bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is patient discharge after blood culture collection in the emergency department safe? A retrospective study in Japan
Authors: Miwa Toshiki , Takamatsu Akane , Honda Hitoshi 
Published: May 2022

Background: Drawing blood cultures in the emergency room (ER) is essential for detecting bloodstream infections (BSIs). Although a practice of drawing blood culture usually indicates a presence of severe infection requiring hospitalization, some patients may nonetheless be safely discharged from the ER. Previous studies demonstrated that patients with a positive blood culture after ER discharge had favorable clinical outcomes. Moreover, given the increasing incidence of febrile illnesses, especially in the era of COVID-19, the shortage of inpatient hospital beds may lend further justification to this practice. We investigated the prevalence, outcomes, and factors associated with patient discharge from the ER after blood collection. Method: The present, nested, case–control study comparing patients initially discharged from the ER with those directly admitted to the study institution was conducted at a 790-bed tertiary-care medical center in Tokyo, Japan. The ratio of the respective patients was 1:3. Factors associated with ER discharge after a blood-culture collection were identified using multivariate logistic regression analysis. Results: From January 2014 through December 2020, 153,432 patients visited the ER. Blood cultures were obtained for 19,010 patients; 2,575 (13.5%) of these had a true BSI, and of the latter, 142 (5.5%) were initially discharged from the ER. During 2020, the proportion of patients with ER discharge increased 1.7 times over previous years. There was no significant difference in 28-day mortality between the groups (2.1% vs 4.5%; P = .31). On multivariate logistic regression analysis, factors significantly associated with the decision to discharge after blood culture collection were the absence of hypotension (aOR], 14,92; 95% CI, 3.38–65.93), lack of altered mental status (aOR, 8.44; 95% CI, 3.28–21.71) at ER presentation, unknown diagnosis at ER discharge (aOR, 3.75; 95% CI, 1.97–7.16), high level C-reactive protein (aOR, 0.91; 95% CI, 0.87–0.94), and a diagnosis of intra-abdominal or hepatobiliary infection (aOR, 0.11; 95% CI, 0.04–0.29). Conclusions: ER discharge after drawing blood for a culture was more frequently seen in the current COVID-19 era and was deemed acceptable under certain circumstances, such as patients with no systemic illnesses or specific diagnosis who may be managed safely without compromising clinical outcomes.Funding: NoneDisclosures: None
Assessment of risk factors associated with outpatient parenteral antimicrobial therapy complications
Authors: Kaul Christina , Yang Jenny , Haller Matthew , Solomon Sadie , Wang Yaojie , Wu Rong , Meng Yu , Pitts Robert , Phillips Michael 
Published: May 2022

Background: Outpatient parenteral antimicrobial therapy (OPAT) is used in the outpatient setting to treat infectious conditions that require a prolonged course of antimicrobials. OPAT has been shown to decrease length of hospital stay and healthcare costs without compromising patient care and has become a widely accepted practice nationally. Due to this trend, the study of OPAT is of vital importance and will continue to be relevant moving forward. Currently, few studies have explored risk factors associated with OPAT complications, and most are limited in their analysis by indication. Further work should be performed to expand upon what is currently known. We characterized factors associated with increased OPAT complication risk. Methods: We conducted a retrospective cohort study at 4 sites across NYU Langone Health in patients admitted from 2017 to 2020. We applied the following inclusion criteria: aged ≥18 years and discharged with OPAT. Complications were defined as follows: vascular-access-related (line occlusion, thrombosis, dislodgement, central-line associated bloodstream infection or CLABSI) and antimicrobial-related (laboratory derangement, drug reaction, Clostridioides difficile infection), all-cause 30-day readmission, and OPAT-related readmission. Data were obtained from electronic medical records and the OPAT database. This study was granted a waiver from informed consent by the NYU Institutional Review Board. Multivariate logistic regression was performed, adjusting for confounding variables (sex, age, hospital of admission, history of chronic medical conditions, line type, and line duration). Results: Overall, 1,846 patient encounters of 5,951 reviewed met inclusion criteria. The median age was 66 (IQR, 26), 42.2% were female. Moreover, 810 (44%) received a peripherally inserted central catheter (PICC) and 1,036 (56%) received a midline cathether. Also, 563 (30.5%) were discharged to subacute rehabilitation (SAR). The most frequent complications were line dislodgement (4.2% of all patients), laboratory derangement (3.0%), and drug reaction (2.4%). Furthermore, 27 patients (1.5%) developed CLABSI. Patients discharged to SAR were more likely to develop CLABSI (OR, 4.1l; P = .005), and they had higher rates of OPAT-related 30-day readmissions (OR, 2.675; P = .004) compared to those who were discharged home, after adjusting for key confounders. Conclusions: Discharge to SAR is strongly associated with increased risk of readmission for OPAT-related complications and CLABSI, after adjusting for key confounders. CLABSI prevention during SAR admission is a critically needed public health intervention.Funding: NoneDisclosures: None
With Great (Computing) Power Comes Great (Human Rights) Responsibility: Cloud Computing and Human Rights
Authors: Krishnamurthy Vivek 
Published: May 2022

AbstractCloud computing underlies many of the most powerful and controversial technologies of our day – from large-scale data processing to face recognition systems – yet the human rights impacts of cloud computing have received little scrutiny. This article explains what cloud computing is, how it works, and what some of its most significant human rights impacts are through three case studies. It offers some initial thoughts on the human rights responsibilities of cloud computing providers under the United Nations Guiding Principles on Business and Human Rights and concludes by suggesting directions for future research.
Express Trusts, Private Law Theory, and Legal Concepts
Authors: Sheehan Duncan 
Published: May 2022

AbstractThis paper explores Peter Jaffey’s views on the trust and fusion and some aspects of his wider private law theory which impact on his view on trusts law. It shows that, although he is correct that the trust involves both proprietary and personal rights, in the end his theory is ahistorical and unDworkinian, despite his acceptance of a view of law based on Dworkin. His theory is also based on implausible views of the role of equity post-Judicature Acts and the ownership of value and does not adequately fit how trusts law works.
Using informatics to advance translational science: Environmental scan of adaptive capacity and preparedness of Clinical and Translational Science Award Program hubs
Authors: Ragon Bart , Volkov Boris B. , Pulley Chris , Holmes Kristi 
Published: May 2022

Abstract
As the USA and the rest of the world raced to fight the COVID-19 pandemic, years of investments from the National Center for Advancing Translational Sciences allowed for informatics services and resources at CTSA hubs to play a significant role in addressing the crisis. CTSA hubs partnered with local and regional partners to collect data on the pandemic, provide access to relevant patient data, and produce data dashboards to support decision-making. Coordinated efforts, like the National COVID Cohort Collaborative (N3C), helped to aggregate and harmonize clinical data nationwide. Even with significant informatics investments, some CTSA hubs felt unprepared in their ability to respond to the fast-moving public health crisis. Many hubs were forced to quickly evolve to meet local needs. Informatics teams expanded critical support at their institutions which included an engagement platform for clinical research, COVID-19 awareness and education activities in the community, and COVID-19 data dashboards. Continued investments in informatics resources will aid in ensuring that tools, resources, practices, and policies are aligned to meet local and national public health needs.
Adapting an Expanded Access program to enable investigational treatments for COVID-19
Authors: Samuels Elias , Champagne Ellen , Gravelin Misty , Racklyeft Jamie , Weatherwax Kevin 
Published: May 2022

Abstract
Retrospective case studies of initiatives supported by the National Institutes of Health’s Clinical and Translational Science Award (CTSA) hubs can be used to identify facilitators and barriers of translational science. This case study investigates how a CTSA Expanded Access program adapted to changing FDA guidance issued in 2020 to support clinicians’ treatment of COVID-19 patients in Michigan. We studied how this program changed throughout the pandemic to support physicians’ requests for remdesivir, convalescent plasma, and other uses of unapproved drugs and novel medical devices. A protocol for retrospective translational science case studies of health interventions developed by CTSA evaluators was used for this case study. Data collection methods included seven interviews and a review of institutional data, peer-reviewed publications, news stories, and other public records. The barriers identified include evolving guidance, misalignment of organizational operations, and the complexity of the research infrastructure. The facilitators of translation include collaboration between research and care teams, increasing engagement with a broad network of supporters, and ongoing professional development for research staff. The findings of this case study can be used to inform future investigations of the principles underlying the translational process.
Exact calculation of corrosion rates by the weight-loss method
Authors: Malaret Francisco 
Published: May 2022

Abstract
Corrosion is an important problem that engineers and scientists must overcome to avoid the collapse of structures, chemical processing plants, and metallic objects, which can lead to not only economic loss but also environmental and human losses. One of the simplest and most widely used methods to quantify corrosion rates (CRs) is the immersion test. The usual approach that has been used to date, to quantify the CR by this method, is to assume that the initial surface area of the corroding object remains constant over time. It is shown that such approximations underestimate the true CR and that they may lead to significant errors. A formula to calculate the CR considering changes in the area is presented in this work. The formula herein can be used to accurately quantify the CR by the immersion test and improve the quality of experimental data and the analysis and modeling of corrosion phenomena.
Hensel minimality I
Authors: Cluckers Raf , Halupczok Immanuel , Rideau-Kikuchi Silvain 
Published: May 2022

AbstractWe present a framework for tame geometry on Henselian valued fields, which we call Hensel minimality. In the spirit of o-minimality, which is key to real geometry and several diophantine applications, we develop geometric results and applications for Hensel minimal structures that were previously known only under stronger, less axiomatic assumptions. We show the existence of t-stratifications in Hensel minimal structures and Taylor approximation results that are key to non-Archimedean versions of Pila–Wilkie point counting, Yomdin’s parameterization results and motivic integration. In this first paper, we work in equi-characteristic zero; in the sequel paper, we develop the mixed characteristic case and a diophantine application.
Undertaking a face-to-face objective structured clinical examination for medical students during the COVID-19 pandemic
Authors: Fitzgerald N. , Moylett E. , Gaffney G. , McCarthy G. , Fapohunda O. , Murphy A. W. , Geoghegan R. , Hallahan B. 
Published: May 2022

AbstractIntroduction and aims:Objective structured clinical examinations (OSCEs) play a pivotal role in medical education assessment. The Advanced Clinical Skills (ACS) OSCE examines clinical skills in psychiatry, general practice, obstetrics and gynaecology and paediatrics. This study examined if the 2020 ACS OSCE for fourth year medical students attending the National University of Ireland, Galway, was associated with any significant result differences compared to the equivalent 2019 OSCE. Additionally, we assessed students’ satisfaction and explored any organisational difficulties in conducting a face-to-face OSCE during the COVID-19 pandemic.Materials and methods:This study compared anonymised data between the 2019 and 2020 ACS OSCEs and analysed anonymised student feedback pertaining to the modified 2020 OSCE.Results:The mean total ACS OSCE result achieved in 2020 was statistically higher compared to the 2019 OSCE [62.95% (SD = 6.21) v. 59.35% (SD = 5.54), t = 6.092, p < 0.01], with higher marks noted in psychiatry (p = 0.001), paediatrics (p = 0.001) and general practice (p < 0.001) with more students attaining honours grades (χ2 = 27.257, df = 3, p < 0.001). No difference in failure rates were found. Students reported feeling safe performing the 2020 OSCE (89.2%), but some expressed face-mask wearing impeded their communication skills (47.8%).Conclusion:This study demonstrates that conducting a face-to-face OSCE during the pandemic is feasible and associated with positive student feedback. Exam validity has been demonstrated as there was no difference in the overall pass rate.
dastanandtuwān, Adjectives or Nouns? A Discussion about Their Grammatical Category and Meaning in Middle Persian
Authors: Jalalian Chaleshtari Mohammad Hasan 
Published: May 2022

AbstractDespite the impressive research of scholars on Middle Persian grammatical problems, there are still many words in surviving texts that are shrouded in ambiguity. One of these words, whose pronunciation in the inscriptions we owe to the Manichaean texts, isdastan. In this article, first the few available instances of this word in Middle Persian inscriptions and Manichaean texts are mentioned, and scholars’ interpretations of its meaning and grammatical category are discussed. Then it is revisited through the analysis of another word,tuwān, with which it is paired in the Manichaean instance. After a review of prior scholarly interpretations of this latter word, it is argued that in Middle Persiantuwānis a noun, and that it became a modal verb during the process of its application to the possessive structure. Finally, it is asserted thatdastanalso is a noun, due to its conjoinment withtuwānin the Manichaean example.
Estimation of ice ablation on a debris-covered glacier from vertical debris-temperature profiles
Authors: Laha Sourav , Winter-Billington Alex , Banerjee Argha , Shankar R. , Nainwal H.C , Koppes Michele 
Published: May 2022

AbstractA supraglacial debris layer controls energy transfer to the ice surface and moderates ice ablation on debris-covered glaciers. Measurements of vertical temperature profiles within the debris enables the estimation of thermal diffusivities and sub-debris ablation rates. We have measured the debris-layer temperature profiles at 16 locations on Satopanth Glacier (central Himalaya) during the ablation seasons of 2016 and 2017. Debris temperature profile data are typically analysed using a finite-difference method, assuming that the debris layer is a homogeneous one-dimensional thermal conductor. We introduce three more methods for analysing such data that approximate the debris layer as either a single or a two-layered conductor. We analyse the performance of all four methods using synthetic experiments and by comparing the estimated ablation rates with in situ glaciological observations. Our analysis shows that the temperature measurements obtained at equispaced sensors and analysed with a two-layered model improve the accuracy of the estimated thermal diffusivity and sub-debris ablation rate. The accuracy of the ablation rate estimates is comparable to that of the in situ observations. We argue that measuring the temperature profile is a convenient and reliable method to estimate seasonal to sub-seasonal variations of ablation rates in the thickly debris-covered parts of glaciers.
The effects of dietary linoleic acid on reducing serum cholesterol and atherosclerosis development are nullified by a high-cholesterol diet in male and female apoE-deficient mice
Authors: Yuan Xingyu , Nagamine Rika , Tanaka Yasutake , Tsai Wei-Ting , Jiang Zhe , Takeyama Ai , Imaizumi Katsumi , Sato Masao 
Published: May 2022

AbstractLinoleic acid (LA) has a two-sided effect with regard to serum cholesterol-lowering and pro-inflammation, although whether this fatty acid reduces serum cholesterol and the development of atherosclerosis under high-cholesterol conditions has yet to be ascertained. In this study, we examine the effects of dietary LA on reducing serum cholesterol and atherosclerosis development under high-cholesterol conditions. Male and female apoE-deficient (ApoE-/-) mice were fed AIN-76-based diets containing 10% SFA and 0·04 % cholesterol, 10% LA and 0·04% low cholesterol (LALC), or 10% LA and 0·1% high cholesterol (LAHC) for 9 weeks. The results revealed significant reduction in serum cholesterol levels and aortic lesions with increasing levels of pro-inflammatory biomarkers (urinary isoprostane and aortic MCP-1 mRNA) in male and female LALC groups compared with those in the SFA groups (P < 0·05). Furthermore, whereas there were significant increases in the serum cholesterol levels and aortic lesions (P < 0·05), there was no difference in aortic MCP-1 mRNA levels in male and female LAHC groups compared with those in the LALC groups. A high-dietary intake of cholesterol eliminated the serum cholesterol-lowering activity of LA but had no significant effect on aortic inflammation in either male or female ApoE-/- mice. The inhibitory effect of LA on arteriosclerosis is cancelled by a high-cholesterol diet due to a direct increase in serum cholesterol levels. Accordingly, serum cholesterol levels might represent a more prominent pathogenic factor than aortic inflammation in promoting the development of atherosclerosis.
Mind the adoption gap: Findings from a field experiment designed to scale up the availability of fodder shrub seedlings in Malawi
Authors: Hughes Karl , Kulomo Decolius , Nyoka Betserai 
Published: May 2022

Abstract
While dairy production has the potential to diversify smallholder agriculture and increase incomes, there are multiple constraints. One is the consistent provision of quality feed. High protein, leguminous fodder shrubs – also referred to as Fodder Tree Technology (FTT) – can help address this constraint, yet adoption levels are generally low. Implemented in Kenya and Malawi, the Shrubs for Change (S4C) project is employing several approaches to address this situation, including those informed by behavioral science. Given that approximately 500 shrubs per cow are needed to generate enough leaf matter to bolster milk production, promoting FTT at scale necessitates the production, distribution, and successful planting of large numbers of shrub seedlings. We implemented a field experiment in Malawi’s Southern Region in late 2021 to test the effectiveness of a social learning intervention intended to motivate dairy farmers to significantly scale up the production of FTT seedlings. This intervention involved meeting with dairy farmers in 39 randomly selected milk production zones to review the numbers of seedlings being produced vis-à-vis local demand, coupled with the development of action plans to address identified production gaps. While we find that this intervention increased the setting up of private nurseries by 10% (p < 0.05), it only increased overall seedling production by an average of 20 additional seedlings per dairy farmer (p > 0.1). We offer several explanations for this lower than expected and statistically insignificant result, which point to the need for iterative rounds of engagement with farmers when supporting them to take up FTT and other complex agronomic and sustainable land management innovations.
Between Church and State: The Challenges of Reforming the Church Courts and Family Law in the Greek Orthodox Patriarchate of Jerusalem
Authors: Engelcke Dörthe 
Published: May 2022

AbstractIn most Middle Eastern jurisdictions, the applicable family law is determined based on the religious affiliation of the parties involved. Whereas Jordanian Islamic family law has last been reformed in 2001, 2010, and 2019, and the law that regulates the shariʿa courts has been amended several times since 1972, the family laws of Christian communities and the church courts have largely been exempted from this reform dynamic. Based on semi-structured interviews as well as the review of written sources, this article investigates why it is difficult to reform the church courts and even more difficult to reform the family laws of Christian communities, using the Greek Orthodox community in Jordan as a case study. I argue that conflicts within the Greek Orthodox Patriarchate of Jerusalem and the fact that the jurisdiction of the patriarchate over family law transcends Jordanian state boundaries have made state-led reform challenging and presented obstacles for Jordanian Christians lobbying for change.
Exploring the Relationship between Household Structure and Utilisation of Maternal Health Care Services in India
Authors: Pradhan Manas Ranjan , Mondal Sourav 
Published: May 2022

AbstractThe role of household structure, especially the mother-in-law (MIL) influencing daughter-in-law’s maternal health care (MHC) seeking behaviour, has been a continuing debate due to the former’s advantageous position in the household. This study assesses the association of household structure and particularly the presence of MIL with MHC utilisation in India using the National Family Health Survey-4 data (2015-16). The sample of women aged 15-49 years who have given birth during the last five years preceding the survey (n=184,641) was considered for analysis. The outcome variables were full-antenatal care, institutional delivery, and postnatal care. Binary logistic regression was used to check the adjusted effects of the household structure on MHC utilisation. The analyses were done with STATA (version 13) with a significance level of 5%. Adjusting the effects of socio-demographic and economic characteristics, women from non-nuclear households with MIL had higher odds of full-antenatal care (OR= 1.04, CI= 0.99-1.08) and institutional delivery (OR=1.05, CI=1.01- 1.10) than their counterparts from nuclear households. Women from non-nuclear households without MIL had lower chances of postnatal care (OR=0.98, CI=0.96-1.00) than those from nuclear households. The study unearths a very weak association between the presence of MIL in the household and MHC services utilisation of the daughter-in-law, a notable change from the earlier literature often portraying MIL as a barrier.