bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Clinical Decision Support System Implementation at a Community Hospital With an Existing Tele-Antimicrobial Stewardship Program
Authors: Khadem Tina M , Ergen Howard J , Salata Heather J , Andrzejewski Christina , McCreary Erin K , Abdel Massih Rima C , Bariola J Ryan 
Published: May 2022

Abstract

Background
Lack of on-site antimicrobial stewardship expertise is a barrier to establishing successful programs. Tele-antimicrobial stewardship programs (TASPs) utilizing a clinical decision support system (CDSS) can address these challenges.

Methods
This interrupted time series study reports the impact of CDSS implementation (February 2020) within an existing TASP on antimicrobial usage in a community hospital. Segmented regression analysis was used to assess differences in antimicrobial usage from January 2018 through December 2021. Pre- and post-CDSS frequencies of intravenous vs oral antimicrobials, time to optimal therapy (TTOT), pharmacist efficiency (number of documented interventions per month), and percentage of hospitalized patients receiving antimicrobials were compared with descriptive statistics.

Results
Implementation of a CDSS into an existing TASP was associated with an immediate 11% reduction in antimicrobial usage (level change, P &lt; .0001). Antimicrobial usage was already trending down by 0.25% per month (pre-CDSS slope, P &lt; .0001) and continued to trend down at a similar rate after implementation (post-CDSS slope, P = .0129). Frequency of use of select oral agents increased from 38% to 57%. Median TTOT was 1 day faster (2.9 days pre-CDSS vs 1.9 days post-CDSS). On average, pharmacists documented 2.2-fold more interventions per month (198 vs 90) and patients received 1.03 fewer days of antimicrobials per admission post-CDSS.

Conclusions
Implementation of a CDSS within an established TASP at a community hospital resulted in decreased antimicrobial usage, higher rates of oral usage, faster TTOT, and improved pharmacist efficiency.
Clinical Features and Duration of Viral Shedding in Individuals With SARS-CoV-2 Omicron Variant Infection
Authors: Jang Young R , Kim Jeong-Min , Rhee Jee E , Kim Dongju , Lee Nam-Joo , Lee Hyeokjin , Kim Jong-Hun , Kim Eun-Jin , Kim Jin Y 
Published: May 2022

Abstract
We analyzed the duration of infectivity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant by viral culture of respiratory samples collected daily from isolated patients with SARS-CoV-2 infection. The culture positivity rate of the Omicron variant was higher than that of the Delta variant within 8 days after symptom onset.
TIME FOR COFFEE regulates phytochrome A-mediated hypocotyl growth through dawn-phased signaling
Authors: Wang Yan , Su Chen , Yu Yingjun , He Yuqing , Wei Hua , Li Na , Li Hong , Duan Jie , Li Bin , Li Jigang , Davis Seth J , Wang Lei 
Published: May 2022

AbstractTo enhance plant fitness under natural conditions, the circadian clock is synchronized and entrained by light via photoreceptors. In turn, the circadian clock exquisitely regulates the abundance and activity of photoreceptors via largely uncharacterized mechanisms. Here we show that the clock regulator TIME FOR COFFEE (TIC) controls the activity of the far-red light photoreceptor phytochrome A (phyA) at multiple levels in Arabidopsis thaliana. Null mutants of TIC displayed dramatically increased sensitivity to light irradiation with respect to hypocotyl growth, especially to far-red light. RNA-sequencing demonstrated that TIC and phyA play largely opposing roles in controlling light-regulated gene expression at dawn. Additionally, TIC physically interacts with the transcriptional repressor TOPLESS (TPL), which was associated with the significantly increased PHYA transcript levels in the tic-2 and tpl-1 mutants. Moreover, TIC interacts with phyA in the nucleus, thereby affecting phyA protein turnover and the formation of phyA nuclear speckles following light irradiation. Genetically, phyA was found to act downstream of TIC in regulating far red light-inhibited growth. Taken together, these findings indicate that TIC acts as a major negative regulator of phyA by integrating transcriptional and post-translational mechanisms at multiple levels.
Parental Love and Procreation
Authors: Shpall Sam 
Published: May 2022

AbstractThe main goal of this paper is to explore the forcefulness of the adoption challenge to procreative parenting. After framing the challenge, I consider two of the most developed attempts to respond to it, due to Luara Ferracioli and Elizabeth Brake. I argue that neither strategy is a promising way to vindicate the permissibility of procreative parenting. I then present several reasons to value procreative parenting that are underappreciated in the recent literature. Though these considerations deserve more philosophical attention, I’m agnostic about whether they are strong enough to overcome the adoption challenge. I explain why this agnosticism is reasonable, and the debate about permissibility arguably intractable, in the context of prevailing deontological assumptions structuring discussions of procreation. I conclude by arguing that an independently interesting metaethical thesis, which I call deontic fictionalism, may give us some perspective on this debate and others like it.
Determinants of Short-Term Corporate Yield Spreads: Evidence from the Commercial Paper Market
Authors: Huang Jing-Zhi , Liu Bibo , Shi Zhan 
Published: May 2022

AbstractWhat drives short-term credit spreads: credit risk, liquidity risk, or both? We investigate this issue using the structural approach to credit risk modeling and a novel data set of secondary market transaction prices for Chinese commercial papers (CPs). In particular, we propose and test a structural model with jump risk and exogenous market illiquidity under which the predicted yield spreads can be decomposed into a credit component and a liquidity component. We find that credit risk and, especially liquidity risk, are important determinants of short-term yield spreads. Our model-based decomposition results show that, on average, credit risk and market liquidity account for about 25% and 52% of CP yield spreads, respectively. For comparison, we also examine the drivers of the US CP yield spreads using security-level data. We find that credit risk accounts for a small fraction of the observed yield spreads but liquidity contributes a much greater proportion.
Schizophrenia in Translation: Why the Eye?
Authors: Silverstein Steven M , Choi Joy J , Green Kyle M , Bowles-Johnson Kristen E , Ramchandran Rajeev S 
Published: May 2022

AbstractSchizophrenia is increasingly recognized as a systemic disease, characterized by dysregulation in multiple physiological systems (eg, neural, cardiovascular, endocrine). Many of these changes are observed as early as the first psychotic episode, and in people at high risk for the disorder. Expanding the search for biomarkers of schizophrenia beyond genes, blood, and brain may allow for inexpensive, noninvasive, and objective markers of diagnosis, phenotype, treatment response, and prognosis. Several anatomic and physiologic aspects of the eye have shown promise as biomarkers of brain health in a range of neurological disorders, and of heart, kidney, endocrine, and other impairments in other medical conditions. In schizophrenia, thinning and volume loss in retinal neural layers have been observed, and are associated with illness progression, brain volume loss, and cognitive impairment. Retinal microvascular changes have also been observed. Abnormal pupil responses and corneal nerve disintegration are related to aspects of brain function and structure in schizophrenia. In addition, studying the eye can inform about emerging cardiovascular, neuroinflammatory, and metabolic diseases in people with early psychosis, and about the causes of several of the visual changes observed in the disorder. Application of the methods of oculomics, or eye-based biomarkers of non-ophthalmological pathology, to the treatment and study of schizophrenia has the potential to provide tools for patient monitoring and data-driven prediction, as well as for clarifying pathophysiology and course of illness. Given their demonstrated utility in neuropsychiatry, we recommend greater adoption of these tools for schizophrenia research and patient care.
Effects of remotely-delivered physical activity education on exercise beliefs and intentions of active and nonactive cancer survivors and their partners
Authors: Ulrich Gillian R , Nogg Kelsey A , Freeman Slaton Z , Ranby Krista W 
Published: May 2022

Abstract
Physical activity (PA) is recommended for cancer survivors and their romantic partners yet cancer couples may be unaware of the benefits of PA specific to them. Exercise interventions targeting survivors and partners simultaneously may prove effective at increasing exercise knowledge, intentions, and outcomes. To examine the effects of a remotely-delivered cancer-specific exercise education video on cancer survivors’ and their partners’ exercise knowledge, beliefs, and intentions. Cancer survivors (N = 209) and their romantic partners (N = 155) completed an online survey with an embedded education video randomized to half the sample. Group differences (education vs. control) on study constructs among the whole sample and on a subset of the sample not meeting exercise guidelines [i.e., less than 150 min of moderate to vigorous physical activity (MVPA) per week; 50.5% survivors, 45.1% partners] were examined. Group differences on study constructs were also tested between survivors and partners meeting exercise guidelines or not. Survivors and partners in the education condition were more likely to correctly report the MVPA guidelines. The education increased survivors’ personal exercise importance, outcome expectations, and likelihood of joining an individual exercise program. Participants meeting guidelines were significantly different on multiple exercise beliefs compared to those who were not. Among those not meeting guidelines, the education increased survivors’ belief in the importance of exercising with their partner. A remotely-delivered exercise education video increased exercise knowledge and beliefs, which represents an important step in the development of couples’ exercise interventions for cancer survivors and their romantic partners.
Association of Concussion History and Prolonged Recovery in Youth
Authors: Chizuk Haley M. , Cunningham Adam , Horn Emily C. , Thapar Raj S. , Willer Barry S. , Leddy John J. , Haider Mohammad N. 
Published: May 2022

Objective:
To determine the number of prior concussions associated with increased incidence of persistent postconcussive symptoms (PPCS) in a cohort of acutely concussed pediatric patients.

Design:
Prospective observational cohort study.

Setting:
Three university-affiliated concussion clinics.

Participants:
Two hundred seventy participants (14.9 ± 1.9 years, 62% male, 54% with prior concussion) were assessed within 14 days of concussion and followed to clinical recovery. Participants with a second head injury before clinical recovery were excluded.

Measures: and Main Outcome:
Concussion history, current injury characteristics, recovery time, and risk for prolonged recovery from current concussion.

Results:
There was no statistically significant change in PPCS risk for participants with 0, 1 or 2 prior concussions; however, participants with 3 or more prior concussions had a significantly greater risk of PPCS. Twelve participants sustained a subsequent concussion after clinical recovery from their first injury and were treated as a separate cohort. Our secondary analysis found that these participants took longer to recover and had a greater incidence of PPCS during recovery from their latest concussion.

Conclusion:
Pediatric patients with a history of 3 or more concussions are at greater risk of PPCS than those with fewer than 3 prior concussions.
Shigellosis Cases With Bacterial Sexually Transmitted Infections: Population-Based Data From 6 US Jurisdictions, 2007 to 2016
Authors: Ridpath Alison D. , Vanden Esschert Kayla L. , Bragg Sarah , Campbell Stephanie , Convery Christine , Cope Anna , Devinney Katelynn , Diesel Jill C. , Kikuchi Nicole , Lee Nicole , Lewis Felicia M.T. , Matthias James , Pathela Preeti , Pugsley River , Sanderson Slutsker Jennifer , Schillinger Julia A. , Thompson Corinne , Tingey Colleen , Wilson Janae , Newman Daniel R. , Marsh Zachary A. , Garcia-Williams Amanda G. , Kirkcaldy Robert D. 
Published: May 2022

Background

Shigella species, which cause acute diarrheal disease, are transmitted via fecal-oral and sexual contact. To better understand the overlapping populations affected by Shigella infections and sexually transmitted infections (STIs) in the United States, we examined the occurrence of reported STIs within 24 months among shigellosis case-patients.

Methods
Culture-confirmed Shigella cases diagnosed from 2007 to 2016 among residents of 6 US jurisdictions were matched to reports of STIs (chlamydia, gonorrhea, and all stages of syphilis) diagnosed 12 months before or after the shigellosis case. We examined epidemiologic characteristics and reported temporal trends of Shigella cases by sex and species.

Results
From 2007 to 2016, 10,430 shigellosis cases were reported. The annual number of reported shigellosis cases across jurisdictions increased 70%, from 821 cases in 2007 to 1398 cases in 2016; males saw a larger increase compared with females. Twenty percent of male shigellosis case-patients had an STI reported in the reference period versus 4% of female case-patients. The percentage of male shigellosis case-patients with an STI increased from 11% (2007) to 28% (2016); the overall percentage among females remained low.

Conclusions
We highlight the substantial proportion of males with shigellosis who were diagnosed with STIs within 24 months and the benefit of matching data across programs. Sexually transmitted infection screening may be warranted for male shigellosis case-patients.
Facilitators and Barriers of HIV Partner Notification Services Among Men Who Have Sex With Men in China: A Qualitative Analysis Using a Socioecological Framework
Authors: Yan Xumeng , Xu Yongshi , Tucker Joseph D. , Miller William C. , Tang Weiming 
Published: May 2022

Background
HIV partner notification services (HIV PS) have been poorly implemented in most low- and middle-income countries, including China. Understanding the social context of partner services for key populations is important for scaling up HIV testing services. This study aims to examine facilitators and barriers of HIV PS using qualitative analysis.

Methods
This article qualitatively analyzed the texts obtained from a crowdsourcing open call and adopted the socioecological framework to understand the social context of Chinese men who have sex with men (MSM) living with HIV that influenced their uptake of HIV partner services. Crowdsourcing means collecting ideas from and sharing solutions with the public. The open call was held to solicit ideas to enhance HIV partner services for Chinese MSM. Two coders conducted a content analysis of the texts from the submissions using inductive and deductive coding methods to identify facilitators and barriers of HIV PS.

Results
Textual data from 53 submissions were analyzed. The most mentioned barrier, stigma associated with HIV PS, was deeply embedded at several levels, highlighting the urgent need for stigma reduction. Among the facilitators, many people mentioned anonymous online notification could protect the privacy and avoid social harm for index partners. Differentiated partner services may improve HIV PS uptake by providing tailored intervention according to the individual circumstances. Some people suggested implicit notification, which meant testing the attitude of the partner before direct disclosure. This was feasible and acceptable in many settings.

Conclusions
The unique social context of MSM living with HIV provides opportunities for embedding HIV partner services. More clinical trials that test the acceptability and effectiveness of the HIV PS interventions are needed.
The Concise Assessment of Leader Management Tool
Authors: Florez Amy R. , Shepard Lindsay N. , Frey Mary E. , Justice Lindsey B. , Constand Sara E. , Gilbert Gregory E. , Kessler David O. , Kerrey Benjamin T. , Calhoun Aaron W. 
Published: May 2022

Introduction
Resuscitation events in pediatric critical and emergency care are high risk, and strong leadership is an important component of an effective response. The Concise Assessment of Leadership Management (CALM) tool, designed to assess the strength of leadership skills during pediatric crises, has shown promising validity and reliability in simulated settings. The objective of this study was to generate further validity and reliability evidence for the CALM by applying it to real-life emergency events.

Methods
A prospective, video-based study was conducted in an academic pediatric emergency department. Three reviewers independently applied the CALM tool to the assessment of pediatric emergency department physicians as they led both a cardiac arrest and a sepsis event. Time to critical event (epinephrine, fluid, and antibiotic administration) was collected via video review. Based on Kane's framework, we conducted fully crossed, person × event × rater generalizability (G) and decision (D) studies. Interrater reliability was calculated using Gwet AC2 and intraclass correlation coefficients. Time to critical events was correlated with CALM scores using Spearman coefficient.

Results
Nine team leaders were assessed in their leadership of 2 resuscitations each. The G coefficient was 0.68, with 26% subject variance, 20% rater variance, and no case variance. Thirty-three percent of the variance (33%) was attributed to third-order interactions and unknown factors. Gwet AC2 was 0.3 and intraclass correlation was 0.58. The CALM score and time to epinephrine correlated at −0.79 (P = 0.01). The CALM score and time to fluid administration correlated at −0.181 (P = 0.64).

Conclusions
This study provides additional validity evidence for the CALM tool's use in this context if used with multiple raters, aligning with data from the previous simulation-based CALM validity study. Further development may improve reliability. It also serves as an exemplar of the rigors of conducting validity work within medical simulation.
Effects of Information, Motivation, Behavioral Skills Model on Urinary Incontinence in Men With Overactive Bladder and Urge Incontinence
Authors: Tuzer Hilal , Gezginci Elif , Yilmazer Tuba 
Published: May 2022

PURPOSE:
The aim of this study was to evaluate the effect of an intervention based on and information, motivation, behavioral skills (IMB) model on urinary incontinence symptoms, impact on daily activities, and incontinence-specific quality of life in men with overactive bladder dysfunction (OAB) and urge incontinence.

DESIGN:
Parallel-group, open-label, randomized-controlled clinical trial.

SUBJECTS AND SETTING:
The sample comprised 60 male patients admitted to the urology clinic of a training and research hospital in Ankara, Turkey. Inclusion criteria were adult men older than 18 years and diagnosed with OAB and urge incontinence.

METHODS:
Data were collected from February 2018 to February 2019. Participants were randomized into 2 equal groups. The intervention group (n = 30) received a structured intervention based on the IMB model, and a control group (n = 30) received standard OAB management. The primary outcome was severity of urge incontinence measured by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes were mean scores on the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and Urinary Incontinence Information Rating. All outcome measures were evaluated before and 6 months after the training.

RESULTS:
Following the intervention, mean ICIQ-SF scores were significantly lower in the IMB model group as compared to the control group. Analysis revealed a significant increase in knowledge scores in both groups when baseline scores were compared to postintervention scores (P = .000 for the intervention group and P = .004 for the control group). The intervention group participants also had a higher postintervention scores when compared to control group subjects (P = .000).

CONCLUSIONS:
A structured behavioral intervention based on the IMB model significantly alleviated the severity of bothersome lower urinary tract symptoms in adult males with OAB and urge incontinence when compared to standard care.
Effectiveness of a Pressure Injury Prevention Care Bundle; Prospective Interventional Study in Intensive Care Units
Authors: Yilmazer Tuba , Tuzer Hilal 
Published: May 2022

PURPOSE:
The purpose of this study was to assess the effectiveness of a pressure injury prevention care bundle.

DESIGN:
Prospective interventional study.

SUBJECTS AND SETTING:
Participants were 13 nurses and 104 patients cared for in the intensive care unit for at least 24 hours in a university hospital in Ankara, Turkey.

METHODS:
The study was conducted in 2 stages: the pre-care and post-care bundle stages. In the pre-care bundle stage, the pressure injury incidence of the patients was followed by the nurses. At the end of the third month, the researcher held a 1-day training program for the nurses about the care bundle use to promote correct implementation. In the post-care bundle stage, the nurses provided care according to the bundle. Compliance with the care bundle was assessed. Pressure injury incidence rates in the pre- and post-care bundle stages were compared.

RESULTS:
The incidence of stage 1 pressure injury was 15.11 (1000 patient-days) in the pre-care bundle stage and 6.79 (1000 patient-days) in the post-care bundle stage; this reduction was not statistically significant.

CONCLUSIONS:
A pressure injury prevention bundle was implemented in an intensive care unit, resulting in a decline in stage 1 pressure injuries.
Improving the Assessment of Deep Learning Models in the Context of Drug-Target Interaction Prediction
Authors: Torrisi Mirko , de la Vega de León Antonio , Climent Guillermo , Loos Remco , Panjkovich Alejandro 
Published: May 2022

AbstractMachine Learning techniques have been widely adopted to predict drug-target interactions, a central area of research in early drug discovery. These techniques have shown promising results on various benchmarks although they tend to suffer from poor generalization. This is typically related to very sparse and nonuniform datasets available, which limits the applicability domain of machine learning techniques. Moreover, widespread approaches to split datasets (into training and test sets) treat a drug-target interaction as an independent entities, when in reality the drug and target involved may take part in other interactions, breaking apart the assumption of independence. We observe that this leads to overly optimistic test results and poor generalization of out-of-distribution samples for various state-of-the-art sequence-based machine learning models for drug-target prediction. We show that previous approaches to reduce bias in binding datasets focus on drug or target information only and, thus, lead to similar pitfalls. Finally, we propose a minimum viable solution to evaluate the generalization capability of a machine learning model based on the systematic separation of test samples with respect to drugs and targets in the training set, thus discerning the three out-of-distribution scenarios seen at test time: (1) drug or (2) target present in the training set, or (3) neither.