bluuebunny/crossref_metadata_2025_split huggingface dataset:
Internalized stigma and its correlates in families of persons with mental illness in Qatar: a cross-sectional study
Authors: Kehyayan Vahe , Omar Hanin , Ghuloum Suhaila , Marji Tamara , Al-Amin Hassen , Abed Alah Muna , Mahfoud Ziyad 
Published: September 2024

AbstractPersons with mental illness (PWMI) experience rejection, isolation, and discrimination in employment, education, and housing due to the prejudice associated with the illness. Families affiliated with PWMI often internalize the public’s prejudice towards mental illness. Such internalized stigma can further impact the health and quality of life of both PWMI and their families. This study aimed to examine the level and correlates of internalized stigma in family members of PWMI in Qatar. A cross-sectional study of 106 family members was conducted using the Family Internalized Stigma Mental Illness Scale. The mean stigma score was 2.04 suggesting a mild level of stigma overall. Being married was found to be a predictor of higher levels of internalized stigma, while having college education or higher predicted lower levels of stigma. The overall stigma scores among family members were not high, which may reflect the protective stance families take towards about their relatives with mental illness. Some sociodemographic attributes predicted trends in internalized stigma among our surveyed sample. Future research efforts in this area may help increase understanding of internalized stigma in this population to inform stigma reduction efforts.
Bleeding Jejunal Diverticula: Always a Timely Reminder
Authors: Rambarran Pranesh , Singh Juhi Priyam , Kinoo Suman Mewa , Singh Bhugwan 
Published: September 2024

AbstractBleeding jejunal diverticula is a rare cause of lower gastrointestinal bleeding. We describe a case of rectal bleeding secondary to jejunal diverticula disease and outline our experience of managing bleeding jejunal diverticula in current practice.
Digital Business as a Field for Research and Education
Authors: Hess Thomas , Riedl René , Becker Luc 
Published: September 2024

AbstractDigital technologies ignite new businesses and force existing companies to restructure their business models. Various independent academic research streams discuss the potential of digital technologies for business. However, these streams’ research findings are published across outlets in various communities, and an approach to bringing these streams together is missing. In this position paper, we propose to integrate these streams under the concept of Digital Business. We see Digital Innovations as the core of Digital Business and offer a framework for structuring the field. Using this framework, we describe the field’s development to date and provide three ideas for further integrating the field in the future. Altogether, a key aim of this paper is to create a conceptual basis that structures both research and education in the field Digital Business.
Heavy rainfalls in Poland and their hyetographs
Authors: Mikołajewski Karol , Stach Alfred , Ruman Marek , Kosek Klaudia , Kundzewicz Zbigniew W. , Licznar Paweł 
Published: September 2024

AbstractIn the light of observed variability in precipitation patterns, there is a growing need for comprehensive data mining of regularly updated rainfall recording databases. Therefore, an analysis of heavy rainfall and hyetographs was conducted using a 30-year high-resolution dataset from 100 rain gauges across Poland, covering 31 646 rainfall events. Distributions of rainfall depths, durations, and intensities were explored, and maxima were compared to global records. Spatial analysis revealed significant variations in the frequency, depths, and durations of extreme rainfall across different regions. Cluster analysis determined model hyetographs for each station. The likelihood of regions belonging to clusters with three to five model hyetographs was assessed using Indicator Kriging. Findings underscore the importance of using local, characteristics rainfalls in hydrodynamic modelling of drainage systems and future rainfall scenarios. These results provide a foundational step towards understanding and monitoring the impacts of climate change on rainfall characteristics, especially extremes, in future decades.
Assessing the Impact of Data-resolution On Ocean Frontal Characteristics
Authors: Yang Kai , Fischer Andrew M. 
Published: September 2024

AbstractEasy access to and advances in satellite remote sensing data has enabled enhanced analysis of ocean fronts, physical and ecologically important areas where water masses converge. Recent development of higher-resolution satellite imagery to detect ocean fronts provides the potential to better capture patterns and trends of ocean change and improve modelling and prediction efforts. This study examines the relationship between satellite data spatial resolution and its influence on the quantification of frontal characteristics, frontal quantity, length, strength and density. We also examine the relationship between Finite-Size Lyapunov Exponents and image resolution. We found higher spatial resolution leads to increased frontal quantity and decreased frontal length. Also, both strength and spatial density of fronts differ at various resolutions. The Finite-Size Lyapunov Exponent value does not change significantly with resolution. Knowledge of the impact of resolution on the quantification of frontal characteristics is crucial as it enables the exploration of novel experimental design to further facilitate the development of improved parameterization and uncertainties in ocean modelling/studies.
Can a Surgical Vulnerability Score Predict Outcomes of Hip Reconstruction in Children with Severe Neuromuscular Disability?
Authors: Bevan Alistair , Buchan Stephanie , Aarvold Alexander , Bennet Simon , Rad Darius , Le Prevost Nick , Edwards Caroline 
Published: September 2024

Abstract
Background
Hip surgery is often necessary for children with severe neuromuscular disabilities to avoid chronic pain resulting from hip migration. This study correlated the Surgical Vulnerability Score (SVS), a novel measure of physiological reserve, with reconstructive hip surgery outcomes to improve shared surgical decision-making.

Materials and methods
Sixty-eight cases performed by a single surgeon were retrospectively evaluated. Cases were graded according to physiological vulnerability using the SVS, which was then correlated with two outcomes: length of hospital stay (LOS) and severity of postoperative complications. The Gross Motor Function Classification System (GMFCS) level was used as a baseline comparison. Sub-analysis compared results for patients who underwent only a femoral varus derotation osteotomy (VDRO) (n = 48) with those who underwent a combined VDRO and Dega Pelvic Osteotomy (Dega PO) (n = 20).

Results
Results showed that a higher SVS was associated with increased LOS (p = 0.001) and severity of postoperative complications (p = 0.0008). A greater GMFCS level was not associated with either LOS (p = 0.246) or the severity of postoperative complications (p = 0.282). For patients who underwent only a VDRO, an increase in SVS had no association with LOS (p = 0.483) or severity of complications (p = 0.981). However, for patients who underwent both a VDRO and Dega PO, a higher SVS was associated with increased LOS (p = 0.0002) and severity of complications (p = 0.0001).

Conclusions
The SVS can aid surgical decision-making and prepare the child’s family for surgery. Early intervention and fixation using only a VDRO may lead to better outcomes, underscoring the importance of hip surveillance programs in the early identification of migrating hips.
Uncovering labeler bias in machine learning annotation tasks
Authors: Haliburton Luke , Leusmann Jan , Welsch Robin , Ghebremedhin Sinksar , Isaakidis Petros , Schmidt Albrecht , Mayer Sven 
Published: September 2024

AbstractAs artificial intelligence becomes increasingly pervasive, it is essential that we understand the implications of bias in machine learning. Many developers rely on crowd workers to generate and annotate datasets for machine learning applications. However, this step risks embedding training data with labeler bias, leading to biased decision-making in systems trained on these datasets. To characterize labeler bias, we created a face dataset and conducted two studies where labelers of different ethnicity and sex completed annotation tasks. In the first study, labelers annotated subjective characteristics of faces. In the second, they annotated images using bounding boxes. Our results demonstrate that labeler demographics significantly impact both subjective and accuracy-based annotations, indicating that collecting a diverse set of labelers may not be enough to solve the problem. We discuss the consequences of these findings for current machine learning practices to create fair and unbiased systems.
Cosymplectic Geometry, Reductions, and Energy-Momentum Methods with Applications
Authors: Lucas J. de , Maskalaniec A. , Zawora B. M. 
Published: September 2024

Abstract
Classical energy-momentum methods study the existence and stability properties of solutions of t-dependent Hamilton equations on symplectic manifolds whose evolution is given by their Hamiltonian Lie symmetries. The points of such solutions are called relative equilibrium points. This work devises a new cosymplectic energy-momentum method providing a new and more general framework to study t-dependent Hamilton equations. In fact, cosymplectic geometry allows for using more types of distinguished Lie symmetries (given by Hamiltonian, gradient, or evolution vector fields), relative equilibrium points, and reduction methods, than symplectic techniques. To make our work more self-contained and to fill some gaps in the literature, a review of the cosymplectic formalism and the cosymplectic Marsden–Weinstein reduction is included. Known and new types of relative equilibrium points are characterised and studied. Our methods remove technical conditions used in previous energy-momentum methods, like the

$$\textrm{Ad}^*$$

Ad
∗

-equivariance of momentum maps. Eigenfunctions of t-dependent Schrödinger equations are interpreted in terms of relative equilibrium points in cosymplectic manifolds. A new cosymplectic-to-symplectic reduction is developed and a new associated type of relative equilibrium points, the so-called gradient relative equilibrium points, are introduced and applied to study the Lagrange points and Hill spheres of a restricted circular three-body system by means of a not Hamiltonian Lie symmetry of the system.
Runway assignment optimisation model for Istanbul Airport considering multiple parallel runway operations
Authors: Güven A. , Aybek Cetek F. , Cecen R.K. 
Published: September 2024

AbstractThe aviation industry has rapidly developed in recent years. Due to the increased number of flight operations, managing air traffic has become essential. The air traffic management system aims to reduce the air traffic control workload and use existing resources more efficiently. This study proposed a new mixed integer linear programming model to minimise the total fuel consumption during taxi operations for the runway assignment problem, comparing the actual Istanbul Airport runway assignment data. The average taxi times are calculated using the 30,000-flight operations data for each arrival and departure taxi route. Also, 47 different aircraft types are obtained using the data for the fuel consumption calculation. The International Civil. Aviation Organisation (IACO) aircraft engine emissions databank provides the fuel consumption values for each aircraft according to engine type. This approach allows our model to calculate more realistic fuel consumption for taxi operations, as each aircraft engine type has a different fuel consumption value. The proposed model is implemented at Istanbul Airport, the busiest airport in Turkey, where multiple parallel runway operations are applied. The results showed that the proposed model reduced total fuel consumption for taxi operations between 6.6% and 14.4% compared to the actual Istanbul Airport runway assignment data.
Model compensation control of composite vertical take-off and landing UAV
Authors: Qi G.Y. , Zhang X.R. , Xu L. 
Published: September 2024

AbstractThe unmanned aerial vehicle (UAV) system for composite vertical take-off and landing (VTOL) is a complex, highly coupled, and nonlinear system which is sensitive to external disturbances and model uncertainties. The composite VTOL UAV system consists of a multi-rotor section and a fixed-wing section. To improve observation accuracy, the compensation function observer (CFO) uses a new structure that includes velocity information. The CFO is utilised to estimate the uncertainty and the external disturbances of the system model, which performs superior estimation accuracy compared to the extended state observer (ESO). In the modeling process of the VTOL UAV, the aerodynamic moment is calculated by means of the cross-product operation of force and force arm, which solves the problem of over-reliance on aerodynamic parameters in the traditional modeling approach. The controlled object is refined by CFO, and model compensation control (MCC) is used to realise the velocity and attitude control of the composite VTOL. The numerical simulation of MATLAB/Simulink and hardware-in-loop simulation (HIL) of Rflysim were implemented, and which were used to compare the MCC, active disturbance rejection control (ADRC), and proportion integration differentiation (PID). The simulation results confirm the superiority of MCC in controlling composite VTOL UAVs in terms of anti-disturbance and tracking speed.
A novel risk-adjusted metric to compare hospitals on their antibiotic-prescribing at hospital discharge
Authors: Livorsi Daniel , Merchant Jamie , Cho Hyunkeun , Goetz Matthew , Alexander Bruce , Beck Brice , Goto Michi 
Published: September 2024

Background: Approximately 40% of all antibiotics related to an acute-care hospital stay are prescribed at the time of hospital discharge. However, there is no metric to compare hospitals on their antibiotic-prescribing at this transition of care. In this study, we sought to build a risk-adjusted metric for comparing hospitals on their overall post-discharge antibiotic use. Methods: This was a retrospective study across all acute-care admissions within the Veterans Health Administration during 2018-2021. For patients discharged to home or self-care, data on antibiotics administered while inpatient and those prescribed at discharge were collected. To predict post-discharge antibiotic use (days of therapy, DOT), we built a zero-inflated negative binomial model with a random intercept for each VA medical center. Data were split into training and testing sets to measure model performance and absolute error. Covariates included patient demographics, medical specialty at discharge, comorbidities, discharge diagnoses of infection, and the length of inpatient antibiotic therapy. Outliers, defined as DOT ≥ 30, were excluded, and the predicted random intercept was used to determine hospital performance. To compare hospitals with a positive versus negative random intercept in our model (i.e. higher vs. lower than expected overall post-discharge use, respectively), we calculated mean total antibiotic duration (inpatient + post-discharge) for two uncomplicated infection types: community-acquired pneumonia (CAP) and skin and soft tissue infections (SSTI). Results: 1,804,400 patients were discharged to home or self-care across 130 hospitals. The mean age was 67.8 (SD 12.9), and 93.7% were male. Antibiotics were prescribed to 41.5% while hospitalized and 19.5% at discharge. The median number of post-discharge DOT among those prescribed post-discharge antibiotics was 7 (IQR 4-12). The predictive model detected post-discharge antibiotic use with fidelity, including accurate identification of any post-discharge antibiotic exposure (area under the precision-recall curve=0.97 ) and reliable prediction of the number of post-discharge DOT in those who were exposed (mean absolute error = 1.65; Figure 1). At negative versus positive random intercept hospitals (Figure 2), antibiotic duration for CAP and SSTIs was 7.3 versus 8.1 days (p < 0 .001) and 9.4 vs. 10.2 days (p < 0 .001), respectively. Conclusion: A model using electronically available data was able to accurately predict antibiotic use prescribed at hospital discharge. Hospitals with lower than expected overall post-discharge antibiotic use also prescribed shorter courses of antibiotic therapy for uncomplicated cases of CAP and SSTI, which may reflect more robust processes at these sites to reduce antibiotic overuse at discharge.Disclosure: Michi Goto: Contracted Research – Merck
FilmArray Meningitis/Encephalitis Panel Impact on Antibiotic Usage in Patients with Suspected Community-Acquired Meningitis
Authors: Pathak Aaron , Pham Caitlynn , Shay Sabra , Lasco Todd , Al Mohajer Mayar 
Published: September 2024

Background: Cerebrospinal fluid (CSF) cultures are commonly performed to evaluate patients with suspected bacterial meningitis. These cultures, however, can take up to 72 hours, leading to delays in antibiotic de-escalation and increased antimicrobial utilization. The turnaround for the BioFire® FilmArray® Meningitis/Encephalitis(FA/ME) panel is less than an hour, which may facilitate early de-escalation. Our study aimed to assess whether the use of FA/ME panels in combination with CSF cultures could impact antimicrobial therapy compared to cultures alone in patients treated for suspected bacterial meningitis. Methods: Our retrospective study included patients from five hospitals in Texas (2017-2023) who received empiric antibiotics for suspected community-acquired meningitis and underwent a lumbar puncture within 96 hours of admission. Patients with ventricular drains, traumatic brain injury, and non-central nervous system infections were excluded. Cases comprised patients who had an FA/ME panel performed, while controls included patients without the panel. Outcomes were defined as the empiric duration of antimicrobial therapy (days) and total days of antibiotic therapy (DOT). Wilcoxon Rank Sum test and multiple linear regression models were applied to assess the relationship between the use of the FA/ME panel and study outcomes. Independent variables comprised demographics, institution type, acuity, clinical presentation, CSF values, and FA/ME panel use. Imputation was performed using multiple imputation by chained equations. Results: A total of 193 patients were included in our study. Seventy-one patients received the FA/ME panel (along with the CSF culture), while 122 patients received the CSF culture alone (controls). The median empiric duration of antibiotic therapy in the cases and controls were 1.71 days and 1.18 days, respectively (p = .160). The median DOT in the cases and controls were eight days and six days, respectively (p = .045). After adjusting for confounders, the FA/ME panel was not significantly associated with changes in the empiric duration of antibiotic therapy (B= 0.18, p = .669, Figure 1) or DOT (B= 1.28, p = .170, Figure 2).Conclusion: Providing FA/ME panel testing without active antimicrobial stewardship interventions did not result in a change in antimicrobial prescribing patterns. The difference from prior literature could be explained by the smaller sample size, limiting the power of the study. Further prospective antimicrobial stewardship efforts should focus on training providers on interpreting FA/ME panel results and providing prospective audits and feedback.
Breaking the Reflex: Impact in Hospital-Acquired Infection Incidence for Clostridioides difficile Infection
Authors: Sharma Mamta , Cosimi Reese , Stewart Alysia , Nicole Nomides , Sturm Lisa , Hart William , Johnson Leonard 
Published: September 2024

Background: Nucleic acid amplification tests (NAAT) do not distinguish between colonization and Clostridioides difficile (C.diff) associated diarrhea. On April 5th 2023 our laboratory introduced a new C. diff testing methodology. Previously, if a C. diff screen result was negative for toxin and positive for glutamate dehydrogenase (GDH), a second confirmatory test was conducted with NAAT. This confirmatory test was removed from our testing algorithm. NAAT testing may be ordered ad hoc when clinically relevant diarrhea persists, and alternative etiologies have been excluded. We wanted to evaluate the impact of change with testing methods. Method: Retrospective review of all inpatient hospital-acquired C.diff infections reported to NHSN database from Ascension Michigan Market which comprises 14 acute care hospitals from June 2019 to August 2023. Data for C diff was analyzed every quarter. The risk adjustments used to calculate the Standardized Infection Ratios (SIRs) for C. diff infections was set at 0.48 based on CDC mean SIR established for acute care hospitals in 2022. Results: A total of 14 acute care hospitals were included from which 866 C.diff cases were reported during this period. Overall, the SIR dropped from 0.59 from June-August 2019 to 0.32 reported from March-May 2023; 45.7 % decrease. The maximum reduction in SIR was seen post intervention at 0.21 from June-August 2023 which was 78.3% below the benchmark of 0.48. (Figure) Conclusions: Strategies to optimize current laboratory tests are critical to differentiate C. diff infection from colonization. The current strategy by changing the testing method led to substantial reduction in C-diff. Diagnostic stewardship studies should ideally include outcome measures targeted to post-intervention patients to determine clinical relevance and patient safety. Optimizing test utilization remains a critical component of quality healthcare delivery. Future NHSN updated surveillance definition will require incorporating clinical decision-making into the metric; that is including a combination of any positive C-diff test plus initiation of antibiotic therapy for C-diff.Disclosure: Reese Cosimi: Advisory Board - Abbvie
Impact of Streptococcus pneumoniae Urinary Antigen Testing in a Large Academic Medical Center
Authors: Burton Jensie , Hornback Krutika , Burgoon Rachel , Albakheet Ahmed M 
Published: September 2024

Background: The Streptococcal pneumoniae urine antigen (SPUA) test was developed to increase microbiologic diagnosis of pneumonia. Concerns have been raised about the test’s low sensitivity and failure to alter outcomes by de-escalating antibiotics (PMID:31956656). However, the cost-effectiveness and real-world clinical utility of the test remain unclear. Methods: From June 1, 2022 - May 31, 2023, all patients with a SPUA test in the MUSC Health System were identified via Epic SlicerDicer. Those with a positive test underwent chart review. Antibiotics were classified as a “broad” or “targeted” regimen for S. pneumoniae. Targeted regimens included penicillins without beta-lactamase inhibitors, 1st-3rd generation cephalosporins, doxycycline, levofloxacin or moxifloxacin (with or without azithromycin), as well as azithromycin monotherapy. Broad regimens included 4th generation or higher cephalosporins, carbapenems, penicillins with beta-lactamase inhibitors, and vancomycin. Results: In one year, 1,518 patients had a SPUA test ordered. 62 (4%) patients had a positive test. Of those 62 patients, 14 patients were discharged before the test resulted (Table). The average turnaround time for the test was 2.2 days. When comparing antibiotic therapy on the day before the SPUA test resulted to two days after the test resulted, only 7 additional patients were switched to a targeted regimen (Figure). Conclusion: Of 1,518 SPUA tests ordered in a year, most (1,456 or 96%) were negative, with minimal changes to antibiotic therapy based on positive Results: These results are similar to other real-world studies, which showed a positive test prevalence between 4-8% (PMID:30265290) with 15-30% of patients changed to targeted antibiotics following a positive result (PMID:23111919, PMID: 28053969). The SPUA test cost approximately $44,022 (based on $29 test price) but has limited utility in a real-world setting.Disclosure: Krutika Hornback: Speaker’s Bureau - Cepheid Diagnostics