bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Quality Initiative to Improve Postdischarge Care for Patients on Outpatient Parenteral Antimicrobial Therapy
Authors: Certain Laura K , Benefield Russell J , Newman Michael , Zhang Mingyuan , Thomas Frank O 
Published: April 2022

Abstract

Background
Patients discharged from the hospital on outpatient parenteral antimicrobial therapy (OPAT) require close monitoring, including weekly blood tests and an early posthospital follow-up visit. However, because patients often receive OPAT in a separate healthcare system from where they received inpatient care, the OPAT plan often fails, with less than 75% of OPAT patients receiving the recommended laboratory monitoring. We sought to determine whether changing our inpatient OPAT documentation method would improve postdischarge care.

Methods
As a quality improvement initiative, we conducted 2 Plan-Do-Study-Act interventions on our OPAT documentation. Our first intervention was to create a standardized OPAT Progress Note, and our second was to turn that note into a SmartForm (Epic) with discrete fields for the key information. We examined the effects of these changes on the rate of completion of recommended laboratory monitoring, attendance at outpatient follow-up visits, and 30-day readmission rates.

Results
Changing our documentation to a standardized Progress Note and then to a SmartForm with discrete fields led to an increase in the proportion of patients with a serum creatinine checked within 10 days of discharge (from 63% to 71% to 73%) and who attended an infectious disease clinic visit within 3 weeks of discharge (from 21% to 36% to 47%). However, the rate of readmissions for OPAT-related problems did not change, nor did a composite outcome of 30-day mortality/unplanned readmission.

Conclusions
Changes in how and where care plans are documented in the inpatient medical record can have significant effects on patient care outcomes after discharge.
Larotrectinib Treatment for Patients With TRK Fusion-Positive Salivary Gland Cancers
Authors: Le Xiuning , Baik Christina , Bauman Jessica , Gilbert Jill , Brose Marcia S , Grilley-Olson Juneko E , Patil Tejas , McDermott Ray , Raez Luis E , Johnson Jennifer M , Shen Lin , Tahara Makoto , Ho Alan L , Norenberg Ricarda , Dima Laura , Brega Nicoletta , Drilon Alexander , Hong David S 
Published: April 2022

Abstract

Background
Larotrectinib is a first-in-class, highly selective, and central nervous system-active tropomyosin receptor kinase (TRK) inhibitor approved for the treatment of adult and pediatric patients with TRK fusion cancer. We report the efficacy and safety of larotrectinib in patients with TRK fusion-positive salivary gland cancers.

Patients and Methods
Patients with TRK fusion-positive salivary gland cancer treated with larotrectinib were identified from two clinical trials (NCT02122913 and NCT02576431). Patients received larotrectinib 100 mg twice daily (BID) except for one patient who received 150 mg BID in the phase I trial. The primary endpoint was objective response rate (ORR) as assessed by the investigator using Response Evaluation Criteria in Solid Tumors version 1.1.

Results
At the data cut-off (July 20, 2020), 24 patients with TRK fusion-positive salivary gland cancer had been treated. The most common histologies were secretory carcinoma (54%), adenocarcinoma (25%), and mucoepidermoid carcinoma (13%). All 24 patients had an ETV6-NTRK3 gene fusion. The ORR was 92% (95% confidence interval, 73-99). Best overall response was complete response in three (13%) patients, partial response in 19 (79%), and progressive disease in two (8%). The rate of progression-free survival at 24 months was 78% (median follow-up 30.9 months). Most treatment-related adverse events (AEs) were grade 1-2, and no patients discontinued treatment due to AEs.

Conclusion
Larotrectinib demonstrated robust and durable efficacy in patients with TRK fusion-positive salivary gland tumors of various histologies, and a favorable safety profile. These findings support NTRK gene fusion testing in patients with advanced salivary gland cancers.

ClinicalTrials.gov numbers
NCT02122913 and NCT02576431.
Degradation of dead cladoceran zooplankton and their contribution to organic carbon cycling in stratified lakes: field observation and model prediction
Authors: Tolomeev Aleksandr P , Dubovskaya Olga P , Kirillin Georgiy , Buseva Zhanna , Kolmakova Olesya V , Grossart Hans-Peter , Tang Kam W , Gladyshev Michail I 
Published: April 2022

Abstract
The contribution of dead zooplankton biomass to carbon cycle in aquatic ecosystems is practically unknown. Using abundance data of zooplankton in water column and dead zooplankton in sediment traps in Lake Stechlin, an ecological-mathematical model was developed to simulate the abundance and sinking of zooplankton carcasses and predict the related release of labile organic matter (LOM) into the water column. We found species-specific differences in mortality rate of the dominant zooplankton: Daphnia cucullata, Bosmina coregoni and Diaphanosoma brachyurum (0.008, 0.129 and 0.020 day−1, respectively) and differences in their carcass sinking velocities in metalimnion (and hypolimnion): 2.1 (7.64), 14.0 (19.5) and 1.1 (5.9) m day−1, respectively. Our model simulating formation and degradation processes of dead zooplankton predicted a bimodal distribution of the released LOM: epilimnic and metalimnic peaks of comparable intensity, ca. 1 mg DW m−3 day−1. Maximum degradation of carcasses up to ca. 1.7 mg DW m−3 day−1 occurred in the density gradient zone of metalimnion. LOM released from zooplankton carcasses into the surrounding water may stimulate microbial activity and facilitate microbial degradation of more refractory organic matter; therefore, dead zooplankton are expected to be an integral part of water column carbon source/sink dynamics in stratified lakes.
Paternal diet induces transgenerational epigenetic inheritance of DNA methylation signatures and phenotypes in sheep model
Authors: Braz Camila U , Taylor Todd , Namous Hadjer , Townsend Jessica , Crenshaw Thomas , Khatib Hasan 
Published: April 2022

Abstract
Transgenerational epigenetic inheritance (TEI) requires transmission of environmentally induced epigenetic changes and associated phenotypes to subsequent generations without continued exposure to the environmental factor that originated the change. TEI is well-established in plants and Caenorhabditis elegans; however, occurrence in mammals is debated and poorly understood. Here, we examined whether paternal diet from weaning to puberty-induced changes in sperm DNA methylation that were transmitted to subsequent generations. Over 100 methylated cytosines, environmentally altered in the F0 generation, were inherited by the F1 and F2 generations. Furthermore, the F0 paternal diet was associated with growth and male fertility phenotypes in subsequent generations. Differentially methylated cytosines were correlated with gene expression. Our results demonstrate that some sperm methylation sites may escape DNA methylation erasure and are transmitted to subsequent generations despite the 2 waves of epigenetic programming: in primordial germ cells and in embryos after fertilization. These results advance our understanding of the complex relationships between nature and nurture.
‘Rails Invisibly Laid to Infinity’
Authors: Dodd Julian 
Published: April 2022

Abstract
This paper addresses what I call ‘the constitutive question’ concerning the rules we follow: namely, what determines the standard for a rule's correct application. John McDowell has offered a putative ‘middle position’ between two extreme, unacceptable answers: empirical idealism, which takes the requirements of a rule in any given situation to be constituted by our reaction to the case; and hard platonism, which takes these requirements to be delivered by unvarnished reality as absolutely the simplest or most natural way to carry on. Tellingly, however, McDowell's position is itself unacceptably idealist in his picture of the way in which we are ‘involved’ on the right-hand side of biconditionals such as, ‘“Diamonds are hard” is true if and only if diamonds are hard’.
In response to this stultifying state of affairs, I suggest that McDowell has followed the empirical idealist and hard platonist in assuming that the requirements of a rule must be grounded by something else: something external to the rule, which mediates between the rule and the standard for its correct application. This assumption is false. What is more, one application of a metaphor to which Wittgenstein has a somewhat equivocal relation—that of rules as rails invisibly laid to infinity—can help this point to stick.
Grit, Resilience, Mindset, and Academic Success in Physical Therapist Students: A Cross-Sectional, Multicenter Study
Authors: Calo Marlena , Judd Belinda , Chipchase Lucy , Blackstock Felicity , Peiris Casey L 
Published: April 2022

Abstract

Objective
The purpose of this study was to determine the relationships between noncognitive traits (grit, resilience, and mindset-type), academic success, and clinical performance in physical therapist students.

Methods
This cross-sectional study using self-administered surveys was undertaken with final-year physical therapist students enrolled in 4 Australian universities. Participants completed validated questionnaires measuring grit, resilience, and mindset type. Academic transcripts were obtained to quantify academic success and clinical performance. A multiple regression analysis explored predictors of academic success and clinical performance in relation to sociodemographic factors, grit, resilience, and mindset type.

Results
A total of 266 students participated in the study (80% recruitment rate). Overall, 25% of students had low resilience, 20% had low grit, and 14% had a fixed mindset type. Grittiness was positively associated with academic success (r = 0.24) and clinical performance (r = 0.22) and negatively associated with failing a clinical placement (r = -0.20). Grit was an independent predictor of overall academic success (β = 0.24, P ≤ .01) and clinical performance (β = 0.15). Students with low grit were twice as likely to fail a clinical placement compared with students with moderate or high grit (risk ratio = 2.03, 95% CI = 1.06 to 3.89).

Conclusion
Grit was an independent predictor for overall academic success and clinical performance in final-year physical therapist students. Low grit may impact negatively on learning and students’ ability to cope with challenges associated with university studies and clinical education. Further studies should investigate interventions that best develop grit in health professional students and the overlapping nature of grit, resilience, and a growth mindset.

Impact
This study helps universities and educators understand noncognitive factors predicting academic success and clinical performance in physical therapist students. Universities and clinical educators may consider screening and providing proactive strategies for students with low grit to improve success and general wellbeing.
Labor Market Returns and the Evolution of Cognitive Skills: Theory and Evidence
Authors: Hermo Santiago , Päällysaho Miika , Seim David , Shapiro Jesse M 
Published: April 2022

AbstractA large literature in cognitive science studies the puzzling “Flynn effect” of rising fluid intelligence (reasoning skill) in rich countries. We develop an economic model in which a cohort’s mix of skills is determined by different skills’ relative returns in the labor market and by the technology for producing skills. We estimate the model using administrative data from Sweden. Combining data from exams taken at military enlistment with earnings records from the tax register, we document an increase in the relative labor market return to logical reasoning skill as compared to vocabulary knowledge. The estimated model implies that changes in labor market returns explain 37% of the measured increase in reasoning skill, and can also explain the decline in knowledge. An original survey of parents, an analysis of trends in school curricula, and an analysis of occupational characteristics show evidence of increasing emphasis on reasoning as compared to knowledge.
Whole blood drug levels do not correlate with QTc intervals in hydroxychloroquine-treated systemic lupus erythematosus patients
Authors: Belmont H Michael , Haj-Ali Mayce 
Published: April 2022

Abstract

Objectives
HCQ is recommended for all patients with SLE, but reports of cardiac toxicity in severe acute respiratory syndrome coronavirus 2 patients raised concerns. We aimed to study the relationship between HCQ blood levels and QTc intervals.

Methods
A retrospective review of 90 SLE patients (cohort 1) was conducted with data collected regarding demographics, QTc interval and chronic kidney disease (CKD). A prospective study of 84 SLE patients (cohort 2) was conducted with data collected regarding demographics, dose of HCQ, duration of HCQ treatment, presence of echocardiographic abnormalities and CKD simultaneous with whole blood HCQ levels measured by HPLC. Statistical analysis utilized one-way analysis of variance, Pearson’s correlation coefficient and t tests.

Results
In cohort 1 there was no significant difference in mean QTc based on 75 HCQ-treated [437.91 msec (s.d. 20.02)] as compared with 15 untreated patients [434.6 msec (s.d. 27.49)]. In patients with CKD, the mean QTc in HCQ users [448 (s.d. 23.37)] as compared with non-users [444.5 msec (s.d. 24.61)] also had no significant difference. In cohort 2, HCQ levels did not correlate with QTc interval (r = 0.017) and this applied regardless of the dose prescribed (r = 0.113 for 400 mg and r = 0.06 for 200 mg), duration of exposure (P = 0.36 for 0–5, &gt;5–10 or &gt;10 years), CKD (r = 0.482) or underlying cardiac abnormalities (r = 0.430).

Conclusions
This is the first study relying on measured blood levels demonstrating the absence of a clinically consequential increase in QTc levels in HCQ-treated SLE patients.
Cytokine profile, ferritin and multi-visceral involvement characterize macrophage activation syndrome during adult-onset Still’s disease
Authors: Ruscitti Piero , Ursini Francesco , Berardicurti Onorina , Masedu Francesco , Bozzalla Cassione Emanuele , Naldi Susanna , Di Cola Ilenia , Di Muzio Claudia , De Stefano Ludovico , Di Nino Elena , Navarini Luca , Vomero Marta , Bugatti Serena , Valenti Marco , Mariani Erminia , Iagnocco Annamaria , Montecucco Carlomaurizio , Giacomelli Roberto , Cipriani Paola 
Published: April 2022

Abstract

Objectives
To multidimensionally characterize macrophage activation syndrome (MAS) complicating adult-onset Still’s disease (AOSD) considering cytokine profile, inflammatory markers and multi-visceral involvement of the disease. To perform a high-dimensional phenotypic analysis of circulating immune cells in AOSD patients with and without MAS. To assess interferon (IFN)-related pathways in AOSD synovial tissues by a bulky RNA sequencing.

Methods
Clinical and biologic data were collected and compared in AOSD patients with and without MAS. Sera biomolecules were analysed by Luminex multiplexing technology. Mass cytometry (CyTOF) was used to characterize circulating immune cells. A bulky RNA sequencing was performed in AOSD synovial tissues.

Results
Forty consecutive AOSD patients were assessed, 14 complicated with MAS. Paralleling with increases of systemic score and ferritin, MAS patients showed higher levels of IL-1α, IL-1β, IL-1Ra, IL-2Ra, IL-6, IL-10, IL-17A, IFN-γ, G-CSF, MCP-1, MIP-1α and SCF. Combining the discriminatory ability of these data in identifying MAS, the best model was composed by systemic score, ferritin, IFN-γ and IL-10. By CyTOF analysis, MAS patients showed an increase of circulating ‘classical monocytes’ and a reduction of total NK cells. Our assessment showed 3477 IFN-related genes (IRGs) were differently expressed in AOSD synovial tissues.

Conclusions
A multidimensional characterization of AOSD patients suggested that IFN-γ, IL-10, ferritin and systemic score discriminated the occurrence of cytokine storm syndrome associated with MAS. The inflammatory milieu of AOSD and MAS may be related to a signature of circulating immune cells. Finally, our results about IRGs reinforced the role of IFN-γ in these patients.
Exploring discordance between Health Literacy Questionnaire scores of people with RMDs and assessment by treating health professionals
Authors: Bakker Mark M , Putrik Polina , Dikovec Cédric , Rademakers Jany , Vonkeman Harald E , Kok Marc R , Voorneveld-Nieuwenhuis Hanneke , Ramiro Sofia , de Wit Maarten , Buchbinder Rachelle , Batterham Roy , Osborne Richard H , Boonen Annelies 
Published: April 2022

AbstractObjectivesWe studied discordance between health literacy of people with rheumatic and musculoskeletal diseases (RMDs) and assessment of health literacy by their treating health professionals, and explored whether discordance is associated with the patients’ socioeconomic background.MethodsPatients with RA, spondyloarthritis (SpA) or gout from three Dutch outpatient rheumatology clinics completed the nine-domain Health Literacy Questionnaire (HLQ). Treating health professionals assessed their patients on each HLQ domain. Discordance per domain was defined as a ≥2-point difference on a 0–10 scale (except if both scores were below three or above seven), leading to three categories: ‘negative discordance’ (i.e. professional scored lower), ‘probably the same’ or ‘positive discordance’ (i.e. professional scored higher). We used multivariable multilevel multinomial regression models with patients clustered by health professionals to test associations with socioeconomic factors (age, gender, education level, migration background, employment, disability for work, living alone).ResultsWe observed considerable discordance (21–40% of patients) across HLQ domains. Most discordance occurred for ‘Critically appraising information’ (40.5%, domain 5). Comparatively, positive discordance occurred more frequently. Negative discordance was more frequently and strongly associated with socioeconomic factors, specifically lower education level and non-Western migration background (for five HLQ domains). Associations between socioeconomic factors and positive discordance were less consistent.ConclusionFrequent discordance between patients’ scores and professionals’ estimations indicates there may be hidden challenges in communication and care, which differ between socioeconomic groups. Successfully addressing patients’ health literacy needs cannot solely depend on health professionals’ estimations but will require measurement and dialogue.
Data versus Collateral
Authors: Gambacorta Leonardo , Huang Yiping , Li Zhenhua , Qiu Han , Chen Shu 
Published: April 2022

AbstractUsing a unique dataset of more than 2 million Chinese firms that received credit from both an important big tech firm (Ant Group) and traditional commercial banks, this paper investigates how different forms of credit correlate with local economic activity, house prices, and firm characteristics. We find that big tech credit does not correlate with local business conditions and house prices when controlling for demand factors, but reacts strongly to changes in firm characteristics, such as transaction volumes and network scores used to calculate firm credit ratings. By contrast, both secured and unsecured bank credit react significantly to local house prices, which incorporate useful information on the environment in which clients operate and on their creditworthiness. This evidence implies that the wider use of big tech credit could reduce the importance of the collateral channel but, at the same time, make lending more reactive to changes in firms’ business activity.
Maintenance Treatment With Antipsychotic Drugs in Schizophrenia: A Cochrane Systematic Review and Meta-analysis
Authors: Ceraso Anna , Lin Jessie Jingxia , Schneider-Thoma Johannes , Siafis Spyridon , Heres Stephan , Kissling Werner , Davis John M , Leucht Stefan 
Published: April 2022

Abstract
Antipsychotic drugs are the mainstay of treatment of schizophrenia, and are known to reduce acute symptoms of the disorder. An original version of the current review, published in 2012, examined whether antipsychotics are effective for relapse prevention, compared to withdrawing these agents for people with schizophrenia or schizophrenia-like psychoses, based on evidence from randomized trials. The current report of the update of the review is focused on some newly investigated outcomes: rates of remission and recovery, change in social functioning and in quality of life. The updated review included 75 randomized controlled trials (RCTs) published from 1959 to 2017, involving 9145 participants. Although some potential sources of bias limited the overall quality, the efficacy of antipsychotic drugs for maintenance treatment in schizophrenia was clear and robust to a series of sensitivity analyses. Antipsychotic drugs were more effective than placebo in preventing relapse at 1 year (drug 24% versus placebo 61%, 30 RCTs, n = 4249, RR = 0.38, 95% CI = 0.32 to 0.45) and in reducing hospitalization (drug 7% versus placebo 18%, 21 RCTs, n = 3558, RR = 0.43, 95% CI = 0.32 to 0.57). Quality of life appeared to be better in drug-treated participants (7 RCTs, n = 1573, SMD = −0.32, 95% CI = −0.57 to −0.07); the same for social functioning (15 RCTs, n = 3588, SMD = −0.43, 95% CI = −0.53 to −0.34). Although based on data from fewer studies, maintenance treatment apparently increased the possibility to achieve remission of symptoms (drug 53%, placebo 31%; 7 RCTs, 867 participants; RR = 1.73, 95% CI = 1.20 to 2.48) and to sustain it over 6 months (drug 36%, placebo 26%; 8 RCTs, 1807 participants; RR = 1.67, 95% CI = 1.28 to 2.19). There were no data on recovery. Antipsychotic drugs as a group were associated with more participants experiencing side effects such as movement disorders (e.g., at least one movement disorder: drug 14% versus placebo 8%, 29 RCTs, n = 5276, RR 1.52, 95% CI = 1.25 to 1.85) and weight gain (drug 9% versus placebo 6%, 19 RCTs, n = 4767, RR = 1.69, 95% CI = 1.21 to 2.35, NNTH = 25, 95% CI = 20 to 50). For people with schizophrenia, the evidence suggests that maintenance on antipsychotic drugs does not only prevent relapses and rehospitalizations, but that patients also benefit in terms of quality of life, functioning and sustained remission. These positive effects must be weighed against the backdrop of the adverse effects of antipsychotics.