured total BA (TBA) concentration in serum samples collected from a prospective cohort of patients with cirrhosis who were followed until the development of HCC, death, or last study date. Competing risk proportional hazard–adjusted models were used to estimate the association between tertiles of serum TBA levels and the risk of developing HCC. We quantified the incremental predictive value of serum bile acid when added to a previously validated clinical model.

Results:
We analyzed data from 940 patients with cirrhosis, of whom 68 patients progressed to HCC during 3406 person-years of follow-up. Higher baseline serum TBA level was significantly associated with an increased risk of developing HCC with an adjusted HR of 3.69 (95% CI = 1.85–7.37) for the highest versus lowest tertile. TBA levels significantly increased predictive ability for progression to HCC at 2 years of follow-up; the c statistic increased from 0.74 to 0.80 (p < 0.001). There was evidence for a significant interaction between TBA level and hepatitis C (p = 0.04).

Conclusions:
In a large prospective cohort study, the prediagnostic serum level of TBAs was associated with a significant increase in the risk of developing HCC among patients with multi-etiology cirrhosis. The TBA-associated risk was additive to that of established demographic and clinical predictors.
Evaluation of balloon sinuplasty for the treatment of pediatric chronic rhinosinusitis
Authors: Fadel Mark A. , Ramaswamy Uma S. 
Published: October 2024

Purpose of review
This year marks 10 years from the publication of the clinical consensus statement on pediatric chronic rhinosinusitis (CRS). Balloon sinuplasty did not meet criteria for consensus at that time because there was insufficient evidence on its efficacy and safety. The purpose of this review is to summarize the current evidence on balloon sinuplasty treatment for pediatric CRS.

Recent findings
Balloon sinuplasty is not a cost-effective measure compared to adenoidectomy and endoscopic sinus surgery (ESS). In the pediatric population, benefits include short operative time, reduced tissue manipulation, and potential for decreased antibiotic courses. Alternatively, balloon dilation has increased equipment costs and there is a lack of robust prospective data that fully elucidates balloon sinuplasty's role in the management of pediatric CRS.

Summary
Pediatric otolaryngologists should continue to perform first-line adenoidectomy and consider ESS based on imaging and other validated clinical scoring systems. Balloon sinuplasty has not yet been proven as an effective treatment for pediatric CRS and further large-scale investigations are required to overcome its lack of cost-effectiveness.
Exploring Reasons for Satisfaction with Job Assignments Among Travel Nurses
Authors: Owens Sharon , West Barbara , Watson Heather 
Published: October 2024

OBJECTIVE
The aim of this study was to explore factors related to a travel nurse completing or extending an assignment or leaving before the end of an assignment.

BACKGROUND
Hospitals use various options for staffing shortages. One option is to contract with travel nurses. The recent increase in travel nurse utilization, coupled with the need to retain permanent staff and see a return on investment, requires an understanding of factors driving travel nurse decision-making.

METHODS
This qualitative research used semistructured interviews and a survey with prepandemic-postpandemic participants that comprised travel nurses from 2 urban academic centers.

RESULTS
Three themes emerged from the interview data: flexibility, support, and conditions.

CONCLUSIONS
Travel nurses report they will stay in an assignment if they feel supported and have flexibility and if the location is desirable. Matching institutional needs with travel nurse experience and assignment expectations can create a mutually beneficial experience for the institution, agency, and the travel nurse.
Improving Access to Hygiene, Sanitation, and Drinking Water in King County and Beyond: Success Factors and Costs
Authors: Holme Francesca , Kellogg Ryan , Andu Semone , Wasse Jessica Knaster , Seinfeld Keith , Gelb Richard 
Published: October 2024

Context
Most major urban areas in the US, including Seattle and King County, have a long-standing lack of public restrooms, handwashing stations, and drinking water, presenting public health risks.

Objective
To aid decision-makers in expanding access, we review available information regarding successful hygiene programs in urban settings to identify shared characteristics and costs.

Design
We reviewed 10 journal articles, 49 news articles, and 54 pieces of gray literature including reports, white papers, and online resources describing real-world hygiene, sanitation, and drinking water programs in US and global urban settings. We selected programs in 8 cities and applied a thematic analysis to identify shared success factors. We also summarized costs where available.

Settings
Calgary (Canada), Denver (Colorado), London (United Kingdom), Los Angeles (California), Portland (Oregon), San Francisco (California), Seattle (Washington), and Vancouver (Canada).

Results
Successful programs usually provide frequent cleaning and maintenance, are designed and operated to discourage crime and misuse, leverage existing infrastructure, and include mobile solutions. Cities can expect an initial cost of at least $133 000 per toilet and annual operating costs of at least $100 000 per toilet.

Conclusions
By employing proven solutions and bringing them to scale over time, cities can promote health while improving quality of life and facilitating movement through public spaces for all. Costs should be understood in the context of expenses such as sidewalk cleaning and human waste removal that are necessitated by a lack of restrooms.
Vesicle-based formulations for pain treatment: a narrative review
Authors: Martinez Juan , Ingram Nicola , Kapur Nikil , Jayne David G. , Beales Paul A. 
Published: October 2024

Abstract
Pain, a complex and debilitating condition, necessitates innovative therapeutic strategies to alleviate suffering and enhance patients' quality of life. Vesicular systems hold the potential to enhance precision of drug localisation and release, prolong the duration of therapeutic action and mitigate adverse events associated with long-term pharmacotherapy. This review critically assesses the current state-of-the-art in vesicle-based formulations (liposomes, polymersomes, ethosomes, and niosomes) for pain management applications. We highlight formulation engineering strategies used to optimise drug pharmacokinetics, present preclinical findings of experimental delivery systems, and discuss the clinical evidence for the benefits of clinically approved formulations. We present the challenges and outlook for future improvements in long-acting anaesthetic and analgesic formulation development.
Failure Mode Effects Analysis of Re-triage of Injured Patients to Receiving High-level Illinois Trauma Centers
Authors: Slocum John D. , Holl Jane L. , Brigode William M. , Voights Mary Beth , Anstadt Michael J. , Henry Marion C. , Mis Justin , Fantus Richard J. , Plackett Timothy P. , Markul Eddie J. , Chang Grace H. , Shapiro Michael B. , Siparsky Nicole , Stey Anne M. 
Published: October 2024

Objective:
This study identified failures in emergency inter-hospital transfer, or re-triage, at high-level trauma centers receiving severely injured patients.

Background:
The re-triage process averages 4 hours despite the fact timely re-triage within 2 hours mitigates injury-associated mortality. Non-trauma and low-level trauma centers reported that the most critical failures were in finding an accepting high-level trauma center. Critical failures at high-level trauma centers have not been assessed.

Methods:
This was an observational cross-sectional study at 9 high-level adult trauma centers and 3 high-level pediatric trauma centers. Failure modes effects analysis of the re-triage process was conducted in 4 phases. Phase 1 purposively sampled trauma coordinators, followed by snowball sampling of clinicians, operations, and leadership to ensure representative participation. Phase 2 mapped each re-triage step. Phase 3 identified failures at each step. Phase 4 scored each failure on impact, frequency, and safeguards for detection. Standardized rubrics were used in phase 4 to rate each failure’s impact (I), frequency (F), and safeguard for detection (S) to calculate their risk priority number (RPN; IxFxS). Failures were rank-ordered for criticality based on their RPN.

Results:
A total of 64 trauma coordinators, surgeons, emergency medicine physicians, nurses, operations, and quality managers across 12 high-level trauma centers participated. There were 178 failures identified at adult and pediatric high-level trauma centers. The most critical failures were: (1) insufficiently trained transport staff (RPN = 648), (2) issues transmitting imaging from sending to receiving centers (RPN = 400), and (3) incomplete exchange of clinical information (RPN = 384).

Conclusions:
The most critical failures were limited transportation and incomplete exchange of clinical, radiologic, and arrival timing information. Further investigation of these failures includes several regions is needed to determine the reproducibility of these findings.
Symptom management for people with advanced dementia who are receiving end of life care
Authors: Drummond Maria , Johnston Bridget 
Published: October 2024

Purpose of review
This review aims to synthesise contemporary research on symptom management for people with advanced dementia who are thought to be in the final year of life. It highlights the unique challenges faced by palliative care and dementia care specialists, offering insights into the clinical decision-making required to support those with advanced dementia in various care settings.

Recent findings
Recent studies indicate that people with advanced dementia often experience significant unmet palliative care needs, particularly regarding symptom management. Pain, breathlessness, and psychological distress are frequently mismanaged, which contributes to suboptimal care. Moreover, the unpredictable trajectory of dementia complicates the identification of end-of-life needs, which can result in fragmented care. Caregivers, both professional and family, struggle with managing complex symptoms, while family caregivers in home settings face added burdens in providing care without sufficient support.

Summary
Palliative care for people with advanced dementia is currently inadequate due to a lack of tailored interventions, poor symptom management, and disjointed care systems. Enhancing training for caregivers, fostering interdisciplinary collaboration, and focusing on integrated care approaches across home and institutional settings are crucial to improving quality of life and symptom control for people with advanced dementia.
Early Complications in Kidney Donors and Course of Health-related Quality of Life 12 mo After Donation: An Analysis of the Swiss Organ Living-Donor Health Registry
Authors: Brügger Charlotte , Hunkeler Zoé , Diebold Matthias , Krättli Joana , Geiger Irene , Wehmeier Caroline , Wolff Thomas , Vogt Bruno , Storni Federico , Golshayan Dela , Zingg Tobias , de Seigneux Sophie , Haidar Fadi , Binet Isabelle , Schnyder Aurelia , Hübel Kerstin , Müller Thomas , Rössler Fabian , Steiger Jürg , Hirt-Minkowski Patricia 
Published: October 2024

Background.
Since 1998, the Swiss Organ Living-Donor Health Registry (SOL-DHR) has recorded peri- and postoperative complications of living kidney (LK) donors, as reported by all Swiss transplant centers and has collected follow-up data prospectively.

Methods.
We analyzed the early complications of 2379 consecutive individuals who donated a kidney between January 1998 and June 2022 and assessed their health-related quality of life (HRQoL) 1 y after donation.

Results.
In total, 447 early complications in 404/2379 LK donors (17.0%) were reported to the SOL-DHR. The frequency of donors with major complications (ie, Dindo-Clavien classification 3/4) was 2.4%. In total, 31 donors needed reoperation, and in 13/31 (42%), donors reoperation was necessary because of bleeding complications. Independent risk factors for major early complications were older donor age (P = 0.005) and type of surgical approach (ie, the laparoscopic retroperitoneal compared with laparoscopic transabdominal surgery; P = 0.01), but not sex. We observed a U-shaped association of body mass index, where very low/high body mass indexes had higher odds of major early complications, without reaching statistical significance. Although HRQoL was affected by kidney donation, 96.5% of donors indicated that they would donate their kidney again. The only independent risk factor for low HRQoL based on mental health scores was worsening EB after living kidney donation (P < 0.0001).

Conclusions.
Overall, living kidney donation is a safe procedure, however, donor age and type of surgical approach affect the risk of complications. A decline in emotional bonding with the recipient after donation may worsen the quality of life of the donor.