bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automatic urine cultures from catheter-obtained samples—time to implement a practice change to improve value
Authors: Kestenbom Inbal , Cohen Neta , Test Gidon , Campigotto Aaron , Science Michelle , Ostrow Olivia 
Published: May 2024

Abstract

Objectives
Urine cultures are often automatically obtained after urinary catheterization in young children, even in the absence of pyuria, to test for urinary tract infections (UTIs). Although this practice conflicts with some newer guidelines, it is frequently followed in busy emergency departments (EDs) to minimize the need for a repeat invasive procedure. To assess the implications of this longstanding practice, we aimed to describe the frequency and characteristics of children with normal urinalysis (UA) and positive urine culture obtained via catheterization, and to describe their clinical course.

Methods
A single center, retrospective cohort study was performed for otherwise healthy children aged 6 to 24 months, presenting to a Pediatric ED between January and June 2019 who underwent UTI testing via a urine catheterization. The point-of-care (POC) UA and urine culture results along with any follow-up phone call documentation were reviewed and analyzed using descriptive statistics.

Results
Of the 818 urine cultures obtained via catheterization during the 6-month study period, 131 (16%) cultures were reported as positive. Of these positive cultures, 14 (10.7%) of the patients meeting inclusion criteria had a normal POC UA. In follow-up phone calls after the ED visit, the majority of these 14 patients were asymptomatic without any antibiotic treatment and 3 (2.3%) patients were still febrile and classified as a potentially missed UTI.

Conclusions
The routine practice of sending urine cultures from all catheterized urine samples in children 6 to 24 months, regardless of POC UA results, rarely detect missed UTIs. In alignment with more recent practice guidelines, this practice should be reconsidered in low-risk children seen in EDs to improve overall care quality and resource utilization.
NCPbook: A comprehensive database of noncanonical peptides
Authors: Sami Abdul , Fu Mengjia , Yin Haoqiang , Ali Usman , Tian Lei , Wang Shunxi , Zhang Jinghua , Chen Xueyan , Li Hehuan , Chen Minghui , Yao Wen , Wu Liuji 
Published: May 2024

Abstract
Noncanonical peptides (NCPs) are a class of peptides generated from regions previously thought of as noncoding, such as introns, 5′ UTRs, 3′ UTRs, and intergenic regions. In recent years, the significance and diverse functions of NCPs have come to light, yet a systematic and comprehensive NCP database remains absent. Here, we developed NCPbook (https://ncp.wiki/ncpbook/), a database of evidence-supported NCPs, which aims to provide a resource for efficient exploration, analysis, and manipulation of NCPs. NCPbook incorporates data from diverse public databases and scientific literature. The current version of NCPbook includes 180,676 NCPs across 29 different species, evidenced by MS, ribosome profiling, or molecular experiments. These NCPs are distributed across kingdoms, comprising 123,408 from 14 plant species, 56,999 from 7 animal species, and 269 from 8 microbial species. Furthermore, NCPbook encompasses 9,166 functionally characterized NCPs playing important roles in immunity, stress resistance, growth, and development. Equipped with a user-friendly interface, NCPbook allows users to search, browse, visualize, and retrieve data, making it an indispensable platform for researching NCPs in various plant, animal, and microbial species.
On an ErdŐs–Kac-Type Conjecture of Elliott
Authors: Gorodetsky Ofir , Grimmelt Lasse 
Published: May 2024

Abstract
Elliott and Halberstam proved that $\sum_{p \lt n} 2^{\omega(n-p)}$ is asymptotic to $\phi(n)$. In analogy to the Erdős–Kac theorem, Elliott conjectured that if one restricts the summation to primes p such that $\omega(n-p)\le 2 \log \log n+\lambda(2\log \log n)^{1/2}$ then the sum will be asymptotic to $\phi(n)\int_{-\infty}^{\lambda} \mathrm{e}^{-t^2/2}\,\mathrm{d}t/\sqrt{2\pi}$. We show that this conjecture follows from the Bombieri–Vinogradov theorem. We further prove a related result involving Poisson–Dirichlet distribution, employing deeper lying level of distribution results of the primes.
Nautical Metaphors and Late-Victorian Literary Culture
Authors: Hornsby Asha 
Published: May 2024

Abstract
This article reveals how nautical conceits were frequently used to articulate stylistic concerns and respond to publishing trends emerging in late-Victorian culture. Reviewers, authors, and press commentators described writing as akin to ship building or seafaring and employed marine metaphors to categorize and critique narratives as ‘vessels’ for certain characters or plots. For example, leisurely multi-volume ‘three-deckers’ were manned by a recognizable ‘crew’ of characters while modern literary ‘steamers’ were more sparsely populated and took shorter and more direct narrative routes. Many accounts discussed also show an acute awareness of commercial pressures of the book-trade and parallel developments in author-publisher relations. Rudyard Kipling, amongst others, envisioned the publishing world as a ‘seascape’ upon which works needed to be carefully launched—especially if the voyage was trans-Atlantic. His unusually inventive and intricate nautical metaphors anchor much of the article’s analysis, while close literary-critical readings of contemporary periodicals shed light on broader patterns of contact between literary and maritime cultures. The linguistic creativity with which the Victorian nautical imagination was expressed demonstrates the depth of maritime influence upon literary discourses of the period while also reflecting very real interconnections developing between nautical and literary industries.
Reputational Bargaining with External Resolution Opportunities
Authors: Ekmekci Mehmet , Zhang Hanzhe 
Published: May 2024

Abstract
Two parties negotiate in the presence of external resolution opportunities (e.g. court, arbitration, or war). The outcome of external resolution depends on the privately held justifiability/strength of their claims. A justified party issues an ultimatum for resolution whenever possible, but an unjustified party strategically bluffs with an ultimatum to establish a reputation for being justified. We show that the availability of external resolution opportunities can benefit or hurt an unjustified party in equilibrium. When the chances of being justified become negligible, agreement is immediate and efficient; and if the set of justifiable demands is rich, our solution modifies the Nash–Rubinstein bargaining solution of Abreu and Gul ((2000), Econometrica, 68, 85–117) in a simple way.
Exploring relief for Behçet’s disease refractory oral ulcers: a comparison of TNF inhibitors versus apremilast
Authors: Lopalco Giuseppe , Morrone Maria , Venerito Vincenzo , Cantarini Luca , Emmi Giacomo , Espinosa Gerard , Lledó Gema Maria , Mosca Marta , Talarico Rosaria , Cauli Alberto , Piga Matteo , Sota Jurgen , Fabiani Claudia , Chiara Emanuele , Biancalana Edoardo , Mattioli Irene , Argolini Lorenza Maria , Di Cianni Federica , Caporali Roberto , Iannone Florenzo 
Published: May 2024

Abstract

Objectives
Oral and genital ulcers are the hallmark manifestation of Behçet’s disease (BD), significantly impacting patients’ quality of life. Our study focuses on comparing the effectiveness and safety of TNF inhibitors (TNFis) and apremilast in controlling oral ulcers of BD, aiming to provide evidence-based guidance for physicians in selecting appropriate treatment modalities.

Methods
A retrospective analysis was performed on BD patients treated between December 2016 and December 2021 with TNFis or apremilast for refractory oral ulcers. The study assessed treatment response by the absence of oral ulcers at 3 and 6 months, with additional evaluations for genital ulcers and articular involvement.

Results
The study included 78 patients, equally allocated between TNFis and apremilast treatments. Both groups showed significant oral ulcer reduction at 3 (P &lt; 0.001) and 6 months (P = 0.01), with no significant difference between the treatments. Apremilast had a notable CS-sparing effect by the 3-month follow-up, persisting through 6 months. Both treatments were equally effective in reducing genital ulcers, with TNFis showing greater effectiveness in addressing articular involvement. Apremilast had a higher discontinuation rate due to gastrointestinal side effects.

Conclusion
TNFis and apremilast are both effective for treating BD refractory oral ulcers. While TNFis may offer broader benefits for other disease manifestations, apremilast is distinguished by its CS-sparing effect, especially for patients with a milder disease phenotype. Treatment selection should consider individual disease severity and clinical features to ensure a personalized and effective management strategy.
The effect of a dynamic lighting schedule on neurobehavioral performance during a 45-day simulated space mission
Authors: Grant Leilah K , Kent Brianne A , Rahman Shadab A , St. Hilaire Melissa A , Kirkley Crystal L , Gregory Kevin B , Clark Toni , Hanifin John P , Barger Laura K , Czeisler Charles A , Brainard George C , Lockley Steven W , Flynn-Evans Erin E 
Published: May 2024

Abstract

Study Objectives
We previously reported that during a 45-day simulated space mission, a dynamic lighting schedule (DLS) improved circadian phase alignment and performance assessed once on selected days. This study aimed to evaluate how DLS affected performance on a 5-minute psychomotor vigilance task (PVT) administered multiple times per day on selected days.

Methods
Sixteen crewmembers (37.4 ± 6.7 years; 5F) underwent six cycles of 2 × 8-hour/night followed by 5 × 5-hour/night sleep opportunities. During the DLS (n = 8), daytime white light exposure was blue-enriched (~6000 K; Level 1: 1079, Level 2: 76 melanopic equivalent daytime illuminance (melEDI) lux) and blue-depleted (~3000–4000 K; L1: 21, L2: 2 melEDI lux) 3 hours before bed. In the standard lighting schedule (SLS; n = 8), lighting remained constant (~4500K; L1: 284, L2 62 melEDI lux). Effects of lighting condition (DLS/SLS), sleep condition (5/8 hours), time into mission, and their interactions, and time awake on PVT performance were analyzed using generalized linear mixed models.

Results
The DLS was associated with fewer attentional lapses (reaction time [RT] &gt; 500 milliseconds) compared to SLS. Lapses, mean RT, and 10% fastest/slowest RTs were worse following 5 compared to 8 hours of sleep but not between lighting conditions. There was an effect of time into mission on RTs, likely due to sleep loss. Overall performance differed by time of day, with longer RTs at the beginning and end of the day. There were more lapses and slower RTs in the afternoon in the SLS compared to the DLS condition.

Conclusions
Future missions should incorporate DLS to enhance circadian alignment and performance. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection.
The Business Judgment Rule as a Protective Armor for Directors’ Responsibilities: A Comparative Study Among Mauritius, United Kingdom, and United States
Authors: Beebeejaun Ambareen , Bissessur Pramod 
Published: May 2024

Abstract
The business judgment rule (BJR) is a corporate law doctrine that protects a decision of directors from fairness review by a court of law unless there is sufficient evidence that the director has breached his fiduciary duties or that the decision-making process is tainted. Given that the BJR acts as a protective armor for directors as their personal liability is not engaged for a corporate decision irrespective of its outcomes provided that some requirements are satisfied, the purpose of this paper is to critically assess whether directors of Mauritian companies are sufficiently protected and encouraged in the exercise of their duties. To achieve the research objective, the black letter research method was adopted to collect secondary data and a comparative analysis with some other countries’ rules on business judgment was conducted. A desk-based approach and content analysis were used to collect this information. The countries selected for the comparison are the United Kingdom and United States. Mauritian law does not afford protection to directors for decisions taken based on business judgment whereas this research has demonstrated that the laws of other countries being the United Kingdom and the United States as well as their judicial instances both recognize and apply the BJR.
The effect of a direct-fed microbial (10-G) on live animal performance, carcass characteristics, and Salmonella prevalence of fed beef heifers
Authors: Tilton Travis J , Martens Kevin , Lucherk Loni W , Word Alyssa B , Holland Ben P , Lawrence Ty E , Tennant Travis C 
Published: May 2024

Abstract
The objective of this study was to determine the efficacy of the direct-fed microbial 10-G upon cattle growth performance, liver and lung health, carcass quality, and yield outcomes, as well as prevalence and enumeration of Salmonella in feces and lymph nodes. Fed beef heifers (N = 1,400; initial shrunk body weight [BW] 343.3 ± 36.2 kg) were blocked by the day of arrival and randomly allocated to one of two treatments (0 [negative control, CON] or 2 g of a direct-fed microbial [10-G] that provided 1 billion CFUs per animal per day of Lactobacillus acidophilus, Enterococcus faecium, Pediococcus pentosaceus, L. brevis, and L. plantarum) with 10 pens per treatment. Recto-anal mucosal fecal samples (RAMs; n = 477) and subiliac lymph nodes (SLNs; n = 479) were collected longitudinally at harvest from 23 to 25 heifers per pen. Data were analyzed using mixed models; pen served as the experimental unit; block and harvest date were random effects. No differences were detected in dry matter intake (P = 0.78), final BW (P = 0.64), average daily gain (P = 0.51), gain to feed (P = 0.71), hot carcass weight (P = 0.54), dressed carcass yield (P = 0.52), 12th rib fat depth (P = 0.13), longissimus muscle area (P = 0.62), calculated empty body fat (P = 0.26), or marbling score (P = 0.82). Distributions of liver scores (P ≥ 0.34), quality grades (P ≥ 0.23), and yield grades (P ≥ 0.11) were also not different between treatments. A tendency was detected for more normal lungs (P = 0.08; 10-G = 65.96%, CON = 61.12%) and fewer inflated lungs at harvest for cattle fed 10-G (P = 0.10; 10-G = 0.29%, CON = 1.16%); other lung outcomes did not differ (P ≥ 0.54). Salmonella prevalence did not differ for RAM samples (P = 0.41; 10-G = 97.74%, CON = 96.82%) or SLN (P = 0.22; 10-G = 17.92%, CON = 13.66%). Salmonella concentration of RAM samples (P = 0.25; 10-G = 3.87 log CFU/g, CON = 3.32 log CFU/g) or SLN (P = 0.37; 10-G = 1.46 log CFU/g, CON = 1.14 log CFU/g) also did not differ between treatments at harvest. These results do not demonstrate any difference in live animal performance, carcass characteristics, or Salmonella carriage for heifers fed 10-G.
Implementing Public Health Modules as an Approach to Improve Knowledge and Attitudes of Medical Students: A Student-Led, Multiyear Study
Authors: Dunleavy Spencer , Edelman David S. , Wimer Gabrielle , Karelas Gregory , Hassan Amir , Clarke Cameron D. , Canfield Stephen M. , Lebwohl Benjamin , Lypson Monica L. , Moise Nathalie 
Published: May 2024

Abstract

Purpose
Public health is a necessary focus of modern medical education. However, while numerous studies demonstrate benefits of public health education during medical school among self-selected students (i.e., those interested in public health), there are few educational models shown to be effective across the general medical student population. This study examined the effect of a multiyear, case-based, longitudinal online public health curriculum required for all medical students at an urban, research-focused U.S. medical school.

Method
The authors created 11 short public health modules to supplement a year-long, organ-based preclerkship course at Columbia University Vagelos College of Physicians and Surgeons. Beginning in 2020, all students were required to complete these modules, with repeated surveys to assess changes in attitudes and knowledge of public health over time. The authors compared responses for these domains before and after each module, across multiple time points throughout the year, and cross-sectionally to a 2019 cohort of students who were not provided the modules.

Results
Across 3 cohorts, 405 of 420 (96.4%) students provided responses and were included in subsequent analyses. After completing the modules, students reported perceiving a greater importance of public health to nearly every medical specialty (P < .001), more positive attitudes toward public health broadly (P < .001), and increased knowledge of public health content (P < .001). These findings were consistent across longitudinal analysis of students throughout the year-long course and when compared to the cohort who did not complete the modules.

Conclusions
Case-based, interactive, and longitudinal public health content can be effectively integrated into the required undergraduate medical education curriculum to improve all medical students’ knowledge and perceptions of public health. Incorporating evidence-based public health education into medical training may help future physicians to better address the needs of the communities and populations in which they practice.
Development of a Hematology–General Medicine Hybrid Team to Improve Care of Patients With Sickle Cell Disease
Authors: Merz Lauren E. , Osei Miriam A. , Green Aliza , Story Charlotte M. , Schuering Kelly M. , Achebe Maureen Okam 
Published: May 2024

Abstract

Problem
Approximately 100,000 individuals in the United States have sickle cell disease (SCD). These individuals face multiple barriers to equitable care. At Brigham and Women’s Hospital, existing health inequities for these patients were compounded by admitting, rounding, and team structures that assigned patients with SCD to multiple medicine teams with a hematologist attending, leading to delays in patient care and gaps in residents’ hematology knowledge.

Approach
A hematology–general medicine hybrid team was created in September 2021 to enhance trainee knowledge, skill, and confidence in managing hematology conditions and improve the quality of care delivered to individuals with SCD. This allowed for regionalization of patients with classical hematology conditions to specific hospital floors under the care of one team with a hematologist as the attending of record.

Outcomes
From October 1, 2021, to January 11, 2022, the majority (745/824, 90%) of in-hospital days for patients with a primary hematology diagnosis were under the care of the hematology–general medicine hybrid team. Regionalization to the home floor of the hybrid team was achieved on 331 (40%) of these 824 hospital days, consistent with regionalization rates for other teams. From October 1, 2021, to September 30, 2022, there were 128 unique patients with SCD admitted over 511 encounters and cared for by approximately 78 residents and 12 medical students. Feedback from residents reported improved knowledge in the management of hematology conditions, especially SCD.

Next Steps
The authors are working on a comprehensive analysis of the hybrid team’s impact on trainee skill and confidence in managing SCD. The authors believe that this model can be replicated at other institutions to optimize trainee education, consolidate care, and address implicit bias against patients with SCD, even with the hematology attending as a consultant instead of as the attending of record.
Digital Twins of Acute Hypoxemic Respiratory Failure Patients Suggest a Mechanistic Basis for Success and Failure of Noninvasive Ventilation
Authors: Weaver Liam , Shamohammadi Hossein , Saffaran Sina , Tonelli Roberto , Laviola Marianna , Laffey John G. , Camporota Luigi , Scott Timothy E. , Hardman Jonathan G. , Clini Enrico , Bates Declan G. 
Published: May 2024

OBJECTIVES:
To clarify the mechanistic basis for the success or failure of noninvasive ventilation (NIV) in acute hypoxemic respiratory failure (AHRF).

DESIGN:
We created digital twins based on mechanistic computational models of individual patients with AHRF.

SETTING:
Interdisciplinary Collaboration in Systems Medicine Research Network.

SUBJECTS:
We used individual patient data from 30 moderate-to-severe AHRF patients who had failed high-flow nasal cannula (HFNC) therapy and subsequently underwent a trial of NIV.

INTERVENTIONS:
Using the digital twins, we evaluated lung mechanics, quantified the separate contributions of external support and patient respiratory effort to lung injury indices, and investigated their relative impact on NIV success or failure.

MEASUREMENTS AND MAIN RESULTS:
In digital twins of patients who successfully completed/failed NIV, after 2 hours of the trial the mean (sd) of the change in total lung stress was –10.9 (6.2)/–0.35 (3.38) cm H2O, mechanical power –13.4 (12.2)/–1.0 (5.4) J/min, and total lung strain 0.02 (0.24)/0.16 (0.30). In the digital twins, positive end-expiratory pressure (PEEP) produced by HFNC was similar to that set during NIV. In digital twins of patients who failed NIV vs. those who succeeded, intrinsic PEEP was 3.5 (0.6) vs. 2.3 (0.8) cm H2O, inspiratory pressure support was 8.3 (5.9) vs. 22.3 (7.2) cm H2O, and tidal volume was 10.9 (1.2) vs. 9.4 (1.8) mL/kg. In digital twins, successful NIV increased respiratory system compliance +25.0 (16.4) mL/cm H2O, lowered inspiratory muscle pressure –9.7 (9.6) cm H2O, and reduced the contribution of patient spontaneous breathing to total driving pressure by 57.0%.

CONCLUSIONS:
In digital twins of AHRF patients, successful NIV improved lung mechanics, lowering respiratory effort and indices associated with lung injury. NIV failed in patients for whom only low levels of positive inspiratory pressure support could be applied without risking patient self-inflicted lung injury due to excessive tidal volumes.
Oxygen reserve index versus conventional peripheral oxygen saturation for prevention of hypoxaemia
Authors: Kim Eun-Hee , Park Jung-Bin , Kang Pyoyoon , Ji Sang-Hwan , Jang Young-Eun , Lee Ji-Hyun , Kim Hee-Soo , Kim Jin-Tae 
Published: May 2024

BACKGROUND
Hypoxaemia occurs frequently during paediatric laryngeal microsurgery.

OBJECTIVE
The oxygen reserve index is a noninvasive and continuous parameter to assess P
aO2 levels in the range of 100 to 200 mmHg. It ranges from 0.0 to 1.0. We investigated whether monitoring the oxygen reserve index can reduce the incidence of SpO2 90% or less.

DESIGN
Randomised controlled trial.

SETTING
A tertiary care paediatric hospital.

PARTICIPANTS
Paediatric patients aged 18 years or less scheduled to undergo laryngeal microsurgery.

INTERVENTION
The patients were randomly allocated to the oxygen reserve index or control groups, and stratified based on the presence of a tracheostomy tube. Rescue intervention was performed when the oxygen reserve index was 0.2 or less and the SpO2 was 94% or less in the oxygen reserve index and control groups, respectively.

MAIN OUTCOME MEASURE
The primary outcome was the incidence of SpO2 90% or less during the surgery.

RESULTS
Data from 88 patients were analysed. The incidence of SpO2 ≤ 90% did not differ between the oxygen reserve index and control groups [P = 0.114; 11/44, 25 vs. 18/44, 40.9%; relative risk: 1.27; and 95% confidence interval (CI): 0.94 to 1.72]. Among the 128 rescue interventions, SpO2 ≤ 90% event developed in 18 out of 75 events (24%) and 42 out of 53 events (79.2%) in the oxygen reserve index and control groups, respectively (P < 0.001; difference: 55.2%; and 95% CI 38.5 to 67.2%). The number of SpO2 ≤ 90% events per patient in the oxygen reserve index group (median 0, maximum 3) was less than that in the control group (median 0, maximum 8, P = 0.031).

CONCLUSION
Additional monitoring of the oxygen reserve index, with a target value of greater than 0.2 during paediatric airway surgery, alongside peripheral oxygen saturation, did not reduce the incidence of SpO2 ≥ 90%.