bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of antimicrobial resistance in Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli isolates among stillbirths and deceased under-five children in Sierra Leone: Data from the Child Health and Mortality Prevention Surveillance sites from 2019 to 2022
Authors: OJULONG JULIUS , Gebru G. N. , Duduyemi B. , Monteiro L. , Kowuor D. , Ameh S. , Ogbuanu I. U. 
Published: February 2024

Abstract

Introduction: Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae are associated with most nosocomial infections worldwide. Although gaps remain in knowledge of their susceptibility patterns, these are in antimicrobial stewardship. This study aimed to describe antimicrobial susceptibility profiles of the above organisms isolated from postmortem blood from stillbirths and under-five children enrolled in the Child Health and Mortality Prevention Surveillance (CHAMPS) programme in Sierra Leone.
Methods: This was a surveillance study of bacteria isolates from postmortem blood cultures taken within 24 hours of death from cases aged 0-59 months between February 2019 and February 2022. This was followed by identification and antibiotic sensitivity testing using Becton Dickinson Phoenix M50 (USA). Descriptive analysis was used to characterize the isolates and their antimicrobial susceptibility patterns.
Results: Of 367 isolates, K. pneumoniae was the most frequently isolated organism (n= 152; 41.4%), followed by E. coli (n= 40; 10.9%) and E. cloacae (n=35; 9.5%). Using BACTEC™ FX 40 (USA), 367 isolates were identified from blood using bacteriological methods. Extended Spectrum beta-lactamase (ESBL) was observed in 143 (94.1%) of K. pneumoniae isolates and 27 (65.5%) of E. coli isolates. Carbapenemase resistant organisms (CRO) were seen in 31 (20.4%) of K. pneumoniae and 5 (12.5%) of E. coli isolates. Multi-drug resistance (MDR) pattern was most prevalent in E.cloacae (33/35; 94.3%) followed by K. pneumoniae (138/152; 90.8%).
Conclusion: Our study showed a high prevalence of multidrug resistance among bacterial isolates in the catchment areas under surveillance by the CHAMPS sites in Sierra Leone. This signals the need to enhance antimicrobial stewardship, infection prevention control measures and extensive antimicrobial resistance surveillance.
Digital New Normal: A New Era of Artificial Neural Networks Application for the Elderly’s Intention to Use Non-face-to-face Leisure Service
Authors: Hyun Byun , Hwang Su-Young , Yi Eun-Surk 
Published: February 2024

Abstract

Objective: Using artificial neural network models and cluster analysis, this study analyzed and predicted the intention to use digital leisure services among the elderly based on their adoption of non-face-to-face services.
Methods: Utilizing raw data from the 2022 Urban Policy Indicator Survey, 2,239 residents of Seoul aged 50 and above were selected for the study. The research predicted the intention to use non-contact leisure services based on demographic characteristics, adaptability to non-face-to-face environments, and frequency of social media usage. Collected data were processed using SPSS 23 and Modeler 14.2, and subjected to frequency analysis, hierarchical clustering, K-means clustering analysis, artificial neural network analysis, logistic regression analysis, cross-tabulation analysis, and one-way ANOVA.
Results: The results identified four clusters. Cluster 3, comprising males in their 60s living with their families, showed the strongest intention to use digital leisure services despite low social media usage and high adaptability to non-face-to-face environments.
Conclusion: This suggests that policies and programs to promote the use of digital leisure services among the elderly should enhance digital accessibility and adaptability to non-face-to-face environments. Additionally, given the limitations of the research subjects and data, further research is needed on a broader age range and more diverse sample of the elderly population. The study also emphasizes the need for digital education programs for the elderly and the provision of leisure services through various digital platforms.
End of life decision making when home mechanical ventilation is used to sustain breathing in Motor Neurone Disease: patient and family perspectives
Authors: Wilson Eleanor , Palmer Jonathan , Armstrong Alison , Messer Ben , Presswood Edward , Faull Christina 
Published: February 2024

Abstract

Background
Motor Neurone Disease (MND), leads to muscle weakening, affecting movement, speech, and breathing. Home mechanical ventilation, particularly non-invasive ventilation (NIV), is used to alleviate symptoms and support breathing in people living with MND. While home mechanical ventilation can alleviate symptoms and improve survival, it does not slow the progression of MND. This study addresses gaps in understanding end-of-life decision-making in those dependent on home mechanical ventilation, considering the perspectives of patients, family members, and bereaved families.
Methods
A UK-wide qualitative study using flexible interviews to explore the experiences of people living with MND (n = 16), their family members (n = 10), and bereaved family members (n = 36) about the use of home mechanical ventilation at the end of life.
Results
Some participants expressed a reluctance to discuss end-of-life decisions, often framed as a desire to "live for the day" due to the considerable uncertainty faced by those with MND. Participants who avoided end-of-life discussions often engaged in ‘selective decision-making’ related to personal planning, involving practical and emotional preparations. Many faced challenges in hypothesising about future decisions given the unpredictability of the disease, opting to make ‘timely decisions’ as and when needed. For those who became dependent on ventilation and did not want to discuss end of life, decisions were often defaulted to others, especially once capacity was lost. ‘Proactive decisions’, including advance care planning and withdrawal of treatment, were found to empower some patients, providing a sense of control over the timing of their death. A significant proportion lacked a clear understanding of the dying process and available options.
Conclusions
The study highlights the complexity and evolution of decision-making, often influenced by the dynamic and uncertain nature of MND. The study emphasises the need for a nuanced understanding of decision-making in the context of MND.
The impact of addiction medicine consultation on outcomes in hospitalized patients
Authors: Serata Emily , Aplin Kara , Salzman Matthew , Hunter Krystal , Rachoin Jean-Sebastien 
Published: February 2024

Abstract

Background
Over the last several years, the incidence and prevalence of substance use disorders (SUD) and related acute illnesses have been rising in the US. Their diagnosis of SUD impacts the clinical course of many hospitalized patients. The primary objective of our study is to assess the impact of a newly implemented inpatient addiction medicine consult service on outcomes in patients with a SUD.
Methods
We included adult SUD patients hospitalized for 24 hours or greater between March 2018 and January 2022. We recorded demographic and clinical variables and analyzed the association between the occurrence of addiction medicine consultation (AMC) with the outcomes of left against medical advice (AMA) and 30-day readmission (READ).
Results
There were 1,020 encounters included in our study: 945 (93%) without AMC and 75 (7%) AMC. AMC patients were younger (53.2 vs. 56.93, P < 0.001), were often male (22.7% vs. 13%, P < 0.001), or had health insurance (74.7% vs. 85.4%, p = 0.015). Their years of use (30 years) and hospital length of stay (4 days) were similar between AMC and non-AMC groups. More patients were using intravenous drugs in the AMC group (25.3% vs 9.8%, < p < 0.001) and opioids (50.7% vs. 19.3%, P < 0.001). In a multivariate regression analysis for the outcomes of interest, after adjusting for demographic variables, AMC was not associated with the outcome AMA (P = 183) but was shown to have a much lower likelihood of 30-day readmission (0.3[0.1–0.8], P = 0.016).
Conclusion
We found that the practice of AMC was associated with similar rates of AMA but fewer 30-day readmission rates in patients with SUD. The comparable rate of AMA could be due to clinicians' higher propensity to consult AMC if patients threaten to leave the hospital. The findings of our study should be confirmed in larger trials but hold significant promise.
Data-guided Gravity Model for Competitive Facility Location
Authors: Zerom Dawit , Drezner Zvi 
Published: February 2024

Abstract
In this paper we introduce a data analytics approach for specifying the gravity model as applied to competitive facility location. The gravity model is used primarily by marketers to estimate the market share attracted by competing retail facilities. Once the market share is computed, various solution techniques can be applied for finding the best locations for one or more new facilities. In competitive facility location research, various parametrized gravity models have been proposed such as the power and the exponential distance decay specifications. However, parameterized approaches may not be robust to slight data inconsistency and possibly leading to inaccurate market share predictions. As the volume of data available to support managerial decision making is growing rapidly, non-parametric (data-guided) approaches are naturally attractive alternatives as they can mitigate parametric biases. We introduce a unified gravity model that encompasses practically all existing parametric gravity models as special cases. We provide a statistical framework for empirically estimating the proposed gravity models focusing on shopping malls data involving shopping frequency.
Comparison of mini-percutaneous nephrolithotomy versus standard percutaneous nephrolithotomy for patients with kidney stones and renal insufficiency: A retrospective study
Authors: WEI Weiyang , ZHOU Chuanpeng , YANG Hao , WANG Qi , HUANG Hongxing , HUANG Yaqiang 
Published: February 2024

Abstract

Objective
To compare the clinical efficacy and safety of mini-percutaneous nephrolithotomy (MPCNL) and standard percutaneous nephrolithotomy (SPCNL) in the treatment of kidney stones combine with renal insufficiency.
Patients and Methods:
The data of 320 patients with renal calculi and an eGFR < 60 mL/min/1.73m2 who underwent percutaneous nephrolithotomy (PCNL) at Zhongshan City People's Hospital from January 2018 to June 2023 were retrospectively analyzed; 164 patients were treated with MPCNL, and 156 were treated with SPCNL. The clinical efficacy of the MPCNL and SPCNL regimens was compared in terms of stone-free rate (SFR), renal function change, hemoglobin (HGB) drop and other complication rates (complications were classified by using the Clavien‒Dindo system).
Results
The SFR was 67.1% in the MPCNL group and 67.9% in the SPCNL group (P = 0.867). The overall eGFR of the two groups was significantly improved at 1 month after the operation (P < 0.001). Postoperative renal function was stable, improved and worse in 50.0% (n = 82) vs. 53.8% (n = 84), 39.0% (n = 64) vs. 42.4% (n = 66) and 11.0% (n = 18) vs. 3.8% (n = 6) of the MPCNL and SPCNL patients, respectively, compared with preoperative renal function (P = 0.053). In addition, the overall postoperative complication rates between the two groups was not significantly different (P = 0.103). Patients who underwent MPCNL had a lower transfusion rate (7.9% vs. 16.7%, P = 0.017) and shorter hospital stay (4.57 ± 3.14 vs. 7.16 ± 4.05 days, P < 0.001) than those in the SPCNL group.
Conclusion
MPCNL and SPCNL have positive effects on the treatment of renal calculi in patients with renal insufficiency; both have acceptable SFRs and complication rates, stable or improved renal function in most patients.
The slopes of sub-barrier heavy-ion fusion excitation functions shed light on the dynamics of quantum tunnelling
Authors: Stefanini Alberto , Montagnoli Giovanna , Fabbro Mirco Del , Corradi Lorenzo , Fioretto Enrico , Szilner Suzana 
Published: February 2024

Abstract
Quantum tunnelling plays a crucial role in heavy-ion fusion reactions at sub-barrier energies, especially in the context of nuclear physics and astrophysics. The nuclear structure of the colliding nuclei and nucleon transfer processes represent intrinsic degrees of freedom. They are coupled to the relative ion motion and, in general, increase the probability of tunnelling. The influence of couplings to nucleon transfer channels relatively to inelastic excitations, on heavy-ion fusion cross sections, is one of the still open problems in this field. We present a new analysis of several systems, based on the combined observation of the energy-weighted excitation functions Eσ in relation to their first energy derivatives d(Eσ)/dE. The relation between d(Eσ)/dE and Eσ removes the basic differences due to the varying Coulomb barrier when comparing different systems. We show that, depending on the nuclear structure and/or the presence of strong transfer channels, this representation reveals characteristic features below the barrier. The possible presence of cross section oscillations makes this analysis less clear for light- or medium-light systems.
PACS Numbers: 25.70.Jj, 24.10.Eq
Posterior cerebral artery (PCA)-accessory PCA (hyperplastic anterior choroidal artery) anastomosis detected on magnetic resonance angiography
Authors: Uchino Akira , Tokushige Kazuo 
Published: February 2024

Abstract
Purpose
To describe a case of posterior cerebral artery (PCA) accessory PCA (hyperplastic anterior choroidal artery) anastomosis detected on magnetic resonance angiography.
Methods
A 76-year-old man with a history of cerebral infarction underwent cranial magnetic resonance (MR) imaging and MR angiography of the intracranial region for the evaluation of brain and vascular lesions. The MR machine was a 3-Tesla scanner. MR angiography was performed using a standard three-dimensional time-of-flight technique.
Results
There were two right PCAs. The parieto-occipital and calcarine arteries of the right PCA arose from the right ICA, indicative of accessory PCA, and there were three stenotic lesions at the proximal segment of this artery. The temporal artery of the right PCA originated from the basilar artery. A small anastomotic channel between these two arteries was identified on partial maximum intensity projection (MIP) images. Computed tomography angiography was additionally performed and the findings were confirmed.
Conclusion
We speculated that the pressure gradient between the PCA and the accessory PCA enlarged the anastomotic channel. Partial MIP images are useful for diagnosing small arterial variations using MR angiography.
Presurgical Pulmonary Function Tests in the First Few Days of Life in Neonates with Congenital Heart Disease, A Pilot Study
Authors: McEvoy Cindy , Leeds Hayden , Muralidaran Ashok , Johnson Alicia , Schilling Diane , Parkhotyuk Kseniya , Shen Irving 
Published: February 2024

Abstract

Objective To compare early pulmonary function tests (PFTs) in neonates with critical congenital heart disease (CHD) compared to a historical reference group.Design Infants > 37 weeks gestation with critical CHD were studied within the first few days of life and prior to cardiac surgery and compared to data from a published reference group. Passive respiratory resistance (Rrs) and compliance (Crs) were measured with the single breath occlusion technique following specific acceptance criteria. The study was powered for a 30% difference in Rrs.Results PFTs in 24 infants with CHD were compared to 31 historical reference infants. There was no difference in the Rrs between the groups. The infants with CHD had a significantly decreased Crs (1.02 ± 0.26 mL/cmH2O/kg versus 1.32 ± 0.36; (p < 0.05; mean ± SD)).Conclusions Further prospective studies are required to quantify early PFTs in infants with CHD of different phenotypes.
Effect of zinc and selenium on breast cancer risk: a NHANES cross-sectional study and mediation analysis
Authors: wang yanbo , du zhen , Du Haowei , Zhao Jianchun , Duan Yuting , Wang Aimin 
Published: February 2024

Abstract
Background: This research aimed to examine the correlation between blood zinc and selenium levels and the occurrence of breast cancer, and the extent to which bilirubin, uric acid and γ-glutamyl transferase (GGT)mediate the effect on breast cancer.
Methods: In all, 25,244 adults were enrolled from the 1990-2020 Nutrition Examination Survey (NHANES). The outcome was considered as the occurrence of breast cancer in this study. Zinc and selenium levels were categorized into quartiles (Q1-Q4), and the correlation between zinc or selenium intake and breast cancer incidence was explored through meticulous adjustments for covariates utilizing both multivariate and stratified logistic regression analyses. Furthermore, the mediation and interaction effects were performed by mediation analyses and generalized linear model.
Results: The incidence of breast cancer was associated with race, marital status and age. Besides, participants with breast cancer showed lower zinc (10.2 vs 12.0 mg/ml, p=0.001) and selenium levels (95 vs 114 μg/ml, p<0.001) and higher incidence of diabetes (15% vs 8.5%, p<0.001) and cardiovascular disease (CVD) (16% vs 7.4%, p<0.001) comorbidities than the control group. Logistic regression analysis showed a strong linear protective association between zinc and selenium levels and breast cancer. Moreover, this association changed slightly after adjusting demographic characteristics, socioeconomic characteristics, health factors, and comorbidities and remained statistically significant. In addition, no interaction was found between diabetes and CVD and the effect of zinc/selenium intake on breast cancer risk (p for interaction > 0.05). Finally, bilirubin potentially mediated the protective association between zinc and breast cancer risk, while bilirubin, uric acid, and GGT levels mediated approximately 10% of the relationship between selenium and breast cancer.
Conclusion: Our study highlighted a negative linear association between blood zinc and selenium concentrations and the risk of breast cancer in women. The mediation analysis has shown that bilirubin, uric acid and GGT play an indirect role.
Effect of lymphocyte-to-monocyte ratio on prognosis in obstructive colorectal cancer patients with colonic stent: a Japanese retrospective multicenter study
Authors: Shiraishi Toshio , Tominaga Tetsuro , Nonaka Takashi , Hashimoto Shintaro , Takamura Yuma , Hisanaga Makoto , Takeshita Hiroaki , Ishii Mitsutoshi , Oyama Syosaburo , Ishimaru Kazuhide , Kunizaki Masaki , Sawai Terumitsu 
Published: February 2024

Abstract

Background
The prognostic value of the lymphocyte-to-monocyte ratio (LMR) has been reported for various cancers, including colorectal cancer (CRC). Insertion of self-expanding metallic stents (SEMS) is considered effective for patients with surgically indicated obstructive CRC, but LMR can vary depending on factors such as inflammation associated with stent dilation, improvement of obstructive colitis and nutritional status. LMR may thus change at the time of evaluation. However, the usefulness of LMR in CRC patients requiring SEMS insertion and the optimal timing for measuring LMR remain unclear. This study investigated the relationship between pre-stent LMR and long-term prognosis in patients who underwent bridge to surgery (BTS) for obstructive CRC with SEMS insertion.
Methods
Participants comprised 175 patients with pathological stage 2 or 3 disease who underwent BTS for obstructive CRC with SEMS insertion. Patients were divided into two groups according to pre-stent LMR, as follows: low pre-stent LMR group (pre-LMR-L, n = 87) and high pre-stent LMR group (pre-LMR-H, n = 83).
Results
Median follow-up was 33 months (range, 1–77 months). Five-year relapse-free survival (RFS) only differed significantly for pre-LMR (pre-LMR-L: 39.9% vs. pre-LMR-H: 63.6%; p = 0.015). Pre-LMR represented a prognostic factor for RFS in both univariate (hazard ratio [HR] 1.845, 95% confidence interval [CI] 1.125–3.026; p = 0.015) and multivariate analyses (HR 2.052, 95%CI 1.242–3.389; p = 0.005). Pre-LMR was not a prognostic factor for overall survival in univariate analysis (HR 1.721, 95%CI 0.878–3.374; p = 0.114).
Conclusions
Pre-LMR-L represents a prognostic factor for postoperative recurrence in patients who undergo BTS for obstructive CRC with SEMS insertion.
Adaptive Kriging-based method with learning function allocation scheme and hybrid convergence criterion for efficient structural reliability analysis
Authors: Zhou Jiaguo , Xu Guoji , Jiang Zexing , Li Yongle , Wang Jinsheng 
Published: February 2024

Abstract

Structural reliability analysis poses a considerable challenge in engineering practice, leading to the development of various state-of-the-art methods. Active learning methods, known for their superior performance, have been extensively investigated for assessing failure probabilities in structural reliability analysis. This paper aims to develop an efficient and accurate Kriging-based active learning method for structural reliability analysis, incorporating a novel learning function allocation scheme and a hybrid convergence criterion. Specifically, a novel learning function allocation scheme is introduced to address the challenge of no single learning function demonstrating superior performance across various engineering contexts. Six active learning functions, including EFF, H, REIF, LIF, FNEIF, and KO, are used to form a portfolio of functions in the allocation scheme. The use of the U learning function initiates the active learning process with a truncated candidate sample pool, alleviating computational burden while maintaining accuracy. Additionally, a hybrid convergence criterion, combining the error-based stopping criterion with a stabilization convergence criterion, is proposed to terminate the active learning process at an appropriate stage. The performance of the proposed method is evaluated through four numerical examples and one engineering case, demonstrating its accuracy and efficiency.
Invasive fusariosis with cutaneous manifestation during chemotherapy treatment of a patient with acute lymphoid leukemia: case report
Authors: Bandeira Fernanda Letícia Reis , Cristino Joseir Saturnino , Crispim Myuki Alfaia Esashika , Mendes Ana Galdina dos Reis , Ferreira Cristina Motta 
Published: February 2024

Abstract
Invasive fungal infections have a high mortality rate, especially when they affect immunocompromised patients. The objective of this article is to report a case of a patient affected by a rare fungal infection of the genus Fusarium spp., during treatment for acute lymphocytic leukemia, covering everything from clinical and laboratory aspects to diagnosis. When dealing with an invasive Fusarium spp. infection, the patient's clinical outcome largely depends on the resolution of immunosuppression, particularly the recovery of neutrophils in neutropenic patients.