bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using Antibiograms to Improve Antibiotic Prescribing in Skilled Nursing Facilities
Authors: Furuno Jon P. , Comer Angela C. , Johnson J. Kristie , Rosenberg Joseph H. , Moore Susan L. , MacKenzie Thomas D. , Hall Kendall K. , Hirshon Jon Mark 
Published: October 2014

Background.Antibiograms have effectively improved antibiotic prescribing in acute-care settings; however, their effectiveness in skilled nursing facilities (SNFs) is currently unknown.Objective.To develop SNF-specific antibiograms and identify opportunities to improve antibiotic prescribing.Design and Setting.Cross-sectional and pretest-posttest study among residents of 3 Maryland SNFs.Methods.Antibiograms were created using clinical culture data from a 6-month period in each SNF. We also used admission clinical culture data from the acute care facility primarily associated with each SNF for transferred residents. We manually collected all data from medical charts, and antibiograms were created using WHONET software. We then used a pretest-posttest study to evaluate the effectiveness of an antibiogram on changing antibiotic prescribing practices in a single SNF. Appropriate empirical antibiotic therapy was defined as an empirical antibiotic choice that sufficiently covered the infecting organism, considering antibiotic susceptibilities.Results.We reviewed 839 patient charts from SNF and acute care facilities. During the initial assessment period, 85% of initial antibiotic use in the SNFs was empirical, and thus only 15% of initial antibiotics were based on culture results. Fluoroquinolones were the most frequently used empirical antibiotics, accounting for 54.5% of initial prescribing instances. Among patients with available culture data, only 35% of empirical antibiotic prescribing was determined to be appropriate. In the single SNF in which we evaluated antibiogram effectiveness, prevalence of appropriate antibiotic prescribing increased from 32% to 45% after antibiogram implementation; however, this was not statistically significant (P = .32).Conclusions.Implementation of antibiograms may be effective in improving empirical antibiotic prescribing in SNFs.
Does Chlorhexidine Bathing in Adult Intensive Care Units Reduce Blood Culture Contamination? A Pragmatic Cluster-Randomized Trial
Authors: Septimus Edward J. , Hayden Mary K. , Kleinman Ken , Avery Taliser R. , Moody Julia , Weinstein Robert A. , Hickok Jason , Lankiewicz Julie , Gombosev Adrijana , Haffenreffer Katherine , Kaganov Rebecca E. , Jernigan John A. , Perlin Jonathan B. , Piatt Richard , Huang Susan S. 
Published: October 2014

Objective.To determine rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization.Design.Pragmatic cluster-randomized trial.Setting.Forty-three hospitals with 74 ICUs; 42 of 43 were community hospitals.Patients.Patients admitted to adult ICUs from July 1, 2009, to September 30, 2011.Methods.After a 6-month baseline period, hospitals were randomly assigned to 1 of 3 strategies, with all participating adult ICUs in a given hospital assigned to the same strategy. Arm 1 implemented methicillin-resistantStaphylococcus aureus(MRSA) nares screening and isolation, arm 2 targeted decolonization (screening, isolation, and decolonization of MRSA carriers), and arm 3 conducted no screening but universal decolonization of all patients with mupirocin and chlorhexidine (CHG) bathing. Blood culture contamination rates in the intervention period were compared to the baseline period across all 3 arms.Results.During the 6-month baseline period, 7,926 blood cultures were collected from 3,399 unique patients: 1,099 sets in arm 1, 928 in arm 2, and 1,372 in arm 3. During the 18-month intervention period, 22,761 blood cultures were collected from 9,878 unique patients: 3,055 sets in arm 1, 3,213 in arm 2, and 3,610 in arm 3. Among all individual draws, for arms 1,2, and 3, the contamination rates were 4.1%, 3.9%, and 3.8% for the baseline period and 3.3%, 3.2%, and 2.4% for the intervention period, respectively. When we evaluated sets of blood cultures rather than individual draws, the contamination rate in arm 1 (screening and isolation) was 9.8% (N= 108 sets) in the baseline period and 7.5% (N= 228) in the intervention period. For arm 2 (targeted decolonization), the baseline rate was 8.4% (N= 78) compared to 7.5% (N= 241) in the intervention period. Arm 3 (universal decolonization) had the greatest decrease in contamination rate, with a decrease from 8.7% (N= 119) contaminated blood cultures during the baseline period to 5.1% (N= 184) during the intervention period. Logistic regression models demonstrated a significant difference across the arms when comparing the reduction in contamination between baseline and intervention periods in both unadjusted (P= .02) and adjusted (P= .02) analyses. Arm 3 resulted in the greatest reduction in blood culture contamination rates, with an unadjusted odds ratio (OR) of 0.56 (95% confidence interval [CI], 0.044-0.71) and an adjusted OR of 0.55 (95% CI, 0.43-0.71).Conclusion.In this large cluster-randomized trial, we demonstrated that universal decolonization with CHG bathing resulted in a significant reduction in blood culture contamination.
Foster Care
Authors: Everett Joyce E. 
Published: October 2014

Social work has long been involved in child foster care. Though its initial involvement de-emphasized the importance of infant–caregiver attachment, Bowlby’s theory of attachment is particularly relevant for child-welfare practice. This entry chronicles the history of child foster care and describes the evolution of legislation most pertinent for the provision of foster care. The characteristics of children in foster care since 2000 and the dynamic flow of children entering and exiting care are described. A brief account of foster care services and future trends in the field are highlighted.
Neurophysiological Correlates of Sevoflurane-induced Unconsciousness
Authors: Blain-Moraes Stefanie , Tarnal Vijay , Vanini Giancarlo , Alexander Amir , Rosen Derek , Shortal Brenna , Janke Ellen , Mashour George A. 
Published: October 2014

AbstractAbstract
In human volunteers, sevoflurane-induced unconsciousness was not consistently correlated with anteriorization of alpha rhythms or frontal cross-frequency coupling patterns, but rather disrupted phase relationships between frontal and posterior brain structures. Since other agents induce disrupted phase relationships, network fragmentation may be a common correlate or cause of anesthetic-induced unconsciousness.
Supplemental Digital Content is available in the text.

Background:
Recent studies of anesthetic-induced unconsciousness in humans have focused predominantly on the intravenous drug propofol and have identified anterior dominance of alpha rhythms and frontal phase–amplitude coupling patterns as neurophysiological markers. However, it is unclear whether the correlates of propofol-induced unconsciousness are generalizable to inhaled anesthetics, which have distinct molecular targets and which are used more commonly in clinical practice.

Methods:
The authors recorded 64-channel electroencephalograms in healthy human participants during consciousness, sevoflurane-induced unconsciousness, and recovery (n = 10; n = 7 suitable for analysis). Spectrograms and scalp distributions of low-frequency (1 Hz) and alpha (10 Hz) power were analyzed, and phase–amplitude modulation between these two frequencies was calculated in frontal and parietal regions. Phase lag index was used to assess phase relationships across the cortex.

Results:
At concentrations sufficient for unconsciousness, sevoflurane did not result in a consistent anteriorization of alpha power; the relationship between low-frequency phase and alpha amplitude in the frontal cortex did not undergo characteristic transitions. By contrast, there was significant cross-frequency coupling in the parietal region during consciousness that was not observed after loss of consciousness. Furthermore, a reversible disruption of anterior–posterior phase relationships in the alpha bandwidth was identified as a correlate of sevoflurane-induced unconsciousness.

Conclusion:
In humans, sevoflurane-induced unconsciousness is not correlated with anteriorization of alpha and related cross-frequency patterns, but rather by a disruption of phase–amplitude coupling in the parietal region and phase–phase relationships across the cortex.
Nutritional composition of takeaway food in the UK
Authors: Jaworowska Agnieszka , M. Blackham Toni , Long Rachel , Taylor Catherine , Ashton Matthew , Stevenson Leonard , Glynn Davies Ian 
Published: October 2014

Purpose
– This paper aims to determine the nutritional profile of popular takeaway meals in the UK. Fast food has a poor nutritional profile; research has focused on the major catering chains, with limited data on takeaway food from independent establishments.

Design/methodology/approach
– Random samples of takeaway meals were purchased from small, independent takeaway establishments. Multiple samples of 27 different takeaway meals, from Indian, Chinese, kebab, pizza and English-style establishments (n = 489), were analysed for portion size, energy, protein, carbohydrate, total fat, salt and total sugars.

Findings
– Takeaway meals were inconsistent with UK dietary recommendations; pizzas revealed the highest energy content, and Chinese meals were lowest in total fat. However, there was a high degree of variability between and within categories, but the majority of meals were excessive for portion size, energy, macronutrients and salt.

Research limitations/implications
– The present study focused on energy, macronutrients, salt and total sugars. Future research should analyse the quality of fat and carbohydrates and micronutrients to provide a more detailed nutritional profile of takeaway food.

Practical implications
– The nutritional variability between establishments suggests that recipe reformulation should be explored in an attempt to improve the nutritional quality of takeaway foods. In addition, portion size reduction could favour both the consumer and the industry.

Social implications
– Takeaway outlets do not provide nutritional information; due to the excessive nutritional profiles, regular intake may increase the risk of non-communicable disease. Therefore, there is a pressing need for this provision to help consumers make conscious food choices.

Originality/value
– This is the first study to analyse energy and macronutrient content of independent takeaway meals in the UK.
Learning from interacting: language, economics and the entrepreneur
Authors: K. O’Rourke Brendan 
Published: October 2014

Purpose– The purpose of this article is to provide a method of gaining transdisciplinary insight by focusing on keywords in the language we use. The language of economics dominates discourse about the economy. Analyzing this discourse from a great variety of perspectives has blossomed but promises much more. The study of the keyword “entrepreneur” illustrates the strengths and weaknesses of this diversity of perspectives, and also points to some possible opportunities for enhancing the quality of their interaction.Design/methodology/approach– A broad discourse analytic approach is drawn upon to understand the role the language of mainstream economics plays in our discussions of the economy, to trace the keyword “entrepreneur” as it has been and is used in economics and more general conversations about the economy and to use a keyword approach to create a transdisciplinary understanding of the way the economy is discussed.Findings– Economics in the sense of the mainstream approach that adopts the rational narrowly self-interested, calculating and decontextualized individual as its default assumption is a very particular language that has detrimentally dominated discussions of the economy. “Entrepreneur” is a keyword, the use of which in economics has both strengthened and put constraints on the way it can be deployed in talking about the economy. Focusing on keywords in the language, we use can provide a method of gaining transdisciplinary insight.Research limitations/implications– A short article with such a broad sweep such as this no doubts illustrates the limits imposed by attempts at transdisciplinary communication, but a potential gain from any such interaction is that we might grow to have more informed and genuinely dialogic interactions about the economy. As another way to attempt communication across diverse positions, looking at keywords in the discourse about the economy seems profitable.Social implications– Discourses of economics and the entrepreneur play a huge role in how people construct their roles and representations in the economy. Producing critical and creative understandings of these discourses that allow social actors to benefit from the diversity of completed and potential research work seems imperative in a world facing our current economic and social problems.Originality/value– Discourse analysis of the economy, the entrepreneur and economics has produced many insights but these insights have remained stranded in intellectual niches. As studies of language and the economy continue to blossom this article stresses the need, and points to some opportunities, for more fruitful interaction, by adopting a keyword approach.
Dyeing properties of PSA/MPIA blended yarn
Authors: Cui Shuling , Dou Chunxiao 
Published: October 2014

Purpose
– The purpose of this paper was to study the dyeing properties of polysulphonamide (PSA)/aramid 1313 (MPIA) blended yarn by selecting suitable dyes and carriers required in the dyeing process.

Design/methodology/approach
– Dyeing the blended yarn with cationic dyes, acid dyes, disperse dyes, reactive dyes and pigment, and comparing the shades, K/S values and fastness of the blended yarns.

Findings
– The PSA/MPIA blended fibre is suitable for dyeing with the cationic dye at high temperature and pressure in the presence of carrier acetophenone, and good homochromatism is seen on the two fibres when using same type of dye.

Originality/value
– PSA fibre is a thermo-resistant and flame-retardant product made in China in recent years. Blended with aramid 1313 fibre, it may acquire good spinnability. But there is little technical report about properties of the blended yarn in the literature at present. This paper reports the dyeing property of such fibres for the first time.
Is tropical montane forest heterogeneity promoted by a resource‐driven feedback cycle? Evidence from nutrient relations, herbivory and litter decomposition along a topographical gradient
Authors: Werner Florian A. , Homeier Jürgen 
Published: October 2014

SummaryRidges of tropical mountains often differ strikingly from neighbouring ravines in terms of forest structure, productivity and species composition. This heterogeneity is poorly understood despite its critical role in biodiversity maintenance, carbon and nutrient budgets.We examined measures of tree biomass and productivity, foliage and litter quality (nutrient concentrations, specific leaf mass, phenolics), herbivory and leaf litter decomposition in each six plots laid out in upper and lower slope position in a tropical montane moist forest in southeastern Ecuador.Productivity, quality of foliage and litter as well as herbivory were significantly lower in upper slope position, and closely correlated with soil nutrient concentrations and accumulated humus. The decomposition of upper slope leaf litter (decomposition ratek) was substantially lower than in litter from lower slope forest, whereas the site of decomposition (slope position) only had a marginal effect on the decomposition rate.Our results suggest that the differences in stand structure, productivity, foliar quality, herbivory and decomposition between slope positions are ultimately due to stronger nutrient limitations in upper slope forest. We propose a general conceptual model that explains origin and maintenance of contrasting forest types along topographical gradients through down‐slope fluxes of nutrients and water, and a nutrient‐driven positive feedback cycle.
Effect of Electronic Monitoring on Social Welfare Dependence
Authors: Andersen Lars H. , Andersen Signe H. 
Published: October 2014

Research SummaryWe studied the effect on social welfare dependence of serving a sentence under electronic monitoring rather than in prison using Danish registry data and two policy shifts that extended the use of electronic monitoring in Denmark. We found that electronic monitoring is less harmful than imprisonment, at least for younger offenders, whereas it does not leave older offenders worse off than imprisonment.Policy ImplicationsAs the United States moves toward noncustodial alternatives to imprisonment, policy makers might benefit from knowledge on experiences from other contexts. The experiences from Denmark are clear: Electronic monitoring is less harmful than imprisonment to the life‐course outcomes of offenders. Because electronic monitoring could be less costly for the corrections administrations than imprisonment, efforts to extend the use of electronic monitoring in the United States could be accelerated.
Increased frequency of class I and II anti‐human leukocyte antigen antibodies in systemic lupus erythematosus and scleroderma and associated factors: a comparative study
Authors: Tozkir Hilmi , Pamuk Omer Nuri , Duymaz Julide , Gurkan Hakan , Yazar Metin , Sari Gulce , Tanrikulu Hazel , Pamuk Gulsum Emel 
Published: October 2014

AbstractAimThere is significant autoantibody production in systemic lupus erythematosus (SLE) and scleroderma (SSc); microchimerism is also thought to play a role in pathogenesis. We determined the frequency of anti‐HLA antibodies in SLE and SSc patients and evaluated associated clinical factors.MethodsWe included 77 SLE patients, 46 SSc patients and 53 healthy controls into the study. Clinical data about the patients were obtained from hospital records. Anti‐human leukocyte (anti‐HLA) antigen antibody analysis of sera was performed by applying Lifecodes anti‐HLA Class I and Class II Screening kits based on xMAP technology.ResultsThe frequencies of class I and II anti‐HLA antibodies were significantly higher in SLE (27.3% and 41.6%) and SSc (26.1% and 41.3%) groups than in healthy controls (1.9% and 5.7%) (all P < 0.001). Frequencies of thrombocytopenia (P = 0.021), anti‐ribonucleoprotein (P = 0.037) and anti‐Ro (P = 0.027) were significantly higher in the class I antibody‐positive SLE group; however, pericarditis was less frequent (P = 0.05). On the other hand, the class II antibody‐positive SLE group had more frequent anti‐ribosomal P antibody (P = 0.038), but less frequent active disease (P = 0.038). In the SSc group, class I antibody‐positive patients had more frequent digital ulcers (P = 0.048) and anti‐centromere antibodies (P = 0.01). There was no association of anti‐HLA antibodies with pulmonary hypertension and interstitial fibrosis in SSc patients.ConclusionsBoth class I and class II antibodies were found to be significantly increased in SLE and SSc. Rather than major organ involvement, anti‐HLA antibodies were associated with the presence of other antibodies in both diseases.
Evaluation and prevention of enamel surface damage during dental restorative procedures
Authors: Milic T , George R , Walsh LJ 
Published: October 2014

AbstractBackgroundThis study examined the effect of operator experience, dominance, tooth position and access, on frequency and extent of iatrogenic damage to approximal tooth surfaces during conventional Class II cavity preparations. The effectiveness of protective devices in minimizing damage was also explored.Methods10 students and 10 experienced dentists each prepared 24 Class II cavity preparations in typodont teeth without protection; 10 utilizing stainless steel matrix bands and 10 utilizing protective wedges. The frequency and extent of damage were analysed with respect to the above variables. Subsequently, 20 natural and 20 typodont teeth were utilized to establish the relationship in depth of damage caused by a high‐speed diamond bur on typodont versus natural teeth.ResultsDentists caused iatrogenic damage on 74% of approximal surfaces without protection, which fell to 50% and 46% respectively when matrix bands and wedges were used as guards. The corresponding rates of damage for students were 94%, 80% and 44%. There was no difference in depth of damage caused on the two types of teeth when bur was in contact with teeth for a very short time.ConclusionsGreater operator experience and the use of guards reduces iatrogenic damage to proximal surfaces during preparation with high‐speed rotary instruments.
Testing goodness‐of‐fit for the proportional hazards model based on nested case–control data
Authors: Lu Wenbin , Liu Mengling , Chen Yi‐Hau 
Published: October 2014

SummaryNested case–control sampling is a popular design for large epidemiological cohort studies due to its cost effectiveness. A number of methods have been developed for the estimation of the proportional hazards model with nested case–control data; however, the evaluation of modeling assumption is less attended. In this article, we propose a class of goodness‐of‐fit test statistics for testing the proportional hazards assumption based on nested case–control data. The test statistics are constructed based on asymptotically mean‐zero processes derived from Samuelsen's maximum pseudo‐likelihood estimation method. In addition, we develop an innovative resampling scheme to approximate the asymptotic distribution of the test statistics while accounting for the dependent sampling scheme of nested case–control design. Numerical studies are conducted to evaluate the performance of our proposed approach, and an application to the Wilms' Tumor Study is given to illustrate the methodology.
Instrumental Variable Additive Hazards Models
Authors: Li Jialiang , Fine Jason , Brookhart Alan 
Published: October 2014

Summary
Instrumental variable (IV) methods are popular in non-experimental studies to estimate the causal effects of medical interventions. These approaches allow for the consistent estimation of treatment effects even if important confounding factors are unobserved. Despite the increasing use of these methods, there have been few extensions of IV methods to censored data problems. In this article, we discuss challenges in applying IV techniques to the proportional hazards model and demonstrate the utility of the additive hazards formulation for IV analyses with censored data. Assuming linear structural equation models for the hazard function, we develop a closed-form, two-stage estimator for the causal effect in the additive hazard model. The methods permit both continuous and discrete exposures, and enable the estimation of causal relative survival measures. The asymptotic properties of the estimators are derived and the resulting inferences are shown to perform well in simulation studies and in an application to a data set on the effectiveness of a novel chemotherapeutic agent for colon cancer.