bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of nursing homes with high rates of invasive methicillin‐resistant Staphylococcus aureus infections
Authors: See Isaac , Jackson Kelly A. , Hatfield Kelly M. , Paul Prabasaj , Li Rongxia , Nadle Joelle , Petit Susan , Ray Susan M. , Harrison Lee H. , Jeffrey Laura , Lynfield Ruth , Bernu Carmen , Dumyati Ghinwa , Gellert Anita , Schaffner William , Markus Tiffanie , Gokhale Runa H. , Stone Nimalie D. , Jacobs Slifka Kara 
Published: January 2025

AbstractBackgroundNursing home residents experience a large burden of invasive methicillin‐resistant Staphylococcus aureus (MRSA) infections. Data are limited regarding nursing home characteristics associated with differences in facility‐level invasive MRSA rates.MethodsWe analyzed 2011–2015 data from CDC's Emerging Infections Program (EIP) active population‐ and laboratory‐based surveillance for invasive MRSA cases within seven states. A nursing home‐onset case was defined as MRSA cultured from a normally sterile site in a person living in a nursing home 3 days before culture collection. Facility rates were calculated as nursing home‐onset cases per 100,000 resident‐days. Nursing home resident‐day denominators and facility characteristics were obtained from four Centers for Medicare & Medicaid Services (CMS) datasets. A general estimating equations model with a logit link assessed characteristics of the facilities with highest rates comprising 50% of nursing home MRSA cases (“high rates”).ResultsThe 626 nursing homes in the surveillance area had 2824 invasive MRSA cases; 82% of facilities had at ≥1 case. The 20% of facilities with highest rates (≥3.84 cases/100,000 resident‐days) had 50% of nursing home‐onset cases. In multivariable regression, facilities with high rates were more likely to have CMS‐derived characteristics of presence of a resident with a multidrug‐resistant organism; or greater proportions of residents who were male, were short stay (in the facility <100 days), had a nasogastric or percutaneous gastrostomy tube, or require extensive assistance with bed repositioning; and more likely to be in an EIP area with higher hospital‐onset MRSA rates. Higher registered nurses staffing levels (hours/resident/day) and higher proportions of White residents were associated with lower rates.ConclusionsFacilities with higher invasive MRSA rates served residents with more clinical and functional care needs. Increasing registered nurse staffing in high‐risk facilities might assist with reduction of invasive MRSA rates. These findings could help prioritize nursing homes for future MRSA prevention work.
Procuring Medical Devices: The Price Effect of Mergers Among Orthopedic Prostheses Producers
Authors: Atella Vincenzo , Ceschin Nicola , Decarolis Francesco 
Published: January 2025

ABSTRACTThis paper quantifies the price effects of a merger between two major producers of orthopedic prostheses. It shows that, in the public procurement markets where these products are purchased, the effect of the merger hinges on the characteristics of both the procurement design and the organizational structure of the buyers. Using data from all public procurement events in Italy between 2012 and 2019, and exploiting a difference‐in‐differences model where pacemakers play the role of the control group, we find that the merger led to a 7.6% increase in prices and that this effect is concentrated in the first three years post‐merger. Further insights are: (i) a heterogeneous impact among gender and age groups such that most of the burden is on female patients aged 65 and above; (ii) short‐term quality does not change, but patenting activity declines; (iii) there is no evidence of the merger triggering ex‐post coordinated effects in the form of bidding and entry patterns compatible with firm collusion.
Kidney function decline improves after lithium discontinuation
Authors: Fransson Filip , Werneke Ursula , Öhlund Louise , Jonsson P. Andreas , Ott Michael 
Published: January 2025

AbstractBackgroundLong‐term lithium treatment decreases kidney function. However, it remains unclear whether stopping lithium improves kidney function.ObjectivesTo study kidney function in patients who stopped and subsequently restarted lithium treatment.MethodsMirror‐image design using data from the LiSIE retrospective cohort study. The mirror was set to when lithium was stopped with a 5‐year pre‐ and post‐mirror period. Adult patients with bipolar, schizoaffective disorder or unipolar depression, who had lithium ≥4.5 years in the pre‐mirror period, were included. Creatinine measurements were available from 1997 to 2017. The main outcome was the difference in mean annual change of the estimated glomerular filtration rate (eGFR) adjusted for sex, hypertension and diabetes mellitus.ResultsA total of 168 participants (94 women, 74 men) were included. Mean annual eGFR change was −1.58 (−1.87 to −1.28) mL/min/1.73 m2/year before and −0.023 (−0.49 to +0.44) mL/min/1.73 m2/year after lithium discontinuation (p < 0.0001 for difference). The improvement was 0.77 (0.35–1.20) mL/min/173 m2/year in participants with eGFR >60 mL/min/1.73 m2, and 3.03 (2.15–3.92) mL/min/1.73 m2/year for participants with eGFR <30 mL/min/1.73 m2. The effect was persistent over the 5‐year post‐mirror study period. For participants restarting lithium, the mean annual eGFR change was −1.71 (−2.26 to −1.16) mL/min/1.73 m2/year, a setback compared to their lithium‐free post‐mirror period (p < 0.0001). We did not see any difference compared to the pre‐mirror period (p = 0.51).ConclusionsStopping lithium slowed down mean eGFR decline. This effect was more pronounced in participants with lower eGFR at the time of lithium discontinuation. In participants who restarted lithium, the annual decline of eGFR reverted to pre‐lithium discontinuation levels.
Voice for ourselves or myself in times of crisis: When and how crisis‐related uncertainty motivates employee voices
Authors: Wang Xiaotian , Duan Jinyun , Xu Yue , Shi Lixiaoyun , Qian Cheng 
Published: January 2025

AbstractDrawing on fairness heuristic theory, we propose that organizational justice serves as a boundary condition determining how employees respond to perceived uncertainty in times of organizational crisis with different types of proactive voice (i.e. prosocial or self‐interested). We conducted a three‐wave survey study to test our hypotheses with a sample of 401 employee‐supervisor dyads during the COVID‐19 period. Results demonstrated the employee crisis‐related uncertainty perception's positive indirect effect on employee prosocial voice via prosocial motive when organizational justice was higher, and its positive indirect effect on employee self‐interested voice via self‐interested motive when organizational justice was lower. We then discussed our implications for organizational crisis and employee voice literature.
Circumstances Versus Efforts: Dissecting the Drivers of Adolescent Obesity Inequality
Authors: Zhang Kangkang , Fan Jiaxue , Xu Xinpeng , You Hua 
Published: January 2025

ABSTRACTBackgroundPrevious studies have focused predominantly on socioeconomic disparities in adolescent obesity, but the sources of inequality may be more extensive.ObjectivesWe aim to quantify and decompose the inequality of opportunity (IOp) in adolescent obesity caused by circumstances and examine the indirect effects of these circumstances on obesity through key effort factors.MethodsBased on the IOp framework and previous evidence, we categorised age, gender, socioeconomic status, and family‐school environments of adolescents (N = 9117) as circumstances and obesity‐related behaviours as efforts. The IOp was quantified and decomposed to determine the contribution of each circumstance. We also analysed the association between sleep debt and the circumstances to calculate the magnitude of indirect effects.ResultsOf the obesity‐related behaviours, only sleep debt showed a significant association with obesity (OR = 1.21, p < 0.05). Age and gender contributed 45.97% to the IOp, whereas socioeconomic status contributed 10.43% and family‐school environments contributed 43.59%. Older and female adolescents whose fathers held high‐status occupations tended to suffer from obesity due to sleep debt, while the opposite was true for adolescents whose mothers exercised, only children, boarders, high school students, and those from wealthier families.ConclusionsFamily‐school environments contribute much greater to the IOp in adolescent obesity than socioeconomic status, and sleep debt plays an essential mediating role. The government bears the responsibility to undertake corresponding prioritised actions.
Resource Segmentation: A New Dimension of the Segmentation Hypothesis in Drought Adaptive Strategies and Its Links to Tree Growth Performance
Authors: Yue Chen , Wang Huimin , Meinzer Frederick C. , Dai Xiaoqin , Meng Shengwang , Shao Hui , Kou Liang , Gao Decai , Chen Fusheng , Fu Xiaoli 
Published: January 2025

ABSTRACTThe segmentation hypothesis, a framework for understanding plant drought adaptive strategy, has long been based on hydraulic resistance and vulnerability. Storage of water and carbohydrate resources is another critical function and shapes plant drought adaption and fitness together with hydraulic efficiency and vulnerability. However, patterns and implications of the interdependency of stored water and carbohydrate resources in the context of the segmentation hypothesis are poorly understood. We measured resource pools (relative water content [RWC] soluble sugar [SS] and starch [S]) and anatomical features of leaves and supporting twigs for 36 trees in a subtropical population during the dry season when the Budyko's aridity index was 0.362. For each tree, we rank‐transformed the RWC (RWCrank), SS (SSrank), and S (Srank) and characterised the resource segmentation within organs using Ln(RWCrank/SSrank) and Ln(RWCrank/Srank). We also assessed the resource segmentation between organs using the difference in resource pools between leaves and twigs (RWCleaf‐twig, SSleaf‐twig, and Sleaf‐twig). Resource segmentation was much more effective than the organ‐level resource pool alone in predicting intraspecific variation of tree growth rates. Fast‐growing individuals were mainly characterised by lower leaf Ln(RWCrank/SSrank), higher twig Ln(RWCrank/SSrank), and lower SSleaf‐twig. The resource segmentation strategy of fast‐growing individuals was associated with anatomical attributes that facilitate phloem SS loading and unloading and thus water supply upstream. Our results highlight that resource segmentation is an important dimension of plant drought adaptive strategies and enables better prediction of tree growth vigour than resource pool attributes individually.
Comparative study of inactivation efficacy of far‐UVC (222 nm) and germicidal UVC (254 nm) radiation against virus‐laden aerosols of artificial human saliva
Authors: Monika  , Damle Eeshan Ajay , Kondabagil Kiran , Kunwar Ambarish 
Published: January 2025

AbstractVirus‐laden aerosols play a substantial role in the spread of numerous infectious diseases, particularly in enclosed indoor settings. Ultraviolet‐C (UVC) disinfection is known to be a highly efficient method for disinfecting pathogenic airborne viruses. Recent recommendations suggest using far‐UVC radiation (222 nm) emitted by KrCl* (krypton‐chloride) excimer lamps to disinfect high‐risk public spaces due to lower exposure risks than low‐pressure (LP) mercury lamps (254 nm). This study experimentally explored the comparative effectiveness of far‐UVC (222 nm) and germicidal UVC (254 nm) in inactivating virus‐laden aerosols of different protective vector media in an air disinfection chamber. The UVC inactivation performances of individual filtered KrCl* excimer lamp and LP mercury lamp were determined for inactivating the bacteriophages, MS2 (icosahedral and non‐enveloped ssRNA virus) and Phi6 (spherical and enveloped dsRNA virus) aerosolized from artificial human saliva or sodium chloride and magnesium sulfate (SM) buffer as a vector media. Disinfection efficacy of filtered KrCl* excimer lamp (222 nm) and LP mercury lamp (254 nm) were evaluated for highly concentrated viral aerosols, which replicate those exhaled from infected individuals and remain suspended in air or deposited on surfaces as fomites. Our results show that using individual filtered KrCl* excimer lamp (222 nm) and LP mercury lamp (254 nm) could greatly accelerate the inactivation of the viral bioaerosols formed from artificial human saliva and SM buffer. In the case of 222 nm exposure, Phi6 exhibited significantly more susceptibility in artificial human saliva than in SM buffer whereas MS2 showed comparable vulnerability in both artificial human saliva and SM buffer. However, in the case of 254 nm exposure, both Phi6 and MS2 demonstrated significantly greater susceptibility in artificial human saliva than in SM buffer. This study offers valuable insights and improves our understanding of the influence of different vector media on UVC disinfection of exhaled virus‐laden aerosols in indoor environments. These findings can guide the deployment of UVC devices which could greatly contribute to mitigating the transmission of exhaled bioaerosols in public settings.
The prevalence of Phytophthora in British plant nurseries; high‐risk hosts and substrates and opportunities to implement best practice
Authors: Green Sarah , Cooke David E. L. , Barwell Louise , Purse Bethan V. , Cock Peter , Frederickson‐Matika Debra , Randall Eva , Keillor Beatrix , Pritchard Leighton , Thorpe Peter , Pettitt Tim , Schlenzig Alexandra , Barbrook Jane 
Published: January 2025

AbstractInvasive Phytophthora species infect a very broad range of herbaceous and woody hosts globally. The UK alone has experienced a particularly damaging series of outbreaks and epidemics of new, invasive Phytophthora species affecting the nation's trees over the last 30 years. The link between Phytophthora outbreaks and the importation and spread of infected nursery stock is well established across many countries worldwide. To understand better the pathways of spread of Phytophthora in the nursery trade in Britain, we applied a standardized nursery sampling method combined with a refined metabarcoding detection method to capture the diversity of Phytophthora species at 134 British plant nurseries representing a range of biosecurity and trading practices over multiple sampling years between 2016 and 2022. This included root and water samples collected from 17 nurseries sampled seasonally and root samples collected from 117 nurseries sampled once as part of plant health inspections. Based on analyses of 1894 pooled samples, DNA barcodes of 85 Phytophthora species or complexes were detected, with variation in species' relative frequencies across nurseries. We present the top 20 host–Phytophthora associations ranked by relative frequency and report five novel Phytophthora records for the UK. We identified surprisingly high‐risk hosts (such as Douglas fir) with the greatest number of Phytophthora associations and revealed Phytophthora nursery niche preferences for water or roots. We discuss the implications of our findings in terms of pathogen diversity and abundance, high‐risk hosts, our information dissemination approach and resulting advice on nursery practices aimed at reducing risk.
Effects of 8 Weeks of Moderate‐ or High‐Volume Strength Training on Sarcoplasmic Reticulum Ca2+ Handling in Elite Female and Male Rowers
Authors: Mazza Oscar , Nielsen Joachim , Mathiesen Jonas , Højme Daniel , Lundby Carsten , Hostrup Morten , Thomassen Martin , Plomgaard Peter , Gejl Kasper Degn , Ørtenblad Niels 
Published: January 2025

ABSTRACTWhile acute exercise affects sarcoplasmic reticulum (SR) function, the impact of resistance training remains unclear. The purpose of the present study was to investigate SR Ca2+ handling plasticity in response to moderate‐ and high‐volume strength training in elite rowers. Twenty elite male (n = 12) and female (n = 8) rowers performed three weekly strength training sessions for 8 weeks and were randomly allocated to either perform 3 sets (3‐SET) or progressive increase from 5 to 10 sets (10‐SET) of 10 repetitions during the training period. Skeletal muscle biopsies were collected before and after the intervention period and analyzed for SR vesicle Ca2+ handling, SR related proteins, and myosin heavy chain (MHC) composition. Muscle strength was determined by isometric midthigh pull (IMTP). Training increased both the overall SR Ca2+ release (19%) and uptake rates (34%), with no differences between groups. SR protein analysis revealed a high variability but suggests an increase of RYR1 and SERCA1, while SERCA2 decreased, corroborating changes in SR function, with no differences between groups. Regardless of training volume, a 9% higher relative MHCIIa proportion and a 7% decrease in the MHCI isoform was observed. There was an overall 8% increase of IMTP. Males exhibited higher SR Ca2+ uptake and release rates compared to females, likely explained by a higher proportion of MHCII. These findings suggest that 8 weeks of moderate‐ or high‐volume strength training enhances SR vesicle Ca2+ uptake and release rates in elite male and female rowers, accompanied by a shift toward a larger proportion of MHCIIa fiber type.
Shattering the Shield: Embracing Complexity in Undergraduate Medical Education
Authors: Bezzina Cara , McQuade Robert , Lowe Wendy , Mair Frances , Pope Lindsey 
Published: January 2025

ABSTRACTBackgroundMultimorbidity and patient complexity are increasing, yet undergraduate medical education curricula remain dominated by single disease frameworks, where students are often shielded from exposure to this complexity. Why this shielding continues to occur is understandable; however, this may leave graduates feeling underprepared for real‐world practice. This study aimed to explore medical students' experiences of encountering, managing and dealing with complexity and to provide informed recommendations for integrating complexity into clinical teaching.MethodologySituated within a constructivist paradigm, this qualitative study involved focus groups (n = 4) with fourth‐ and fifth‐year medical students (n = 17) from two Scottish Universities. Data were analysed using reflexive thematic analysis.FindingsLearners in this study recognised multimorbidity, complex communication and emotionally charged interactions in their definitions of complexity. They described varying levels of exposure to complexity and opportunities to engage meaningfully with complex patients. Students felt that supervisors who shield students from learning opportunities with complex patients, together with a failing healthcare system, were critical limiting factors in their development. Learners emphasised the powerful role of supervisors in their learning experiences, which limited their ability to experiment and learn from productive failure but felt that with guided scaffolding and supervision, teaching and learning in this space could be meaningfully enhanced.ConclusionExposure to and engagement with complex patients offer critical learning opportunities that may allow students to explore and better develop skills in managing complexity. With appropriate scaffolding, students can be empowered to embrace complexity in the clinical learning environment, potentially equipping them to care for complex patients.
Video analysis of neonatal intubations using video laryngoscopy: a prospective comparison of clinical practice with resuscitation guidelines
Authors: Ní Chathasaigh Caitríona M , Dunne Emma A , Geraghty Lucy E , O'Donnell Colm P F , O'Currain Eoin , Curley Anna E 
Published: January 2025

BackgroundThe Neonatal Resuscitation Program recommends direct laryngoscopy (DL) as the primary method for neonatal intubation. Video laryngoscopy (VL) is suggested as an option, particularly for training novice operators or for intubating infants with difficult airways. The programme outlines specific steps for intubation, including managing the external environment and techniques for visualising key anatomical landmarks. It is unclear whether the DL method can be effectively applied to VL.ObjectivesTo determine the degree of adherence to resuscitation guidelines during intubation using VL, and to examine the relationship between guideline adherence and intubation success.MethodsIn a cohort of newborn infants who were intubated with VL, we simultaneously recorded the view obtained with the video laryngoscope and an external view of the procedure with a GoPro video camera, and synchronised the recordings for analysis. In each set of recordings, we assessed infant and operator positions, interventions during the procedure, and the anatomical landmarks visualised.ResultsWe assessed 95 intubation attempts in 57 infants (median corrected gestational age: 28 weeks; median weight: 1160 g). Sixty-six of these attempts (69%) were successful. Operators spent more time attempting to insert the endotracheal tube through a visible glottis than locating it. Sixty-six (69%) attempts were performed with an appropriate lift manoeuvre. The vocal cords were visualised in only 58 (61%) attempts, while the glottis was seen in 85 (89%).ConclusionsNeonatal intubation using VL differed from the technique recommended in resuscitation guidelines. Revised guidelines considering the use of VL may be warranted.
Alcohol restrictions and suicide rates in South Africa during the COVID-19 pandemic: results of a natural experiment
Authors: Hodgson Anthony Fish , Bantjes Jason , Pirkis Jane , Hawton Keith , Basera Wisdom , Matzopoulos Richard 
Published: January 2025

BackgroundAlcohol use is a well-established potentially modifiable risk factor for suicide, yet few studies have investigated the impact of alcohol restrictions on suicide rates, particularly in low- and middle-income countries.MethodsWe used data from nationally representative annual surveys of postmortem investigations in 2017 (n=6117) and 2020/21 (n=6586) to estimate changes in suicide rates associated with the COVID-19 pandemic and related alcohol restrictions.FindingsAge standardised suicide mortality rates per 100 000 were 10.91 (10.64, 11.18) in 2017 and 10.82 (10.56, 11.08) in 2020/2021, with approximately 4.4 times more deaths among males than females in both periods. No significant differences were observed between overall suicide rates during the 2020/2021 pandemic period compared with 2017 (risk ratio=1.04 (1.00, 1.07)), but in the 15–24-year age group, suicide rates were 11% higher among males and 31% higher among females than in 2017. Partial alcohol restrictions during the pandemic were not associated with lower suicide risk. However, the shift from partial to full restriction on the sale of alcohol was associated with an 18% (95% CI 10% to 25%) reduction in suicides for both sexes combined and a 22% (95% CI 13% to 30%) reduction in suicides among men, but no significant reduction among women.InterpretationOur findings offer some support for the hypothesis that restricting access to alcohol at a population level is associated with a reduction in suicide rates and suggests that restricted access to alcohol may have been one of the reasons global suicide rates did not increase during the pandemic in some countries.