bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medicare's Hospital Readmission Reduction Program reduced fall‐related health care use: An unexpected benefit?
Authors: Hoffman Geoffrey J. , Alexander Neil B. , Ha Jinkyung , Nguyen Thuy , Min Lillian C. 
Published: October 2023

AbstractObjectiveTo assess whether Medicare's Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in severe fall‐related injuries (FRIs).Data Sources and Study SettingSecondary data from Medicare were used.Study DesignUsing an event study design, among older (≥65) Medicare fee‐for‐service beneficiaries, we assessed changes in 30‐ and 90‐day FRI readmissions before and after HRRP's announcement (April 2010) and implementation (October 2012) for conditions targeted by the HRRP (acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia) versus “non‐targeted” (gastrointestinal) conditions. We tested for modification by hospitals with “high‐risk” before HRRP and accounted for potential upcoding. We also explored changes in 30‐day FRI readmissions involving emergency department (ED) or outpatient care, care processes (length of stay, discharge destination, and primary care visit), and patient selection (age and comorbidities).Data CollectionNot applicable.Principal FindingsWe identified 1.5 million (522,596 pre‐HRRP, 514,844 announcement, and 474,029 implementation period) index discharges. After its announcement, HRRP was associated with 12%–20% reductions in 30‐ and 90‐day FRI readmissions for patients with CHF (−0.42 percentage points [ppt], p = 0.02; −1.53 ppt, p < 0.001) and AMI (−0.35, p = 0.047; −0.97, p = 0.001). Two years after implementation, HRRP was associated with reductions in 90‐day FRI readmission for AMI (−1.27 ppt, p = 0.01) and CHF (−0.98 ppt, p = 0.02) patients. Results were similar for hospitals at higher versus lower baseline risk of FRI readmission. After HRRP's announcement, decreases were observed in home health (AMI: −2.43 ppt, p < 0.001; CHF: −8.83 ppt, p < 0.001; pneumonia: −1.97 ppt, p < 0.001) and skilled nursing facility referrals (AMI: −5.95 ppt, p < 0.001; CHF: −3.19 ppt, p < 0.001; pneumonia: −10.27 ppt, p < 0.001).ConclusionsHRRP was associated with reductions in FRIs, primarily for HF and pneumonia patients. These decreases may reflect improvements in transitional care including changes in post‐acute referral patterns that benefit patients at risk for falls.
Cytokine expression of IL‐8 before and after root canal treatment in patients with symptomatic apical periodontitis: A clinical trial
Authors: Abouelenien Sarah Samir , Shaker Olfat Gamil , Morsy Dina Ahmed 
Published: October 2023

AbstractThis study's objective was to compare the cytokine expression of IL‐8 in periapical tissues of single‐rooted teeth with symptomatic apical periodontitis (SAP) before and after root canal treatments. As well as, comparing IL‐8 levels in peri‐apical tissues between vital and necrotic teeth with SAP.MethodologyThirty‐six patients were allocated according to their pulp status into two experimental groups (n = 18) receiving the same treatment protocol; group 1: Vital pulps with SAP, and group 2: non‐vital pulps with SAP. Conventional endodontic treatment was done on two visits; isolation and disinfection of the operative field were undertaken, and two‐stage access cavity preparation was implemented. The first pre‐instrumentation peri‐apical sample (S1) was collected prior to cleaning and shaping procedures. A 2.5% NaOCl irrigation was used to thoroughly irrigate the canal after performing root canal preparation utilising the ProTaper Next (PTN) rotary system. After 1 week, the second post‐instrumentation peri‐apical sample (S2) was collected. Using an ELISA kit, the quantity of IL‐8 was evaluated following the collection of all samples.ResultsIn all pre‐instrumentation samples, IL‐8 was detected (100%). The level of IL‐8 expression was significantly decreased from the S1 to S2 of all samples (p < 0.001). The intra‐group comparison showed a statistically significant reduction in the level of IL‐8 expression between S1 and S2 in both vital and non‐vital groups where p < 0.001* in both groups. The inter‐group comparison of levels of IL‐8 expression (vital and non‐vital) revealed a significant difference between both groups regarding the pretreatment sample with the higher levels of IL‐8 shown in the non‐vital group (p < 0.001). While in the post‐treatment sample, both groups showed a significant reduction in the level of IL‐8 expression but the difference between them was not statistically significant (p = 0.226).ConclusionRoot canal instrumentation seems to be efficient in decreasing the levels of anti‐inflammatory cytokines, namely IL‐8. Further research should clarify how intra‐canal medicaments affect inflammatory mediator levels.
High resolution in turbid waters: Ampullae of Lorenzini in the daggernose shark Carcharhinus oxyrhynchus (Valenciennes, 1839) (Elasmobranchii: Carcharhinidae)
Authors: Haueisen Mariana , Reis Roberto E. 
Published: October 2023

AbstractThe present work aimed to analyse the distribution of the electrosensory pores of the daggernose shark Carcharhinus oxyrhynchus, identifying the organ's importance in the natural history of the species. By examining photographs and digital microscope videos, we found that C. oxyrhynchus possesses the highest abundance of pores among Carcharhiniformes. This suggests a well‐developed electroreceptor system, which may have maximized its evolutionary success in high‐turbidity environments. Furthermore, as a morphologically derived species, C. oxyrhynchus comprises a more complex and specialized electrosensory system. Notably, the species exhibits ontogenetic variation in pore abundance, highlighting the importance of a high‐resolution system for adults. The higher density of pores in the ventral region indicates a preference for benthic prey, despite also feeding on pelagic items. Moreover, the species has a high‐resolution electrosensory system and a high density of pores in the snout, which emphasizes the importance of the elongated snout that expands the electroreception search area coverage. Evolutionary convergence was observed in the development of the electrosensory system, as C. oxyrhynchus shares the characteristics of pore distribution and abundance with phylogenetically unrelated species.
Applying a model of integrated STEM teacher identity to understand change in elementary teachers' STEM self‐efficacy and career awareness
Authors: Holincheck Nancy M. , Galanti Terrie M. 
Published: October 2023

AbstractThis sequential mixed methods study applies a recently published model of integrated science, technology, engineering, and mathematics (STEM) teacher identity to analyze teacher artifacts from a graduate STEM education course for in‐service teachers (n = 23). This model captures the complexity of integrating STEM in elementary classrooms as an intertwining of professional teacher identity and STEM learning identity. Increases in participating teachers' self‐efficacy and STEM career awareness motivated the research team to look for explanatory qualitative evidence in teacher reflections. Analysis using the nine dimensions of the model elicited robust evidence of professional teacher identity (teaching interest, self‐efficacy, motivation, self‐image, and task perception) and limited evidence of STEM learner identity (competence, performance, recognition, and content interest) in teachers' identity statements. Changes in self‐efficacy and STEM career awareness were associated with only three of nine identity dimensions. Application of this model of integrated STEM teacher identity can provide a deeper understanding of teacher readiness to engage elementary students in authentic problem solving. Findings indicate that purposeful prompting of reflection in STEM teacher education informed by the model may support the cultivation of integrated STEM teacher identities.
The operational impact of introducing cold stored platelets
Authors: Blake John T. , Krok Elizabeth , Pavenski Katerina , Pambrun Chantale , Petraszko Tanya 
Published: October 2023

AbstractBackgroundCold stored platelets (CSP) undergo physical changes that make them better at initiating a clot. While cold stored platelets are superior for reducing bleeding in actively bleeding patients, room temperature platelets (RTP) are better for increasing platelet count in patients requiring a prophylactic transfusion. However, whether the overhead required to maintain a dual platelet inventory of both RTP and CSP could be compensated by reduced platelet wastage resulting from the longer shelf life of CSP has not been determined.Study Design and MethodsA simulation model of a regional blood supply was built, with focus on the operations of a case hospital. Two scenarios were considered: “No‐CSP,” in which the hospital issues only RTP, and “CSP,” in which the hospital issues both RTP and CSP Within the CSP scenario, conditions were tested under which the hospital receives only RTP and converts some to cold stored platelets and a second strategy where the hospital receives CSP from the regional supplier in addition to converting RTP.ResultsA centralized supply of CSP is necessary since on‐site conversion is limited by platelet age. Product shortages decrease with increased CSP inventory, but CSP wastage increases. It was also determined that, because relatively few RTP units can be converted on‐site, RTP wastage is not significantly decreased with the introduction of CSP.ConclusionGiven the clinical benefits for treatment of trauma, CSP is a desirable addition to a blood formulary. However, it is unlikely that significant reductions in RTP wastage will occur because of the introduction of CSP.
Recyclable CRISPR/Cas9-mediated gene disruption and deletions in
Histoplasma
Authors: Joehnk Bastian , Ali Nebat , Voorhies Mark , Walcott Keith , Sil Anita 
Published: October 2023

ABSTRACT

Targeted gene disruption is challenging in the dimorphic fungal pathogen
Histoplasma
due to the low frequency of homologous recombination. Transformed DNA is either integrated ectopically into the genome or maintained extrachromosomally by
de novo
addition of telomeric sequences. Based on a system developed in
Blastomyces
, we adapted a CRISPR/Cas9 system to facilitate targeted gene disruption in
Histoplasma
with high efficiency. We express a codon-optimized version of Cas9 as well as guide RNAs from a single ectopic vector carrying a selectable marker. Once the desired mutation is verified, one can screen for isolates that have lost the Cas9 vector by simply removing the selective pressure. Multiple mutations can then be generated in the same strain by retransforming the Cas9 vector carrying different guides. We used this system to disrupt a number of target genes including
RYP2
and
SRE1
, where loss-of-function mutations could be monitored visually by colony morphology or color, respectively. Interestingly, expression of two guide RNAs targeting the 5′- and 3′-ends of a gene allowed isolation of deletion mutants where the sequence between the guide RNAs was removed from the genome. Whole-genome sequencing showed that the frequency of off-target mutations associated with the Cas9 nuclease was negligible. Finally, we increased the frequency of gene disruption by using an endogenous
Histoplasma
regulatory sequence to drive guide RNA expression. These tools transform our ability to generate targeted mutations in
Histoplasma
.

IMPORTANCE

Histoplasma
is a primary fungal pathogen with the ability to infect otherwise healthy mammalian hosts, causing systemic and sometimes life-threatening disease. Thus far, molecular genetic manipulation of this organism has utilized RNA interference, random insertional mutagenesis, and a homologous recombination protocol that is highly variable and often inefficient. Targeted gene manipulations have been challenging due to poor rates of homologous recombination events in
Histoplasma
. Interrogation of the virulence strategies of this organism would be highly accelerated by a means of efficiently generating targeted mutations. We have developed a recyclable CRISPR/Cas9 system that can be used to introduce gene disruptions in
Histoplasma
with high efficiency, thereby allowing disruption of multiple genes.
Short‐Term Ambient Air Pollution Exposure and Risk of Out‐of‐Hospital Cardiac Arrest in Sweden: A Nationwide Case‐Crossover Study
Authors: Dahlquist Marcus , Frykman Viveka , Hollenberg Jacob , Jonsson Martin , Stafoggia Massimo , Wellenius Gregory A. , Ljungman Petter L. S. 
Published: October 2023

Background
Air pollution is one of the main risk factors for cardiovascular disease globally, but its association with out‐of‐hospital cardiac arrest at low air pollution levels is unclear. This nationwide study in Sweden aims to investigate if air pollution is associated with a higher risk of out‐of‐hospital cardiac arrest in an area with relatively low air pollution levels.

Methods and Results

This study was a nationwide time‐stratified case‐crossover study investigating the association between short‐term air pollution exposures and out‐of‐hospital cardiac arrest using data from the SRCR (Swedish Registry for Cardiopulmonary Resuscitation) between 2009 and 2019. Daily air pollution levels were estimated in 1×1‐km grids for all of Sweden using a satellite‐based machine learning model. The association between daily air pollutant levels and out‐of‐hospital cardiac arrest was quantified using conditional logistic regression adjusted for daily air temperature. Particulate matter <2.5 μm exposure was associated with a higher risk of out‐of‐hospital cardiac arrest among a total of 29 604 cases. In a multipollutant model, the association was most pronounced for intermediate daily lags, with an increased relative risk of 6.2% (95% CI, 1.0–11.8) per 10 μg/m
3
increase of particulate matter <2.5 μm 4 days before the event. A similar pattern of association was observed for particulate matter <10 μm. No clear association was observed for O
3
and NO
2
.

Conclusions
Short‐term exposure to air pollution was associated with higher risk of out‐of‐hospital cardiac arrest. The findings add to the evidence of an adverse effect of particulate matter on out‐of‐hospital cardiac arrest, even at very low levels below current regulatory standards.
An Experimental Analysis of the Prize-Probability Tradeoff in Stopping Problems
Authors: Antler Yair , Arad Ayala 
Published: October 2023

Abstract
We experimentally examine how individuals commit to a cutoff stopping rule when facing a sequence of independent lotteries. We identify two main behavior patterns: (1) a small share of participants consistently choose stopping rules whose gain bound (i.e., the accumulated gain at which the sequence stops) is larger than the loss bound, and (2) a larger share of participants consistently choose rules whose loss bound is larger than the gain bound. We introduce a procedural choice model that accounts for these patterns and show that the behavior of most of our participants is inconsistent with prominent theories of decision under risk.
Inaccurate Statistical Discrimination: An Identification Problem
Authors: Bohren J. Aislinn , Haggag Kareem , Imas Alex , Pope Devin G. 
Published: October 2023

Abstract
We study inaccurate beliefs as a source of discrimination. Economists typically characterize discrimination as stemming from a taste-based (preference) or accurate statistical (belief-based) source. While individuals may have inaccurate beliefs about how relevant characteristics (e.g., productivity, signals) are correlated with group identity, fewer than 7% of empirical discrimination papers in economics consider the possibility of such inaccurate statistical discrimination. Using theory and a labor market experiment, we show that failing to account for inaccurate beliefs leads to a misclassification of source. We outline three methods to identify source: varying observed signals, belief elicitation, and an intervention to target inaccurate beliefs.
Kefeli Mescidi in Istanbul
Authors: Varsallona Jessica 
Published: October 2023

Abstract
This article offers a brief analysis of the architectural features of the building Kefeli Mescidi in Istanbul and supports its identification as a Byzantine monastic dining hall. The analysis of Late Byzantine written sources in connection to the topographical and material data of the building supports the association with the famous Constantinopolitan monastery of St John of Petra and its refectory.
Beyond the Dār al-Islām/Dār al-ḥarb Paradigm
Authors: Rizzo Alessandro 
Published: October 2023

Abstract
For a long time, scholarship concerning the relations between the Mamluks and Christian powers has been heavily influenced by the traditional dichotomy between dār al-Islām and dār al-ḥarb. This paradigm has often led historians to misinterpret the nature of the diplomatic documents issued by the chancery in Cairo.
Taking into account new perspectives on the dialogue between Muslim and non-Muslim powers, the article examines the principles underlying the diplomatic dialogue in wartime and in peacetime through the lens of Mamluk diplomatic sources. Through this analysis, the paper illustrates how the discipline of Diplomatics can offer a direct approach to reconsidering some historiographical narratives and to understanding the real nature of diplomatic exchange and its symbolic representation.
Association Between Immune-Related Disease and Allergic Rhinitis: A Two-Sample Mendelian Randomization Study
Authors: Zhao Jinming , Zhang Mengmeng , Li Zufei 
Published: October 2023

Background Immune-related diseases can interact with each other, and growing evidence suggests that these diseases are associated with allergic rhinitis (AR). However, it is unclear whether previously observed associations reflect causal relationships. Objective This study estimated the genetic association between various immune-related diseases and AR using two-sample Mendelian randomization (MR). Methods Eight immune-related diseases were selected as exposure factors, and AR was selected as the outcome. The 8 immune-related disease categories included atopic dermatitis (AD), Graves’ disease (GD), asthma, Crohn's disease (CD), multiple sclerosis (MS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ulcerative colitis (UC). Data from GWAS (Genome-Wide Association Studies) were selected to construct instrumental variables (IVs) for each disease, and multiple single-nucleotide polymorphisms (SNPs) were selected as IVs. Corresponding data were retrieved according to the selected SNPs, and all data were summarized and analyzed. Results A total of 416 SNPs were screened as IVs, and the results of IVW support a causal relationship between AR risk and AD (OR: 1.026, 95% CI: 1.014-1.038, P = 9.59 × 10−6), asthma (OR: 1.057, 95% CI: 1.029-1.086, P = .0001), and CD (OR: 1.006, 95% CI: 1.002-1.011, P = .0085). Furthermore, GD (OR: 0.995, 95% CI: 0.991-0.999, P = .0213) and SLE (OR: 0.997, 95% CI: 0.995-1.000, P = .025) may be protective factors. Conclusion This MR study found that AD, asthma and CD increase the risk of AR in populations of European ancestry, GD and SLE may be protective factors. These results suggest that confounding factors may have influenced associations previously reported in observational studies.
Knowledge and practice of nurses regarding the care of patients with head trauma in intensive care units in the West Bank
Authors: Shehade Wa’el , Ayed Ahmad , Harazneh Lobna 
Published: October 2023

Background: Nurses in the intensive care unit are responsible for the continuous assessment and management of physiological parameters associated with head trauma. Nurses have a vital and significant role in the care of patients suffering from moderate-to-severe head trauma, both during acute and non-acute care. The purpose of this study was to investigate the Knowledge and Practice of nurses regarding the care of patients with head trauma in an intensive care unit. Design and methods: The study was designed as a cross-sectional study. The study recruited 165 nurses who work at intensive care unit (ICU) nurses in Palestinian hospitals. The data collected by a self-administered questionnaire developed by the researcher. Results: Among the 165 intensive nurses, the study findings revealed the majority of nurses 99 (60.0%) have low level knowledge regarding Care of Patients with a head trauma, and showed that most of the nurses 115 (69.7%) have poor level practice regarding Care of Patients with a head trauma. Conclusions: According to the results of the current study, approximately two-thirds of the studied nurses had unsatisfactory knowledge level regarding head trauma care. More than two-thirds of the studied nurses had poor level practice regarding head trauma care. Also, the study confirmed no statistical significant relation between knowledge and demographic characteristics. There was significant differences between total practice scores and both experience in general and experience in ICU.
Determining the True Incidence of Glenohumeral Instability Among Players in the National Football League: An Epidemiological Study of Non–Missed Time Shoulder Instability Injuries
Authors: Anderson Matthew J.J. , Confino Jamie E. , Mack Christina D. , Herzog Mackenzie M. , Levine William N. 
Published: October 2023

Background: Shoulder instability encompasses a spectrum of glenohumeral pathology ranging from subluxation to dislocation. While dislocation frequently leads to removal from play, athletes are often able to play through subluxation. Previous research on glenohumeral instability among athletes has largely focused on missed-time injuries, which has likely disproportionately excluded subluxation injuries and underestimated the overall incidence of shoulder instability. Purpose: To describe the epidemiology of shoulder instability injuries resulting in no missed time beyond the date of injury (non–missed time injuries) among athletes in the National Football League (NFL). Study Design: Descriptive epidemiology study. Methods: The NFL's electronic medical record was retrospectively reviewed to identify non–missed time shoulder instability injuries during the 2015 through 2019 seasons. For each injury, player age, player position, shoulder laterality, instability type, instability direction, injury timing, injury setting, and injury mechanism were recorded. For injuries that occurred during games, incidence rates were calculated based on time during the season as well as player position. The influence of player position on instability direction was also investigated. Results: Of the 546 shoulder instability injuries documented during the study period, 162 were non–missed time injuries. The majority of non–missed time injuries were subluxations (97.4%), occurred during games (70.7%), and resulted from a contact mechanism (91.2%). The overall incidence rate of game-related instability was 1.6 injuries per 100,000 player-plays and was highest during the postseason (3.5 per 100,000 player-plays). The greatest proportion of non–missed time injuries occurred in defensive secondary players (28.4%) and offensive linemen (19.8%), while kickers/punters and defensive secondary players had the highest game incidence rates (5.5 and 2.1 per 100,000 player-plays, respectively). In terms of direction, 54.3% of instability events were posterior, 31.9% anterior, 8.5% multidirectional, and 5.3% inferior. Instability events were most often anterior among linebackers and wide receivers (50% and 100%, respectively), while posterior instability was most common in defensive linemen (66.7%), defensive secondary players (58.6%), quarterbacks (100.0%), running backs (55.6%), and tight ends (75.0%). Conclusion: The majority of non–missed time shoulder instability injuries (97.4%) were subluxations, which were likely excluded from or underreported in previous shoulder instability studies due to the inherent difficulty of detecting and diagnosing shoulder subluxation.