bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cell-Autonomous Processes That Impair Xenograft Survival into the Cerebellum
Authors: Magrassi Lorenzo , Nato Giulia , Delia Domenico , Buffo Annalisa 
Published: May 2022

AbstractIn immunocompetent animals, numerous factors including the immune system of the host regulate the survival of neuro-glial precursors transplanted into the cerebellum. We transplanted human neuro-glial precursors derived in vitro from partial differentiation of IPS cells into the developing cerebellum of mice and rats before maturation of the host immune system. These approaches should facilitate the development of immune-tolerance for the transplanted cells. However, we found that human cells survived the engraftment and integrated into the host cerebellum and brain stem up to about 1 month postnatally when they were rejected in both species. On the contrary, when we transplanted the same cells in NOD-SCID mice, they survived indefinitely. Our findings are consistent with the hypothesis that the slower pace of differentiation of human neural precursors compared to that of rodents restricts the induction of immune-tolerance to human antigens expressed before completion of the maturation of the immune system. As predicted by our hypothesis, when we engrafted the human neuro-glial precursor cells either in a more mature state or mixed with extracts from adult cerebellum, we prolonged the survival of the graft.
Measuring Engagement with Mental Health and Behavior Change Interventions: an Integrative Review of Methods and Instruments
Authors: Bijkerk Laura Esther , Oenema Anke , Geschwind Nicole , Spigt Mark 
Published: May 2022

Abstract
Background
Engagement is a complex construct consisting of behavioral, cognitive, and affective dimensions, making engagement a difficult construct to measure. This integrative review aims to (1) present a multidisciplinary overview of measurement methods that are currently used to measure engagement with adult mental health and behavior change interventions, delivered in-person, blended, or digitally, and (2) provide a set of recommendations and considerations for researchers wishing to study engagement.

Methods
We used an integrative approach and identified original studies and reviews on engagement with mental health or behavior change interventions that were delivered in-person, digitally, or blended.

Results
Forty articles were analyzed in this review. Common methods to assess engagement were through objective usage data, questionnaire-based data, and qualitative data, with objective usage data being used most frequently. Based on the synthesis of engagement measures, we advise researchers to (1) predefine the operationalization of engagement for their specific research context, (2) measure behavioral, cognitive, and affective dimensions of engagement in all cases, and (3) measure engagement over time.

Conclusions
Current literature shows a bias towards behavioral measures of engagement in research, as most studies measured engagement exclusively through objective usage data, without including cognitive and affective measures of engagement. We hope that our recommendations will help to reduce this bias and to steer engagement research towards an integrated approach.
Using olive mill waste compost with sprinkler irrigation as a strategy to achieve sustainable rice cropping under Mediterranean conditions
Authors: Peña David , Fernández Damián , Albarrán Angel , Gómez Soraya , Martín Carmen , Sánchez-Terrón Jaime , Vicente Luis , López-Piñeiro Antonio 
Published: May 2022

AbstractTraditional rice (Oryza sativa L.) cropping systems under flooding irrigation combined with conventional tillage management are under increasing threat due to a loss of soil quality and a scarcity of water resources, especially in Mediterranean environments. Hence, the development of such management strategies as no-tillage, the application of organic amendments, and water-saving methods could be vital in enhancing the sustainability of rice crops. This work tests the combination of various management systems for growing rice under Mediterranean conditions. It assesses for the first time their influence on soil properties and rice yield components. A field experiment was carried out in southern Spain over 3 years (2015–2017) with six treatments: tillage and continuous flood irrigation either without or with application of two-phase olive mill waste compost; tillage and sprinkler irrigation either without or with application of mill waste compost; direct seeding (no tillage) and sprinkler irrigation either without or with application of mill waste compost. Applying mill waste compost in combination with sprinkler-rice systems improved significantly the soils’ properties. Sprinkler-rice yield was similar to that of rice under tillage and flooding, but it used less irrigation water. In 2017, the greatest rice yield occurred under tillage and sprinkler irrigation with application of mill waste compost (8581 kg ha-1), showing the importance of soil organic matter on yields. Additionnally, flooding increased significantly weed density because it lowered herbicide efficacy, making weed control a key issue for rice yields. Thus, the novelty of this communication is showing that the application of mill waste compost combined with sprinkler irrigation may be a sustainable alternative for rice crops under Mediterranean conditions, increasing the water efficiency and reducing weed pressure, while improving different soil properties.
Multistate Models for the Recovery Process in the Covid-19 Context: An Empirical Study of Chinese Enterprises
Authors: Yang Lijiao , Chen Yu , Jiang Xinyu , Tatano Hirokazu 
Published: May 2022

AbstractThe Covid-19 pandemic has severely affected enterprises worldwide. It is thus of practical significance to study the process of enterprise recovery from Covid-19. However, the research on the effects of relevant determinants of business recovery is limited. This article presents a multistate modeling framework that considers the determinants, recovery time, and transition likelihood of Chinese enterprises by the state of those enterprises as a result of the pandemic (recovery state), with the help of an accelerated failure time model. Empirical data from 750 enterprises were used to evaluate the recovery process. The results indicate that the main problems facing non-manufacturing industries are supply shortages and order cancellations. With the increase of supplies and orders, the probability of transition between different recovery states gradually increases, and the recovery time of enterprises becomes shorter. For manufacturing industries, the factors that hinder recovery are more complex. The main problems are employee panic and order cancellations in the initial stage, employee shortages in the middle stage, and raw material shortages in the full recovery stage. This study can provide a reference for enterprise recovery in the current pandemic context and help policymakers and business managers take necessary measures to accelerate recovery.
A Machine Learning Strategy for Race-Tracking Detection During Manufacturing of Composites by Liquid Moulding
Authors: Fernández-León Joaquín , Keramati Keayvan , Garoz David , Baumela Luis , Miguel Carlos , González Carlos 
Published: May 2022

AbstractThis work presents a supervised machine learning (ML) model to detect race-tracking disturbances during the liquid moulding manufacturing of structural composites. Race-tracking is generated by unexpected resin channels at mould edges that may induce dry spots and porosity formation. The ML model uses the pressure signals recorded by a sensor network as input, providing a classification of the race-tracking event from a set of possible scenarios, and a subsequent variable regression for their position, size and strength. Such a model is based on the residual network (ResNet), a well-known artificial intelligence architecture that makes use of convolutional neural networks for image recognition. Training of the ML classifier and regressors was carried out with the aid of a synthetically generated simulation data set obtained throughout computational fluid dynamics simulations. The time evolution of the pressure sensors was used as grey-level images, or footprints, as inputs to the ResNet ML. The trained model was able to recognise the presence of race-tracking channels from the pressure data yielding good accuracy in terms of label prediction as well as position, size and strength. The model correlation was carried out with a set of injection experiments performed with a constant thickness closed mould containing induced race-tracking channels. The ability of ML models to provide an approximation to the inverse problem, relating the pressure sensor distortions to the cause of such events, is analysed and discussed.
Taking a Deep Breath: an Examination of Current Controversies in Surgical Procedures in Lung Transplantation
Authors: Hirdman Gabriel , Niroomand Anna , Olm Franziska , Lindstedt Sandra 
Published: May 2022

Abstract
Purpose of Review
This article reviews controversial questions within the field of lung transplantation, with a focus on data generated within the last 3 years. We aim to summarize differing opinions on a selection of topics, including bridge-to-transplantation, intraoperative machine circulatory support, bronchial anastomosis, size mismatch, delayed chest closure, and ex vivo lung perfusion.

Recent Findings
With the growing rate of lung transplantations worldwide and increasing numbers of patients placed on waiting lists, the importance of determining best practices has only increased in recent years. Factors which promote successful outcomes have been identified across all the topics, with certain approaches promoted, such as ambulation in bridge-to-transplant and widespread intraoperative ECMO as machine support.

Summary
While great strides have been made in the operative procedures involved in lung transplantation, there are still key questions to be answered. The consensus which can be reached will be instrumental in further improving outcomes in recipients.
Machine learning-based framework to cover optimal Pareto-front in many-objective optimization
Authors: Asilian Bidgoli Azam , Rahnamayan Shahryar , Erdem Bilgehan , Erdem Zekiye , Ibrahim Amin , Deb Kalyanmoy , Grami Ali 
Published: May 2022

AbstractOne of the crucial challenges of solving many-objective optimization problems is uniformly well covering of the Pareto-front (PF). However, many the state-of-the-art optimization algorithms are capable of approximating the shape of many-objective PF by generating a limited number of non-dominated solutions. The exponential increase of the population size is an inefficient strategy that increases the computational complexity of the algorithm dramatically—especially when solving many-objective problems. In this paper, we introduce a machine learning-based framework to cover sparse PF surface which is initially generated by many-objective optimization algorithms; either by classical or meta-heuristic methods. The proposed method, called many-objective reverse mapping (MORM), is based on constructing a learning model on the initial PF set as the training data to reversely map the objective values to corresponding decision variables. Using the trained model, a set of candidate solutions can be generated by a variety of inexpensive generative techniques such as Opposition-based Learning and Latin Hypercube Sampling in both objective and decision spaces. Iteratively generated non-dominated candidate solutions cover the initial PF efficiently with no further need to utilize any optimization algorithm. We validate the proposed framework using a set of well-known many-objective optimization benchmarks and two well-known real-world problems. The coverage of PF is illustrated and numerically compared with the state-of-the-art many-objective algorithms. The statistical tests conducted on comparison measures such as HV, IGD, and the contribution ratio on the built PF reveal that the proposed collaborative framework surpasses the competitors on most of the problems. In addition, MORM covers the PF effectively compared to other methods even with the aid of large population size.
Assessing the association between cefepime percentage free trough level and neurotoxicity
Authors: Zia Aleena , Desai Armisha , Tieman Molly , Pritchard Haley 
Published: May 2022

Background: Cefepime has a known association with neurotoxicity due to its ability to cross the blood–brain barrier. The symptoms of neurotoxicity are highly variable. It has been postulated that cefepime neurotoxicity is associated with elevated levels of the drug. However, studies assessing for an association between serum drug level and the incidence of neurotoxicity have yet to establish a consistent threshold. We assessed serum cefepime levels and incidence of neurotoxicity to help develop a dosing strategy to minimize adverse effects. Method: In total, 32 inpatients admitted from January 2019 to November 2021 who received cefepime according to institutional standard dosing regimens for at least 72 hours were reviewed by infectious diseases pharmacists who obtained serum cefepime levels and performed pharmacokinetic analyses to obtain percentage free trough levels. Cefepime percentage free trough levels were defined as therapeutic if they were above the known minimum inhibitory concentration (MIC) of the treated organism and were <40 μg/mL. Patient charts were reviewed for clinical findings consistent with cefepime-induced neurotoxicity. Numerical and statistical analyses were performed to assess factors with a significant association with neurotoxicity. Results: Overall, 16 (47.1%) patients showed some evidence of neurotoxicity, 9 (56.3%) of whom had a likely alternate clinical cause of symptoms (Table 1). We did observe that patients with creatinine clearance <60 mL/min were more likely to have symptoms concerning for neurotoxicity. Conclusions: Cefepime percentage free trough levels were highly variable, and no association with neurotoxicity was observed. Patients with decreased creatinine clearance were significantly more likely to develop neurologic findings consistent with cefepime-induced neurotoxicity. Further study is needed to establish a relationship between cefepime pharmacokinetic values and incidence of neurotoxicity.Funding: NoneDisclosures: None
Systematic review of antibiotic stewardship interventions for urinary tract infection management in the ambulatory setting
Authors: Munsiff Sonal , Sakai Alexandra , Dumyati Ghinwa 
Published: May 2022

Background: Urinary tract infections (UTIs) are common indications for antibiotics in ambulatory setting, and inappropriate use is prevalent. Fluoroquinolones account for 40% of antibiotics prescribed for uncomplicated UTIs, despite clinical guidance against their use as firstline agents. We conducted a systematic review to determine which antibiotic stewardship intervention(s) are effective in improving antibiotic prescribing for UTIs in the ambulatory setting. Methods: Following PRISMA guidelines, English-language literature from 1995 to September 21, 2021, was searched for articles about antimicrobial stewardship, UTI, and ambulatory setting from PubMed, Embase, and Central. Additional articles were identified from authors’ collections and references of pertinent articles. Studies were included if the authors implemented intervention targeting adults 18 years and older in outpatient setting (excluding emergency departments). Interventions were categorized into Guideline Development and Dissemination (GDD), Audit and Feedback, Clinical Decision Support System (CDSS), and Multimodal Interventions. Results: The literature search identified 1,899 papers; 14 papers were included in this review; and 4 additional papers were identified from other sources. The main interventions were GDD in 6 studies, audit and feedback in 3 studies, CDSS in 4 studies, and multimodal interventions in 5 stidues. These studies had heterogeneity of the practice settings and interventions. Moreover, 11 studies targeted primary care, 2 studies targeted urgent care, 1 study targeted both primary and urgent care, 2 studies were conducted in spinal cord injury clinics, and 2 studies were conducted in hospital-wide outpatient sites. Outcomes included (1) statistically significant increase in guideline-concordant antibiotic prescribing in 12 studies (range, 4.6%–246%); (2) statistically significant decrease in fluoroquinolone prescriptions (range, 9.1%–86.3%) in 7 of 9 studies focusing on fluoroquinolones; (3) significant decreases in drug resistance in urine pathogens in 2 studies that evaluated this. Provider education, in conjunction with passive CDSS tools, such as integrating order sets for UTI prescriptions with prefilled instructions into electronic medical records appeared most beneficial. Several studies have investigated negative impact and have found no increase in retreatment rates or worse outcomes. Conclusions: Our systematic literature review identified a limited number of studies with a variety of interventions that improved antibiotic use for UTIs in the ambulatory care setting. Provider education, in conjunction with CDSS tools, can be less time-consuming than audit and feedback and can target a large number of providers and practices. Future studies need to address sustainability over longer periods and should target specialty clinic populations because they have high burden of patients with multidrug-resistant UTI organisms.Funding: NoneDisclosures: None
Antibiotic use and impact on illness course in children with influenza-like-illness in the emergency department
Authors: Poole Nicole , O’Leary Sean , Rao Suchitra , Suresh Krithika , Moss Angela 
Published: May 2022

Background: Child absenteeism from childcare or school leads to economic loss from parental work absenteeism, overutilization of acute-care resources, and excess medicalization of children with minor illnesses. We sought to determine the difference in days missed from childcare or school and days of illness for children with influenza-like illness (ILI) in the emergency department (ED) who are or are not prescribed an antibiotic. Methods: We conducted a secondary data analysis of a prospective randomized control trial evaluating the impact of rapid molecular testing on provider decision making. The study included children aged 2 months–12 years attending childcare or school seen in the ED from December 2018 through December 2019 with ILI (CDC definition) with parental survey completion 10 days after their ED visit. The primary exposure was receipt of antibiotics over the course of illness, which was assessed by chart review and parent survey. The primary outcome was number of days missed from class. The secondary outcome was number of days of illness after initial ED visit. Wilcoxon tests were used to compare missed class days or illness days by antibiotic receipt. Multivariable negative binomial regression was used to analyze outcomes, controlling for clinically important patient characteristics. Results: Of 251 children included in this study, the median age was 4.2 years (IQR, 1.6–7.0); 52% were male, 40% were White, 54% were Hispanic, and 75% had government insurance. Antibiotics were prescribed in 26% of ILI encounters. There was no statistically significant association between antibiotic receipt and number missed class days (2.0 days [IQR, 1.0–4.0] vs 3.0 days [IQR, 1.0–5.0]; P = .08) or illness days (4.0 days [IQR, 3.0–7.0] vs 5.0 days [IQR, 3.0–7.0]; P = .13) after the initial ED visit. After adjusting for covariates, there was no significant difference in missed class days or illness days for patients prescribed antibiotics in relation to days sick before ED visit. The rates of missed class days and illness days were 87% and 30% greater, respectively, in patients with additional medical visits during the course of illness. Conclusions: Days sick prior to ED presentation and receipt of an antibiotic for ILI had no influence on child absenteeism or illness duration. However, children missed more class and received more antibiotics if they had multiple medical visits during an illness. Further study is needed on sociobehavioral factors leading to medicalization of children with minor illnesses and its impact on the unnecessary use of antibiotics.Funding: NoneDisclosures: None
Human factors analysis of the disinfection of central-line needleless connectors
Authors: Martinello Richard , Hebden Joan , Drews Frank , Pegues David 
Published: May 2022

Background: Patients requiring vascular catheters are at risk for bloodstream infections (BSIs), particularly those with central venous access devices (CVADs). Central-line–associated bloodstream infections (CLABSIs) may occur as a result of the introduction of pathogenic microbes during CVAD access procedures, including through the needleless connector. The use of an antiseptic scrub is recommended to disinfect the needleless connector before device access, and this procedure has been shown to reduce the risk for CLABSI. We identified perceived barriers and facilitators and assessed compliance with instructions for use of chlorhexidine or alcohol antisepsis products (CHG or IPA; 5-second scrub time plus 5-second dry time) and alcohol antisepsis products (IPA; facility protocol 15-second scrub time plus let dry) for needleless connector disinfection. Methods: We performed a multiple-methods study involving focus groups composed of a convenience sample of nurses and clinical observations of CVAD needleless-connector access procedures in 3 medical ICUs and 1 surgical ICU at 2 academic medical centers. We used open-ended questions to guide the focus-group discussions. We directly observed nursing staff performing needleless-connector disinfection following a time–motion paradigm using an electronic tool to document the observed needleless-connector access events and to measure needleless-connector antiseptic scrub times and dry times. Results: In total, 8 focus groups involving 28 nurses revealed access to the antiseptic product and lesser workload as best-practice facilitators of needleless-connector disinfection. Identified barriers were often the opposite of the facilitators, particularly the time required per needleless connector access using IPA and knowledge deficits regarding the need for disinfection between multiple needleless-connector accesses. From 36 observations, including a total of 48 access events, we determined that the mean scrub times were below the recommended times, especially for IPA (Table 1). Drying time after use of either antisepsis product was negligible. Conclusions: A lack of access to the disinfection product, emergency situations, and increased workload were perceived barriers to needleless-connector disinfection. Observed scrub times and drying times were shorter than recommended, much more so for IPA. These deficits in the performance of needleless-connector disinfection may increase the risk of CLABSI. Ongoing education and periodic competency evaluation of needleless-connector disinfection are needed to imbed and sustain best practices.Funding: Professional Disposables, Inc.Disclosures: None