bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in central line-associated bloodstream infection and catheter-associated urinary tract infection rates: An exploratory analysis
Authors: Gettler Erin B. , Kalu Ibukunoluwa C. , Okeke Nwora L. , Lewis Sarah S. , Anderson Deverick J. , Smith Becky A. , Advani Sonali D. 
Published: April 2023

AbstractThis retrospective review of 4-year surveillance data revealed a higher central line-associated bloodstream infection (CLABSI) rate in non-Hispanic Black patients and higher catheter-associated urinary tract infection (CAUTI) rates in Asian and non-Hispanic Black patients compared with White patients despite similar catheter utilization between the groups.
Relationship between overweight and obesity and insufficient micronutrient intake: a nationwide study in Taiwan
Authors: Lin Shih-Pi , Fang Hsin-Yu , Li Ming-Chieh 
Published: April 2023

Abstract
The aim of the present study is to examine whether overweight or obese people in Taiwan have an inadequate intake of selected micronutrients. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013–2016. We evaluated fourteen nutrient intakes using the 24 h dietary recall method. The dietary reference intake (DRI) adherence was estimated by the prevalence of participants whose intake was lower than the recommended dietary allowance (RDA) or adequate intakes (AIs) for selected micronutrients. Body mass index (BMI) ≥ 27 kg/m2 and waist circumference (WC), with men having WC ≥ 90 cm or women having WC ≥ 80 cm, were defined as obesity. A total of 3075 participants aged 19 years and above were included. After adjusting for confounders, we found that obese women have a lower DRI adherence of vitamin C (odds ratio (OR) 0⋅73, 95 % confidence interval (CI) 0⋅56, 0⋅95) and magnesium (OR 0⋅72, 95 % CI 0⋅54, 0⋅95), compared with normal-weight women. Obese men have a higher DRI adherence of vitamin B3 (OR 1⋅70, 95 % CI 1⋅29, 2⋅23), iron (OR 1⋅46, 95 % CI 1⋅06, 2⋅00) and zinc (OR 1⋅41, 95 % CI 1⋅07, 1⋅85), compared with normal-weight men. Similar findings were found using WC to define obesity. We conclude that obese women may have insufficient intakes of vitamin A, vitamin C and magnesium.
Retourner sa veste au Québec : une étude des défections transpartisanes politiques de 1980 à 2018
Authors: Lalancette Mireille , Marland Alex , Wesley Jared 
Published: April 2023

RésuméCet article aborde le phénomène des défections dans les partis politiques grâce à une étude du cas des députés québécois. Les entrevues avec les anciens parlementaires et une analyse des discours médiatiques à propos de leur départ documentent les motivations à quitter ou à rejoindre un autre parti. Cette recherche propose deux typologies novatrices : la première identifie les types de défections et la seconde explore les motivations à quitter. Les analyses montrent que les députés québécois partent surtout en raison de conflits liés aux valeurs et aux politiques, mais très peu pour le prestige. En ouvrant un dialogue avec les travaux d'Hirshman, l'article illustre aussi le rôle de la prise de parole et de l’écoute dans la décision pour un député de quitter un parti ou de rester dans celui-ci.
The Effects of Antitrust Laws on Horizontal Mergers: International Evidence
Authors: Chung Chune Young , Hasan Iftekhar , Hwang JiHoon , Kim Incheol 
Published: April 2023

AbstractThis study examines how antitrust law adoptions affect horizontal merger and acquisition outcomes. Using the staggered introduction of competition laws in 20 countries, we find antitrust regulation decreases acquirers’ 5-day cumulative abnormal returns surrounding horizontal merger announcements. A decrease in deal value, target book assets, and industry peers’ announcement returns are consistent with the market power hypothesis. Exploiting antitrust law adoptions addresses a downward bias to an estimated effect of antitrust enforcement. The potential bias from heterogeneous treatment effects does not nullify our results. Overall, antitrust policies seem to deter post-merger monopolistic gains, potentially improving customer welfare.
Wild meat consumption in urban Sierra Leone during the Covid-19 pandemic
Authors: Sainge Moses N. , Wusha-Conteh Fartimah , Fa Julia E. , Sullivan Martin J.P. , Cuni-Sanchez Aida 
Published: April 2023

AbstractWild meat is associated with an increased risk of zoonotic diseases. In some West African countries wild meat consumption declined as the result of official restrictions following Ebola outbreaks during 2013–2016, and was also affected by the current Covid-19 pandemic. In Sierra Leone, a country affected by these diseases, we documented wild meat use in four markets in the capital, Freetown. From a total of 197 interviews, we analysed the influence of age and gender on the types of wild meat eaten and the reasons for their consumption. We found that more men than women consumed wild meat, and for both genders taste was the main reason for eating wild meat. Age did not affect wild meat consumption amongst women. Evidence for changes in consumer behaviour in response to zoonotic disease risk was mixed. Although some consumers avoided wild meat because of disease risk, none stated this was the primary reason for not eating wild meat, and monkeys (presumed to carry a high zoonotic disease risk) were amongst the species cited as being consumed often. More work is needed to identify the best pathway towards safe and sustainable consumption of wild meat in urban Sierra Leone.
Behavioural and heuristic models are as-if models too – and that’s ok
Authors: Moscati Ivan 
Published: April 2023

AbstractI examine some behavioural and heuristic models of individual decision-making and argue that the diverse psychological mechanisms these models posit are too demanding to be implemented, either consciously or unconsciously, by actual decision makers. Accordingly, and contrary to what their advocates typically claim, behavioural and heuristic models are best understood as ‘as-if’ models. I then sketch a version of scientific antirealism that justifies the practice of as-if modelling in decision theory but goes beyond traditional instrumentalism. Finally, I relate my account of decision models to the recent controversy about mentalism versus behaviourism, reject both positions, and offer an alternative view.
Beyond replication: An exact replication study of Łodzikowski (2021)
Authors: Foung Dennis , Kohnke Lucas 
Published: April 2023

AbstractReplication studies have become an emerging line of research in recent decades, including in computer-assisted language learning (CALL). Exact replication, which closely follows a study’s protocol, is rare as it is hard to recreate results without establishing a highly controlled environment. However, using data available online, we were able to conduct an exact replication of Łodzikowski’s (2021) study, which reported on the use of an allophonic transcription tool by 55 Polish learners of English. Allophonic features are used by native speakers to produce acoustic variants of the same phoneme. The original study offered learners an allophonic transcription tool, examined how they used it and considered its association with phonological awareness. This study extended the original research by addressing the limitations of its regression and transcription analyses. Our findings allowed us to offer several suggestions on (1) how an allophonic transcription tool can be better designed to help learners, (2) how CALL researchers can acquire more data for more useful research and (3) why more replication studies are needed in CALL.
Patient and Staff Attitudes Toward Clothing Restrictions on a Pediatric Psychiatric Unit
Authors: Schmidt Scott C. 
Published: April 2023

AbstractIntroductionPediatric psychiatric inpatients are among the most vulnerable individuals in society. While the use of seclusion and restraint is well chronicled in the field of research in this population, there is limited literature describing the effects, meaning, and attitudes of mandating the wear of clothing in hospital settings. This research explores the phenomenon of the practice of mandatory wear of hospital-issued clothing and its meaning to patients and the awareness and attitudes of this practice among staff caring for this population. This research aims to improve understanding of the experiences of patients regarding this practice at a large, urban hospital providing care for children using a mixed methods design. A qualitative, descriptive phenomenological analysis was conducted through individual interviews with adolescent patients (N = 5) on an inpatient psychiatric unit. Additionally, a cross-sectional self-reported questionnaire examined the awareness and attitudes toward this practice among unit staff (N = 41). The patients’ attitudes toward clothing restrictions was predominantly negative, noting a lack of self-expression, feeling like a mental health patient, desires to wear ones’ personal clothing, and feelings of shame and punishment. Among the staff there was a modest correlation between age, number of years practicing as a health professional, and years practicing in a pediatric setting with feelings of a need for a change in the clothing policy to allow patients to wear their own clothing on admission. Staff age and number of years working at the institution demonstrated a modest correlation between awareness of legal statutes regarding patients’ rights to their own clothing. This research found a readiness among staff to adopt a clothing policy that would permit patients to wear their own clothing on admission, which would improve the negative experiences described among the patients in the sample.FundingNo Funding
Number Needed to Treat and Number Needed to Harm From Two Phase 3 Studies of Sublingual Dexmedetomidine for Treating Acute Agitation in Patients With Schizophrenia and Bipolar Disorder
Authors: L Citrome , R Risinger , L Rajachandran , E Patton , H Robison 
Published: April 2023

AbstractBackgroundEpisodes of acute agitation can occur in individuals who suffer from schizophrenia or bipolar disorder and these can be a significant challenge for patients and for those who provide care to them. Sublingual dexmedetomidine is a selective alpha2-adrenergic receptor agonist that was recently approved by the US Food and Drug Administration for the treatment of agitation in adults with schizophrenia or bipolar disorder. The sublingual form of dexmedetomidine does not undergo first-pass hepatic metabolism, thus resulting in greater absorption than when ingested. In two Phase 3 studies of adults with schizophrenia or bipolar disorder, sublingual dexmedetomidine significantly reduced acute agitation at 2 hours, as measured by the five-item Positive and Negative Syndrome Scale-Excited Component (PEC). When initially appraising the potential utility of a new medication, number needed to treat (NNT) and needed to harm (NNH) can be helpful to assess the size of the treatment effect and, hence, clinical relevance.ObjectiveCalculation of NNT and NNH through post hoc analysis of Phase 3 data.MethodsPost hoc analysis of data were performed on data from two double-blind, randomized, placebo-controlled studies of sublingual dexmedetomidine in adults with schizophrenia or bipolar disorder experiencing acute agitation. Patients were randomized to a single dose of sublingual dexmedetomidine 180 μg, 120 μg, or placebo. The primary endpoint was mean change from baseline in the PEC total score. A therapeutic response was defined as a ≥40% reduction from baseline in PEC total score at 2 hours. NNT was calculated for PEC response rate for sublingual dexmedetomidine versus placebo. NNH was calculated using the incidence of adverse events for sublingual dexmedetomidine versus placebo. Likelihood to be helped or harmed (LHH) was calculated as the ratio of NNH to NNT.ResultsNNT (95% CI) was 3 (2, 3) for 180 mcg and 3 (3, 4) for 120 ug in patients with schizophrenia and 3 (2, 3) for 180 mcg and 4 (3, 6) for 120 ug in patients with bipolar disorder. NNH was greater than 10 for all AEs except somnolence, where NNH was 7 (5, 10) for all doses pooled from both studies. LLH values were greater than 1 for efficacy versus applicable tolerability outcomes in all cases.ConclusionsThis post hoc analysis demonstrated favorable NNT and NNH values for sublingual dexmedetomidine. In all instances therapeutic response was encountered more frequently than any adverse event. These values compare favorably to similar analyses for other approved agents for the treatment of agitation associated with schizophrenia or bipolar disorder, including intramuscular and inhaled formulations.FundingBioXcel Therapeutics, Inc.
Comorbidities and Presenting Symptoms in a Real-World Population With Obstructive Sleep Apnea
Authors: Parthasarathy Sairam , Zhang Jerry , Hyman Danielle , Doherty James , Saad Ragy , Fox Benjamin , Marshall Nell J. , Parks Gregory 
Published: April 2023

AbstractBackgroundObstructive sleep apnea (OSA) is a highly prevalent sleep disorder that is often associated with numerous medical and psychiatric comorbidities. Patients with OSA experience a variety of symptoms that can be burdensome and affect their quality of life and satisfaction with care. Excessive daytime sleepiness (EDS) is a common symptom of OSA, and can persist despite primary airway therapy (e.g., positive airway pressure [PAP]). This analysis aimed to characterize common comorbidities, as well as symptoms present at OSA diagnosis and their burden in a real-world population of participants with OSA.MethodsUS residents (≥18 years of age, self-reported clinician diagnosis of OSA [from 1/1/2015 to 3/31/2020]) completed a survey in Evidation Health’s Achievement app that assessed self-reported sleepiness (Epworth Sleepiness Scale [ESS]), self-reported PAP usage, self-reported physician-diagnosed comorbidities, and information on their symptoms at time of OSA diagnosis. Self-reported PAP use was categorized as nonuse (no PAP use), nonadherent (<4 h/night or <5 d/wk), intermediate (4–6 h/night, ≥5 d/wk), or highly adherent (≥6 h/night, ≥5 d/wk). EDS was defined as ESS score >10. All data were summarized descriptively.ResultsIn total, 2289 participants completed the survey (50.3% female; 82.5% White; mean ± standard deviation [SD] age, 44.8 ± 11.1 years; mean ± SD age at OSA diagnosis, 40.7 ± 11.4 years; mean ± SD body mass index, 35.4 ± 8.7 kg/m2); 42.5% had EDS. Among the total population, 30.6% were PAP non-users, 6.7% were nonadherent, 9.8% were intermediate adherent, and 52.9% were highly adherent. Across the study population, the most common self-reported physician-diagnosed comorbidities were anxiety (44%) and depression (42%) followed by hypertension (39%), dyslipidemia (26%), and asthma (21%). Among the symptoms participants reported having had at the time of OSA diagnosis, the most common were EDS (79%), fatigue (79%), snoring (75%), and awakening with a dry mouth or sore throat (63%). Concentration/Memory problems (48%) and mood changes (46%) were also common. In the overall population, the symptoms present at the time of OSA diagnosis that were most likely to be highly burdensome were fatigue (53%), EDS (46%), snoring (35%), difficulty concentrating/memory issues (31%), and mood changes (25%).ConclusionsThese real-world survey data identify anxiety and depression as the most frequently reported comorbidities in a population of participants with OSA, each affecting over 40% of participants. In addition to classic OSA symptoms (e.g., EDS, fatigue, snoring, and awakening with dry mouth/sore throat), concentration/memory problems and mood changes were also common at the time of OSA diagnosis and were among the presenting symptoms most frequently reported as highly burdensome, along with fatigue, EDS, and snoring.FundingAxsome Therapeutics and Jazz Pharmaceuticals
Safety And Tolerability of Aripiprazole 2-Month Ready-to-Use 960 mg in Adult Patients With Schizophrenia or Bipolar I Disorder
Authors: Harlin Matthew , Yildirim Murat , Such Pedro , Madera-McDonough Jessica , Jan Michael , Larsen Frank 
Published: April 2023

AbstractIntroductionAripiprazole 2-month ready-to-use 960 mg (Ari 2MRTU 960) is a new long-acting injectable (LAI) antipsychotic formulation for gluteal administration every 2 months, intended for the treatment of schizophrenia and maintenance monotherapy treatment of bipolar I disorder (BP-I). This 32-week trial evaluated the safety, tolerability, and pharmacokinetic profile of multiple-dose gluteal administration of Ari 2MRTU 960 in clinically stable adult patients with a diagnosis of schizophrenia or BP-I, versus that of aripiprazole once-monthly 400 mg (AOM 400; an LAI indicated for the treatment of schizophrenia and maintenance monotherapy treatment of BP-I).MethodsThis was an open-label, multiple-dose, randomized, parallel-arm trial conducted at 16 sites in the US. Eligible patients (N=266) were randomized to receive Ari 2MRTU 960 every 56±2 days (n=132; 4 injections in total) or AOM 400 every 28±2 days (n=134; 8 injections in total). Safety and tolerability were evaluated throughout the study; assessments included adverse event reporting, patient reporting of injection site pain, and monitoring of extrapyramidal symptoms.ResultsIn the Ari 2MRTU group, 102 patients (77.3%) completed the study; in the AOM 400 group, 92 patients (68.7%) completed the study. The overall incidence of treatment-emergent adverse events (TEAEs) was similar between Ari 2MRTU 960 and AOM 400 (71.2% versus 70.9%, respectively). The most frequently reported TEAEs were increased weight (22.7% for Ari 2MRTU 960 versus 20.9% for AOM 400) and injection site pain (18.2% for Ari 2MRTU 960 versus 9.0% for AOM 400), none of which were assessed as serious or severe by the investigators. All injection site pain events in the Ari 2MRTU 960 group were assessed as mild or moderate in severity; most (15.9%) coincided with the first injection and resolved within 5 days. Extrapyramidal symptom scores remained unchanged in both treatment groups.ConclusionsMultiple-dose administration of Ari 2MRTU 960 was generally well tolerated in patients with schizophrenia or BP-I and did not show any new safety concerns.FundingOtsuka Pharmaceutical Development & Commercialization, Inc. (Princeton, NJ, USA) and H. Lundbeck A/S (Valby, Denmark)
Increasing Awareness of Naloxone-Induced Noncardiogenic Pulmonary and Peripheral Edema
Authors: Conley Kimberly D. , Murphy-Parker Dana , Conley Virginia M. 
Published: April 2023

AbstractIntroductionNaloxone use has increased in recent years in response to the nation’s opioid crisis. Once only available to health care professionals, it is now obtainable by prescription for persons at risk for substance overdose and their families. Increasing its availability is seen by some as an “over-the-counter solution” to the opioid problem. However, while naloxone has been viewed as relatively safe, with a low side effect profile when appropriately dosed and monitored, it is not without safety concerns that may go unrecognized or misattributed to other causes.MethodsHere we present a case study of a 41-year-old female who presented to our medication-assisted treatment (MAT) clinic complaining of sudden onset weight gain, shortness of breath, upper and lower extremity peripheral edema, tachycardia, insomnia, and nocturnal enuresis. These symptoms made it difficult for her to work at her housekeeping job, resulting in missed workdays. She had seen a primary care provider for her symptoms and been prescribed a rescue inhaler for her shortness of breath. This patient had previously been treated for opioid use disorder with buprenorphine/naloxone and experienced similar symptoms, which disappeared when she relapsed on opioids. However, symptoms reappeared upon resuming her prescribed treatment.ResultsThe patient was identified as experiencing side effects to naloxone, causing noncardiogenic edema. Her MAT medication was switched to buprenorphine. Within two weeks her heart rate had returned to normal, she had lost weight, and she no longer had nocturnal enuresis or needed the rescue inhaler. Her peripheral edema resolved so she was able to walk better and resume work. At the same time, buprenorphine continued to relieve her cravings.There is a dearth of information related to naloxone-induced edema. Our patient had not received a formal evaluation of pulmonary edema, but her pulmonary and cardiac symptoms were consistent with that diagnosis. Although pulmonary edema is mentioned in the product literature, peripheral edema is not. A literature search indicates that the number of case studies on naloxone-induced pulmonary edema have increased since 2018, but only one other case of naloxone-induced peripheral edema was discovered.Conclusions/ImportanceNaloxone is used in a variety of settings by differing types of health care providers. As the number of persons treated with naloxone increases, there will likely be a corresponding increase in incidences of pulmonary and/or peripheral edema as side effects. Providers and patients who are not aware of these manifestations and their relationship to naloxone treatment may easily attribute presenting symptoms to cardiogenic or other causes, as this case illustrates. It is important for providers in all settings to consider new onset shortness of breath and edema within the context of the person’s whole health and to be aware of their implications for mental as well as physical health.FundingNo Funding