bluuebunny/crossref_metadata_2025_split huggingface dataset:
SUBA-Itraconazole for Primary Antifungal Prophylaxis After Allogeneic Hematopoietic Cell Transplantation
Authors: Lindsay Julian , Othman Jad , Kong Yvonne , Yip Annie , Van Hal Sebastiaan , Larsen Stephen , Bryant Christian , Gibson John , Kerridge Ian , Fay Keith , Stevenson William , Arthur Chris , Chen Sharon C A , Kong David C M , Greenwood Matthew , Pergam Steven A , Liu Catherine , Slavin Monica A 
Published: February 2024

Abstract

Background
Itraconazole (ITZ) is an effective agent when used as primary invasive fungal disease (IFD) prophylaxis, but is limited by drug tolerability and variability in serum concentrations. A new formulation, SUBA-itraconazole (for “super bioavailability”; S-ITZ), addresses the limitations of conventional ITZ formulations.

Methods
We conducted a retrospective cohort study at 2 Australian centers to evaluate the safety, tolerability, and effectiveness of S-ITZ as primary antifungal prophylaxis in hematopoietic cell transplant (HCT) recipients without grade II–IV acute graft-vs-host disease, from day 1 until approximately day 100 (cohort A) or day 1 until neutrophil engraftment (cohort B). A total of 204 patients and 1410 trough plasma ITZ concentrations were assessed.

Results
The incidence of breakthrough proven/probable IFD at day 180 was 1.0% (95% confidence interval [CI], .2%–3.2%), with 1.6% in cohort A and 0% in cohort B, and overall fungal-free survival of proven/probable IFD was 82.9% (95% CI, 76.8%–87.4%). Preengraftment early permanent S-ITZ discontinuation was 3.4% overall, with no significant difference between cohorts. No patients required cessation due to gastrointestinal intolerance attributed to S-ITZ. The geometric mean trough plasma ITZ concentration was 1130ng/mL (interquartile range, 566–1801ng/mL; coefficient of variation, 56.57%) and the median time to achieve therapeutic levels was 10 days.

Conclusions
S-ITZ is a safe and well-tolerated oral formulation and is a novel alternative for primary IFD prophylaxis after HCT.
Eosinophilic Liver Abscess: A Case of Locally Acquired Fasciola hepatica in Alberta, Canada
Authors: King Teagan , Cabada Miguel M , Kowalewska-Grochowska Kinga , Vaughan Stephen D 
Published: February 2024

Abstract
Fasciola hepatica is a trematode causing acute and chronic infection. A 33-year-old Canadian woman with eosinophilic liver abscesses and no relevant travel was diagnosed with F hepatica infection. F hepatica is reported in livestock in Alberta. This is the first case of locally acquired fascioliasis in Canada in &gt;100 years.
Directed droplet motion along thin fibers
Authors: Khattak Hamza K , Shanzeela Aileen , Raphael Elie , Dalnoki-Veress Kari 
Published: February 2024

Abstract
When microscopic droplets are placed between fibers held at a fixed angle, the droplets spontaneously move toward the apex of the fibers. The speed of the droplet motion increases both with the angle between the fibers and the distance the droplet spans across the fibers. The speed of these droplets can be described by a simple scaling relationship. Bending these fibers into a sawtooth geometry results in a droplet ratchet where cyclic motion in a fiber results in extended linear motion of the droplet, and can even be used to induce droplet mergers.
Oxytocin differentially modulates the early neural responses to faces and non-social stimuli
Authors: Moses Eleanor , Nelson Nicole , Taubert Jessica , Pegna Alan J 
Published: February 2024

Abstract
Oxytocin (OT) alters social cognition partly through effects on the processing and appraisal of faces. It is debated whether the hormone also impacts the processing of other, non-social, visual stimuli. To this end, we conducted a randomized, counter-balanced, double-blind, placebo (PL)-controlled within-subjects’ electro-encephalography (EEG) study with cismale participants (to control for gender dimorphic hormonal effects; n = 37). Participants received intranasal OT (24IU) and completed a one-back task viewing emotional (fearful/ happy) and neutral faces, and threat (snakes/spiders) and non-threat (mushrooms/flowers) non-social stimuli. OT differentially impacted event-related potentials (ERP)s to faces and non-social stimuli. For faces regardless of emotion, OT evoked greater occipital N1 and anterior P1 amplitudes at ∼155 ms than after PL, and lead to sustained differences over anterior, bilateral parietal and occipital sites from 205 ms onwards. For all non-social stimuli, OT evoked greater right parietal N1 amplitudes, and later only impacted threat stimuli over right parietal and occipital sites. None of these OT-induced modulations was related to individual anxiety levels. This pattern of results indicates that OT differentially modulates the processing of faces and non-social stimuli, and that the hormone’s effect on visual processing and cognition does not occur as a function of non-clinical levels of anxiety.
High HIV diversity, recombination, and superinfection revealed in a large outbreak among persons who inject drugs in Kentucky and Ohio, USA
Authors: Switzer William M , Shankar Anupama , Jia Hongwei , Knyazev Sergey , Ambrosio Frank , Kelly Reagan , Zheng HaoQiang , Campbell Ellsworth M , Cintron Roxana , Pan Yi , Saduvala Neeraja , Panneer Nivedha , Richman Rhiannon , Singh Manny B , Thoroughman Douglas A , Blau Erin F , Khalil George M , Lyss Sheryl , Heneine Walid 
Published: February 2024

Abstract
We investigated transmission dynamics of a large human immunodeficiency virus (HIV) outbreak among persons who inject drugs (PWID) in KY and OH during 2017–20 by using detailed phylogenetic, network, recombination, and cluster dating analyses. Using polymerase (pol) sequences from 193 people associated with the investigation, we document high HIV-1 diversity, including Subtype B (44.6 per cent); numerous circulating recombinant forms (CRFs) including CRF02_AG (2.5 per cent) and CRF02_AG-like (21.8 per cent); and many unique recombinant forms composed of CRFs with major subtypes and sub-subtypes [CRF02_AG/B (24.3 per cent), B/CRF02_AG/B (0.5 per cent), and A6/D/B (6.4 per cent)]. Cluster analysis of sequences using a 1.5 per cent genetic distance identified thirteen clusters, including a seventy-five-member cluster composed of CRF02_AG-like and CRF02_AG/B, an eighteen-member CRF02_AG/B cluster, Subtype B clusters of sizes ranging from two to twenty-three, and a nine-member A6/D and A6/D/B cluster. Recombination and phylogenetic analyses identified CRF02_AG/B variants with ten unique breakpoints likely originating from Subtype B and CRF02_AG-like viruses in the largest clusters. The addition of contact tracing results from OH to the genetic networks identified linkage between persons with Subtype B, CRF02_AG, and CRF02_AG/B sequences in the clusters supporting de novo recombinant generation. Superinfection prevalence was 13.3 per cent (8/60) in persons with multiple specimens and included infection with B and CRF02_AG; B and CRF02_AG/B; or B and A6/D/B. In addition to the presence of multiple, distinct molecular clusters associated with this outbreak, cluster dating inferred transmission associated with the largest molecular cluster occurred as early as 2006, with high transmission rates during 2017–8 in certain other molecular clusters. This outbreak among PWID in KY and OH was likely driven by rapid transmission of multiple HIV-1 variants including de novo viral recombinants from circulating viruses within the community. Our findings documenting the high HIV-1 transmission rate and clustering through partner services and molecular clusters emphasize the importance of leveraging multiple different data sources and analyses, including those from disease intervention specialist investigations, to better understand outbreak dynamics and interrupt HIV spread.
Regional anesthesia is associated with prolonged operative time and unplanned inpatient admission in distal radius fractures
Authors: Horn Ryan W. , Johnson Charles A. , Newton William N. , Brewbaker Carey L. , Daley Dane N. 
Published: February 2024

Background:
Regional anesthesia is commonly used as an alternative to general anesthesia in the surgical treatment of distal radius fractures. The purpose of this study is to evaluate the effect general versus regional anesthesia has on post-operative outcomes and perioperative time in the open treatment of distal radius fractures.

Methods:
The National Surgical Quality Improvement Program database was queried to identify adult who underwent open reduction and internal fixation of distal radius fractures between 2005 and 2018. Patients were classified as receiving either general anesthesia or regional anesthesia. Mean perioperative times and length of stay were compared between groups. Univariate analysis and multivariate logistic regression were used to assess the risk of prolonged operative time and of 30-day post-operative complications, based on anesthesia type.

Results:
A total of 13,059 patients were identified, with 11,761 (90.1%) receiving GA and 1,298 (9.9%) receiving RA. RA was associated with a significantly longer duration of anesthesia (124.5 vs. 115.7 min) and total operative time (77.0 vs. 72.6 min) but shorter wake-up times (11.8 vs. 13.0 min). Using multivariate analysis, RA was independently associated with an increased risk of prolonged operative time (OR 1.448; CI 1.234-1.699; P<0.001) and unplanned inpatient admission (OR 1.225, CI 1.019-1.545, P=0.033). The risk of all other acute postoperative complications was similar between groups.

Conclusion:
Regional anesthesia is independently associated with prolonged operative time and unplanned inpatient admission but not with acute postoperative complications in the open treatment of distal radius fractures.

Level of Evidence:
III
Barriers and Facilitators to End-of-Life Care Delivery in ICUs: A Qualitative Study
Authors: Janczewski Lauren M. , Chandrasekaran Adithya , Abahuje Egide , Ko Bona , Slocum John D. , Tesorero Kaithlyn , Nguyen My L. T. , Yang Sohae , Strong Erin A. , Bhakta Kunjan , Huml Jeffrey P. , Kruser Jacqueline M. , Johnson Julie K. , Stey Anne M. 
Published: February 2024

Objectives:
To understand frontline ICU clinician’s perceptions of end-of-life care delivery in the ICU.

Design:
Qualitative observational cross-sectional study.

Setting:
Seven ICUs across three hospitals in an integrated academic health system.

SUBJECTS:
ICU clinicians (physicians [critical care, palliative care], advanced practice providers, nurses, social workers, chaplains).

Interventions:
None.

Measurements and Main Results:
In total, 27 semi-structured interviews were conducted, recorded, and transcribed. The research team reviewed all transcripts inductively to develop a codebook. Thematic analysis was conducted through coding, category formulation, and sorting for data reduction to identify central themes. Deductive reasoning facilitated data category formulation and thematic structuring anchored on the Systems Engineering Initiative for Patient Safety model identified that work systems (people, environment, tools, tasks) lead to processes and outcomes. Four themes were barriers or facilitators to end-of-life care. First, work system barriers delayed end-of-life care communication among clinicians as well as between clinicians and families. For example, over-reliance on palliative care people in handling end-of-life discussions prevented timely end-of-life care discussions with families. Second, clinician-level variability existed in end-of-life communication tasks. For example, end-of-life care discussions varied greatly in process and outcomes depending on the clinician leading the conversation. Third, clinician-family-patient priorities or treatment goals were misaligned. Conversely, regular discussion and joint decisions facilitated higher familial confidence in end-of-life care delivery process. These detailed discussions between care teams aligned priorities and led to fewer situations where patients/families received conflicting information. Fourth, clinician moral distress occurred from providing nonbeneficial care. Interviewees reported standardized end-of-life care discussion process incorporated by the people in the work system including patient, family, and clinicians were foundational to delivering end-of-life care that reduced both patient and family suffering, as well as clinician moral distress.

Conclusions:
Standardized work system communication tasks may improve end-of life discussion processes between clinicians and families.
Using the Plan-Do-Study-Act Evaluation Framework to Improve the Recruitment of Women Experiencing Homelessness
Authors: Galvin Annalynn M. , Walters Scott T. , Lewis Melissa A. , Thompson Erika L. 
Published: February 2024

Background and Objectives:
Strategic recruitment is necessary to reach recruiting goals when conducting research with vulnerable and transient populations, such as postpartum women experiencing homelessness. The current study evaluated the recruitment process for a qualitative study using the Plan-Do-Study-Act (PDSA) method.

Methods:
In a study conducting semistructured interviews about reproductive interconception care barriers and facilitators for local women who were recently pregnant and homeless in 2022, PDSA cycles were used to improve community organizations' assistance with identifying participants, facilitate screening and interviewing processes, and ensure participants were safeguarded.

Results:
Iterative PDSA cycles were conducted across a 20-week period. Ultimately, 12 women were interviewed, with increasing participant location and organizational assistance over time. Following 4 key lessons were identified: provide in-person and remote options for conducting data collection; include fair compensation that balances time versus study coercion; weigh feasibility versus importance of sample size with eligibility criteria; and support partnerships with organization connections.

Conclusions:
The PDSA method served as a parsimonious framework for evaluation. The lessons learned will help facilitate future recruitment efforts for this difficult-to-recruit and vulnerable population.
Lower Perceived Neighborhood Collective Efficacy Indirectly Influences the Association Between Perceived Maternal Exposure to Community Violence and Household Food Insecurity
Authors: Daundasekara Sajeevika S. , Marshall Allison N. , Schuler Brittany R. , Testa Alexander , Hernandez Daphne C. 
Published: February 2024

Background and Objectives:
Individuals of color and of low socioeconomic status are at greater risk of experiencing community violence and food insecurity, which are both influenced by neighborhood conditions. We evaluated neighborhood collective efficacy as a linkage between community violence exposure and household food insecurity.

Methods:
Mothers from the Future of Families and Child Wellbeing Study who completed phone surveys when the child was 3 (time 1, T1) and 5 years old (time 2, T2) were included (n = 2068). A covariate-adjusted structural equation model estimated direct and indirect effects of community violence exposure on household food insecurity. A covariate-adjusted multiple mediator model estimated the indirect effects of the 2 neighborhood collective efficacy subscales (informal social control; social cohesion and trust).

Results:
At T1, 40% of mothers reported community violence exposure; 15% experienced food insecurity at T2. Mean neighborhood collective efficacy (range 1-5) at T1 was 2.44 (SD = 0.94). Neighborhood collective efficacy indirectly influenced the association between community violence exposure and food insecurity (indirect effect = 0.022, 95% CI = 0.007 to 0.040). Only social cohesion and trust contributed independent variance to the indirect effect model (indirect effect = 0.028, 95% CI = 0.001 to 0.056).

Conclusions:
Community-based efforts to reduce household food insecurity should emphasize building social cohesion and trust in communities experiencing violence.
Measurement Matters: MRI Analysis of Differing Anatomic Measurement Techniques for Velar Length and the Velopharyngeal Needs Ratio
Authors: Mason Kazlin N. , Hanson Bailey , Black Jonathan S. 
Published: February 2024

Background:
Advances in imaging tools provide opportunities to enhance how velopharyngeal (VP) variables are quantified to facilitate surgical decisions. The purpose of this study was to use magnetic resonance imaging (MRI) to determine if quantitative differences were present between measures of linear and curvilinear velar length, and subsequently, the VP needs ratio.

Methods:
Data were prospectively collected from patients presenting with repaired cleft palate and/or congenital palatal insufficiency with or without VPI at a single center tertiary children’s hospital. Quantitative measures of the velopharynx using a novel nonsedated MRI protocol were obtained. Paired samples t tests were conducted to assess if differences were present between the VP needs ratio and measurements of linear and curvilinear velar length at rest and during sustained phonation. Intraclass correlation coefficients were calculated to assess intra/inter-rater reliability.

Results:
Significant differences were present between measurements of linear and curvilinear velar length at rest (P ≤ 0.001) and during sustained phonation (P ≤ 0.001). Significant differences were also present in the VP needs ratio (P ≤ 0.001). Curvilinear velar length at rest and during sustained phonation was longer than that of linear velar length at rest and during sustained phonation. No significant differences were observed between measures of effective velar length (P = 0.393).

Conclusions:
Measurement differences influence the VP needs ratio. This may have implications for comparisons to previously reported normative reference values and for those who are anatomically at risk for VPI. MRI provides an enhanced imaging modality to assess normative benchmarks and the anatomic variables used to define VP anatomy for clinical decision-making.
Predictors of blood pressure response to continuous positive airway pressure treatment in patients with sleep apnea
Authors: Seidel Maximilian , Kiziler Muhammed F. , Matiakis Marios , Bertram Sebastian , Wang Simon , Seibert Felix S. , Babel Nina , Westhoff Timm H. 
Published: February 2024

Background:
Sleep apnea is associated with hypertension. Metaanalyses indicate that treatment of sleep apnea by continuous positive airway pressure (CPAP) reduces blood pressure (BP) by a mean of 3 mmHg. To date, predictors of BP response to CPAP remain incompletely understood. We hypothesized that the magnitude of CPAP-induced BP reduction depends on baseline apnea–hypopnea index (AHI) and the extent of daytime sleepiness

Methods:
We performed a retrospective study on the association of BP response to CPAP with polysomnographic readings, intensity of sleepiness (measured by Epworth Sleepiness Scale, ESS), and epidemiologic parameters in 2461 patients with obstructive sleep apnea. BP response was defined as the difference between office BP at polysomonography examinations before and after initiation of CPAP.

Results:
Five hundred and fifty-five patients fulfilled all inclusion and exclusion criteria and were included in the analysis. Median monthly CPAP usage was 143.7 h (85.4–204.1 h). BP was significantly higher at baseline than at follow-up (129.9 ± 15.5 vs. 128.3 ± 15.2, P = 0.021) resulting in mean reduction of BP of −1.5 ± 19.2 mmHg. patients with a higher than median baseline AHI (median 21) showed a more pronounced reduction of BP than those with lower AHI (AHI ≥21: 130.5 ± 15.3 vs. 128.6 ± 14.6, P = 0.06; AHI <21: 129.5 ± 15.8 vs. 127.9 ± 15.8, P = 0.18). CPAP therapy led to a significant reduction in sleepiness (8.3 ± 4.8 vs. 6.6 ± 4.5, P < 0.0001). Those subjects with higher than median sleepiness score (ESS ≥8), however, did not show a significant difference in BP response compared with those with a lower sleepiness score. Receiver-operating characteristic (ROC) curve analyses investigating the accuracy of AHI and ESS to predict a BP reduction at least 5 mmHg revealed an AUC of 0.51 and 0.52, respectively.

Conclusion:
The study confirms that CPAP therapy for sleep apnea has a mild BP lowering effect. Although this effect is slightly higher in patients with above-average AHI, neither AHI nor ESS can be used to define threshold values predicting a BP decrease at least 5 mmHg.
Evaluation of Recurrence Rates of Pseudomonas Pneumonia in Mechanically Ventilated ICU Patients Receiving ≤7 Versus >7 Days of Antibiotic Therapy
Authors: Bollinger Christopher , Carroll Zachary , Collazo Valeria Laboy , Murray Brian 
Published: February 2024

Background

Pseudomonas aeruginosa (PA) is commonly implicated in ventilator-associated pneumonia (VAP). Consensus guidelines for VAP recommend a 7-day course of appropriate antibiotics. However, recent studies have shown higher recurrence rates of PA pneumonia with shorter courses of antibiotics. This study was designed to compare PA pneumonia recurrence rates in patients who received appropriate antibiotics for ≤7 days vs >7 days.

Methods
A retrospective, single-center, observational cohort study of adults diagnosed with PA-VAP between January 2017 and May 2022 was conducted. Patients were divided into a >7-day cohort or a ≤7-day cohort based on duration of appropriate antibiotics. The primary outcome was the recurrence rate of PA pneumonia.

Results
A total of 106 patients were included, 59 in the >7-day cohort and 47 in the ≤7-day cohort. The median (interquartile range) duration of appropriate antipseudomonal therapy was 12 days (8–18 days) in the >7-day cohort and 7 days (6–7 days) in the ≤7-day cohort. Pseudomonas aeruginosa recurrence was observed in 15 (25.4%) patients in the >7-day cohort and 20 (42.6%) patients in the ≤7-day cohort (P = 0.059). Over 33% of patients in the >7-day cohort had persistently positive PA cultures after at least 7 days of appropriate antibiotic therapy.

Conclusion
Extending duration of antipseudomonal antibiotics beyond 7 days did not significantly reduce the recurrence of PA pneumonia. However, the lower rate of recurrence in the >7-day group and high rate of persistent positive cultures may be clinically significant, suggesting a role for extended treatment. Further prospective studies are needed to determine the optimal duration of therapy for PA-VAP.
Alcohol Dependence, Treatment Seeking, and Treatment Preferences Among Elderly
Authors: Jirwe Maria , Andreasson Sven , Wallhed Finn Sara 
Published: February 2024

Abstract

Introduction
In Sweden, alcohol consumption has increased among people aged 65 years and older. Among older adults, 2.7% of men and 1.6% of women fulfill criteria for alcohol dependence. The large majority do not seek treatment. Little is known about treatment seeking among older adults with alcohol dependence.

Aim
The aim of this study was to describe elderly's views on alcohol dependence, treatment seeking, and treatment preferences. Possible gender differences will also be explored.

Methods
Between December 2017 and March 2018, two focus group interviews and 10 individual interviews were conducted, using semistructured interviews. In total, 13 elderly participated. Data were analyzed using the framework approach.

Results
Two themes and five subthemes were identified: (a) “regret and feelings of shame when losing control” consisting of two subthemes, namely, (1) loss of control over your alcohol consumption and (2) regret and feelings of shame, and (b) “taking back control over your life” consisting of three subthemes, namely, (1) becoming aware that you have problematic alcohol use, (2) to seek help for alcohol dependence, and (3) views on treatment options and treatment settings.

Conclusions
Increased alcohol use was attributed to a decrease in responsibility and belonging. Alcohol dependence was associated with shame and stigma, which was especially strong for women. Preferred treatments were tailored for the individual, rather than to general factors such as age or gender. Moreover, important components of treatment were to be met with respect, continuity, and controlled drinking as a treatment goal. Future research should focus on interventions to reduce stigma and the development of patient-centered treatments.