bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional, Racial, and Mortality Disparities Associated With Neurosurgeon Staffing at Level I Trauma Centers
Authors: Homo Richelle L. , Grigorian Areg , Chen Jefferson , Figueroa Cesar , Chin Theresa , Kuza Catherine M. , Lekawa Michael , Nahmias Jeffry 
Published: December 2020

Background Traumatic brain injury (TBI) occurs in approximately 30% of trauma patients. Because neurosurgeons hold expertise in treating TBI, increased neurosurgical staffing may improve patient outcomes. We hypothesized that TBI patients treated at level I trauma centers (L1TCs) with ≥3 neurosurgeons have a decreased risk of mortality vs. those treated at L1TCs with <3 neurosurgeons. Methods The Trauma Quality Improvement Program database (2010-2016) was queried for patients ≥18 years with TBI. Patient characteristics and mortality were compared between ≥3 and <3 neurosurgeon-staffed L1TCs. A multivariable logistic regression analysis was used to identify risk factors associated with mortality. Results Traumatic brain injury occurred in 243 438 patients with 5188 (2%) presenting to L1TCs with <3 neurosurgeons and 238 250 (98%) to L1TCs with ≥3 neurosurgeons. Median injury severity score (ISS) was similar between both groups (17, P = .09). There were more Black (37% vs. 12%, P < .001) and Hispanic (18% vs. 12%, P < .001) patients in the <3 neurosurgeon group. Nearly 60% of L1TCs with <3 neurosurgeons are found in the South. Mortality was higher in the <3 vs. the ≥3 group (12% vs. 10%, P < .001). Patients treated in the <3 neurosurgeon group had a higher risk for mortality than those treated in the ≥3 neurosurgeon group (odds ratio (OR) 1.13, 95% confidence intervals (CI) 1.01-1.26, P = .028). Discussion There exists a significant racial disparity in access to neurosurgeon staffing with additional disparities in outcomes based on staffing. Future efforts are needed to improve this chasm of care that exists for trauma patients of color.
Clinical and Demographical Characteristics of Cleft Lip and/or Palate in the Northwest of Iran: An Analysis of 1500 Patients
Authors: Galeh Sima Dabbaghi , Nouri-Vaskeh Masoud , Alipour Mahdieh , Fakhim Shahin Abdollahi 
Published: December 2020

Objective: Orofacial clefts (OFCs) can occur as an isolated defect or as a manifestation of other syndromes. The current study aimed to evaluate demographic characteristics and distribution of different types of accompanying anomalies for OFCs in the northwest of Iran. Design: A retrospective cohort study. Setting: Tertiary pediatric hospital. Patients and Participants: This study was conducted on 1500 cleft lip and/or palate patients born between July 2010 and June 2020 in the northwest of Iran. Main Outcome Measures: Demographic and clinical characteristics of the children with OFCs including familial history, accompanying anomalies and syndromes, maternal passive smoking, mothers’ and fathers’ age, consanguineous marriage, and birth order. Results: Among 1500 patients, 441 had cleft lip, 615 had cleft palate, and 444 had cleft lip and palate. The positive family history of OFCs was found to be 20.9% to 25.4% depending on the cleft type. Accompanying anomalies were identified in 29.8% of cases. Cardiac, facial, and ear abnormalities were the most common types. Also, 2.9% were identified with syndromes and sequences. These included Pierre Robin Sequence, Velo-cardio-facial syndrome, and Down syndrome most frequently. Conclusion: These findings may provide references for appropriate resources to establish and direct counseling and primary preventive projects in the northwest of Iran.
Quantification of Bilateral Coronal Synostosis: Anterior Brachycephaly
Authors: Kronig Otto D. M. , Kronig Sophia A. J. , Van Adrichem Léon N. A. 
Published: December 2020

Objectives: Very few studies focus on the quantification of severity of synostotic anterior brachycephaly. Aim of this study is to implement Utrecht Cranial Shape Quantifier (UCSQ) in brachycephaly patients to objectively quantify severity for both clinical and research purposes. Design: Retrospective study. Setting: Primary craniofacial center. Patients and Participants: Fifteen preoperative patients with bilateral coronal craniosynostosis (age <1.5 years). Intervention: Utrecht Cranial Shape Quantifier was used to quantify severity using the variables: width of frontal peak ratio, difference forehead peak and occiput peak, and width between sides of the head. Main Outcome Measure(s): The UCSQ variables were combined and related to Argenta clinical classification and cephalic index (CI) using 1-way analysis of variance (ANOVA). All parameters were derived from computed tomography scans. Results: Statistically significant differences were found between group means of UCSQ in the 3 categories of Argenta (ANOVA; F(2,12) = 22.461; P < .01). Tukey post hoc test showed a significant difference between Argenta types 1 and 2, types 1 and 3, and types 2 and 3 (all P < .01). Statistically significant differences were found between traditional CI and Argenta types ( F(2,12) = 4.956; P = .03). Tukey post hoc test showed significantly difference between Argenta type 1 and 3 ( P = .02). No differences were found between other types. Low correlation was found between UCSQ and CI ( r = 0.47). Conclusions: Utrecht Cranial Shape Quantifier objectively captures and quantifies the shape of synostotic brachycephaly, and we therefore developed a suitable method to put severity of synostotic (anterior) brachycephaly into numbers.
What lies beneath resilience: Analyzing the affective-relational basis of shared leadership in the Chilean miners’ catastrophe
Authors: Sanfuentes Matías , Valenzuela Francisco , Castillo Alejandro 
Published: December 2020

This article addresses how shared forms of leadership can activate resilient organizing to cope with catastrophic events by examining the case of the 33 Chilean miners’ rescue who survived confinement at 600 m below ground for 69 days. Qualitative analysis of interview and document data reveals how the miners as a group engaged in the sharing of agency vis-a-vis the task of absorbing strain and anxiety, thus enabling a sophisticated work capacity and a constructive relational dynamic. The miners’ resilient capabilities emerged from the activation of collective resources in three distinct yet complementary modes of interaction: self-organization, collaboration, and mutual caring. Our empirical findings indicate that the distribution of agency becomes essential for the promotion of both collective sensemaking and emotional containment in contexts of crisis. By accounting for such affective-relational underpinning of the sharing of leadership, this article contributes a more nuanced understanding of crisis management and the organization of positive, constructive responses to adversity, breakdown, and conflict.
A research on an intelligent recognition tool for bronze inscriptions of the Shang and Zhou dynasties
Authors: Guo Rui 
Published: December 2020

The intelligent recognition tool for bronze inscriptions of the Shang and Zhou dynasties—the “Shang Zhou Bronze Inscriptions Intelligent Mirror”—was successfully invented in Shanghai. This mirror, based on the computer technology of artificial intelligence (AI) image recognition and image retrieval, succeeds in automagical recognition of bronze inscriptions, both single letters and full texts. This research leads the trend of the AI recognition of Ancient Chinese characters and accumulates valuable experience for the development of inter-disciplinary research on Chinese character recognition. This essay emphasizes the importance of the bronze inscriptions of the Shang and Zhou dynasty database in the AI recognition of bronze inscriptions, introduces the functional components of this tool, and shares the whole research process in order to offer experience for the related research on AI recognition of other types of Ancient Chinese characters as well as ideographs in the world scope. “Shang Zhou Bronze Inscriptions Intelligent Mirror” as a tool for bronze inscription recognition also has room for improvement and support, and guidance from experts in similar areas is greatly welcomed.
Somatic GATA2 mutations define a subgroup of myeloid malignancy patients at high risk for invasive fungal disease
Authors: Vedula Rahul S. , Cheng Matthew P. , Ronayne Christine E. , Farmakiotis Dimitrios , Ho Vincent T. , Koo Sophia , Marty Francisco M. , Lindsley R. Coleman , Bold Tyler D. 
Published: December 2020

Abstract
Invasive fungal disease (IFD) can be a severe treatment complication in patients with myeloid malignancies, but current risk models do not incorporate disease-specific factors, such as somatic gene mutations. Germline GATA2 deficiency is associated with a susceptibility to IFD. To determine whether myeloid gene mutations were associated with IFD risk, we identified 2 complementary cohorts of patients with myeloid malignancy, based on (1) the diagnosis of invasive aspergillosis (IA), or (2) the presence of GATA2 mutations identified during standard clinical sequencing. We found somatic GATA2 mutations in 5 of 27 consecutive patients who had myeloid malignancy and developed IA. Among 51 consecutive patients with GATA2 mutations identified in the evaluation of myeloid malignancy, we found that IFD was diagnosed and treated in 21 (41%), all of whom had received chemotherapy or had undergone an allogeneic stem cell transplant. Pulmonary infections and disseminated candidiasis were most common. The 90-day mortality was 52% among patients with IFD. Our results indicate that patients with somatic GATA2 mutations are a vulnerable subgroup of patients with myeloid malignancy who have high risk for treatment-associated IFD and suggest that a focused approach to antifungal prophylaxis be considered.
Buckling and snapping of a thin polymeric membrane exposed to a solvent drop
Authors: Samy R. A. , Satpathi N. S. , Sen A. K. 
Published: December 2020

Abstract
We report the behavior of a thin and flat rectangular polymeric membrane, fixed at both ends, in contact with a solvent droplet. Depending on the solvent type and volume, and membrane thickness, three different regimes —no buckling, buckling, and snapping— are observed. Our study reveals that the behavior depends on the solubility parameter of the solvent and the ratio of the sum of swelling-induced force and capillary force to the elastic restoring force, i.e., the force ratio. We attempt to explain the phenomenon using the poroelastic and elastic recoil timescales. Using correlations from simple scaling, our model can estimate the maximum force ratio in terms of known quantities and predict the operating regime and maximum deflection. We expect our study will find significance in the design and analysis of systems involving flexible microbeams.
The effects of heterogeneous confidence on cooperation in spatial prisoner's dilemma game
Authors: He Guipeng , Zhang Liming , Huang Changwei , Li Haihong , Dai Qionglin , Yang Junzhong 
Published: December 2020

AbstractConfidence, which characterizes the feeling when people evaluate something, could influence their choices or behaviors significantly. Under the framework of evolutionary game theory, Szolnoki and Chen (Phys. Rev. E,98(2018) 022309) found that, both underconfident and overconfident individuals can promote cooperation in the population. In their work, underconfident and overconfident individuals are both assumed to have homogeneous confidence levels and the confidence levels remain unchanged during the whole evolutionary process. As a direct extension, in this work, we treat confidence level as an attribute of the individuals and assign each one a confidence level, which may be static or time-varied. The effects of heterogeneous confidence on cooperation in evolutionary games are investigated and two different cases are considered. For the static case, we assume that individuals' confidence levels are drawn from a uniform distribution in a certain interval. Whereas, for the time-varied case, the confidence levels of individuals can coevolve with the strategies. By numerical simulation, we find that the static heterogeneous confidence can enhance cooperation when the parameters of distribution satisfy certain conditions. Some analytic explanations based on the observations of strategy configurations among the population are provided. Furthermore, when individuals' confidence levels are allowed to coevolve with their strategies during the evolutionary dynamics, cooperation could be significantly improved. We also find that there exists an optimal increment for the confidence level which leads to the highest cooperation level.
Intrinsic piezoelectricity in monolayer MSi2N4 (M = Mo, W, Cr, Ti, Zr and Hf)
Authors: Guo San-Dong , Zhu Yu-Tong , Mu Wen-Qi , Ren Wen-Cai 
Published: December 2020

Abstract
Motived by experimentally synthesized

(Hong Y. L. et al., Science, 369 (2020) 670), the intrinsic piezoelectricity in monolayer

(

, W, Cr, Ti, Zr and Hf) are studied by density functional theory (DFT). Among the six monolayers,

has the best piezoelectric strain coefficient d
11 of 1.24 pm/V, and the second is 1.15 pm/V for

. Taking

as a example, strain engineering is applied to improve d
11. It is found that tensile biaxial strain can enhance d
11 of

, and the d
11 at 4% strain can improve by 107% with respect to the unstrained one. By replacing the N by P or As in

, the d
11 can be raised substantially. For

and

, the d
11 is as high as 4.93 pm/V and 6.23 pm/V, which is mainly due to smaller

and very small minus or positive ionic contribution to piezoelectric stress coefficient e
11 with respect to

. The discovery of this piezoelectricity in monolayer

enables active sensing, actuating and new electronic components for nanoscale devices, and is recommended for experimental exploration.
Two Cases of anti–PIT-1 Hypophysitis Exhibited as a Form of Paraneoplastic Syndrome not Associated With Thymoma
Authors: Kanie Keitaro , Iguchi Genzo , Inuzuka Megumi , Sakaki Kentaro , Bando Hironori , Urai Shin , Shichi Hiroki , Fujita Yasunori , Matsumoto Ryusaku , Suda Kentaro , Yamamoto Masaaki , Fukuoka Hidenori , Taniguchi Takao , Ogawa Wataru , Takahashi Yutaka 
Published: December 2020

Abstract
Anti–pituitary-specific transcription factor 1 (PIT-1) hypophysitis (anti–PIT-1 antibody syndrome) is a thymoma-associated autoimmune disease characterized by acquired growth hormone (GH), prolactin (PRL), and thyrotropin (TSH) deficiencies due to autoimmunity against PIT-1. Ectopic expression of PIT-1 in the thymoma plays a causal role in development of the disease. Here, we report 2 cases of anti–PIT-1 hypophysitis exhibiting as a form of paraneoplastic syndrome with conditions other than thymoma. A 79-year-old woman (case 1) and an 86-year-old man (case 2) were referred with a suspicion of anti–PIT-1 hypophysitis because of acquired GH, PRL, and TSH deficiencies. Case 1 was complicated by diffuse large B-cell lymphoma (DLBCL) of the bladder and case 2 was diagnosed with malignancy with multiple metastases of unknown origin. Because circulating anti–PIT-1 antibody was detected, both patients were diagnosed with anti–PIT-1 hypophysitis. Circulating PIT-1–reactive T cells were detected in case 1 via enzyme-linked immunospot (ELISPOT) assay. Interestingly, the PIT-1 protein was ectopically expressed in the DLBCL cells of case 1, whereas DLBCL tissues derived from patients without anti–PIT-1 hypophysitis were negative for PIT-1. In case 2, the materials were not available because of best supportive care was under way. These data show that anti–PIT-1 hypophysitis is associated not only with thymoma but also with other malignancies. Additionally, the ectopic expression of PIT-1 in the DLBCL tissues and presence of PIT-1–reactive T cells suggested that the underlying mechanisms were similar to those observed in thymoma. Thus, anti–PIT-1 hypophysitis is defined as a form of paraneoplastic syndrome.
Contribution of Gestational Weight Gain on Maternal Glucose Metabolism in Women with GDM and Normal Glucose Tolerance
Authors: Alvarado Fernanda L , O’Tierney-Ginn Perrie , Catalano Patrick 
Published: December 2020

Abstract

Context
Efforts to decrease the risk of developing metabolic complications of pregnancy such as gestational diabetes (GDM) through lifestyle intervention (decreasing excessive gestational weight gain (GWG)) during pregnancy have met with limited success.

Objective
The purpose of this study was to determine the relationship between the longitudinal changes in weight/body composition and insulin sensitivity and response in women with normal glucose tolerance (NGT) and those who developed GDM.

Design
We conducted a secondary analysis of a prospective cohort developed before conception and again at 34 to 36 weeks gestation. A total of 29 NGT and 17 GDM women were evaluated for longitudinal changes in insulin sensitivity/response using the hyperinsulinemic-euglycemic clamp and an IV-glucose tolerance test. Body composition was estimated using hydrodensitometry. Both absolute change (Δ) and relative change (%Δ) between these 2 time points were calculated. We performed simple and multiple linear regression analysis to assess the relationship between GWG and measures of glucose metabolism, ie, insulin sensitivity and response.

Results
Based on the primary study design there was no significant difference in clinical characteristics between women with NGT and those developing GDM. Prior to pregnancy, women who developed GDM had lower insulin sensitivity levels (P = 0.01) compared with NGT women. Absolute change and %Δ in insulin sensitivity/insulin response and body weight/body composition were not significantly different between NGT and GDM women. Changes in body weight contributed to only 9% of the Δ in insulin sensitivity both in women developing GDM and NGT women.

Conclusions
These data suggest that other factors—such as maternal pre-pregnancy insulin sensitivity and placental derived factors affecting insulin sensitivity—rather than maternal GWG account for the changes in glucose metabolism during human pregnancy.
DEFINIÇÃO DAS UNIDADES FISIOGRÁFICAS DO MUNICÍPIO DE SÃO FRANCISCO DE ASSIS, COM APLICAÇÕES DE SIG
Authors: Robaina Luís Eduardo De Souza , Trentin Romario 
Published: December 2020

A compartimentação fisiográfica tem como base os elementos do ambiente que definem a composição das encostas (litologia e solos) e a forma (relevo). Neste trabalho, utilizou-se os elementos do ambiente combinados com Sistemas de Informações Geográficas e árvores de decisão no intuito de descrever, classificar e compartimentar o município de São Francisco de Assis, localizado na Bacia do rio Ibicuí, na porção Oeste do Estado do Rio Grande do Sul. Foram definidos oito unidade fisiográficas, sendo que seis delas são constituídas por subunidades: Unidade Beluno, composta por duas subunidades representa 14,7% do total da área do município apresenta o relevo mais movimentado do município; Unidade do Chapadão, composta por duas subunidades, ocupa 3,67%, formado por relevo suave entre escarpas; Unidade Vales Fluviais com 10,32% da área, ocorre como rampas junto aos rios Ibicuí e Jaguari. Unidade Cerros representa o recuo do Planalto, por ação erosiva e ocorre em 1,51% da área, com duas subunidades; Unidade Santa Rosa marca as áreas de nascentes da bacia do rio Itu, com área de 6,95%; Unidade São Francisco de Assis, com 50,23% da área, é composta por quatro subunidades, constituindo um relevo suave de colinas, com substrato é de rochas sedimentares areníticas e solos arenosos, por vezes gerando campos de areia; Unidade Serra dos Canários, com 5,77% da área, é composta por duas subunidades, formando as áreas nas maiores altitudes do município; Unidade Vila Kramer, com 6,84% da área, formando solos, bem desenvolvidos com presença de argila devido a alteração das porções de topo com material vítreo dos derrames. O trabalho de compartimentação permite compreender os processos superficias atuantes e auxilia em trabalhos de planejamento.
Can an outpatient risk assessment tool predict who needs postoperative haemoglobin monitoring?
Authors: Nikolaus Oliver B. , Rowe Taylor , Springer Bryan D. , Fehring Thomas K. , Martin John R. 
Published: December 2020

Aims Recent improvements in surgical technique and perioperative blood management after total joint replacement (TJR) have decreased rates of transfusion. However, as many surgeons transition to outpatient TJR, obtaining routine postoperative blood tests becomes more challenging. Therefore, we sought to determine if a preoperative outpatient assessment tool that stratifies patients based on numerous medical comorbidities could predict who required postoperative haemoglobin (Hb) measurement. Methods We performed a prospective study of consecutive unilateral primary total knee arthroplasties (TKAs) and total hip arthroplasties (THAs) performed at a single institution. Prospectively collected data included preoperative and postoperative Hb levels, need for blood transfusion, length of hospital stay, and Outpatient Arthroplasty Risk Assessment (OARA) score. Results A total of 504 patients met inclusion criteria. Mean age at time of arthroplasty was 65.3 years (SD 10.2). Of the patients, 216 (42.9%) were THAs and 288 (57.1%) were TKAs. Six patients required a blood transfusion postoperatively (1.19%). Transfusion after surgery was associated with lower postoperative day 1 Hb (median of 8.5 (interquartile range (IQR) 7.9 to 8.6) vs 11.3 (IQR 10.4 to 12.2); p < 0.001), longer length of stay (1 day (IQR 1 to 1) vs 2 days (IQR 2 to 3); p < 0.001), higher OARA score (median of 60.0 (IQR 40 to 75) vs 5.0 (IQR 0-35); p = 0.001), and total hip arthroplasty (p < 0.001). All patients who received a transfusion had an OARA score > 34; however, this did not reach statistical significance as a screening threshold. Conclusion Risk of blood transfusion after primary TJR was uncommon in our series, with an incidence of 1.19%. Transfusion was associated with OARA scores > 60. The OARA score, not American Society of Anesthesiologists grade, reliably identified patients at risk for postoperative blood transfusion. Selective Hb monitoring may result in substantial cost savings in the era of cost containment. Cite this article: Bone Joint J 2021;103-B(1):65–70.