bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multimodal intervention to decrease inappropriate outpatient antibiotic prescribing for upper respiratory tract infections in a large integrated healthcare system
Authors: Davidson Lisa E. , Gentry Erin M. , Priem Jennifer S. , Kowalkowski Marc , Spencer Melanie D. 
Published: May 2022

AbstractObjective:To evaluate the effectiveness of Carolinas Healthcare Outpatient Antimicrobial Stewardship Empowerment Network (CHOSEN), a multicomponent outpatient stewardship program to reduce inappropriate antibiotic prescribing for upper respiratory infections by 20% over 2 years.Design:Before-and-after interrupted time series of antibiotics prescribed between 2 periods: April 2016–October 2017 and May 2018–March 2020.Setting:The study included 162 primary-care practices within a large healthcare system in the greater Charlotte, North Carolina region.Participants:Adult and pediatric patients with encounters for upper respiratory infections for which an antibiotic is inappropriate.Methods:Patient and provider educational materials, along with a web-based provider prescribing dashboard aimed at reducing inappropriate antibiotic prescribing were developed and distributed. Monthly antibiotic prescribing rates were calculated as the number of eligible encounters with an antibiotic prescribed divided by the total number of eligible encounters. A segmented regression analysis compared monthly antibiotic prescribing rates before versus after CHOSEN implementation, while also accounting for practice type and seasonal trends in prescribing.Results:Overall, 286,580 antibiotics were prescribed during 704,248 preintervention encounters and 277,177 during 832,200 intervention encounters. Significant reductions in inappropriate prescribing rates were observed in all outpatient specialties: family medicine (relative difference before and after the intervention, −20.4%), internal medicine (−19.5%), pediatric medicine (−17.2%), and urgent care (−16.6%).Conclusions:A robust multimodal intervention that combined a provider prescribing dashboard with a targeted education campaign demonstrated significant decreases in inappropriate outpatient antibiotic prescribing for upper respiratory tract infections in a large integrated ambulatory network.
A healthy lifestyle during adolescence was inversely associated with fatty liver indices in early adulthood: findings from the DONALD cohort study
Authors: Schnermann Maike Elena , Schulz Christina-Alexandra , Perrar Ines , Herder Christian , Roden Michael , Alexy Ute , Nöthlings Ute 
Published: May 2022

AbstractA healthy lifestyle during adolescence is associated with insulin sensitivity or liver enzyme levels and thus might contribute to the prevention of non-alcoholic fatty liver disease (NAFLD). Therefore, we examined the association between adherence to a hypothesis-based lifestyle score including dietary intake, physical activity, sedentary behaviour, sleep duration and BMI in adolescence and fatty liver indices in early adulthood. Overall, 240 participants of the DOrtmund Nutritional and Anthropometric Longitudinally Designed study completed repeated measurements of lifestyle score factors during adolescence (females: 8·5–15·5 years, males: 9·5–16·5 years). Multivariable linear regression models were used to investigate the association between adolescent lifestyle scores and NAFLD risk (hepatic steatosis index (HSI) and fatty liver index (FLI)) in early adulthood (18–30 years). Participants visited the study centre 4·9 times during adolescence and achieved on average 2·8 (min: 0·6, max: 5) out of five lifestyle score points. Inverse associations were observed between the lifestyle score and fatty liver indices (HSI: ß=−5·8 % (95 % CI −8·3, −3·1), P < 0·0001, FLI: ß=−32·4 % (95 % CI −42·9, −20·0), P < 0·0001) in the overall study population. Sex-stratified analysis confirmed these results in men, while inverse but non-significant associations were observed in women (P > 0·05). A higher lifestyle score was associated with lower HSI and FLI values, suggesting that a healthy lifestyle during adolescence might contribute to NAFLD prevention, predominantly in men. Our findings on repeatedly measured lifestyle scores in adolescents and their association with NAFLD risk in early adulthood warrant confirmation in larger study populations.
Crop–livestock systems transformation in the semiarid zones of North Africa over a decade: approach and case-study in Southern Tunisia
Authors: Alary V. , Frija A. 
Published: May 2022

AbstractUnderstanding and representing the transformation of agricultural production systems has attracted increasing interest due to its importance for identifying drivers of changes and coping mechanisms in response to global challenges. These challenges are all the most pressing in North African countries exposed to a dramatic reduction in rainfall and increasing temperatures that affect sustainability in more than half of this semi-arid territory. This paper describes an improved way to understand such transformations through a cross-cutting analysis of crop–livestock system indicators over a period of 10 years in one community in Southern Tunisia. Our methodology is divided into four steps: (i) systems identification, (ii) indicator-based assessment of system crop–livestock sustainability, (iii) hierarchical clustering to identify sustainable intensification (SI)-based farm types and, finally, (iv) analysis of trajectories of these farm types. Results showed that the sustainability of the systems studied increasingly depends on diversification rather than intensification, which dominated in the 2000s. However, diversification has not necessarily improved socio-economic viability. Over the 10-year period, results revealed a dramatic increase of almost 50% in the population of small-scale farms whose viability depends on a range of on- and off-farm activities to meet the short-term needs that correspond to a buffer strategy. Additionally, the dominant SI processes were shown to be mostly based on diversification to livestock activities with both milking and fattening. Our holistic and timeline approach to system transformation makes it possible to account for sustainability between (systems) generations, which will be highly needed in future discussions about sustainability.
Gender-specific co-developmental trajectories of internalizing and externalizing problems from middle childhood to early adolescence: Environmental and individual predictors
Authors: Gong Xue , Guo Nan , Huebner E. Scott , Tian Lili 
Published: May 2022

AbstractThis study aimed to identify gender-specific co-developmental trajectories of internalizing and externalizing problems from middle childhood to early adolescence, along with key environmental and individual predictors among Chinese youth. A total of 1653 Chinese elementary school students (Mage= 9.40;SD= 0.51; 54.57% boys) participated in assessments at six time points, using 6-month assessment intervals. Parallel process latent class growth modeling identified four trajectories for boys: Congruent-low (65.74%), moderate-decreasing internalizing and moderate-stable externalizing problems (18.40%), high increasing-internalizing and low-stable externalizing problems (8.20%), and high decreasing-internalizing and low-stable externalizing problems (7.65%). Three trajectories were identified for girls: Congruent-low (81.09%), moderate co-occurring (7.19%), and high increasing-internalizing and low-stable externalizing problems (11.72%). Multivariate logistic regression analyses revealed that peer victimization served as an environmental risk predictor for the adverse co-developmental trajectories of internalizing and externalizing problems for boys and girls. High sensation-seeking and low self-control served as individual risk variables predicting the trajectories ofhigh increasing-internalizing and low-stable externalizing problems, and low self-control also predicted the trajectories ofhigh decreasing-internalizing and low-stable externalizing problemsfor boys. The findings highlight the importance of gender differences in understanding the progression of internalizing and externalizing problems and inform effective strategies for prevention and intervention.
Mind-mindedness and preschool children’s behavioral difficulties: The moderating role of maternal parenting distress
Authors: Hobby Lucy , Bird Amy L. , Townsend Michelle L. , Barnes Jacqueline 
Published: May 2022

AbstractMind-mindedness (MM) is a caregiver’s tendency to appreciate their infant’s internal mental states. This longitudinal study investigated whether maternal MM (10 months) was linked with children’s later behavioral problems (51 months) and the moderating role of maternal parenting distress (PD; 36 months) in a sample of 91 mother–infant dyads. Appropriate MM comments were coded from video-recorded, semi-structured play interactions between mothers and their infants; PD was obtained from maternal completion of the PD subscale of the Parenting Stress Index – Short Form (PSI-SF); and child internalizing and externalizing behavior problems were gathered from maternal report on the Strengths and Difficulties Questionnaire (SDQ). Moderated regression analyses revealed higher early appropriate MM was associated with significantly fewer internalizing emotional problems at 51 months among mothers with lower PD at 36 months, and higher early appropriate MM was associated with lower conduct problems at 51 months in mothers with higher PD at 36 months. Findings demonstrated the importance of considering nuanced contexts such as at-risk mothers and differential presentations of child difficulties in the analysis of the relationship between MM and child behavioral difficulties and the development of MM interventions.
The Takarazuka Opera Company? On the Persistent Ties between the Takarazuka Revue and Opera
Authors: Solander Tove 
Published: May 2022

AbstractAlthough the Takarazuka Revue is technically a musical company, its founder's ambition was to create a uniquely Japanese form of opera or operetta, merging elements from Western and Japanese forms. Like opera, and unlike musicals in general, trouser roles play a central part in the all-female Takarazuka Revue, and are typically cited as its main appeal. Research from a Japanese-studies perspective tends to discuss the Takarazuka Revue trouser roles, otokoyaku, as a gender-reversal of all-male kabuki, or put them in the context of androgynous or cross-dressing Japanese idols. This article addresses their connection to trouser roles in non-Japanese music theatre, specifically opera. It does so through three lenses: first, the Takarazuka Revue's opera loans and adaptations; second, the shared aesthetic appeal of trouser roles in these two theatre forms; and finally, the singing styles employed in the Takarazuka Revue, including their change over time and relation to classical singing.
Differential expression of FSHR and LHR genes and proteins during development of rabbit ovarian follicles
Authors: Khalil Eman , Metwally Mohamed , Bahgaat Hatem , Kassab Ahmed , El-Shafey Anwar 
Published: May 2022

SummaryThe development of an ovarian follicle is a complex process at the cellular and molecular level that is mainly regulated by follicle-stimulating hormone receptor (FSHR) and luteinizing hormone receptor (LHR). To elucidate the contribution of these receptors to ovarian follicle development, it is necessary to determine their expression profiles during this biological process. Therefore, this study aimed to investigate the relationship between ovarian development pattern and the differential ovarian expression pattern ofFSHRandLHRgenes as well as proteins at different developmental stages. Ovaries were collected from 30 New Zealand rabbits at day 0 (birth), week 2 (neonate), week 4 (cub), week 16 (maturity), and day 18 pregnancy. Ovarian histology, and gene as well as protein expression were determined using light microscopy, real-time PCR and western blotting, respectively. The results showed that the expression levels ofFSHRmRNA and protein increased coincidently with age and the growth of ovarian follicles. The levels ofLHRmRNA and protein remained low from the day of birth until week 4 and became significantly higher by week 16 coinciding with appearance of growing and antral follicles, which have a defined thecal layer. FSHR gene and protein expression decreased with pregnancy, whereas LHR increased, reaching a peak level during pregnancy. It can be concluded that changes in FSHR and LHR gene and protein expression could be related to the growth and development of follicles, indicating the regulatory role for these receptors in rabbit folliculogenesis.
Lodewyk H.S. van Mierop (March 31, 1927–October 17, 2021): a true giant
Authors: Anderson Robert H. , Bleiweis Mark S. , Fricker F.J. , Saidi Arwa , Chandran Arun , Fudge James C. , Gupta Dipankar , Peek Giles J. , Spicer Diane E. , Jacobs Jeffrey P. 
Published: May 2022

AbstractWe honour a great man and a true giant. Lodewyk H.S. van Mierop (March 31, 1927 – October 17, 2021), known as Bob, was not only a Paediatric Cardiologist but also a dedicated Scientist. He made many significant and ground-breaking contributions to the fields of cardiac anatomy and embryology. He was devoted as a teacher, spending many hours with medical students, Residents, and Fellows, all of whom appreciated his regularly scheduled educational sessions. Those of us who were fortunate to know and spend time with him will always remember his great mind, his willingness to share his knowledge, and his ability to encourage spirited and fruitful discussions. His life was most productive, and he will long be remembered by many through his awesome and exemplary scientific contributions.His legacy continues to influence the current and future generations of surgeons and all providers of paediatric and congenital cardiac care through the invaluable archive he established at University of Florida in Gainesville: The University of Florida van Mierop Heart Archive. Undoubtedly, with these extraordinary contributions to the fields of cardiac anatomy and embryology, which were way ahead of his time, Professor van Mierop was a true giant in Paediatric Cardiology. The invaluable archive he established at University of Florida in Gainesville, The University of Florida van Mierop Heart Archive, has been instrumental in teaching medical students, Residents, Medical Fellows, and Surgical Fellows. Only a handful of similar archives exist across the globe, and these archives are the true legacy of giants such as Dr. van Mierop. We have an important obligation to leave no stone unturned to continue to preserve these archives for the future generations of surgeons, physicians, all providers of paediatric and congenital cardiac care, and, most importantly, our patients.
The role of neutrophil-to-lymphocyte ratio in predicting mortality after bidirectional Glenn procedure
Authors: Ukil Isildak Fatma , Yavuz Yasemin 
Published: May 2022

AbstractThis study aimed to address the role of various inflammation-related blood indices for the assessment of in-hospital outcomes in subjects undergoing Glenn procedure. Subjects who underwent the Glenn procedure for hypoplastic left heart syndrome were analysed retrospectively. Subjects were divided into two groups: Group 1 consisted of 78 patients who were discharged, and Group 2 included 12 patients who died after surgery. Post-operative third-day neutrophil count and neutrophil-to-lymphocyte ratio value were significantly higher in the exitus group compared to the discharged group (p = 0.006 and p = 0.003, respectively). Third-day neutrophil-to-lymphocyte ratio was positively correlated with duration of intubation (r = 0.253, p = 0.018), length of stay in ICU (r = 0.296, p = 0.006) and length of hospital stay (r = 0.297, p = 0.005). Multiple logistic regression analysis revealed that patients with high third-day neutrophil-to-lymphocyte ratio (≥6) had 14.227-fold higher risk of death compared to those with lower values. In addition, higher pulmonary arterial pressure was associated with increased risk of death. Receiver operating characteristics analysis revealed that neutrophil-to-lymphocyte ratio had 66.67% sensitivity, 84% specificity, 81.61% accuracy, 40.00% positive predictive value and 94.03% negative predictive value with a cut-off point of ≥6 to predict mortality. Third-day neutrophil-to-lymphocyte ratio and increased post-operative pulmonary arterial pressure are significant predictors for in-hospital mortality in Glenn procedure recipients. A cut-off value of ≥6 for third-day neutrophil-to-lymphocyte ratio predicts mortality with 66.67% sensitivity and 84% specificity. Given its simplicity and availability, post-operative neutrophil-to-lymphocyte ratio should be monitored on a daily basis to identify patients with high risk for mortality after Glenn procedure.
How to Balance Green and Grain in Marginal Mountainous Areas?
Authors: Zeng Yi , Ran Lishan , Fang Nufang , Wang Zhen , Xu Zhenci , Lu Xixi , Yu Qiang , Wang Ling , Yu Shuxia , Shi Zhihua 
Published: May 2022

AbstractChina has implemented the world's largest‐ever vegetation restoration program in marginal mountainous areas to sustain life on land. However, land competition between the demand for grain and the need for green has threatened sustainable vegetation restoration. Here, focusing on China's marginal mountainous areas with the highest density of slope cropland, we explore the optimal solution in the trade‐offs between green and grain. We find that current vegetation restoration strategies are not sufficiently optimized, which may threaten the survival and development of local farmers and in turn destroy existing vegetation restoration achievements. Through adjusting vegetation restoration objectives carefully tailored to local conditions, the population experiencing grain shortages can be greatly reduced by 51–66% (from 18.26 million to 6.29–8.90 million) compared with the current scheme. The optimal design will alleviate the conflict between grain and green, thereby promoting sustainable ecological restoration in China. Our research provides an important reference for the world's mountainous areas to achieve a win‐win situation between green and grain.
Arctic – Atlantic Exchange of the Dissolved Micronutrients Iron, Manganese, Cobalt, Nickel, Copper and Zinc With a Focus on Fram Strait
Authors: Krisch Stephan , Hopwood Mark J. , Roig Stéphane , Gerringa Loes J. A. , Middag Rob , Rutgers van der Loeff Michiel M. , Petrova Mariia V. , Lodeiro Pablo , Colombo Manuel , Cullen Jay T. , Jackson Sarah L. , Heimbürger‐Boavida Lars‐Eric , Achterberg Eric P. 
Published: May 2022

AbstractThe Arctic Ocean is considered a source of micronutrients to the Nordic Seas and the North Atlantic Ocean through the gateway of Fram Strait (FS). However, there is a paucity of trace element data from across the Arctic Ocean gateways, and so it remains unclear how Arctic and North Atlantic exchange shapes micronutrient availability in the two ocean basins. In 2015 and 2016, GEOTRACES cruises sampled the Barents Sea Opening (GN04, 2015) and FS (GN05, 2016) for dissolved iron (dFe), manganese (dMn), cobalt (dCo), nickel (dNi), copper (dCu) and zinc (dZn). Together with the most recent synopsis of Arctic‐Atlantic volume fluxes, the observed trace element distributions suggest that FS is the most important gateway for Arctic‐Atlantic dissolved micronutrient exchange as a consequence of Intermediate and Deep Water transport. Combining fluxes from FS and the Barents Sea Opening with estimates for Davis Strait (GN02, 2015) suggests an annual net southward flux of 2.7 ± 2.4 Gg·a−1 dFe, 0.3 ± 0.3 Gg·a−1 dCo, 15.0 ± 12.5 Gg·a−1 dNi and 14.2 ± 6.9 Gg·a−1 dCu from the Arctic toward the North Atlantic Ocean. Arctic‐Atlantic exchange of dMn and dZn were more balanced, with a net southbound flux of 2.8 ± 4.7 Gg·a−1 dMn and a net northbound flux of 3.0 ± 7.3 Gg·a−1 dZn. Our results suggest that ongoing changes to shelf inputs and sea ice dynamics in the Arctic, especially in Siberian shelf regions, affect micronutrient availability in FS and the high latitude North Atlantic Ocean.
Calcium Isotopic Constraints on the Transition From Aragonite Seas to Calcite Seas in the Cambrian
Authors: Wei Guang‐Yi , Hood Ashleigh v. S. , Planavsky Noah J. , Li Da , Ling Hong‐Fei , Tarhan Lidya G. 
Published: May 2022

AbstractThe primary mineralogy of marine carbonates has varied over geological time in concert with the secular evolution of global climate and seawater chemistry. Here, we employed a multi‐proxy geochemical and petrographic approach, including measuring the Ca isotope (δ44Ca) and Sr content of Ediacaran–Cambrian carbonates, to provide new insights into the timing of the transition from a “dolomite‐aragonite sea” to a “calcite sea” across the Ediacaran‐Cambrian transition. We find robust evidence for the persistence of an aragonite sea well into Cambrian Age 2 (and potentially up through Age 4). Together with an updated petrographic compilation of abiotic carbonate precipitates (i.e., ooids and cements), these new δ44Ca and Sr data provide further evidence that there was a protracted transition from aragonite seas to calcite seas in the Cambrian. We propose that this transition was mediated, in part, by changes in seawater Mg/Ca ratios potentially regulated by the global marine redox state and extents of authigenic clay precipitation.
Investigating Parametric Dependence of Climate Feedbacks in the Atmospheric Component of CNRM‐CM6‐1
Authors: Peatier S. , Sanderson B. M. , Terray L. , Roehrig R. 
Published: May 2022

AbstractWe sample 30 calibration parameters of the CNRM‐CM6‐1 atmospheric component to produce a perturbed parameter ensemble. An error score aggregating four annual‐averaged metrics is used here as an example to represent the model performance. We propose a method using statistical emulators of climatic fields and feedback parameters to produce model candidates spanning the maximal range of net feedback while minimizing the error score. Optimal candidates are found for a range of climate sensitivity chosen to span 3.8–10.1 K. The candidates show large errors in the extremes of the climate sensitivity range and none of them have better scores than the released version of CNRM‐CM6. However, 65% of the optimal candidates have errors within the inter‐model standard deviation of the seven models participating in the Cloud Feedback Model Intercomparison Project, spanning and ECS range of (4.14–7.22 K). These optimal calibrations will be used to assess feedback diversity in coupled experiments.
Causal Links Between Arctic Sea Ice and Its Potential Drivers Based on the Rate of Information Transfer
Authors: Docquier D. , Vannitsem S. , Ragone F. , Wyser K. , Liang X. S. 
Published: May 2022

AbstractArctic sea ice has substantially changed over the past four decades, with a large decrease in sea‐ice area and volume. The exact causes of these changes are not entirely known. In our study, we make use of the Swedish Meteorological and Hydrological Institute Large Ensemble. This ensemble consists of 50 members realized with the EC‐Earth3 global climate model and covers the period 1970‐2100. We apply for the first time the Liang‐Kleeman information flow method to analyze the cause‐effect relationships between Arctic sea ice and its potential drivers. We show that recent and future changes in Arctic sea ice are mainly driven by air and sea‐surface temperatures and ocean heat transport. Conversely, changes in Arctic sea ice also considerably impact temperature and ocean heat transport. Finally, we find a progressive decrease in the influence of sea‐ice area and volume on air temperature and ocean heat transport through the twenty‐first century.