bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monocentric observational cohort study to investigate the transmission of third-generation cephalosporin-resistant Enterobacterales in a neonatal intensive care unit in Heidelberg, Germany
Authors: Nurjadi Dennis , Eichel Vanessa M. , Pöschl Johannes , Gille Christian , Kranig Simon , Heeg Klaus , Boutin Sébastien 
Published: September 2023

ABSTRACT

Third-generation cephalosporin-resistant Enterobacterales is a major threat for newborns in neonatal intensive care units (NICUs). The route of acquisition in a non-outbreak setting should be investigated to implement adequate infection prevention measures. To identify risk factors for colonization with and to investigate the transmission pattern of third-generation cephalosporin-resistant Enterobacterales in a NICU setting. This monocentric observational cohort study in a tertiary NICU in Heidelberg, Germany, enrolled all hospitalized neonates screened for cephalosporin-resistant Enterobacterales. Data were collected from 1 January 2018 to 31 December 2021. Weekly screening by rectal swabs for colonization with third-generation cephalosporin-resistant Enterobacterales was performed for all newborns until discharge. Whole-genome sequencing was performed for molecular characterization and transmission analysis. In total, 1,287 newborns were enrolled. The median length of stay was 20 (range 1–250) days. Eighy-eight infants (6.8%) were colonized with third-generation cephalosporin-resistant Enterobacterales. Low birth weight [<1500 g (adjusted odds ratio, 5.1; 95% CI 2.2–11.5;
P
< 0.001)] and longer hospitalization [per 30 days (adjusted odds ratio, 1.7; 95% CI 1.5–2.0;
P
< 0.001)] were associated with colonization or infection with drug-resistant Enterobacterales in a multivariate analysis.
Enterobacter cloacae
complex was the most prevalent third-generation cephalosporin-resistant Enterobacterales detected, 64.8% (59 of 91). Whole-genome sequencing, performed for the available 85 of 91 isolates, indicated 12 transmission clusters involving 37 patients. This cohort study suggests that transmissions of third-generation cephalosporin-resistant Enterobacterales in newborns occur frequently in a non-outbreak NICU setting, highlighting the importance of surveillance and preventive measures in this vulnerable patient group.

IMPORTANCE
Preterm newborns are prone to infections. Therefore, infection prevention should be prioritized in this vulnerable patient group. However, outbreaks involving drug-resistant bacteria, such as third-generation resistant Enterobacterales, are often reported. Our study aims to investigate transmission and risk factors for acquiring third-generation cephalosporin-resistant Enterobacterales in a non-outbreak NICU setting. Our data indicated that premature birth and low birth weight are significant risk factors for colonization/infection with third-generation cephalosporin-resistant Enterobacterales. Furthermore, we could identify putative transmission clusters by whole-genome sequencing, highlighting the importance of preemptive measures to prevent infections in this patient collective.
Delayed approach to postdural puncture headache
Authors: Guo Haiyan , Villaluz Joseph 
Published: September 2023

A postpartum female in her mid-20s presented with atypical symptoms of postdural puncture headache. However, on initial presentation, the patient reported no headache. Primary symptoms of acute, severe interscapular pain and upper extremity radiculopathy at the time of epidural placement were observed. The absence of a positional headache and the severity of pain at presentation prompted MRI analysis to establish a clinical diagnosis.MRI findings revealed a significant cerebrospinal fluid (CSF) leak causing a mass effect on the cervicothoracic spinal cord and severe stenosis at the cauda equina. An epidural blood patch (EBP) was considered; however, it was postulated that the narrow epidural space would not be sufficient to accommodate the volume associated with an EBP. She was managed conservatively until subsequent imaging revealed CSF resorption. She received an epidural blood patch on day 7. Thereafter, her symptoms improved, allowing her to nurse her infant and be discharged home.
Antenatal corticosteroids in specific groups at risk of preterm birth: a systematic review
Authors: Saito Kana , Nishimura Etsuko , Ota Erika , Namba Fumihiko , Swa Toshiyuki , Ramson Jenny , Lavin Tina , Cao Jenny , Vogel Joshua Peter 
Published: September 2023

ObjectiveThis study aimed to synthesise available evidence on the efficacy of antenatal corticosteroid (ACS) therapy among women at risk of imminent preterm birth with pregestational/gestational diabetes, chorioamnionitis or fetal growth restriction (FGR), or planned caesarean section (CS) in the late preterm period.MethodsA systematic search of MEDLINE, EMBASE, CINAHL, Cochrane Library, Web of Science and Global Index Medicus was conducted for all comparative randomised or non-randomised interventional studies in the four subpopulations on 6 June 2021. Risk of Bias Assessment tool for Non-randomised Studies and the Cochrane Risk of Bias tool were used to assess the risk of bias. Grading of Recommendations Assessment, Development and Evaluations tool assessed the certainty of evidence.ResultsThirty-two studies involving 5018 pregnant women and 10 819 neonates were included. Data on women with diabetes were limited, and evidence on women undergoing planned CS was inconclusive. ACS use was associated with possibly reduced odds of neonatal death (pooled OR: 0.51; 95% CI: 0.31 to 0.85, low certainty), intraventricular haemorrhage (pooled OR: 0.41; 95% CI: 0.23 to 0.72, low certainty) and respiratory distress syndrome (pooled OR: 0.59; 95% CI: 0.45 to 0.77, low certainty) in women with chorioamnionitis. Among women with FGR, the rates of surfactant use (pooled OR: 0.38; 95% CI: 0.23 to 0.62, moderate certainty), mechanical ventilation (pooled OR: 0.42; 95% CI: 0.26 to 0.66, moderate certainty) and oxygen therapy (pooled OR: 0.48; 95% CI: 0.30 to 0.77, moderate certainty) were probably reduced; however, the rate of hypoglycaemia probably increased (pooled OR: 2.06; 95% CI: 1.27 to 3.32, moderate certainty).ConclusionsThere is a paucity of evidence on ACS for women who have diabetes. ACS therapy may have benefits in women with chorioamnionitis and is probably beneficial in FGR. There is limited direct trial evidence on ACS efficacy in women undergoing planned CS in the late preterm period, though the totality of evidence suggests it is probably beneficial.PROSPERO registration numberCRD42021267816.
Measurement and outcomes of co-production in health and social care: a systematic review of empirical studies
Authors: Nordin Annika , Kjellstrom Sofia , Robert Glenn , Masterson Daniel , Areskoug Josefsson Kristina 
Published: September 2023

BackgroundCo-production is promoted as an effective way of improving the quality of health and social care but the diversity of measures used in individual studies makes their outcomes difficult to interpret.ObjectiveThe objective is to explore how empirical studies in health and social care have described the outcomes of co-production projects and how those outcomes were measured.Design and methodsA scoping review forms the basis for this systematic review. Search terms for the concepts (co-produc* OR coproduc* OR co-design* OR codesign*) and contexts (health OR ‘public service* OR “public sector”) were used in: CINAHL with Full Text (EBSCOHost), Cochrane Central Register of Controlled trials (Wiley), MEDLINE (EBSCOHost), PsycINFO (ProQuest), PubMed (legacy) and Scopus (Elsevier). There was no date limit. Papers describing the process, original data and outcomes of co-production were included. Protocols, reviews and theoretical, conceptual and psychometric papers were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The Mixed Methods Appraisal Tool underpinned the quality of included papers.Results43 empirical studies were included. They were conducted in 12 countries, with the UK representing >50% of all papers. No paper was excluded due to the Mixed Methods Quality Appraisal screening and 60% of included papers were mixed methods studies. The extensive use of self-developed study-specific measures hampered comparisons and cumulative knowledge-building. Overall, the studies reported positive outcomes. Co-production was reported to be positively experienced and provided important learning.ConclusionsThe lack of common approaches to measuring co-production is more problematic than the plurality of measurements itself. Co-production should be measured from three perspectives: outputs of co-production processes, the experiences of participating in co-production processes and outcomes of co-production. Both self-developed study-specific measures and established measures should be used. The maturity of this research field would benefit from the development and use of reporting guidelines.
Association between using a prehospital assessment unit and hospital admission and mortality: a matched cohort study
Authors: Wolthers Signe Amalie , Blomberg Stig Nikolaj Fasmer , Breindahl Niklas , Anjum Sair , Hägi-Pedersen Daniel , Ersbøll Annette , Andersen Lars Bredevang , Christensen Helle Collatz 
Published: September 2023

ObjectivesThis study aimed to compare hospital admission and 30-day mortality between patients assessed by the prehospital assessment unit (PAU) and patients not assessed by the PAU.DesignThis was a matched cohort study.SettingThis study was conducted between November 2021 and October 2022 in Region Zealand, Denmark.Participants989 patients aged >18, assessed by the PAU, were identified, and 9860 patients not assessed by the PAU were selected from the emergency calls using exposure density sampling.ExposurePatients assessed by the PAU. The PAU is operated by paramedics with access to point-of-care test facilities. The PAU is an alternative response vehicle without the capability of transporting patients.Primary and secondary outcome measuresThe primary outcome was hospital admission within 48 hours after the initial call. The key secondary outcomes were admission within 7 days, 30-day mortality and admission within 6 hours. Descriptive statistical analyses were conducted, and logistic regression models were used to estimate adjusted OR (aOR) and 95% CI.ResultsAmong the PAU assessed, 44.1% were admitted within 48 hours, compared with 72.9% of the non-PAU assessed, p<0.001. The multivariable analysis showed a lower risk of admission within 48 hours and 7 days among the PAU patients, aOR 0.31 (95% CI 0.26 to 0.38) and aOR 0.50 (95% CI 0.38 to 0.64), respectively. The 30-day mortality rate was 3.8% in the PAU-assessed patients vs 5.5% in the non-PAU-assessed patients, p=0.03. In the multivariable analysis, no significant difference was found in mortality aOR 0.99 (95% CI 0.71 to 1.42). No deaths were observed in PAU-assessed patients without subsequent follow-up.ConclusionThe recently introduced PAU aims for patient-centred emergency care. The PAU-assessed patients had reduced admissions within 48 hours and 7 days after the initial call. Study findings indicate that the PAU is safe since we identified no significant differences in 30-day mortality.Trial registration numberNCT05654909.
Did implementation of no-fault auto-insurance in British Columbia, Canada, impact return to work following road trauma? Protocol for a before–after survival analysis
Authors: Chan Herbert , Erdelyi Shannon , Jiang Alex , McLeod Christopher , Koehoorn Mieke , Brubacher Jeffrey R 
Published: September 2023

IntroductionRoad trauma (RT) is a major public health problem that often results in prolonged absenteeism from work. Limited evidence suggests that recovery after RT is associated with automobile insurance compensation schemes. In May 2021, British Columbia, Canada switched from fault-based to no-fault auto-insurance coverage. This manuscript presents the protocol for a planned evaluation of that natural experiment: We will evaluate the impact of changing automobile insurance schemes on return to work following RT.Methods and analysisThe evaluation will use a before–after design to analyse auto-insurance claims (1 April 2019 to 30 April 2024) in order to compare recovery of claimants with non-catastrophic injuries who filed claims under the no-fault insurance scheme to that of those who filed claims under the previous system. Claimants will be followed from date of injury until they return to work or have been followed for 6 months (right-censored). We will perform sensitivity analyses to examine the robustness of our findings. First, we will exclude injuries that occurred during the COVID-19 provincial State of Emergency. Second, we will use propensity score methods rather than conventional covariate adjustment to address potential imbalance between characteristics of claimants pre-change and post-change. Finally, as the implementation effect may have a heterogeneous association with time off work, we will use quantile regression with right-censoring at 6 months to model differences in return to work at the 25th, 50th, 75th and 90th percentiles.Ethics and disseminationThe study uses de-identified data and is approved by the University of British Columbia Clinical Research Ethics Board (H20-03644). This research is funded by the Insurance Corporation of British Columbia (ICBC). Findings will be published in the peer-reviewed literature and summarised in a report prepared for ICBC. We anticipate that our findings will inform policy decisions in other jurisdictions considering switching to no-fault auto-insurance schemes.
Universal horizons and black hole spectroscopy in gravitational theories with broken Lorentz symmetry
Authors: Zhang Chao , Wang Anzhong , Zhu Tao 
Published: September 2023

AbstractThe violation of Lorentz invariance (LI) in gravitational theories, which allows superluminal propagations, dramatically alters the causal structure of the spacetime and modifies the notion of black holes (BHs). Instead of metric horizons, now universal horizons (UHs) define the boundaries of BHs, within which a particle cannot escape to spatial infinities even with an infinitely large speed. Then, a natural question is how the quasi-normal modes (QNMs) of a BH are modified, if one considers the UH as its causal boundary. In this paper, we study in detail this problem in Einstein–Aether theory, a vector-tensor theory that violates LI but yet is self-consistent and satisfies all observations to date. Technically, this poses several challenges, including singularities of the perturbation equations across metric horizons and proper identifications of ingoing modes at UHs. After overcoming these difficulties, we show that the QNMs of the Schwarzschild BH, also a solution of Einstein–Aether theory, consist of two parts, the metric and aether parts. The QNMs of the metric perturbations are quite similar to those obtained in general relativity and are consistent with current observations of gravitational waves. But the ones from aether perturbations are different, and our numerical studies indicate that they are even not stable. The latter is consistent with our previous studies, which showed that the stealth Schwarzschild BH suffers a Laplacian instability along the angular direction. The method and techniques developed in this paper can be applied to the studies of QNMs in other theories of gravity with broken LI.
Dixon-Rosenfeld lines and the Standard Model
Authors: Chester David , Marrani Alessio , Corradetti Daniele , Aschheim Raymond , Irwin Klee 
Published: September 2023

AbstractWe present three new coset manifolds named Dixon-Rosenfeld lines that are similar to Rosenfeld projective lines except over the Dixon algebra $$\mathbb {C}\otimes \mathbb {H}\otimes \mathbb {O}$$

C
⊗
H
⊗
O

. Three different Lie groups are found as isometry groups of these coset manifolds using Tits’ formula. We demonstrate how Standard Model interactions with the Dixon algebra in recent work from Furey and Hughes can be uplifted to tensor products of division algebras and Jordan algebras for a single generation of fermions. The Freudenthal–Tits construction clarifies how the three Dixon-Rosenfeld projective lines are contained within $$\mathbb {C}\otimes \mathbb {H}\otimes J_{2}(\mathbb {O})$$

C
⊗
H
⊗

J
2

(
O
)

, $$\mathbb {O}\otimes J_{2}(\mathbb {C}\otimes \mathbb {H})$$

O
⊗

J
2

(
C
⊗
H
)

, and $$\mathbb {C}\otimes \mathbb {O}\otimes J_{2}(\mathbb {H})$$

C
⊗
O
⊗

J
2

(
H
)

.
Page curves on codim-m and charged branes
Authors: Guo Yu , Miao Rong-Xin 
Published: September 2023

AbstractThis paper investigates Page curves on the branes with higher codimensions and charges. We study two kinds of doubly holographic modes, the AdS/dCFT and cone holography. In AdS/dCFT, the gravitations on the brane are massive, and the black hole on the codim-m brane is coupled with the non-gravitational bath on the AdS boundary. Following the standard approach, we derive the Page curve for eternal black holes. On the other hand, cone holography includes massless graviton on the brane, and the bath becomes gravitating. By adding suitable DGP gravity on the end-of-the-world brane, we recover non-trivial entanglement islands and Page curves, which strongly support that the island is consistent with massless gravity. Finally, we analyze the effects of charges and find that, as the charges increase, the Page time increases, and the parameter space for non-trivial Page curves widens.
A multilevel mHealth intervention boosts adherence to hydroxyurea in individuals with sickle cell disease
Authors: Hankins Jane S. , Brambilla Donald , Potter Michael B. , Kutlar Abdullah , Gibson Robert , King Allison A. , Baumann Ana A. , Melvin Cathy , Gordeuk Victor R. , Hsu Lewis L. , Nwosu Chinonyelum , Porter Jerlym S. , Alberts Nicole M. , Badawy Sherif M. , Simon Jena , Glassberg Jeffrey A. , Lottenberg Richard , DiMartino Lisa , Jacobs Sara , Fernandez Maria E. , Bosworth Hayden B. , Klesges Lisa M. , Shah Nirmish 
Published: September 2023

Abstract
Hydroxyurea reduces sickle cell disease (SCD) complications, but medication adherence is low. We tested 2 mobile health (mHealth) interventions targeting determinants of low adherence among patients (InCharge Health) and low prescribing among providers (HU Toolbox) in a multi-center, non-randomized trial of individuals with SCD ages 15-45. We compared the percentage of days covered (PDC), labs, healthcare utilization, and self-reported pain over 24 weeks of intervention and 12 weeks post-study with a 24-week preintervention interval. We enrolled 293 patients (51% male; median age 27.5 years, 86.8% HbSS/HbSβ0-thalassemia). The mean change in PDC among 235 evaluable subjects increased (39.7% to 56.0%; P &lt; 0.001) and sustained (39.7% to 51.4%, P &lt; 0.001). Mean HbF increased (10.95% to 12.78%; P = 0.03). Self-reported pain frequency reduced (3.54 to 3.35 events/year; P = 0.041). InCharge Health was used ≥1 day by 199 of 235 participants (84.7% implementation; median usage: 17% study days; IQR: 4.8-45.8%). For individuals with ≥1 baseline admission for pain, admissions per 24 weeks declined from baseline through 24 weeks (1.97 to 1.48 events/patient, P = 0.0045) and weeks 25-36 (1.25 events/patient, P = 0.0015). PDC increased with app use (P &lt; 0.001), with the greatest effect in those with private insurance (P = 0.0078), older subjects (P = 0.033), and those with lower pain interference (P = 0.0012). Of the 89 providers (49 hematologists, 36 advanced care providers, 4 unreported), only 11.2% used HU Toolbox ≥1/month on average. This use did not affect change in PDC. Tailoring mHealth solutions to address barriers to hydroxyurea adherence can potentially improve adherence and provide clinical benefits. A definitive randomized study is warranted. This trial was registered at www.clinicaltrials.gov as #NCT04080167.
Excess mortality in persons with severe mental disorder in Sweden: a cohort study of 12 103 individuals with and without contact with psychiatric services
Authors: Tidemalm Dag , Waern Margda , Stefansson Claes-Göran , Elofsson Stig , Runeson Bo 
Published: September 2023

Abstract
Background
Investigating mortality in those with mental disorder is one way of measuring effects of mental health care reorganisation. This study's aim was to investigate whether the excess mortality in those with severe mental disorder remains high in Sweden after the initiation of the Community Mental Health Care Reform. We analysed excess mortality by gender, type of mental health service and psychiatric diagnosis in a large community-based cohort with long-term mental disorder.

Methods
A survey was conducted in Stockholm County, Sweden in 1997 to identify adults with long-term disabling mental disorder (mental retardation and dementia excluded). The 12 103 cases were linked to the Hospital Discharge Register and the Cause of Death Register. Standardised mortality ratios (SMRs) for 1998–2000 were calculated for all causes of death, in the entire cohort and in subgroups based on treatment setting and diagnosis.

Results
Mortality was increased in both genders, for natural and external causes and in all diagnostic subgroups. Excess mortality was greater among those with a history of psychiatric inpatient care, especially in those with substance use disorder. For the entire cohort, the number of excess deaths due to natural causes was threefold that due to external causes. SMRs in those in contact with psychiatric services where strikingly similar to those in contact with social services.

Conclusion
Mortality remains high in those with long-term mental disorder in Sweden, regardless of treatment setting. Treatment programs for persons with long-term mental disorder should target physical as well as mental health.
Are structured interviews truly able to detect and diagnose Bipolar II disorders in epidemiological studies? The king is still nude!
Authors: Carta Mauro Giovanni , Hardoy Maria Carolina , Fryers Tom 
Published: September 2023

Abstract
Introduction
A research commentary published in 2005 pointed out that the apparently low prevalence of Bipolar Disorder diagnosis as reported by epidemiological studies may be related to the under-estimate of bipolar disorder cases generally yielded by methodological instruments that are applied in such investigations.

New data apparently challenge this notion
More recent publications have presented new results that apparently contradict the issues raised by the commentary, stating that the CIDI interview, which is used in the most important epidemiological studies is not only valid but highly reliable in identifying bipolar disorders.

Commentary
This paper analyzes the new data and concludes that they do not give a clear indication as to how reliably the CIDI can recognize undiagnosed bipolar disorder cases. Further research studies are needed on larger "negative" (to the CIDI) samples before the field will be persuaded that CIDI really does what it is supposed to do.