bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of Patient Safety Measures to Identify Inappropriate Diagnosis of Common Infections
Authors: White Andrea T , Vaughn Valerie M , Petty Lindsay A , Gandhi Tejal N , Horowitz Jennifer K , Flanders Scott A , Bernstein Steven J , Hofer Timothy P , Ratz David , McLaughlin Elizabeth S , Nielsen Daniel , Czilok Tawny , Minock Jennifer , Gupta Ashwin 
Published: February 2024

Abstract

Background
Inappropriate diagnosis of infections results in antibiotic overuse and may delay diagnosis of underlying conditions. Here we describe the development and characteristics of 2 safety measures of inappropriate diagnosis of urinary tract infection (UTI) and community-acquired pneumonia (CAP), the most common inpatient infections on general medicine services.

Methods
Measures were developed from guidelines and literature and adapted based on data from patients hospitalized with UTI and CAP in 49 Michigan hospitals and feedback from end-users, a technical expert panel (TEP), and a patient focus group. Each measure was assessed for reliability, validity, feasibility, and usability.

Results
Two measures, now endorsed by the National Quality Forum (NQF), were developed. Measure reliability (derived from 24 483 patients) was excellent (0.90 for UTI; 0.91 for CAP). Both measures had strong validity demonstrated through (a) face validity by hospital users, the TEPs, and patient focus group, (b) implicit case review (ĸ 0.72 for UTI; ĸ 0.72 for CAP), and (c) rare case misclassification (4% for UTI; 0% for CAP) due to data errors (&lt;2% for UTI; 6.3% for CAP). Measure implementation through hospital peer comparison in Michigan hospitals (2017 to 2020) demonstrated significant decreases in inappropriate diagnosis of UTI and CAP (37% and 32%, respectively, P &lt; .001), supporting usability.

Conclusions
We developed highly reliable, valid, and usable measures of inappropriate diagnosis of UTI and CAP for hospitalized patients. Hospitals seeking to improve diagnostic safety, antibiotic use, and patient care should consider using these measures to reduce inappropriate diagnosis of CAP and UTI.
Use of ACEi/ARBs, SGLT2 inhibitors and MRAs can help us reach the therapeutic ceiling in CKD
Authors: Sarafidis Pantelis 
Published: February 2024

ABSTRACT
Chronic kidney disease (CKD) is increasing in prevalence worldwide, posing major implications for public health such as kidney failure requiring dialysis, and increased risk of cardiovascular and all-cause mortality. Diabetic and hypertensive kidney disease represent the two most common causes of CKD. Until a few years ago, lifestyle modifications, blood pressure, glycaemic and lipid control, along with angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker monotherapy were the only measures for retarding these two diseases and were the cornerstone of treatment for CKD of any aetiology. Effective application of all these measures could reduce the estimated glomerular filtration rate (eGFR) decline in proteinuric CKD roughly from 10–12 to 5–6 mL/min/1.73 m2/year, hence leaving a large unmet need in CKD treatment. In recent years, major kidney outcome trials showed that the addition of sodium–glucose cotransporter-2 inhibitors (SGLT2i) in patients with CKD with or without type 2 diabetes (T2D) and of the non-steroidal mineralocorticoid receptor antagonist finerenone in patients with CKD with T2D can largely improve kidney and cardiovascular outcomes. Elegant analyses of these trials shed further light on these effects, showing that SGLT2i or finerenone use on top of standard-of-care treatment in patients with albuminuric CKD can further reduce chronic eGFR annual loss to 2–2.5 mL/min/1.73 m2, while SGLT2is in normoalbuminuric CKD can reduce this loss &lt;0.5 mL/min/1.73 m2, i.e. well below the aging-related GFR loss. Therefore, current evidence suggests that available treatments, if properly implemented, can help us reach the therapeutic ceiling in the majority of CKD patients.
‘Back from the silence with something to say’: Ursula Le Guin’sLaviniaand silence as classical reception
Authors: Hauser Emily 
Published: February 2024

AbstractThis article explores the power of silence in the feminist recovery of classical texts to open up engaged spaces for women’s creative reworkings, taking as a case study Lavinia and her reception in Ursula Le Guin’s (2008) novel of the same name. By re-evaluating silence in dialogue with feminist and classical reception scholarship, I argue that Le Guin is able to bring a different angle to the reception of classical literary women, focusing on the gaps and spaces in Lavinia’s character that provide a medium for engagement with the incomplete text of the Aeneid. Silence thus becomes a locus in which Le Guin can transform Vergil’s silencing of Lavinia into a generative vision of the open space of interpretation available in classical literature and its reception.
Why, how, when, and for whom does digital disconnection work? A process-based framework of digital disconnection
Authors: Vanden Abeele Mariek M P , Vandebosch Heidi , Koster Ernst H W , De Leyn Tom , Van Gaeveren Kyle , de Segovia Vicente David , Van Bruyssel Sara , van Timmeren Tim , De Marez Lieven , Poels Karolien , DeSmet Ann , De Wever Bram , Verbruggen Marijke , Baillien Elfi 
Published: February 2024

Abstract
Digital disconnection has emerged as a concept describing the actions people take to limit their digital connectivity to enhance their well-being. To date, evidence on its effectiveness is mixed, leading to calls for greater consideration of why, how, when, and for whom digital disconnection works. This article responds to these calls, presenting a framework that differentiates four key harms that contribute to experiences of digital ill-being (time displacement, interference, role blurring, and exposure effects). Using these four harms as a starting point, the framework explains: (1) why people are motivated to digitally disconnect; (2) how specific disconnection strategies (i.e., placing limits on time, access, channels, and contents, interactions and features) may help them; and for whom (3) and under which conditions (when) these strategies can be effective.
ISG15 blocks cardiac glycolysis and ensures sufficient mitochondrial energy production during Coxsackievirus B3 infection
Authors: Bredow Clara , Thery Fabien , Wirth Eva Katrin , Ochs Sarah , Kespohl Meike , Kleinau Gunnar , Kelm Nicolas , Gimber Niclas , Schmoranzer Jan , Voss Martin , Klingel Karin , Spranger Joachim , Renko Kostja , Ralser Markus , Mülleder Michael , Heuser Arnd , Knobeloch Klaus-Peter , Scheerer Patrick , Kirwan Jennifer , Brüning Ulrike , Berndt Nikolaus , Impens Francis , Beling Antje 
Published: February 2024

Abstract

Aims
Virus infection triggers inflammation and, may impose nutrient shortage to the heart. Supported by type I interferon (IFN) signalling, cardiomyocytes counteract infection by various effector processes, with the IFN-stimulated gene of 15 kDa (ISG15) system being intensively regulated and protein modification with ISG15 protecting mice Coxsackievirus B3 (CVB3) infection. The underlying molecular aspects how the ISG15 system affects the functional properties of respective protein substrates in the heart are unknown.

Methods and results
Based on the protective properties due to protein ISGylation, we set out a study investigating CVB3-infected mice in depth and found cardiac atrophy with lower cardiac output in ISG15−/− mice. By mass spectrometry, we identified the protein targets of the ISG15 conjugation machinery in heart tissue and explored how ISGylation affects their function. The cardiac ISGylome showed a strong enrichment of ISGylation substrates within glycolytic metabolic processes. Two control enzymes of the glycolytic pathway, hexokinase 2 (HK2) and phosphofructokinase muscle form (PFK1), were identified as bona fide ISGylation targets during infection. In an integrative approach complemented with enzymatic functional testing and structural modelling, we demonstrate that protein ISGylation obstructs the activity of HK2 and PFK1. Seahorse-based investigation of glycolysis in cardiomyocytes revealed that, by conjugating proteins, the ISG15 system prevents the infection-/IFN-induced up-regulation of glycolysis. We complemented our analysis with proteomics-based advanced computational modelling of cardiac energy metabolism. Our calculations revealed an ISG15-dependent preservation of the metabolic capacity in cardiac tissue during CVB3 infection. Functional profiling of mitochondrial respiration in cardiomyocytes and mouse heart tissue by Seahorse technology showed an enhanced oxidative activity in cells with a competent ISG15 system.

Conclusion
Our study demonstrates that ISG15 controls critical nodes in cardiac metabolism. ISG15 reduces the glucose demand, supports higher ATP production capacity in the heart, despite nutrient shortage in infection, and counteracts cardiac atrophy and dysfunction.
Anterior mitral leaflet laceration using the MitraCut technique for transapical transcatheter Tendyne implantation after unsuccessful Carillon indirect annuloplasty: a case report
Authors: de Manna Nunzio Davide , Martens Andreas , Jüttner Marieke , Berliner Dominik , Bauersachs Johann , Ruhparwar Arjang , Kempf Tibor , Ius Fabio 
Published: February 2024

Abstract

Background
The introduction of a transapical transcatheter beating heart replacement system has significantly expanded therapeutic options for patients with severely diseased mitral valves, particularly those ineligibles for traditional surgery or transcatheter repair. However, challenges, such as left ventricular outflow tract obstruction (LVOT-O) and the risk of dynamic systolic anterior motion (SAM) in cases with elongated anterior mitral leaflet (AML) post-prosthesis implantation, impede the widespread adoption of transcatheter mitral valve replacement (TMVR).

Case summary
In 2022, a 75-year-old male with severe mixed-genesis mitral regurgitation (MR) underwent Carillon Mitral Contour System annuloplasty. Recurrent heart failure admissions (New York Heart Association IV) and prohibitive risk for open-heart surgery (European System for Cardiac Operative Risk Evaluation II 8.27%) prompted evaluation for Tendyne TMVR with the MitraCut technique. This beating heart transapical approach involved scissor-mediated splitting of the elongated 27 mm AML, essential for mitigating LVOT-O risk and dynamic SAM. The screening echocardiogram revealed the poorly tethered AML near the thickened septum at the simulated neo-LVOT site.

Discussion
This case underscores the intricate management challenges associated with severe MR, highlighting the successful application of the MitraCut technique as a viable alternative in high-risk scenarios. The imperative for further research and clinical studies is emphasized to comprehensively elucidate outcomes and safety parameters, providing valuable insights for refining TMVR applications within this context.
A case report of right bundle branch block and junctional beats during ablation at the right ventricle outflow tract: metallic occluder’s unanticipated effect
Authors: Pu Sijia , Liu Huiyi , Deng Hai , Xue Yumei , Lin Weidong 
Published: February 2024

Abstract

Background
Previously, ablation at the outflow tract was considered to be safe and rarely affected the His–Purkinje system due to their spatial distance. However, we have reported a case of right bundle branch block (RBBB) and junctional beats that were recorded during radiofrequency catheter ablation in a patient who had a history of peri-membranous ventricular septal defect (pmVSD) closure and the implantation of a metallic occluder.

Case summary
A 16-year-old girl with a metallic occluder for peri-membranous ventricular septum defect underwent an ablation procedure for premature ventricular complexes. During the ablation at the right ventricular outflow tract (RVOT), RBBB and junctional beats were recorded. His bundle potentials and the high-frequency potential generated by electrical interference were observed when mapping the margin of the occluder. To ensure safety, we attempted ablation at the right coronary cusp in the left ventricular outflow tract, which eventually proved to be successful, presenting an alternative ablation strategy.

Conclusion
This is a rare report of RBBB and junctional beats observed during ablation at RVOT in a patient with pmVSD and a metallic occluder. The observed damage to the His–Purkinje system may be attributed to uncontrolled radiofrequency energy heating up caused by the metallic device. This case emphasizes the importance of thorough electroanatomic and activation mapping prior to starting the ablation procedure, especially in complicated cases. Furthermore, it suggests that ablation at a relatively remote position is both feasible and relatively safe for patients with occluder devices.
Effects of Cognitive Inhibition Preceding Voluntary Step Responses to Visual Stimuli in Young and Older Adults
Authors: Kwag Eunyoung , Bachmann Dominic , Kim Kyungwan , Komnik Igor , Zijlstra Wiebren 
Published: February 2024

Abstract

Objectives
Age-related changes in executive functions, especially inhibitory control, correlate to decreased balance control and increased fall risk. However, only a few studies focused on the performance of tasks integrating balance and inhibitory control. This study aims to determine the effects of cognitive inhibition preceding the initiation of voluntary steps in young and older adults.

Methods
Performance of 3 stepping tasks (a Simon, Flanker, and a combined Simon–Flanker task [SFT]) were analyzed in 23 young adults and 43 older adults. Each task included congruent and incongruent trials in different step directions. Analyses focused on temporal aspects of step responses as identified by changes in Center of Pressure (CoP) and foot position. A 3-way repeated-measures ANOVA was used to evaluate “inhibition,” “age,” and “task” effects.

Results
With large effect sizes, “inhibition” as well as “age” resulted in longer durations of an initial preparatory phase as well as the step response phase. The SFT showed the largest “task” effects. Duration of CoP movement had the largest impact on total step execution in older adults. A significant interaction effect of “age*inhibition” was found on the duration of CoP movement, but not on CoP onset.

Discussion
Overall, our results demonstrate that cognitive inhibition has more impact in older adults, the longer duration of CoP movements in older adults may reflect an ineffective step preparation. Our examination of the duration of subsequent phases which comprise perceptual processing and conflict resolution, response initiation, and step execution sheds light on how cognitive inhibition affects voluntary stepping behavior in young and older adults.
Associations Between Self-Reported Visual and Hearing Functioning and Cognitive Function Among Hispanics/Latino: Hispanic Community Health Study
Authors: Zheng D Diane , Lam Byron L , Joslin Charlotte E , Gonzalez Hector M , Baiduc Rachael R , Tarraf Wassim , Stickel Ariana , Daviglus Martha , Garcia-Bedoya Olga , Schneiderman Neil , Gonzalez Franklyn , Lee David J 
Published: February 2024

Abstract

Background and Objectives
To investigate the associations between self-reported visual functioning (VF) and hearing functioning with cognition in the Hispanic/Latino population.

Research Design and Methods
We utilized data from the Miami Ocular Study of Latinos ancillary study to Hispanic Community Health Study/Study of Latinos with 1,056 participants aged 45 and older. The outcomes were cognitive performances assessed by the Digit Symbol Substitution Test (DSST), Word Fluency, Brief-Spanish English Verbal Learning Test-recall (B-SEVLT recall), words recalled over 3 trials, and the Six-Item Screener. VF was measured by National Eye Institute Visual Function Questionnaire (NEI-VFQ), and hearing function was measured by Hearing Handicap Inventory Screening Questionnaire for Adults and Elderly (HHIA/E-S). Multiple regressions were performed for each cognitive outcome while controlling for covariates and complex sampling design.

Results
NEI-VFQ was associated with 3 of the 5 cognitive outcomes. A 4-point NEI-VFQ score difference was associated with a 0.56-point difference in DSST (standard error [SE] = 0.27, p &lt; .001), 0.17 in Word fluency (SE = 0.16, p &lt; .01), and 0.08 in B-SEVLT-recall (SE = 0.07, p &lt; .01). HHIA/E-S was not associated with any of the cognitive measures examined.

Discussion and Implications
These data suggest that impaired VF is associated with worse cognition in the Hispanic/Latino population. Although previous work in this cohort indicated hearing loss assessed by pure tone audiometry was associated with worse cognition, we found self-perceived hearing function was not associated with cognition, suggesting the potential limitation of self-reported hearing function as a proxy for hearing loss in epidemiological research in Hispanic/Latino populations. Results also imply impaired VF and hearing function may be linked to cognition differently in the Hispanic population, and more research is needed to better understand the underlying linking mechanisms. Visual and hearing impairments are common and treatable and represent important modifiable risk factors that can be treated to preserve cognitive function in Hispanics/Latinos.
Participatory approaches to programme design, planning and early implementation: experiences from a safe surgery project in Nigeria
Authors: Atta Kabiru , Abdulazeez Jumare , Khan Farhad , Efem Iyeme , Abdullahi Halimatu Sadiyya , Dada Mansur , Uro-Chukwu Henry C , Levin Karen , Stafford Renae 
Published: February 2024

Abstract
MOMENTUM Safe Surgery in Family Planning and Obstetrics is a global project that strengthens surgical ecosystems through partnership with country institutions. In Nigeria, the project implements in Bauchi, Ebonyi, Kebbi and Sokoto states and the Federal Capital Territory, focusing on surgical obstetrics, holistic fistula care and female genital mutilation/cutting prevention and care. The project utilized participatory approaches during its design, planning and early implementation phases. During the design phase, the project employed a co-creation process featuring a desk review, key informant interviews and stakeholder workshops at community, facility, and government levels to actively listen to, identify and incorporate local perspectives on surgical ecosystem gaps and priorities. Initial findings, shared at state- and national-level workshops, helped collectively identify and prioritize context-specific interventions. The resulting co-created workplan features interventions to strengthen surgical services based on the National Surgical, Obstetrics, Anaesthesia and Nursing Plan (NSOANP). Upon workplan approval, the planning phase involved meeting with each State Ministry of Health (MOH) to prioritize workplan interventions for implementation and to define the finer details needed to drive early implementation processes. Preliminary achievements during early implementation include state commitments to include a costed facility NSOANP in 2023 annual operational plans, mitigation of health facility staffing shortages and review of national fistula and surgical Health Management Information System indicator data flow and advocacy to the Federal MOH resulting in improved fistula data quality and availability. Well-established state and national systems, structures, policies and guidelines enable this programming approach. Since communication between institutional actors is often limited, these approaches necessitate building and maintaining relationships and knowledge-sharing, which requires a significant up-front time investment that must be balanced with donor/partner desires for rapid deliverables. Linking different actors within the health system together through co-creation/co-implementation represents a crucial step in building sustainable country ownership and oversight for surgical ecosystems strengthening interventions.
Assessing the relationship between coverage of essential health services and poverty levels in low- and middle-income countries
Authors: Guerra Stefanny , Roope Laurence Sj , Tsiachristas Apostolos 
Published: February 2024

Abstract
Universal health coverage (UHC) aims to provide essential health services and financial protection to all. This study aimed to assess the relationship between the service coverage aspect of universal health coverage and poverty in low- and middle-income countries (LMICs). Using country-level data from 96 LMICs from 1990 to 2017, we employed fixed-effects and random-effects regressions to investigate the association of eight service coverage indicators (inpatient admissions; antenatal care; skilled birth attendance; full immunization; cervical and breast cancer screening rates; diarrhoea and acute respiratory infection treatment rates) with poverty headcount ratios and gaps at the $1.90, $3.20 and $5.50 poverty lines. Missing data were imputed using within-country linear interpolation or extrapolation. One-unit increases in seven service indicators (breast cancer screening being the only one with no significant associations) were associated with reduced poverty headcounts by 2.54, 2.46 and 1.81 percentage points at the $1.90, $3.20 and $5.50 lines, respectively. The corresponding reductions in poverty gaps were 0.99 ($1.90), 1.83 ($3.20) and 1.89 ($5.50) percentage points. Apart from cervical cancer screening, which was only significant in one poverty headcount model ($5.50 line), all other service indicators were significant in either the poverty headcount or gap models at both $1.90 and $3.20 poverty lines. In LMICs, higher service coverage rates are associated with lower incidence and intensity of poverty. Further research is warranted to identify the causal pathways and specific circumstances in which improved health services in LMICs might help to reduce poverty.