bluuebunny/crossref_metadata_2025_split huggingface dataset:
Educational inequalities in major depressive disorder prevalence, timing and duration among adults over the life course: a microsimulation analysis based on the Lifelines Cohort Study
Authors: Lepe Alexander , Hoveling Liza A , Boissonneault Michaël , de Beer Joop A A , Reijneveld Sijmen A , de Kroon Marlou L A , Liefbroer Aart C 
Published: April 2024

Abstract

Background
Educational inequalities in major depressive disorder (MDD) pose a major challenge. Tackling this issue requires evidence on the long-term impact of intervening on modifiable factors, for example lifestyle and psychosocial factors. For this reason, we aimed to simulate the development of educational inequalities in MDD across the life course, and to estimate the potential impact of intervening on modifiable factors.

Methods
We used data from the prospective Dutch Lifelines Cohort Study to estimate the required input for a continuous-time microsimulation. The microsimulation allowed us to project the development of educational inequalities in MDD between ages 18 and 65, and to assess the potential benefit of intervening on quality of social contacts, health literacy and smoking.

Results
On average, an additional 19.1% of individuals with low education will ever experience MDD between ages 18 and 65 compared with those with high education. Additionally, individuals with low education generally will develop MDD 0.9 years earlier and spend 1.2 years more with MDD, than individuals with high education. Improving the quality of social contacts in individuals with low education produced the largest effect; it would reduce the inequalities in the prevalence, onset and duration of MDD by an average of 18.4%, 18.3% and 28.6%, respectively.

Conclusions
Intervening on modifiable factors, particularly quality of social contacts, in individuals with low education could help reduce the estimated educational inequalities in MDD over the life course.
‘The Black Prince of Baker Street’ and the Black Presence in Britain, 1837–1849
Authors: Scriven Tom 
Published: April 2024

Abstract
Between 1838 and 1849 a man repeatedly visited London claiming to be ‘Louis Christophe’, seeking access to money deposited in the Bank of England by his ‘brother’ the deceased King of Haiti, Henri Christophe. By following this impostor around London and the wider Atlantic, this article makes an important contribution to understanding of the Black presence in Britain during the early Victorian period. Alongside his interactions with the Black community, it documents how ‘Louis Christophe’ was able to defraud British philanthropists, the forms of racial prejudice he received during the decade, and the legacy of the Haitian Revolution.
Exact mixed-integer quadratic formulation and solution for large-scale thermal unit commitment
Authors: Kang Chuanxiong , Wang Yongwen , Wu Shaofei , Ding Guili , Chen Chen 
Published: April 2024

Abstract
Thermal unit commitment (UC) is a nonlinear combinatorial optimization problem that minimizes total operating costs while considering system load balance, on/off restrictions and other constraints. Successfully solving the thermal UC problem contributes to a more reliable power system and reduces thermal costs. This paper presents an exact mixed-integer quadratic programming (EMIQP) method for large-scale thermal UC problems. EMIQP revolutionizes the landscape by seamlessly translating the intricate nonlinear combinatorial optimization problem of UC into an exact mixed-integer quadratic formulation. This approach also elegantly reimagines on/off constraints as mixed-integer linear equations, employing both the sum and respective approaches. Our case studies unequivocally demonstrate the exceptional prowess of the EMIQP method, consistently securing the global optimum. Moreover, the mathematical-based EMIQP method produces identical results at each run, which is extremely important for UC in the real world.
Inappropriate prescribing contributes to high antibiotic exposure in young children in Australia
Authors: Netea Stejara A , Messina Nicole L , Gardiner Kaya , Pittet Laure F , Curtis Nigel ,   the MIS BAIR trial consortium, Casalaz Dan , Donath Susan , Flanagan Katie L , Freyne Bridget , Ponsonby Anne-Louise , Robins-Browne Roy M , Shann Frank , South Mike , Vuillermin Peter , Abruzzo Veronica , Bellamy Karen , Brophy Clare , Elia Sonia , Free Jackie , Gentile-Andrit Marie , Mitchell Kirsten , Morrison Clare , O'Neill Brooke , Owald Monica , Reilly Faith , Quinn Julie , Wall Kate , Goodall Casey , Ormond Gill 
Published: April 2024

Abstract

Background
Antibiotic exposure increases antimicrobial resistance and has also been associated with long-term harms, including allergies, inflammatory diseases and weight gain. We assessed antibiotic exposure in the first 2 years of life in Australian children, the factors influencing this and its appropriateness.

Methods
Data from 1201 participants in the MIS BAIR randomized controlled trial were used. Multivariable logistic regression was used to identify factors associated with antibiotic exposure.

Results
At 1 and 2 years of age, exposure to at least one course of antibiotics was 43% and 67%, with the highest first antibiotic prescription rate between 9 and 18 months. Amoxicillin was the most frequently used antibiotic (59%), followed by cefalexin (7%). The most common diagnoses for which antibiotics were prescribed were respiratory tract infections from 0 to 6 months of age and otitis media from 6 to 12 months. Factors associated with antibiotic exposure from 0 to 12 months of age were delivery by Caesarean section (adjusted odd-ratio (aOR) 1.5, 95%CI 1.1–1.9), birth in winter (aOR 1.7, 95%CI 1.2–2.4), maternal antibiotic exposure during the last trimester of pregnancy (aOR 1.6, 95%CI 1.1–2.3), cessation of breastfeeding by 6 months of age (aOR 1.5, 95%CI 1.1–2.0) and day-care attendance (aOR 1.4, 95%CI 1.1–1.8). Based on parent-reported questionnaires, 27% of infants were treated in the first year of life for conditions unlikely to need antibiotic treatment.

Conclusion
At least two-thirds of children were prescribed antibiotics in the first 2 years of life, and more than a quarter of these exposures may have been unnecessary.
Occurrence and characterization of rmtB-harbouring Salmonella and Escherichia coli isolates from a pig farm in the UK
Authors: Navickaite Indre , Holmes Harry , Dondi Letizia , Randall Luke , Fearnley Catherine , Taylor Emma , Fullick Edward , Horton Robert , Williamson Susanna , AbuOun Manal , Teale Christopher , Anjum Muna F 
Published: April 2024

Abstract

Objectives
To characterize and elucidate the spread of amikacin-resistant Enterobacteriaceae isolates from environmental samples on a pig farm in the UK, following the previous identification of index Salmonella isolates harbouring the rmtB gene, a 16S rRNA methylase.

Methods
Environmental samples were collected during two visits to a pig farm in the UK. Isolates were recovered using selective media (amikacin 128 mg/L) followed by real-time PCR and WGS to analyse rmtB-carrying Salmonella and Escherichia coli isolates.

Results
Salmonella and E. coli isolates harbouring the rmtB gene were detected at both farm visits. All Salmonella isolates were found to be monophasic S. enterica serovar Typhimurium variant Copenhagen of ST34. rmtB-harbouring E. coli isolates were found to be one of three STs: ST4089, ST1684 and ST34. Long-read sequencing identified the rmtB gene to be chromosomally located in Salmonella isolates and on IncFII-type plasmids in E. coli isolates. The results showed the rmtB gene to be flanked by IS26 elements and several resistance genes.

Conclusions
We report on the occurrence of rmtB-harbouring Enterobacteriaceae on a pig farm in the UK. rmtB confers resistance to multiple aminoglycosides and this work highlights the need for surveillance to assess dissemination and risk.
8 Burn Shock: What Defines a Failing Fluid Resuscitation?
Authors: Plum Abigail , Johnson Ryan M , Galicia Kevin E , Kubasiak John 
Published: April 2024

Abstract

Introduction
Major burn injuries often elicit burn shock requiring acute fluid resuscitation for patient survival. Successful resuscitation is a significant challenge for patient management as under-resuscitation and over-resuscitation can lead to greater adverse events. At the ABA-State of the Science in 2021, proposed definitions included &gt;1,500ml IVF per hour, although no clear clinical data supported this expert consensus. A clear definition of a failing resuscitation may better guide physician decision-making for additional interventions. The primary objective of this study was to examine the association between intervention provided within three hours following a defined indication of failing resuscitation and patient survival.

Methods
The study utilized the Acute Burn ResUscitation Multicenter Prospective Trial (ABRUPT), consisting of patients ≥18 years with burns ≥20% of total body surface area (TBSA), to examine three indications of failing resuscitation. Three mutually exclusive analyses were conducted on patients that had fluid resuscitation of ≥1000 mL in one hour, fluid resuscitation of ≥1500 mL in one hour, or two consecutive hours of urine output &lt; 30 mL. Intervention was defined as the patient having new vasopressors or a new ventilator within three hours of the first indication of failing resuscitation. Multivariable logistic regression models were used to assess the associations of interest and to adjust for confounders.

Results
Patients with a failing resuscitation indicator of ≥1000 mL/hr who received an intervention were 46% more likely to be alive at the end of the study (OR=0.54: 95% CI=0.22-1.33). Patients with a failing resuscitation indicator of ≥1500 mL/hr who received an intervention were 50% less likely to be alive at the end of the study (OR=1.5: 95% CI=0.47-5.01). Patients with a failing resuscitation indicator of urine output &lt; 30 mL who received an intervention were 6% less likely to be alive at the end of the study (OR=1.06: 95% CI=0.51-2.22). These results were adjusted for age, TBSA %, and inhalation injury.

Conclusions
A lower indication for failing resuscitation (≥1000 mL/hr) followed by an intervention shows potential for increased patient survival, although adjusted analyses were insignificant likely due to the small patient sample size. Further work is needed to conclude a sufficient definition of failing resuscitation for burn shock.

Applicability of Research to Practice
Identifying a clear definition of failing resuscitation will serve as a consistent guide for physician response to burn shock.
37 The Impact of the Intersectionality of Sex and Race on Body Image in Burn Survivors
Authors: Humbert Andrew , McMullen Kara , Bamer Alyssa M , Orton Caitlin M , Roaten Kimberly , Schneider Jeffrey C , Solis-Beach Kyra , Trinh Nhi-Ha , Yenikomshian Haig A , Amtmann Dagmar 
Published: April 2024

Abstract

Introduction
Health disparities associated with racial and ethnic minoritized status as well as sex are well documented in burn survivors. Specifically, previous work has found that people from racial and ethnic minority backgrounds as well as females tend to have lower satisfaction with appearance after injury1,2. However, the impact of the intersection between race/ethnicity and sex outside their individual effects has not been well studied. This study aims to assess: 1) the independent association between race/ethnicity and sex with body image, as measured using the Burn Specific Health Scale body image subscale (BSHS-BI), with higher scores corresponding to a better outcome; and 2) test if the association between sex and BSHS-BI differs by survivors’ race/ethnicity.

Methods
Adult participants enrolled in a large longitudinal study who had at least one BSHS-BI score and complete race/ethnicity, sex, age, and total burn surface area (TBSA) data were included. Race/ethnicity and sex were obtained through a combination of self-report and electronic health records. Due to sample size restrictions, race/ethnicity was categorized as White, non-Hispanic; Hispanic; or other, non-Hispanic. A linear mixed effects model was used to analyze the effects of race/ethnicity and sex after adjusting for age, TBSA, and follow-up time. A second linear mixed effects model was used to analyze the interaction between race/ethnicity and sex to determine if race modifies the association between sex and BSHS-BI.

Results
Data from 1,191 participants with injuries from 1996 to 2021 were included in the final analysis. The study sample was796 (66.8%) male, 398 (33.2%) female, 869 (73.0%) White, non-Hispanic, 145 (12.2%) Hispanic, and 177 (14.9%) other, non-Hispanic. The mean age was 43 (standard deviation (SD) = 17) and mean TBSA was 21 (SD = 44). After adjusting for age, TBSA, and follow-up time, mean BSHS-BI score for females was significantly lower than males (0.62 points lower; p &lt; 0.001) and those identifying as Hispanic had mean scores 0.32 (p=.002) higher than White, non-Hispanic and 0.41 (p=0.02) higher than other, non-Hispanic. No significant differences in BSHS-BI were found between White, non-Hispanic and other, non-Hispanic groups. There was no evidence that the association between sex and BSHS-BI differed by race/ethnicity.

Conclusions
Those who self-identified as male and Hispanic had significantly better BSHS-BI scores; however, there was no evidence that the intersection between sex and race/ethnicity was associated with BSHS-BI after accounting for individual sex and race/ethnicity effects.

Applicability of Research to Practice
Consistent with previous research, the results suggest that sex and race/ethnicity are important characteristics to consider when addressing body image changes after burn injury.
69 The Burn Is Just the Symptom: Analyzing Psychosocial Determinants of Health in the Burn Population
Authors: Harris Kathryn E , Kalnberg Patty , Gallagher James , Heffernan Jamie M , An Anjile , Lorico Jeremiah P , Hsu Chun Yun 
Published: April 2024

Abstract

Introduction
There is an understanding in the burn community that burns occur as a result of something, whether it be medical conditions, psychiatric illness, poverty, living conditions, etc. Social determinants of health (SDOH) are defined as non-medical factors that can affect one’s health. These factors, along with psychiatric illness, can impact inpatient care and discharge planning. Our objective was to determine the prevalence of psychosocial factors in our burn population and analyze their impact on length of stay (LOS) and discharge disposition.

Methods
A retrospective chart review from January 1, 2022 to December 31, 2022 was performed at a large, urban, American Burn Association (ABA)-verified burn center using data from the ABA Burn Care Quality Platform (BCQP). All admitted patients ≥18 years old who sustained a burn injury were included. The two SDOH captured by BCQP, insurance status and living situation, were collected, in addition to psychiatric diagnosis, substance use disorder and alcohol use disorder. Primary outcome was LOS and secondary outcome was discharge disposition. Continuous variables were represented as median (interquartile range) and categorical variables as n (%). The Wilcoxon rank-sum test and Fisher’s exact test were used to compare LOS and discharge disposition between psychosocial variables of interest.

Results
Out of 302 patients, 129 (43%) had at least one negative SDOH. Of these 129 patients, 97% of them were uninsured/underinsured and 14% were undomiciled. Of the total population, 16% had a psychiatric diagnosis, 4.6% had alcohol use disorder and 8.6% had substance use disorder with a higher prevalence in the uninsured/underinsured and undomiciled population. There were 18 patients (6%) who were undomiciled prior to admission. The median LOS for all 302 patients was 8 days (IQR: 2, 17) and was not significantly different by insurance. Patients with a psychiatric diagnosis had significantly longer median LOS (15 days) when compared to those without (7 days, p=0.009). Undomiciled patients also had significantly longer median LOS (12 days vs 7 days, p = 0.034). Comparing by insurance, patients were discharged home with self-care at a similar rate (68% for insured, 62% for uninsured/underinsured). Patients in the uninsured/underinsured group were less likely to go to subacute rehab (4.3%) compared to the well-insured (11%). Only 28% of undomiciled patients were discharged back to a shelter or street.

Conclusions
The care of our burn patients is not defined by insurance status. However, the burn community needs a better, systematic process of collecting additional SDOH to further understand the impact they have on our patients. The longer LOS for those with psychiatric illness and homelessness highlights the need for specialized care both in the inpatient and post-discharge setting.

Applicability of Research to Practice
Directly applicable
70 Anxiety and Depression Increase Sleep Disturbances for Burn Survivors: A Burn Model System Study
Authors: Kim Anika , McMullen Kara , Stewart Barclay T , Schneider Jeffrey C , Ryan Colleen M , Won Paul , Yenikomshian Haig A 
Published: April 2024

Abstract

Introduction
In aftercare, burn survivors have many challenges arising from their injuries. Sleep disturbance, despite its significant impact on quality of life, remains a poorly understood and studied consequence. This study investigates the interplay between sleep quality, mental health, and recovery in adult burn survivors.

Methods
This retrospective study used the Burn Model System National Longitudinal Database (2015 to 2023) to examine sleep disturbance (SD) in adult burn patients. Subjects were divided into two groups based on their PROMIS-29 SD scores at 6, 12, 24 months, and 5 years follow-up: no to mild and moderate to severe SD. Mixed-effects modeling was used to compare the clinical characteristics of the two groups at 6 months. Person-level and site-level random effects were included to account for variations among subjects and treatment sites.

Results
The study included 558 adult burn survivors with a mean age of 47.7 years and a mean Total Body Surface Area (TBSA) burn size of 16.0%. Mean SD scores were highest at 6 months (51.1) and decreased by 24 months (49.1) (higher scores = more SD). The study identified a positive association between SD and depression and anxiety scores (higher scores = more anxiety and depression). A one-unit increase in SD corresponded to a 0.184 increase in depression scores and a 0.343 increase in anxiety scores at 6 months (p-value &lt; 0.001) (see Table 1). The association remained significant when controlling for person and burn injury site differences. No other significant differences were found between demographic or clinical characteristics at 6 months.

Conclusions
This study highlights the complex interaction between SD, mental health, and recovery after burn injuries. Our data reveal that while subjects with depression and anxiety are more likely to experience SD after burn injury, there's a promising trend of improvement over time. These findings lay the foundation for improving targeted interventions and education in the clinical care of adult burn survivors.

Applicability of Research to Practice
Insights from the study identify a subgroup of burn survivors who might benefit from personalized interventions addressing sleep, anxiety, and depression. Furthermore, integrating the expected sleep patterns after burn injuries into patient and caregiver education at discharge and providing patient-specific coping strategies will further enhance the recovery outlook and personalize the aftercare experience.
74 Patient’s Perception of Likelihood to Attend Follow-Up in Burn Surgery Clinic
Authors: Coward Alexandra , Gilbert Megan , Ivanko Anastasiya , Heard Jason , Sen Soman , Palmieri Tina L , Greenhalgh David G , Romanowski Kathleen S 
Published: April 2024

Abstract

Introduction
Previous work has demonstrated that follow-up rates in burn patients are concerningly low. The ability to predict which patients will follow up in the clinic could improve short and long-term patient outcomes; through providing alternative means to obtain care. This study aims to evaluate if patients are aware of their likelihood of attending follow-up appointments.

Methods
Following the determination by the IRB that this was an exempt project and did not require informed consent, a survey assessing patient’s confidence that they would attend follow-up, was obtained for all admitted Burn Surgery patients at the time of discharge from September 2021 to June 2022 (N=251). Chart review then determined if patients presented for follow-up within thirty days of discharge. Univariate statistical analysis was performed. For all statistically significant variables, multivariate logistic regression with backward elimination was performed.

Results
Of the 251 included patients, 65% (N=165) presented for follow-up. These patients were able to accurately predict if they would present to follow-up (p &lt; 0.0001). Of patients who were either very or somewhat confident that they would follow up (217 patients), 151 (69.6%) did attend a follow-up. Of patients who were either very or somewhat unconfident (8 patients), 5 patients (62.5%) did not attend a follow-up. A history of substance use disorder (p=0.004), tobacco use (p=0.0004), housing insecurity (p &lt; 0.0001), disposition to a location other than their prior residence (p=0.02), and MediCal or Medicare insurance (p=0.003) were associated with lack of follow up care. Factors independently associated with follow-up include confidence in presenting on survey Odds Ratio (OR)=1.36 (95% Confidence Interval (CI) 0.18-9.8), no housing insecurity OR=4.17 (95% CI 1.53-11.32), and no history of substance use disorder OR=3.09 (95% CI 1.47-6.49).

Conclusions
Patients can accurately predict if they will follow up after discharge, while housing insecurity and history of substance use disorder are independently associated with a lack of follow-up care. Further research on alternatives to traditional follow-up is warranted to improve patient outcomes.

Applicability of Research to Practice
Alternative methods of follow-up should be considered for patients who do not think they will be able to follow up in burn clinic.