bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of Pseudomonas aeruginosa infection in intensive care unit before (2007–2010) and after (2011–2014) the beginning of an antimicrobial stewardship program
Authors: Strazzulla Alessio , Adrien Vladimir , Houngnandan Segla Robert , Devatine Sandra , Bahmed Ouerdia , Abroug Sarra , Hamrouni Sarra , Monchi Mehran , Diamantis Sylvain 
Published: April 2024

Abstract

Objectives:
To investigate the factors associated with Pseudomonas aeruginosa isolates in intensive care unit (ICU) before and after an antimicrobial stewardship program.

Materials:
Monocentric retrospective cohort study. Patients admitted to the ICU in 2007–2014 were included. Characteristics of P. aeruginosa patients were compared to overall ICU population. Clinical and microbiological characteristics of P. aeruginosa patients before (2007–2010) and after (2011–2014) the beginning of the AMP were compared.

Results:
Overall, 5,263 patients were admitted to the ICU, 274/5,263 (5%) had a P. aeruginosa isolate during their staying. In 2011–2014, the percentage P. aeruginosa isolates reduced (7% vs 4%, P ≤ .0001). Patients with P. aeruginosa had higher rates of in-hospital death (43% vs 20%, P < .0001) than overall ICU population. In 2011–2014, rates of multidrug-resistant (11% vs 2%, P = .0020), fluoroquinolone-resistant (35% vs 12%, P < .0001), and ceftazidime-resistant (23% vs 8%, P = .0009) P. aeruginosa reduced. Treatments by fluoroquinolones (36% vs 4%, P ≤ .0001), carbapenems (27% vs 9%, P = .0002), and third-generation cephalosporins (49% vs 12%, P ≤ .0001) before P. aeruginosa isolation reduced while piperacillin (0% vs 13%, P < .0001) and trimethoprim-sulfamethoxazole (8% vs 26%, P = .0023) increased. Endotracheal intubation reduced in 2011–2014 (61% vs 35%, P < .0001). Fluoroquinolone-resistance was higher in patients who received endotracheal intubation (29% vs 17%, P = .0197). Previous treatment by fluoroquinolones (OR = 2.94, P = .0020) and study period (2007–2010) (OR = 2.07, P = .0462) were the factors associated with fluoroquinolone-resistance at the multivariate analysis.

Conclusions:
Antibiotic susceptibility in P. aeruginosa isolates was restored after the reduction of endotracheal intubation, fluoroquinolones, carbapenems, and third-generation cephalosporins and the increased use of molecules with a low ecological footprint, as piperacillin and trimethoprim-sulfamethoxazole.
It takes a village: decreasing inappropriate antibiotic prescribing for upper respiratory tract infections
Authors: Shubeilat Jamilah L. , Ilges Dan , Ton Angie N. , Seville Maria Teresa A. 
Published: April 2024

Abstract

Objective:
Prescribing of antibiotics for viral upper respiratory infections (URIs) remains a pressing public health problem. We sought to reduce inappropriate prescribing of antibiotics for URIs in Mayo Clinic Arizona.

Design:
Single-center, quasi-experimental, and retrospective cohort study

Setting:
Emergency medicine and all primary care departments

Methods:
The interventions included sharing baseline prescribing data, education, resources, and quarterly peer comparison reports. Encounters with diagnostic codes for respiratory infections commonly caused by viruses were categorized as Tier 3 (ie, never appropriate to prescribe antibiotics). Our goal was to reduce inappropriate prescribing for Tier 3 encounters by 22% in 2022.

Results:
Department education was completed by June 2022. The annual antibiotic prescribing rate for Tier 3 encounters was reduced by 29%, from a baseline rate of 23.6% in 2021 to 16.4% in 2022 (P < .001). The posteducation prescribing rate was 13.1%. Repeat respiratory-related healthcare contact within 14 days of Tier 3 encounters did not differ between patients prescribed and not prescribed an antibiotic in all of 2022 (4.7% antibiotic vs 4.2% no antibiotic, P = .595) or during the posteducation period (3.7% vs 4.6%, P = .604).

Conclusion:
A multi-faceted intervention, which included baseline education, syndrome-specific order panels, resources for symptomatic management, and peer comparison reports, resulted in significant reduction of inappropriate antibiotic prescribing for URIs.
Derivation and internal validation of the multivariate toxigenic C. difficile diarrhea model and risk score for emergency room and hospitalized patients with diarrhea
Authors: Davies Sarah , Zhang Jimmy , Yi Yongjun , Burge Eric R. , Desjardins Marc , Austin Peter C. , van Walraven Carl 
Published: April 2024

Abstract

Background:
Many factors have been associated with the risk of toxigenic C. difficile diarrhea (TCdD). This study derived and internally validated a multivariate model for estimating the risk of TCdD in patients with diarrhea using readily available clinical factors.

Methods:
A random sample of 3,050 symptomatic emergency department or hospitalized patients undergoing testing for toxigenic C. difficile at a single teaching hospital between 2014 and 2018 was created. Unformed stool samples positive for both glutamate dehydrogenase antigen by enzyme immunoassay and tcdB gene by polymerase chain reaction were classified as TCdD positive. The TCdD Model was created using logistic regression and was modified to the TCdD Risk Score to facilitate its use.

Results:
8.1% of patients were TCdD positive. TCdD risk increased with abdominal pain (adjusted odds ratio 1.3; 95% CI, 1.0–1.8), previous C. difficile diarrhea (2.5, 1.1–6.1), and prior antibiotic exposure, especially when sampled in the emergency department (4.2, 2.5–7.0) versus the hospital (1.7, 1.3–2.3). TCdD risk also increased when testing occurred earlier during the hospitalization encounter, when age and white cell count increased concurrently, and with decreased eosinophil count. In internal validation, the TCdD Model had moderate discrimination (optimism-corrected C-statistic 0.65, 0.62–0.68) and good calibration (optimism-corrected Integrated Calibration Index [ICI] 0.017, 0.001–0.022). Performance decreased slightly for the TCdD Risk Score (C-statistic 0.63, 0.62–0.63; ICI 0.038, 0.004–0.038).

Conclusions:
TCdD risk can be predicted using readily available clinical risk factors with modest accuracy.
BUILDING MODELS IN SMALL CARDINALS IN LOCAL ABSTRACT ELEMENTARY CLASSES
Authors: MAZARI-ARMIDA MARCOS , YANG WENTAO 
Published: April 2024

Abstract
There are many results in the literature where superstablity-like independence notions, without any categoricity assumptions, have been used to show the existence of larger models. In this paper we show that stability is enough to construct larger models for small cardinals assuming a mild locality condition for Galois types.
Theorem 0.1.
Suppose

$\lambda <2^{\aleph _0}$

. Let

${\mathbf {K}}$

be an abstract elementary class with

$\lambda \geq {\operatorname {LS}}({\mathbf {K}})$

. Assume

${\mathbf {K}}$

has amalgamation in

$\lambda $

, no maximal model in

$\lambda $

, and is stable in

$\lambda $

. If

${\mathbf {K}}$

is

$(<\lambda ^+, \lambda )$

-local, then

${\mathbf {K}}$

has a model of cardinality

$\lambda ^{++}$

.

The set theoretic assumption that

$\lambda <2^{\aleph _0}$

and model theoretic assumption of stability in

$\lambda $

can be weakened to the model theoretic assumptions that

$|{\mathbf {S}}^{na}(M)|< 2^{\aleph _0}$

for every

$M \in {\mathbf {K}}_\lambda $

and stability for

$\lambda $

-algebraic types in

$\lambda $

. This is a significant improvement of Theorem 0.1, as the result holds on some unstable abstract elementary classes.
Algorithmically generated memories: automated remembrance through appropriated perception
Authors: Henriksen Ellen Emilie 
Published: April 2024

Abstract
This article is on algorithmically generated memories: data on past events that are stored and automatically ranked and classified by digital platforms, before they are presented to the user as memories. By mobilising Henri Bergson's philosophy, I centre my analysis on three of their aspects: the spatialisation and calculation of time in algorithmic systems, algorithmic remembrance, and algorithmic perception. I argue that algorithmically generated memories are a form of automated remembrance best understood as perception, and not recollection. Perception never captures the totality of our surroundings but is partial and the parts of the world we perceive are the parts that are of interest to us. When conscious beings perceive, our perception is always coupled with memory, which allows us to transcend the immediate needs of our body. I argue that algorithmic systems based on machine learning can perceive, but that they cannot remember. As such, their perception operates only in the present. The present they perceive in is characterised by immense amounts of data that are beyond human perceptive capabilities. I argue that perception relates to a capacity to act as an extended field of perception involves a greater power to act within what one perceives. As such, our memories are increasingly governed by a perception that operates in a present beyond human perceptual capacities, motivated by interests and needs that lie somewhat beyond interests of needs formulated by humans. Algorithmically generated memories are not only trying to remember for us, but they are also perceiving for us.
POLICIES FOR INCLUSIVE GROWTH
Authors: Griffith Rachel 
Published: April 2024

AbstractSeveral decades ago, Sig Prais concluded that the root cause of the UK’s poor industrial performance was the poor quality of education and training. In this lecture, I will make a related argument, focussing on the lack of opportunity in the United Kingdom for workers who have not succeeded in the formal education system and the long-lasting impacts this has on their economic, health and social wellbeing. I will highlight the importance of providing opportunities for continued training over a worker’s lifetime for appropriate skills that are valued in the workplace in order to achieve inclusive growth.
Karenia mikimotoi induced adverse impacts on abalone Haliotis discus hannai in Fujian coastal areas, China
Authors: Liao Ling-Zhi , Lin Jia-Ning , Ding Xin-Shu , Feng Song , Yan Tian 
Published: April 2024

Abstract
Large-scale outbreaks of the dinoflagellate Karenia mikimotoi caused substantial mortality of abalone, Haliotis discus hannai in Fujian, China in 2012, resulting in 20 billion in economic losses to abalone industries. However, the mechanism behind the mortality, especially the reaction of abalone to this microalgal toxicity, which possibly differed significantly from the former ‘fish killer’ strain in the South China Sea (SCS). Our study revealed that K. mikimotoi FJ-strain exhibited a four-fold higher haemolytic toxicity than the SCS-strain during the late exponential phase. At the microalgal cell density of 3 × 107 cell L−1, the FJ-strain caused abalone mortality of 67% in 48 h, with decreased granulocyte–hyalinocyts ratio and phagocytic activity by 58.96% and 75.64%, respectively, increased haemocyte viability by 4.8-fold and severe gill damage. The toxic effect only worked for the haemolytic toxicity from active algal cells, which were probably produced under the contact of algal cells and abalone gills. However, under exposure to the SCS-strain, more than 80% of individuals survived under aeration. The results indicated that FJ-strain was a new K. mikimotoi ecotype with stronger toxicity. It evoked severe effects, with complete abalone mortality within 24 h under the cascading effect of non-aeration (dissolved oxygen declined to 2.0 mg L−1), when exposed to K. mikimotoi FJ-strain at the above density. Thus, apart from the microalgal toxicity, DO depletion exacerbated the mortality of abalone in the experiment. The massive abalone mortalities in Fujian were probably caused by the combination of microalgal toxic effects and oxygen depletion, leading to immunological depression and histopathological disruption.
The long-term effectiveness of a personality-targeted substance use prevention program on aggression from adolescence to early adulthood
Authors: Lawler Siobhan , Barrett Emma L. , Teesson Maree , Kelly Erin , Champion Katrina E. , Debenham Jennifer , Smout Anna , Chapman Cath , Slade Tim , Conrod Patricia J. , Newton Nicola C. , Stapinski Lexine 
Published: April 2024

AbstractBackgroundAddressing aggressive behavior in adolescence is a key step toward preventing violence and associated social and economic costs in adulthood. This study examined the secondary effects of the personality-targeted substance use preventive program Preventure on aggressive behavior from ages 13 to 20.MethodsIn total, 339 young people from nine independent schools (M age = 13.03 years, s.d. = 0.47, range = 12–15) who rated highly on one of the four personality traits associated with increased substance use and other emotional/behavioral symptoms (i.e. impulsivity, anxiety sensitivity, sensation seeking, and negative thinking) were included in the analyses (n = 145 in Preventure, n = 194 in control). Self-report assessments were administered at baseline and follow-up (6 months, 1, 2, 3, 5.5, and 7 years). Overall aggression and subtypes of aggressive behaviors (proactive, reactive) were examined using multilevel mixed-effects analysis accounting for school-level clustering.ResultsAcross the 7-year follow-up period, the average yearly reduction in the frequency of aggressive behaviors (b = −0.42; 95% confidence interval [CI] −0.64 to −0.20; p < 0.001), reactive aggression (b = −0.22; 95% CI 0.35 to −0.10; p = 0.001), and proactive aggression (b = −0.14; 95% CI −0.23 to −0.05; p = 0.002) was greater for the Preventure group compared to the control group.ConclusionsThe study suggests a brief personality-targeted intervention may have long-term impacts on aggression among young people; however, this interpretation is limited by imbalance of sex ratios between study groups.
The Muse of Zenon: from Syracuse to the Museum of Guadalajara
Authors: Lenaghan Julia , Lenaghan Patrick 
Published: April 2024

AbstractThis article traces a statue, which Zenon of Aphrodisias carved, from Syracuse to its discovery at the Palace of Cogolludo in 2007. The study of this statue of the Muse Euterpe broadly demonstrates the appreciation for a figure from the classical world to Early Modern Europe and focuses attention on two understudied moments in the history of sculpture. It shows that Zenon carved the figure in the 4th c. CE, and its story reveals new connections between sculptors of Aphrodisias and specific patrons of the period. The statue's subsequent history attests to the high regard for ancient art and epigraphy in the Iberian Peninsula in 1500–1700. Since the statue probably belonged to Luis de la Cerda, ninth Duke of Medinaceli, it draws attention to a remarkable patron and a neglected aspect of Spanish cultural history.
A boy with fatigue and heart block: what’s the mechanism?
Authors: Phillips Tarin C. , Kisling Adam J. , Needleman Matthew 
Published: April 2024

AbstractWhen the atrioventricular node is damaged, accessory pathways can perform primary atrioventricular conduction but may spontaneously degrade during childhood. After surgical atrial septal defect repair during infancy, an adolescent male presented with fatigue due to iatrogenic complete atrioventricular node block with a degrading antegrade accessory pathway resulting in symptomatic bradyarrhythmia.
Comparative efficacy of akathisia treatments: A network meta-analysis
Authors: Gambolò Luca , Bottignole Dario , D’Angelo Marta , Bellini Lorenzo , Stirparo Giuseppe 
Published: April 2024

AbstractObjectiveAkathisia, a common side effect of psychotropic medications, poses a significant challenge in neuropsychiatry, affecting up to 30% of patients on antipsychotics. Despite its prevalence, akathisia remains poorly understood, with difficulties in diagnosis, patient reporting, and treatment efficacy. This research aimed to shed light on effective interventions to improve akathisia management.MethodsA systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted, encompassing controlled trials in English and Italian languages. Databases, such asPubMed, Scopus, and EMBASE, were searched until July 9, 2023. Treatment effectiveness was assessed using standardized mean differences (SMDs) in post-treatment akathisia scores.ResultsThirteen studies involving 446 individuals met the inclusion criteria. Benzodiazepines, beta-blockers, and NaSSA demonstrated significant efficacy as compared with placebo. Anticholinergic, anticonvulsant, triptan, and other treatments did not show significant differences. Benzodiazepines ranked highest in P-scores (0.8186), followed by beta-blockers and NaSSA.ConclusionsEffective management of akathisia is crucial, with benzodiazepines, beta-blockers, and NaSSA offering evidence-based options. Treatment rankings provide guidance for clinicians. Future research should prioritize larger, more robust studies to address limitations associated with small sample sizes and publication bias. This research enhances our understanding of interventions for akathisia, offering promising options to improve patient quality of life and prevent complications related to non-adherence and mismanagement.
‘Things that shouldn’t be’: a qualitative investigation of violation-related appraisals in individuals with OCD and/or trauma histories
Authors: Krause Sandra , Radomsky Adam S. 
Published: April 2024

AbstractBackground:Cognitive models of mental contamination (i.e. feelings of internal dirtiness without contact with a contaminant) propose that these feelings arise when individuals misappraise a violation. However, an operational definition of ‘violation’ and identification of specific violation misappraisals is limited.Aims:This study’s aim was to elaborate on cognitive models using qualitative data from those with lived experience to fill these gaps.Method:Twenty participants with a diagnosis of obsessive-compulsive disorder and/or a trauma history took part in a semi-structured interview about violation. Grounded theory was used to analyse interview transcripts.Discussion:Three categories emerged, each with several themes – qualities of violation, violation-related appraisals, and violation-related behaviours. Different violation-related appraisals were associated with different emotions and urges. Specific self-focused appraisal sub-themes (i.e. permanence of consequences; self-worth; responsibility, self-blame and regret) were most closely related to emotions tied to mental contamination. These findings support and expand upon existing cognitive models of mental contamination, identifying key violation-related appraisals and differentiating between mental contamination-related appraisals and those related to other emotional sequelae. Future quantitative and experimental research can evaluate the potential of these appraisals as intervention targets.
Comparison of ten policy options to equitably reduce children’s exposure to unhealthy food marketing
Authors: Gage Ryan , Liu Wei , Pearson Amber L , Smith Moira , Barr Michelle , Shortridge Ashton , Signal Louise 
Published: April 2024

Abstract

Objective:
Reducing children’s exposure to unhealthy food marketing is crucial to combat childhood obesity. We aimed to estimate the reduction of children’s exposure to food marketing under different policy scenarios and assess exposure differences by socio-economic status.

Design:
Data on children’s exposure to unhealthy food marketing were compiled from a previous cross-sectional study in which children (n 168) wore wearable cameras and Global Positioning System (GPS) units for 4 consecutive days. For each exposure, we identified the setting, the marketing medium and food/beverage product category. We analysed the percentage reduction in food marketing exposure for ten policy scenarios and by socio-economic deprivation: (1) no product packaging, (2) no merchandise marketing, (3) no sugary drink marketing, (4) no confectionary marketing in schools, (5) no sugary drink marketing in schools, (6) no marketing in public spaces, (7) no marketing within 400 m of schools, (8) no marketing within 400 m of recreation venues, (9) no marketing within 400 m of bus stops and (10) no marketing within 400 m of major roads.

Setting:
Wellington region of New Zealand.

Participants:
168 children aged 11–14 years.

Results:
Exposure to food marketing varied by setting, marketing medium and product category. Among the ten policy scenarios, the largest reductions were for plain packaging (60·3 %), no sugary drink marketing (28·8 %) and no marketing in public spaces (22·2 %). There were no differences by socio-economic deprivation.

Conclusions:
The results suggest that plain packaging would result in the greatest decrease in children’s exposure to food marketing. However, given that children are regularly exposed to unhealthy food marketing in multiple settings through a range of marketing mediums, comprehensive bans are needed to protect children’s health.
Nutrition environments in early childhood education: do they align with best practice?
Authors: Aristova Anna , Spence Alison C , Irwin Christopher , Elford Audrey , Graham Laura , Love Penelope 
Published: April 2024

Abstract

Objective:
To assess the comprehensiveness (scope of nutrition guidance) and strength (clarity of written language) of centre-based nutrition policies (CBNP) within early childhood education (ECE) centres. To also consider the applicability of an existing CBNP assessment tool and policy alignment with best practice food provision and feeding practices.

Design:
Cross-sectional online study to assess written ECE CBNP using the Wellness Child Care Assessment Tool.

Setting:
Licenced ECE centres in the state of Victoria, Australia.

Participants:
ECE centres (operating at least 8 h per d, 48 weeks per annum), stratified by location (rural and metropolitan), centre management type (profit and not-for-profit) and socio-economic area (low, middle, high).

Results:
Included individual CBNP (n 118), predominantly from metropolitan centres (56 %) and low-medium socio-economic areas (78 %). Policies had low overall Wellness Child Care Assessment Tool scores, particularly strength scores which were low across all four domains (i.e. nutrition education, nutrition standards, health promotion and communication/evaluation). The nutrition standards domain had the lowest strength score. The communication/evaluation domain had the lowest comprehensiveness score. Content analysis indicated low scores may relate to the Wellness Child Care Assessment Tool applicability for the Australian context due to differences in best practice guidance.

Conclusion:
Despite the presence of written nutrition policies in ECE centres, many showed weak language and lacked comprehensiveness and strength. This may relate to poor implementation of best practice food provision or feeding practices. Low scores, however, may partly stem from using an assessment tool that is not country-specific. The redevelopment of country-specific tools to assess ECE CBNP may be warranted.