bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla
Authors: Guergan Selin , Hoopmann Uta , Roehm Carmen , Boeer Bettina , Fugunt Regina , Helms Gisela , Seller Anna , Marx Mario , Oberlechner Ernst , Hartkopf Andreas , Preibsch Heike , Brucker Sara , Wallwiener Diethelm , Hahn Markus , Gruber Ines Verena
Published: June 2021

Purpose

Clip-marking of axillary lymph nodes with initial biopsy-confirmed metastasis is required for targeted axillary dissection (TAD), which includes sentinel lymph node dissection (SLND) and selective localization and removal of the clipped targeted lymph node. There have been several studies which examined the feasibility of TAD in routine clinical use. In this context, the optimal clip visualisation was noted as one of the crucial limiting factors. We, therefore, evaluated the sonographic detectability of 10 different commercially available markers within an in vitro model simulating the anatomical composition of the axilla.

Methods

In this standardised model consisting of porcine fat with 30 mm thickness, the visibility of a total of ten markers was analysed in all 3 planes (parallel, diagonal, orthograde) with wire guidance and then classified into either “visibility good”, “visibility moderate” or “visibility poor” with regard to the alignment of the transducer. Additionally, “real-life conditions” were simulated, in which the markers were searched without any wires guidance.

Results

It was observed that, while not all markers are detectable in fatty tissue, markers with spherical shape (non-embedded Inconel or Nitinol) or rectangular-shaped Titanium markers with embedded material have a clear advantage. 3D-shaped markers can always be detected in all three axes, which is of particular importance in the axilla with its pyramid shape and fatty tissue.

Conclusion

The shape and the embedding of the material play a crucial role for visibility and efficacy of the marker, as reliable marking of suspicious and pathological axillary lymph nodes is essential for TAD.
Psychological distress and lower health-related quality of life are associated with need for dietary support among colorectal cancer survivors with overweight or obesity
Authors: Ramp Dominique , Mols Floortje , Ezendam Nicole , Beijer Sandra , Bours Martijn , Winkels Renate , de Vries Jolanda , Seidell Jaap C. , Kampman Ellen , Hoedjes Meeke
Published: June 2021

Objective

Two-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological distress and low health-related quality of life (HRQoL) may be barriers to improving diet. We aimed to assess associations between psychological distress and HRQoL and the need for dietary support in CRC survivors with overweight or obesity.

Methods

All alive individuals diagnosed with CRC between 2000 and 2009, as registered by the Dutch population-based Eindhoven Cancer Registry, were eligible for participation and received a questionnaire. Multivariable logistic regression analyses were conducted to assess associations between HRQoL (EORTC QLQ-C30), symptoms of anxiety and depression (HADS), and self-reported need for dietary support (single-item).

Results

A total of 1458 completed the questionnaire (response rate 82%), and 756 (43%) had a BMI of 25.0 or higher and complete data on “need for dietary support” and were included for analyses. BMI ranged between 25.0 and 60.6 (mean, 28.9; SD, 3.6). The majority (71.7%) was overweight (BMI ≥ 25), and 28.3% obese (BMI ≥ 30). Twenty-one percent reported a need for dietary support which was associated with more psychological distress and lower HRQoL. Those who experienced symptoms of anxiety or depression were more likely to report a need for dietary support (27.6% and 28.7%) than those who did not experience symptoms of anxiety (12.3%; OR 2.02; 95% CI 1.22–3.35) or depression (13.5%; OR 1.96; 95% CI 1.19–3.22).

Conclusions

Results suggest that psychological distress and lower HRQoL should be taken into account while promoting a healthy diet in overweight or obese CRC survivors since these factors may hinder adherence to a healthy diet.
Psychotherapeutisch Tätige geben Auskunft: Zur Entwicklung der Fähigkeit, die Orientierung von Praxis an Theorie narrativ darzustellen. Eine Pilotstudie aus dem Projekt TheoPrax
Authors: Strobl Bernadette , Datler Wilfried
Published: June 2021

Vor dem Hintergrund allgemeiner Überlegungen zum Verhältnis von Disziplin und Profession sowie Theorie und Praxis wird von einer Pilotstudie des ForschungsprojektsTheoPraxberichtet. Es wurde untersucht, in welcher Qualität 24 psychoanalytisch ausgebildete Psychotherapeut*innen über die Orientierung ihrer Praxis an Theorie unter Bezugnahme auf eine konkrete Arbeitssituation präzise Auskunft geben können. Dazu kommen eine besondere Form des Interviews sowie ein spezielles Ratingverfahren zum Einsatz. Überdies wurden 27 Lehrer*innen interviewt. Ein Vergleich zeigt, dass die Qualität der narrativen Darstellungen der Psychotherapeut*innen deutlich höher ausfällt als die Qualität der narrativen Darstellungen der Lehrer*innen. Dies wird mit unterschiedlichen Aus- und Weiterbildungsstrukturen in Verbindung gebracht. Ein weiterer Vergleich mit den Ratings von Interviews, die mit Psychagog*innen geführt wurden, stützt diese Annahme. Ein Ausblick auf weitere Forschungsaktivitäten wird gegeben.
Making the climate crisis personal through a focus on human health
Authors: Limaye Vijay S.
Published: June 2021

Climate change–driven health impacts are serious, widespread, and costly. Importantly, such damages are largely absent from policy debates around the costs of delay and inaction on this crisis. While climate change is a global problem, its impacts are localized and personal, and there is growing demand for specific information on how climate change affects human health in different places. Existing research indicates that climate-fueled health problems are growing, and that investments in reducing carbon pollution and improving community resilience could help to avoid tens to hundreds of billions of dollars in climate-sensitive health impacts across the USA each year, including those stemming from extreme heat, air pollution, hurricanes, and wildfires. Science that explores the underappreciated local health impacts and health-related costs of climate change can enhance advocacy by demonstrating the need to both address the root causes of climate change and enhance climate resilience in vulnerable communities. The climate crisis has historically been predominantly conceived as a global environmental challenge; examination of climate impacts on public health enables researchers to localize this urgent problem for members of the public and policymakers. In turn, approaches to climate science that focus on health can make dangerous climate impacts and the need for cost-effective solutions more salient and tangible.
Creativity in students’ modelling competencies: conceptualisation and measurement
Authors: Lu Xiaoli , Kaiser Gabriele
Published: June 2021

Modelling competencies are currently included in numerous curricula worldwide and are generally accepted as a complex, process-oriented construct. Therefore, effective measurement should include multiple dimensions, like the sub-competencies required throughout the modelling process. Departing from the characteristics of modelling problems as open and often underdetermined real-world problems, we propose to enrich the current conceptualisation of mathematical modelling competencies by including creativity, which plays an important role in numerous phases of the mathematical modelling process but has scarcely been considered in modelling discourse. In the study described in this paper, a new instrument for the evaluation of this enriched construct has been developed and implemented. The modelling competencies incorporating creativity of the students were evaluated based on the adequacy of the models and the modelling processes proposed, and the appropriateness and completeness of the approaches were evaluated in detail. Adapting measurement approaches for creativity that have been developed in the problem-solving discourse, certain criteria of creativity were selected to evaluate the creativity of the students’ approaches in tackling modelling problems—namely, usefulness, fluency, and originality. The empirical study was conducted among 107 Chinese students at the upper secondary school level, who attended a modelling camp and independently solved three complex modelling problems. The results reveal significant correlations between fluency and originality in students’ performances across all tasks; however, the relationships between usefulness and the other two creativity aspects were not consistent. Overall, the results of the study support the importance of the inclusion of creativity in the construct of modelling competencies.
“There must be Someone’s Name Under Every Bit of Text, Even if it is Unimportant or Incorrect”: Plagiarism as a Learning Strategy
Authors: Bielska Beata , Rutkowski Mateusz
Published: June 2021

The article offers analyses of the phenomenon of copying (plagiarism) in higher education. The analyses were based on a quantitative survey using questionnaires, conducted in 2019 at one of the Polish universities. Plagiarism is discussed here both as an element of the learning process and a subject of public practices. The article presents students’ definitions of plagiarism, their strategies for unclear or difficult situations, their experiences with plagiarism and their opinions on how serious and widespread this phenomenon is. Focusing on the non-plagiarism norm, that is the rule that students are not allowed to plagiarize, and in order to redefine it we have determined two strategies adopted by students. The first is withdrawing in fear of making a mistake (omitting the norm), which means not using referencing in unclear situations, e.g. when the data about the source of information are absent. The second is reducing the scope of the norm applicability (limiting the norm), characterized by the fact that there are areas where the non-plagiarism norm must be observed more closely and those where it is not so important, e.g. respondents classify works as credit-level and diploma-level texts, as in the credit-level work they “can” sometimes plagiarize since the detection rate is poor and consequences are not severe. The presented results are particularly significant for interpreting plagiarism in an international context (no uniform definition of plagiarism) and for policies aimed at limiting the scale of the phenomenon (plagiarism detection systems1).
Anisotropic transport properties of graphene-based conductor materials
Authors: Slawig Diana , Rizzi Leo , Rothe Tom , Schuster Jörg , Tegenkamp Christoph
Published: June 2021

We analyzed nanographite-based materials in a combined study including experimental analysis via 4-point probe STM and simulation to provide a complete picture of microscopic and macroscopic properties of the material. The two- and three-dimensional transport regimes were determined and evaluated regarding the anisotropy of the conductivity. The experimental results yield the full macroscopic conductivity tensor. Microstructural simulations are used to map those macroscopic properties to the microscopic building blocks of the sample. By combining those two, we present a coherent and comprehensive description of the electrical material parameters across several length scales.
Potential implications of solar radiation modification for achievement of the Sustainable Development Goals
Authors: Honegger Matthias , Michaelowa Axel , Pan Jiahua
Published: June 2021

Solar radiation modification, particularly stratospheric aerosol injection, holds the potential to reduce the impacts of climate change on sustainable development, yet could itself generate negative impacts and is subject to intense scholarly debate based on relatively little evidence. Based on expert elicitation involving over 30 individuals with backgrounds across the domains of the United Nations’ Sustainable Development Goals (SDGs), we identify a broad range of potential implications of solar radiation modification for the SDGs. Depending on design and application scenarios, applications could potentially assist in the pursuit of several of the goals by limiting temperature rise and limiting acceleration in atmospheric water cycles as well as extreme weather events. However, by adding to particulates, introducing an additional layer of complexity and potential for conflict in global governance, as well as otherwise altering planetary environments, they might also detract from the pursuit of SDGs and introduce novel risks. The overall impact of solar radiation modification on sustainable development is currently highly uncertain and dependent on climate change mitigation pathways and governance. We identify key areas for further transdisciplinary research the pursuit of which might reduce some uncertainty and help inform emerging governance processes.
Handwriting versus keyboarding: Does writing modality affect quality of narratives written by beginning writers?
Authors: Spilling Eivor Finset , Rønneberg Vibeke , Rogne Wenke Mork , Roeser Jens , Torrance Mark
Published: June 2021

To date, there is no clear evidence to support choosing handwriting over keyboarding or vice versa as the modality children should use when they first learn to write. 102 Norwegian first-grade children from classrooms that used both electronic touchscreen keyboard on a digital tablet and pencil-and-paper for writing instruction wrote narratives in both modalities three months after starting school and were assessed on several literacy-related skills. The students’ texts were then analysed for a range of text features, and were rated holistically. Data were analysed using Bayesian methods. These permitted evaluation both of evidence in favour of a difference between modalities and of evidence in favour of there being no difference. We found moderate to strong evidence in favour of no difference between modalities. We also found moderate to strong evidence against modality effects being moderated by students’ literacy ability. Findings may be specific to students who are just starting to write, but suggest that for children at this stage of development writing performance is independent of modality.
Integration of microbial reductive dehalogenation with persulfate activation and oxidation (Bio-RD-PAO) for complete attenuation of organohalides
Authors: Wu Rifeng , Wang Shanquan
Published: June 2021

Due to the toxicity of bioaccumulative organohalides to human beings and ecosystems, a variety of biotic and abiotic remediation methods have been developed to remove organohalides from contaminated environments. Bioremediation employing organohalide-respiring bacteria (OHRB)-mediated microbial reductive dehalogenation (Bio-RD) represents a cost-effective and environmentally friendly approach to attenuate highly-halogenated organohalides, specifically organohalides in soil, sediment and other anoxic environments. Nonetheless, many factors severely restrict the implications of OHRB-based bioremediation, including incomplete dehalogenation, low abundance of OHRB and consequent low dechlorination activity. Recently, the development of in situ chemical oxidation (ISCO) based on sulfate radicals (SO
4
·−
) via the persulfate activation and oxidation (PAO) process has attracted tremendous research interest for the remediation of lowly-halogenated organohalides due to its following advantages, e.g., complete attenuation, high reactivity and no selectivity to organohalides. Therefore, integration of OHRB-mediated Bio-RD and subsequent PAO (Bio-RD-PAO) may provide a promising solution to the remediation of organohalides. In this review, we first provide an overview of current progress in Bio-RD and PAO and compare their limitations and advantages. We then critically discuss the integration of Bio-RD and PAO (Bio-RD-PAO) for complete attenuation of organohalides and its prospects for future remediation applications. Overall, Bio-RD-PAO opens up opportunities for complete attenuation and consequent effective in situ remediation of persistent organohalide pollution.
Hunters who will not report illegal wolf killing: Self-policing or resistance with political overtones?
Authors: Skogen Ketil , von Essen Erica , Krange Olve
Published: June 2021

Illegal killing of wildlife is challenging conservation efforts worldwide. Ecological research has shown that illegal killing is severely affecting the transboundary Swedish-Norwegian wolf population. A previous study indicated that unwillingness to report illegal killing of wolves among Swedish hunters contains an element of protest against perceived unjust treatment of hunting and hunters but that it could also simply be a reflection of ineffective law enforcement in the backcountry, driving hunters to effect forms of self-policing. Based on a survey of Norwegian hunters, the present research goes one step further. One in five hunters decline to report illegal wolf killings, and unwillingness to report is predicted by lack of trust in environmental institutions and a general anti-elite sentiment. Hunting-related issues and other factors also affect outcomes, but to a lesser degree. We conclude that unwillingness to report is often part of an oppositional stance related not only to wildlife management and conservation, but to contemporary social change in rural areas and perceived societal power relations. It is unlikely that reluctance to report is driven by frustration over inefficient official enforcement. While a political dimension is not always articulated, overlooking it may stoke conflicts and fortify a perception of unjust power relations.
On a Rigidity Problem of Beardon and Minda
Authors: Li Baokui , Wang Yuefei
Published: June 2021

In this paper, we give a positive answer to a rigidity problem of maps on the Riemann sphere related to cross-ratios, posed by Beardon and Minda (Proc Am Math Soc 130(4):987–998, 2001). Our main results are: (I) Let $$E\not \subset {\hat{\mathbb {R}}}$$

E
⊄

R
^

be an arc or a circle. If a map $$f:{\hat{\mathbb {C}}}\mapsto {\hat{\mathbb {C}}}$$

f
:

C
^

↦

C
^

preserves cross-ratios in E, then f is a Möbius transformation when $${\bar{E}}\not =E$$

E

¯

≠
E

and f is a Möbius or conjugate Möbius transformation when $${\bar{E}}=E$$

E

¯

=
E

, where $${\bar{E}}=\{{\bar{z}}|z\in E\}$$

E

¯

=
{

z

¯

|
z
∈
E
}

. (II) Let $$E\subset {\hat{\mathbb {R}}}$$

E
⊂

R
^

be an arc satisfying the condition that the cardinal number $$\#(E\cap \{0,1,\infty \})<2$$

#
(
E
∩
{
0
,
1
,
∞
}
)
<
2

. If f preserves cross-ratios in E, then f is a Möbius or conjugate Möbius transformation. Examples are provided to show that the assumption $$\#(E\cap \{0,1,\infty \})<2$$

#
(
E
∩
{
0
,
1
,
∞
}
)
<
2

is necessary.
Trustworthy digital infrastructure for identity systems: why should privacy matter to security engineers?
Authors: Maple Carsten , Epiphaniou Gregory , Bottarelli Mirko
Published: June 2021

Privacy and security have long been perceived as competing objectives, but they both exist in a state of tension within systems.

Engineers may be tempted to consider security as essential, while privacy is a nice-to-have. Prof Carsten Maple, Dr Gregory Epiphaniou and Mirko Bottarelli of the University of Warwick and the Alan Turing Institute explain that, as applications and platforms gather ever more data, we need to move to a ‘privacy by design’ approach while implementing data protection mechanisms with existing security engineering methods.

Privacy and security have long been perceived as competing objectives. For example, it is widely acknowledged that national security is often (and should often be) prioritised over any concerns for personal privacy. However, privacy and security are, more generally, in tension within cyber systems. This is most noticeably present in the design and operation of systems where information that can be used to determine and protect the security might have private and personal aspects.
Academic and post-secondary participation of students with ABI after the BrainSTEPS program
Authors: Riccardi Jessica Salley , Eagan-Johnson Brenda , Vaccaro Monica , Ciccia Angela H.
Published: June 2021

Purpose:

To describe and analyze educational and post-high school participation of individuals who sustained an acquired brain injury (ABI) during childhood and participated in a state-wide school-based brain injury support program, BrainSTEPS in Pennsylvania (BrainSTEPS).

Method:

Retrospective analysis of programmatic information and data collected through electronic and phone surveys during a follow-up survey for a statewide, school-based, school consultation program for students with ABI.

Participants:

Caregivers reported on 190 individuals with ABI who participated in Pennsylvania’s BrainSTEPS Program.

Results:

Individuals post-ABI who participated in the BrainSTEPS were most likely to have experienced a mild ABI in high school due to sports. Post-injury, students were most likely to be enrolled in regular education, have graduated high school, pursued four-year college education and be attending post-secondary education and living with family. Additional significant relationships were not reported within the concussion or moderate-severe traumatic brain injury subgroups. Significant relationships for educational outcomes included higher likelihood of regular educational placement at the time of referral given an older grade at injury and regular educational placement before injury. For post-high school outcomes, a younger age at survey was associated with current attendance in post-secondary education, compared to other vocational options.

Conclusions:

Individuals with a history of ABI before school age and during primary and secondary education present with heterogeneous educational and post-high school outcomes. A greater breadth of measures of formal and informal educational and vocational supports and post-high school attainment should be implemented to accurately capture the needs and outcomes of these students to inform supports and services.
Applications of Artificial Intelligence and Machine Learning in Disasters and Public Health Emergencies
Authors: Lu Sally , Christie Gordon A. , Nguyen Thanh T. , Freeman Jeffrey D. , Hsu Edbert B.
Published: June 2021

Indexed literature (from 2015 to 2020) on artificial intelligence (AI) technologies and machine learning algorithms (ML) pertaining to disasters and public health emergencies were reviewed. Search strategies were developed and conducted for PubMed and Compendex. Articles that met inclusion criteria were filtered iteratively by title followed by abstract review and full text review. Articles were organized to identify novel approaches and breadth of potential AI applications. A total of 1217 articles were initially retrieved by the search. Upon relevant title review, 1003 articles remained. Following abstract screening, 667 articles remained. Full text review for relevance yielded 202 articles. Articles that met inclusion criteria totaled 56 articles. Those identifying specific roles of AI and ML (17 articles) were grouped by topics highlighting utility of AI and ML in disaster and public health emergency contexts. Development and use of AI and ML have increased dramatically over the past few years. This review discusses and highlights potential contextual applications and limitations of AI and ML in disaster and public health emergency scenarios.
The provision of undergraduate clinical placements in ENT during the coronavirus disease 2019 pandemic – exploring patient perspectives on a variety of approaches
Authors: Patel B , Gera R , Lozidou A , Hannan S A , Saeed S R
Published: June 2021

Background

The coronavirus disease 2019 pandemic has greatly disrupted routine ENT services. Subsequently, universities have chosen to either augment or suspend clinical placements.

Objective

This study aimed to elicit patients’ perspectives toward various approaches to clinical placements in ENT during the coronavirus disease 2019 pandemic.

Methods

Cross-sectional questionnaires were given to patients attending the ENT department for routine out-patient care. Responses were measured using a five-point Likert scale. Seventy-nine patients completed the survey.

Results

Ninety-five per cent of respondents felt the coronavirus disease 2019 pandemic had not reduced their comfort in interacting with medical students. Most participants reported being comfortable with students participating directly or remotely in their care, and with students having access to their anonymised data. Twenty-five per cent of participants stated that they are uncomfortable with consultations being recorded and shared for medical education purposes.

Conclusion

A number of approaches to clinical placements remain acceptable to patients. Educational leads should continue to offer placements in ENT that can incorporate direct or remote observation of consultations.
Producing and communicating natural history in the long 18th century: Moravian observations concerning Greenland’s climate in unpublished sources
Authors: Borm Jan , Kodzik Joanna , Charbit Sylvie
Published: June 2021

This paper discusses weather observations of Moravian missionaries in Greenland in the long 18th century, placing them in the broader context of their missionary work at Neu-Herrnhut and other stations as well as their comments on the natural world. Some of their climate-related remarks and measurements were published and discussed in print, notably in David Cranz’ History of Greenland and a number of scholarly reviews at the time. These publications are compared to and complemented by data retrieved by the authors from unpublished source material in the Moravian Archives in Herrnhut, Germany, demonstrating that the Moravian diaries can fill in significant gaps in Greenland’s weather charts before systematic measurements were introduced in the 19th century. Their special interest for climate studies is underscored in conclusion, in particular their observations of extreme climate events that can allow us to better characterise the amplitude and geographical extent of such events and to compare them with climate model simulations in order to better understand the respective roles of external (volcanism, solar activity) and internal (atmospheric circulation) forcings and the impacts of potential feedbacks within the ocean–atmosphere system.
“Liberating the Small Devils”: Red Guard Newspapers and Radical Publics, 1966–1968
Authors: Volland Nicolai
Published: June 2021

Red Guard newspapers and pamphlets (wenge xiaobao) were a key source for early research on the Cultural Revolution, but they have rarely been analysed in their own right. How did these publications regard their status and function within the larger information ecosystem of the People's Republic, and what is their role in the history of the modern Chinese public sphere? This article focuses on a particular subset of Red Guard papers, namely those published by radical groups within the PRC's press and publication system. These newspapers critiqued the pre-Cultural Revolution press and reflected upon the possible futures of a new, revolutionary Chinese press. Short-lived as these experiments were, they constitute a test case to re-examine the functioning of the public in a decidedly “uncivil” polity. Ultimately, they point to the ambiguous potential of the public for both consensus and conflict, liberation and repression, which characterizes the press in 20th-century China.
Teaching Theory and Space: Human Territoriality in Political Science
Authors: Tagma Halit Mustafa E.
Published: June 2021

Learning theories in political science can be difficult for students. This article describes a technique that helps students to understand how a theory about human characteristics may impact behavior. I use a mini-simulation in which two volunteers are asked to enact a gimmick in front of the classroom, demonstrating the theory of human territoriality (Asal et al. 2018). As the volunteers engage in small talk, I point out that they engage with one another at a certain distance and angle that reflects social space. As the exercise progresses, students easily relate to the theory of human territoriality, which is defined as the symbolic and physical connection to a space considered as their own. This mini-simulation achieves the following learning objectives: understanding (1) that theories are relevant and help to explain human behavior; (2) the workings of the individual level of analysis; and (3) that theories are not universal and have limits to their application across culture, time, and space. This teaching technique does not require preparation time or resources, and students easily comprehend the expected learning outcomes. Having received overwhelmingly positive feedback in evaluations, I offer this as a viable technique for teaching theory in general because it helps students to comprehend what a theory is supposed to do—that is, to understand, explain, and sometimes predict behavior.
BIALL Covid-19 Industry Survey 2020: an Introduction
Authors: Brown Karen
Published: June 2021

The British and Irish Association of Law Librarians (BIALL) carried out a survey of BIALL members during May 2020 in order to gain a view, at a point in time, of the impact of Covid-19.1 National lockdowns in both the United Kingdom and Ireland had come into force in March 2020. The survey was a way of gauging how the legal information community was responding to the challenges and changing circumstances brought about as a result of the pandemic. This brief introduction by Karen Brown, President of BIALL, sets the scene for the results of the survey which appear in the pages that follow.2
“The surprise questions” using variable time frames in hospitalized patients with advanced cancer
Authors: Kim Sun Hyun , Suh Sang-Yeon , Yoon Seok Joon , Park Jeanno , Kim Yu Jung , Kang Beodeul , Park Youngmin , Kwon Jung Hye , Park Kwonoh , Kim Jung-Young , Choi Hana , Ahn Hong-Yup , Hamano Jun , Hui David
Published: June 2021

Objective

Several studies supported the usefulness of “the surprise question” in terms of 1-year mortality of patients. “The surprise question” requires a “Yes” or “No” answer to the question “Would I be surprised if this patient died in [specific time frame].” However, the 1-year time frame is often too long for advanced cancer patients seen by palliative care personnel. “The surprise question” with shorter time frames is needed for decision making. We examined the accuracy of “the surprise question” for 7-day, 21-day, and 42-day survival in hospitalized patients admitted to palliative care units (PCUs).

Method

This was a prospective multicenter cohort study of 130 adult patients with advanced cancer admitted to 7 hospital-based PCUs in South Korea. The accuracy of “the surprise question” was compared with that of the temporal question for clinician's prediction of survival.

Results

We analyzed 130 inpatients who died in PCUs during the study period. The median survival was 21.0 days. The sensitivity, specificity, and overall accuracy for the 7-day “the surprise question” were 46.7, 88.7, and 83.9%, respectively. The sensitivity, specificity, and overall accuracy for the 7-day temporal question were 6.7, 98.3, and 87.7%, respectively. The c-indices of the 7-day “the surprise question” and 7-day temporal question were 0.662 (95% CI: 0.539–0.785) and 0.521 (95% CI: 0.464–0.579), respectively. The c-indices of the 42-day “the surprise question” and 42-day temporal question were 0.554 (95% CI: 0.509–0.599) and 0.616 (95% CI: 0.569–0.663), respectively.

Significance of results

Surprisingly, “the surprise questions” and temporal questions had similar accuracies. The high specificities for the 7-day “the surprise question” and 7- and 21-day temporal question suggest they may be useful to rule in death if positive.
Terminating Twins: Survival of One/Twin Research Reviews: Twin Discordance for Primordial Dwarfism; Twin Study of Public Service Motivation; Four-Parameter Model for Twin Research; Global Twinning at a Peak; Germline Differences of Monozygotic Twins/In the News: Twins and Dyngus Day; Triplets Born in Austrian Displaced Persons’ Camp; Superior, Film About Estranged Identical Twin Sisters; Adopting Own Twins After Surrogacy; Twins and Primordial Dwarfism Revisited
Authors: Segal Nancy L.
Published: June 2021

Selective termination is the term used for the elimination of an abnormal fetus. In contrast, multifetal pregnancy reduction refers to the termination of one or more members of a twin or higher-order multiple birth set, respectively, to reduce the high risks associated with these pregnancies. The procedure can also be used when a serious physical condition is detected prenatally in a member of a multiple birth set. In a minority of cases, selective termination has reduced two healthy fetuses to one when parents wanted just one additional child in the family. In the present article, the perspectives of a surviving twin whose family wished to terminate both healthy fetuses are examined. Next, past and present twin studies of primordial dwarfism, public service motivation, an analytical model, the global twinning rate and germline differences are summarized. The article concludes with a synopsis of twin-related news that covers twins and Dyngus Day, triplets born in an Austrian displaced persons’ camp, the film Superior — about estranged identical twin sisters, a couple adopting their own twins after surrogacy and a new case of twins and primordial dwarfism, a condition introduced in the research reviews.
Anthropogenic and Climatic Contributions to Observed Carbon System Trends in the Northeast Pacific
Authors: Franco Ana C. , Ianson Debby , Ross Tetjana , Hamme Roberta C. , Monahan Adam H. , Christian James R. , Davelaar Marty , Johnson William K. , Miller Lisa A. , Robert Marie , Tortell Philippe D.
Published: June 2021

The ocean absorbs anthropogenic carbon, slowing atmospheric CO2 increase but driving ocean acidification. Long‐term changes in the carbon system are typically assessed from single‐point time series or from hydrographic sections spaced by decades. Using higher resolution observations (1–3 year−1) from the Line P time series, we investigate processes modulating trends in the carbon system of the northeast subarctic Pacific. Dissolved inorganic carbon (DIC) and apparent oxygen utilization (AOU) from 1990 to 2019 reveal substantial trends over most of the upper water column along the 1,500 km coastal to open ocean transect. At the surface, an increasing trend in salinity‐normalized DIC (sDIC33) (+0.5 ± 0.4 μmol kg−1 yr−1) is associated with a decrease in pH (0.01–0.02 decade−1) and a decrease in aragonite saturation state (0.04–0.08 decade−1). These observed trends are driven by anthropogenic CO2 uptake, partially offset by trends in surface salinity or temperature. Stratification associated with recent marine heat waves appears to have caused anomalously low surface pCO2. sDIC33 trends of similar magnitude were found below the seasonal thermocline on the 26.7–26.8 isopycnals (150–300 m), which are ventilated in the western Pacific. Roughly, a third (20%–50%) of the subsurface sDIC33 trend is driven by increased remineralization, likely caused by long‐term decreases in ventilation in the western Pacific. Bidecadal oscillations in the ventilation of the 26.7–26.8 isopycnals arising from the Lunar Nodal Cycle cause oscillations in sDIC33 and AOU at the offshore end of our transect. We trace the oscillations to alternating periods of higher anthropogenic carbon uptake or higher carbon remineralization.
Postseismic Deformation and Afterslip Evolution of the 2015 Gorkha Earthquake Constrained by InSAR and GPS Observations
Authors: Hong Shunying , Liu Mian
Published: June 2021

In the past few years, space‐geodesy has measured continued postseismic deformation in the region of the 2015 Gorkha Mw 7.8 earthquake. Previous studies have suggested that the postseismic deformation is dominated by afterslip, but the spatiotemporal evolution of the afterslip, hence its cause and impact on regional seismicity are disputed, and contribution from other postseismic processes has not been well constrained. Here, we constructed an afterslip model using InSAR and GPS observations over three years after the Gorkha earthquake. First, the Sentinel‐1A satellite data were processed using Permanent Scatterer Interferometric Synthetic Aperture Radar method to extract deformational signals at high‐coherence points, and a fitting method was used to extract the postseismic displacement sequences. We then used InSAR and GPS data in a joint inversion for the evolution of afterslip, and compared its contribution to the observed postseismic displacement to that of viscoelastic relaxation and poroelastic rebound. Our results confirm that afterslip has dominated the observed postseismic deformation in the Gorkha region. Within 3 years of the Gorkha earthquake, afterslip released ∼1.20 × 1020 N m, about 14% of that released by the mainshock and the largest aftershock, or equivalent to an Mw 7.32 earthquake. The afterslip has occurred mostly downdip of the coseismic slip zone, in the ductile shear zone, apparently controlled by rheological properties. The updip shallow portion of the Main Frontal Thrust (MFT) zone has not been ruptured by coseismic slip or unlocked by afterslip, thus could potentially produce future earthquakes.
Geodetic Coupling Models as Constraints on Stochastic Earthquake Ruptures: An Example Application to PTHA in Cascadia
Authors: Small David T. , Melgar Diego
Published: June 2021

Current stochastic rupture modeling techniques do not consider the potential influence of inter‐seismic coupling, a first‐order property of a megathrust, which can show correlation between areas of high coupling and areas of greater slip as seen in recent large ruptures globally. Therefore, it is reasonable to assume that it should be considered as prior information in rupture modeling. Here, we first present a mathematical formalism to introduce coupling models as prior information into stochastic rupture modeling. We then focus on how introducing slip deficit information into the stochastic rupture models influences slip distributions for the Cascadia subduction zone (CSZ). We compare rupture models created with two end member models of coupling, one with a shallow coupling and another with coupling deeper downdip. We also discuss the comparison to models created without assuming knowledge of the coupling distribution except for variation in the downdip limit of slip. Variations occur and correlate well with areas with the largest differences in slip deficit rates. The ruptures are then used for regional probabilistic tsunami hazard assessment. Overall, the tsunami amplitudes generated are much more hazardous in the northern extent of the CSZ where differences in coupling distribution are more prevalent. Models obtained from assuming a shallower downdip limit have tsunami amplitudes more similar to those from the geodetic coupling models. Although uncertainties are present in the accuracy of coupling, imposing either constraint created different hazard estimations when compared to those where no prior coupling information was used.
Superimposed Rifting at the Junction of the Central and Equatorial Atlantic: Formation of the Passive Margin of the Guiana Shield
Authors: Loparev Artiom , Rouby Delphine , Chardon Dominique , Dall’Asta Massimo , Sapin François , Bajolet Flora , Ye Jing , Paquet Fabien
Published: June 2021

The passive margin of the Guiana Shield formed at the junction of the Central and Equatorial Atlantic Oceans that developed successively by a complex rifting process that achieved the final dispersal of Western Gondwana. Yet, the resulting spatial distribution of crustal thinning along the margin remains to be mapped and its controlling parameters deciphered. We used subsurface data to map the variability of crustal thinning along the margin. We show that the margin segments width primarily depends on their obliquity to rifting extension direction. The necking domain of the transform/oblique margin segments is much narrower (<100 km) than divergent segments that include hyper‐extended or distal margin domains as well (200–300 km). Moreover, for a similar obliquity, the width of margin segments resulting from the Central Atlantic rifting are wider than those resulting from the Equatorial Atlantic rifting. This is primarily due to the higher obliquity and rate of the latter. Additionally, along the Central Atlantic margin segments, thinning was accommodated by lower‐crustal ductile deformation, the thick syn‐rift in‐fill was associated with magmatism and a thicker than average oceanic crust. In contrast, the Equatorial Atlantic margin segments show little ductile deformation, reduced clastic syn‐rift infill and thinner than average oceanic crust. These observations suggest that the lithosphere affected by the Central Atlantic rifting was warmer than that affected by the Equatorial Atlantic rifting. Finally, the two‐step thinning in the overlapping area of the two rift systems individualized a promontory of thinned continental crust that remained as the Demerara Plateau.
Why Contribute to a Scientific Book?
Authors: Lunn Jenny
Published: June 2021

Editing a book can be a rewarding professional experience, but there are misconceptions about scientific books in terms of their quality, value, and discoverability.
Why are Surface Ocean pH and CaCO3 Saturation State Often out of Phase in Spatial Patterns and Seasonal Cycles?
Authors: Xue Liang , Cai Wei‐Jun , Jiang Li‐Qing , Wei Qinsheng
Published: June 2021

As two most important metrics for ocean acidification (OA), both pH and calcium carbonate mineral saturation states (Ω) respond sensitively to anthropogenic carbon dioxide (CO2). However, contrary to intuition, they are often out of phase in the global surface ocean, both spatially and seasonally. For example, during warm seasons, Ω is lowest at high‐latitude seas where there are very high pH values, challenging our understanding that high‐latitude seas are a bellwether for global OA. To explain this phenomenon, we separate spatial and seasonal variations of both pH and Ω into thermal components mainly associated with internal acid‐base equilibrium of seawater CO2 systems, and nonthermal components mainly associated with external CO2 addition/removal using a global surface ocean climatological data set. We find that surface pH change is controlled by the balance between its thermal and nonthermal components, which are out of phase but comparable in magnitude. In contrast, surface Ω change is dominated by its nonthermal components, with its thermal components in phase and significantly smaller in magnitude. These findings explain why surface ocean pH and Ω are often out of phase in spatial patterns and seasonal cycles. When pH is primarily controlled by nonthermal components e.g., gas exchange, mixing and biology, pH and Ω will be in phase because their nonthermal components are intrinsically in phase. In comparison, when pH is primarily controlled by thermal components for example, rapid seasonal cooling or warming, pH and Ω will be out of phase because thermal and nonthermal components of pH are out‐of‐phase in nature.
Diverse Dynamical Response to Orographic Gravity Wave Drag Hotspots—A Zonal Mean Perspective
Authors: Sacha P. , Kuchar A. , Eichinger R. , Pisoft P. , Jacobi C. , Rieder H. E.
Published: June 2021

In the extratropical atmosphere, Rossby waves (RWs) and internal gravity waves (GWs) propagating from the troposphere mediate a coupling with the middle atmosphere by influencing the dynamics therein. In state‐of‐the‐art chemistry‐climate models (CCMs), RW effects are well resolved while the majority of GW effects have to be parameterized. Here, we analyze orographic GW (OGW) interaction with resolved dynamics in a comprehensive CCM on daily time scales. For this, we apply a recently developed method of strong OGW drag event composites for three pronounced northern hemisphere OGW hotspots. We show that strong OGW drag events are associated with anomalous resolved wave propagation in the stratosphere. Causal links are inferred from previously published work and are supported by the anomalies in zonal circulation and wave activity tendencies. The nature of these anomalies varies depending on the hotspot region, which underlines the parameterized OGW‐resolved dynamics interaction being a two‐way process.
Laboratory Verification of Electron‐Scale Reconnection Regions Modulated by a Three‐Dimensional Instability
Authors: Greess S. , Egedal J. , Stanier A. , Daughton W. , Olson J. , Lê A. , Myers R. , Millet‐Ayala A. , Clark M. , Wallace J. , Endrizzi D. , Forest C.
Published: June 2021

During magnetic reconnection in collisionless space plasma, the electron fluid decouples from the magnetic field within narrow current layers, and theoretical models for this process can be distinguished in terms of their predicted current layer widths. From theory, the off‐diagonal stress in the electron pressure tensor is related to the thermal noncircular orbit motion of electrons around the magnetic field lines. This stress becomes significant when the width of the reconnecting current layer approaches the small characteristic length scale of the electron motion. To aid in situ spacecraft and numerical investigations of reconnection, the structure of the electron diffusion region is here investigated using the Terrestrial Reconnection Experiment. In agreement with the closely matched kinetic simulations, laboratory observations reveal the presence of electron‐scale current layer widths. Although the layers are modulated by a current‐driven instability, three‐dimensional simulations demonstrate that it is the off‐diagonal stress that is responsible for breaking the frozen‐in condition of the electron fluid.
Revisiting the Atlantic South Equatorial Current
Authors: Luko C. D. , da Silveira I. C. A. , Simoes‐Sousa I. T. , Araujo J. M. , Tandon A.
Published: June 2021

The southern branch of the South Equatorial Current (SSEC) is the northern limit of the South Atlantic Subtropical Gyre. When this current reaches Brazil around 14°S it bifurcates into a southward flow as the Brazil Current (BC) and the surface portion of the northward flowing North Brazil Undercurrent (NBUC). The SSEC system is a key component of the western boundary supply, influencing the NBUC/BC variability and, therefore, global climate through the Meridional Overturning Circulation. In this study, using altimetry satellite data and reanalyzes outputs (1993–2018), we revisit the SSEC mean state and show this current arriving at the South Atlantic western boundary as a multi‐banded flow with surface signatures resulting from different subsurface cores. These bands have velocities between 0.02 and 0.07 m s−1 and, as shown by ADCP data from the PIRATA project, their signature in synoptic scenarios is obscured by eddies and waves with velocities between 0.1 and 0.3 m s−1. In addition, the SSEC annual cycle analysis shows that the seasonality of the bands is out of phase with each other, presenting westward transport anomalies between 0.4 and 2.6 Sv. Finally, our results show that the seasonality of this multi‐banded flow both defines where the BC is born, and modulates the seasonality of semi‐permanent mesoscale eddies off Brazil.