bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Serum IL-6 (Interleukin 6) With Functional Outcome After Intracerebral Hemorrhage
Authors: Leasure Audrey C. , Kuohn Lindsey R. , Vanent Kevin N. , Bevers Matthew B. , Kimberly W. Taylor , Steiner Thorsten , Mayer Stephan A. , Matouk Charles C. , Sansing Lauren H. , Falcone Guido J. , Sheth Kevin N. 
Published: March 2021

Background and Objectives:
IL-6 (interleukin 6) is a proinflammatory cytokine and an established biomarker in acute brain injury. We sought to determine whether admission IL-6 levels are associated with severity and functional outcome after spontaneous intracerebral hemorrhage (ICH).

Methods:
We performed an exploratory analysis of the recombinant activated FAST trial (Factor VII for Acute ICH). Patients with admission serum IL-6 levels were included. Regression analyses were used to assess the associations between IL-6 and 90-day modified Rankin Scale. In secondary analyses, we used linear regression to evaluate the association between IL-6 and baseline ICH and perihematomal edema volumes.

Results:

Of 841 enrolled patients, we included 552 (66%) with available admission IL-6 levels (mean age 64 [SD 13], female sex 203 [37%]). IL-6 was associated with poor outcome (modified Rankin Scale, 4–6; per additional 1 ng/L, odds ratio, 1.30 [95% CI, 1.04–1.63];
P
=0.02) after adjustment for known predictors of outcome after ICH and treatment group. IL-6 was associated with ICH volume after adjustment for age, sex, and ICH location, and this association was modified by location (multivariable interaction,
P
=0.002), with a stronger association seen in lobar (β, 12.51 [95% CI, 6.47–18.55],
P
<0.001) versus nonlobar (β 5.32 [95% CI, 3.36–7.28],
P
<0.001) location. IL-6 was associated with perihematomal edema volume after adjustment for age, sex, ICH volume, and ICH location (β 1.22 [95% CI, 0.15–2.29],
P
=0.03). Treatment group was not associated with IL-6 levels or outcome.

Conclusions:
In the FAST trial population, higher admission IL-6 levels were associated with worse 90-day functional outcome and larger ICH and perihematomal edema volumes.
Comprehensive Methodology for the Evaluation of High-Resolution WRF Multiphysics Precipitation Simulations for Small, Topographically Complex Domains
Authors: Sofokleous Ioannis , Bruggeman Adriana , Michaelides Silas , Hadjinicolaou Panos , Zittis George , Camera Corrado 
Published: March 2021

ABSTRACTA stepwise evaluation method and a comprehensive scoring approach are proposed and implemented to select a model setup and physics parameterizations of the Weather Research and Forecasting (WRF) Model for high-resolution precipitation simulations. The ERA5 reanalysis data were dynamically downscaled to 1-km resolution for the topographically complex domain of the eastern Mediterranean island of Cyprus. The performance of the simulations was examined for three domain configurations, two model initialization approaches and 18 combinations of atmospheric physics parameterizations. Two continuous and two categorical scores were used for the evaluation. A new extreme event score, which combines hits and frequency bias, was introduced as a complementary evaluator of extremes. A composite scaled score was used to identify the overall best performing parameterizations. The least errors in mean daily and monthly precipitation amounts and daily extremes were found for the domain configuration with the largest extent and three nested domains. A 5-day initialization frequency did not improve precipitation, relative to 30-day continuous simulations. The parameterization type with the largest impact on precipitation was microphysics. The cumulus parameterization was also found to have an impact on the 1-km nested domain, despite that it was only activated in the coarser “parent” domains. Comparison of simulations with 12-, 4-, and 1-km resolution revealed the better skill of the model at 1 km. The impact of the various model configurations in the small-sized domain was different from the impact in larger model domains; this could be further explored for other atmospheric variables.
Acting as Change Agents: Insight Into Québec Occupational Therapists’ Current Practice: Actions menées à titre d’agents de changement : aperçu des pratiques actuelles parmi les ergothérapeutes du Québec
Authors: Carrier Annie , Éthier Alexandra , Beaudoin Michaël , Hudon Anne , Bédard Denis , Jasmin Emmanuelle , Verville France 
Published: March 2021

Background. Change agents’ actions have been studied mainly from a theoretical perspective. Purpose. This study aimed to empirically identify occupational therapists’ actual change agent actions. Method. As part of a research partnership with the Canadian Association of Occupational Therapists-Québec chapter, we conducted this cross-sectional pilot study using an online survey. Findings. The change agent practices of our 103 participants involve many types of actions but show underinvestment in mass communication. Mass communication actions are more frequent when participants have greater experience, additional academic degrees, and training in change agency. Also, occupational therapists with additional academic degrees and change agency training tend to use a wider variety of actions. Finally, our participants’ actions principally target actors in the clinical context, rarely political actors. Implications. Our results suggest that occupational therapists can and will invest in the full range of change agent actions provided they can acquire the necessary knowledge and skills.
What is Professionalism in Occupational Therapy? A Concept Analysis: Qu’est-ce que le professionnalisme en ergothérapie? Analyse de ce concept
Authors: Lecours Alexandra , Baril Nancy , Drolet Marie-Josée 
Published: March 2021

Background. Professionalism has been given different definitions over time. These are, commonly theoretical and difficult to operationalize. Purpose. This study aimed to provide an operational definition of the concept of professionalism in occupational therapy. Method. Based on a concept analysis design, a meta-narrative review was conducted to extract information from 30 occupational therapy manuscripts. Findings. Professionalism is a complex competence defined by the manifestation of distinct attitudes and behaviours that support excellence in the occupational therapy practice. In addition, professionalism is forged and evolves according to personal and environmental characteristics. The manifestation of professionalism can lead to positive consequences for occupational therapists, clients, and the discipline, notably contributing to a positive and strong professional identity. Moreover, professionalism is also subject to cultural influences, which leads to variations in its development, manifestations, and consequences. Implications. This study offers a contemporary operational definition of professionalism and levers to promote its development and maintenance.
Impact Mapping for Geospatial Reasoning and Decision Making
Authors: Illingworth David A. , Feigh Karen M. 
Published: March 2021

Objective The reported study evaluated a novel approach to aiding geospatial reasoning and decision making. Background Impact mapping aims to alleviate the cognitive demands of geospatial tasks in part by externalizing data in the form of an integrated decision surface. This is achieved by aggregating data across multiple sources of information and visualizing their combined utility rather than objective measurements or individual utility. Previous research has shown that geospatial decisions improve when aided in this manner, but it remains unknown if dynamic decision making, often plagued by fatigue and anchoring bias, would benefit similarly. Method The experiment implemented a systematic manipulation of the presence of a composite impact map and the number of attributes present in a two-stage disaster relief, resource allocation task to investigate when and how impact mapping is beneficial or deleterious to decision makers. Results The presence of the composite impact map increased the utility of selected sites, increased re-planning decisions, reduced information display views, and reduced workload. Generally, the effect of the composite impact map was greater when participants were asked to evaluate more attributes. Conclusion Composite impact maps appear to improve repeated geospatial reasoning and minimize anchoring bias because they alleviate the cognitive demands otherwise necessary to interpret and maintain information from multiple attributes. Application Data visualization techniques, such as impact mapping, can improve repeated geospatial decision making in environments that include high cognitive demand.
Dynamic multi-objective matrix control for a class of switched systems
Authors: Thamallah Ali , Sakly Anis , M’Sahli Faouzi 
Published: March 2021

This article focuses on the tracking and stabilizing issues of a class of discrete switched systems. These systems are characterized by unknown switching sequences, a non-minimum phase, and time-varying or dead modes. In particular, for those governed by an indeterminate switching signal, it is very complicated to synthesize a control law able to systematically approach general reference-tracking difficulties. Taking into account the difficulty to express the dynamic of this class of systems, the present paper presents a new Dynamic matrix control method based on the multi-objective optimization and the truncated impulse response model. The formulation of the optimization problem aims to approach the general step-tracking issues under persistent and indeterminate mode changes and to overcome the stability problem along with retaining as many desirable features of the standard dynamic matrix control (DMC) method as possible. In addition, the formulated optimization problem integrates estimator variables able to manipulate the optimization procedure in favor of the active mode with an appropriate adjustment. It also provides a progressive and smooth multi-objective control law even in the presence of problems whether in subsystems or switching sequences. Finally, simulation examples and comparison tests are conducted to illustrate the potentiality and effectiveness of the developed method.
Creatinine Assessment in Non–Steady-State Conditions: A Critical Review
Authors: Nix David E. , Erstad Brian L. 
Published: March 2021

Objectives: To discuss methods for the assessment of creatinine clearance (Clcr) when serum creatinine (SCr) is not at steady state in order to estimate kidney function and apply the estimate to kidney function staging for clinical assessment or drug dosing. Data Sources: A PubMed search was conducted from 1976 to mid-January 2021 with other articles identified through review of bibliographies of retrieved articles and citations in Scopus. Study Selection and Data Extraction: Articles assessing Clcr under non–steady-state conditions and studies evaluating predictive equations were selected. Data Synthesis: When SCr is systematically changing (ie, trending up or down), kinetic methods to estimate Clcr are appropriate. Estimates from kinetic methods should be individual based and not indexed to body surface area, and careful monitoring is required to confirm predictions as the situation evolves. Standard methods intended for steady-state conditions should not be used to estimate Clcr in patients with unstable SCr. Relevance to Patient Care and Clinical Practice: Creatinine continues to be a monitoring parameter of choice and is an important variable in all the commonly used equations for estimating Clcr and most important for estimating glomerular filtration rate. However, standard methods of estimating Clcr for medication dosing are not accurate under non–steady-state conditions. Conclusion: The methods for kinetic clearance estimation and standards methods for clearance estimation, such as the Cockcroft-Gault equation, are mutually exclusive. There are no benefits of using the kinetic method in patients with stable SCr concentrations, and standard equations are not appropriate with unstable SCr concentrations.
Exploring the Relationship Between Perceived Visual Access to Nature and Nurse Burnout
Authors: Mihandoust Sahar , Pati Debajyoti , Lee Jaehoon , Roney Jamie 
Published: March 2021

Objective: This study aims to investigate the relationship between perceived visual access to nature views in nurse work and break environments and scores for subscales of Maslach Burnout Inventory among nurses. Background: Burnout is a severe problem among nurses. Literature shows a relationship between stress and burnout and between nature exposure and stress. However, the possible consequent relationship between connection to nature and nurse burnout needs further study. Methods: This cross-sectional study explored the relationship between the subscales (Emotional Exhaustion, Depersonalization, and Personal Accomplishment [EE, DP, and PA]) of the Maslach Burnout Inventory as “outcome variables” and perception of view duration, frequency of exposure to views, view content and artwork content as “explanatory variables” in a subset regression model. The study model also included organizational stressors, environmental design factors, unit type, workload, and personal factors as control variables. Fifty-one nurses working in six units in a large tertiary care hospital participated in the study. Results: Percentage of perceived nature views and organizational stressors were the top two best predictors correlating with EE (37% of the EE variance; p < .05). Percentage of perceived nature views, organizational stressors, and environmental design were the top three predictors correlating with DP (43% of variance for DP; p < .05). No significant relationship was found between study variables and PA. Conclusions: The results of this study recommend perceiving nature views as an independent or integrated intervention to meditation and relaxation techniques. From a design standpoint, this study suggests that a unit and breakroom design with access to nature views could work as a consistent preventive intervention for burnout.
Sensitivity and specificity of neuroimaging signs in patients with idiopathic intracranial hypertension
Authors: Prabhat Nandita , Chandel Shivani , Takkar Dr Aastha , Ahuja Chirag , Singh Ramandeep , Kathirvel Soundappan , Lal Vivek 
Published: March 2021

Background The primary role of neuroimaging in idiopathic intracranial hypertension (IIH) is to exclude secondary causes of raised intracranial pressure. Recently, a few imaging markers have been described which may suggest diagnosis of IIH in atypical cases. We carried out this study to assess the prevalence and accuracy of these neuroimaging signs in predicting the diagnosis of IIH. Methods Eighty treatment-naive patients with IIH and 30 controls were recruited as per a predefined criterion. Magnetic resonance imaging (MRI) brain with detailed sella imaging was done in all patients. Results The most common abnormality noted was optic nerve tortuosity in 82.5% of patients, followed by posterior scleral flattening in 80%, perioptic subarachnoid space (SAS) dilatation in 73.8% and partial empty sella in 68.8% of patients. The presence of optic nerve tortuosity was the most sensitive sign on neuroimaging, though the highest specificity was seen for posterior scleral flattening and perioptic SAS dilatation. The presence of more than three neuroimaging features correlated with severity of vision loss. Conclusion In suggestive clinical scenarios, posterior scleral flattening, perioptic SAS dilatation and optic nerve tortuosity are highly sensitive and specific signs in IIH. This study also highlights the utility of MRI as a valuable tool for prognosis of visual outcome in patients with IIH.
Life from the fragments: Ambivalence, critique, and minoritarian affect
Authors: Wilkinson Eleanor , Lim Jason 
Published: March 2021

In this commentary, we respond to Ruez and Cockayne’s ‘Feeling Otherwise’ and consider what is at stake in debates concerning the moods and modes of critique. There is a tendency in geographical work on affect to privilege affirmation, yet a key question remains as to who benefits from such moods of critique and the kinds of analysis that they afford. We argue that dominant theorisations of affirmation and negativity often elide uncomfortable discussions of power, domination, and violence. We offer a reading of the relations between affirmation and negativity through ‘minoritarian affects’ – a reading that arises in the midst of living through racial capitalism, coloniality, patriarchy, and heteronormativity and which builds an indeterminate future from the fragments of our lives and bodies.
Lessons Learned From the First Pilot Study of the Compensatory Reserve Index After Congenital Heart Surgery Requiring Cardiopulmonary Bypass
Authors: Ehrmann Daniel E. , Leopold David K. , Campbell Kristen , Silveira Lori , Gist Katja M. , Phillips Ryan , Shahi Niti , Moulton Steven L. , Kim John S. 
Published: March 2021

Background: Early warning systems that utilize dense physiologic data and machine learning may aid prediction of decompensation after congenital heart surgery (CHS). The Compensatory Reserve Index (CRI) analyzes changing features of the pulse waveform to predict hemodynamic decompensation in adults, but it has never been studied after CHS. This study sought to understand the feasibility, safety, and potential utility of CRI monitoring after CHS with cardiopulmonary bypass (CPB). Methods: A single-center prospective pilot cohort of patients undergoing pulmonary valve replacement was studied. Compensatory Reserve Index was continuously measured from preoperative baseline through the first 24 postoperative hours. Average CRI values during selected procedural phases were compared between patients with an intensive care unit (ICU) length of stay (LOS) <3 days versus LOS ≥3 days. Results: Twenty-three patients were enrolled. On average, 17,445 (±3,152) CRI data points were collected and 0.33% (±0.40) of data were missing per patient. There were no adverse events related to monitoring. Five (21.7%) patients had an ICU LOS ≥3 days. Compared to the ICU LOS <3 days group, the ICU LOS ≥3 days group had a greater decrease in CRI from baseline to immediately after CPB (−0.3 ± 0.1 vs −0.1 ± 0.2, P = .003) and were less likely to recover to baseline CRI during the monitoring period (20% vs 83%, P = .017). Conclusions: Compensatory Reserve Index monitoring after CHS with CPB seems feasible and safe. Early changes in CRI may precede meaningful clinical outcomes, but this requires further study.
Decreased Quality of Life in Children With Anomalous Aortic Origin of a Coronary Artery
Authors: Agrawal Hitesh , Mery Carlos M. , Sami Sarah A. , Qureshi Athar M. , Noel Cory V. , Cutitta Katherine , Masand Prakash , Tejtel S. Kristen Sexson , Wang Yunfei , Molossi Silvana 
Published: March 2021

Background: Anomalous aortic origin of a coronary artery (AAOCA) is associated with sudden death in the young. We sought to determine quality of life (QOL) in patients/families affected by AAOCA. Methods: Patients with AAOCA (8-18 years) were prospectively included from January 2016 to May 2017. Parent proxy and patient Pediatric Cardiac Quality of Life Inventory (PCQLI) were used to evaluate QOL and Pediatric Quality of Life Inventory (PedsQL) Family Impact Module to assess the impact of AAOCA on families, as primary outcomes. Secondary outcomes included peer relationship, anxiety, and depression assessed using patient-reported outcomes measurement information system. Patients deemed high-risk were offered surgery/exercise restriction. Generalized linear mixed regression models were used to determine significant predictors of outcomes. Results: Fifty-three patients, the majority (n = 31, 59%) unrepaired, and 49 caregivers were included. Using PCQLI, patient and parent proxy QOL scores were similar to published scores for children with long-QT syndrome. Patients’ QOL score was associated with exertional symptoms, perceived chronic disease, and altered parent’s concentration ability. Likewise, parent proxy QOL scores were associated with mother’s living situation, exertional symptoms, parent missing work for ≥1 day, and disturbed parental functioning at work. Family impact scores were associated with lower maternal education, among other measures. Risk categories or surgical status did not impact patient, parent proxy reported, or family impact QOL. Conclusion: Anomalous aortic origin of a coronary artery is associated with decreased QOL as perceived by patients and caregiver and is associated with numerous facets of family functioning. These findings are independent of risk categorization or surgical status.
Interference Screw Versus Suture Anchors for Femoral Fixation in Medial Patellofemoral Ligament Reconstruction: A Biomechanical Study
Authors: Gould Heath P. , Delaney Nicholas R. , Parks Brent G. , Melvani Roshan T. , Hinton Richard Y. 
Published: March 2021

Background: Femoral-sided graft fixation in medial patellofemoral ligament (MPFL) reconstruction is commonly performed using an interference screw (IS). However, the IS method is associated with several clinical disadvantages that may be ameliorated by the use of suture anchors (SAs) for femoral fixation. Purpose: To compare the load to failure and stiffness of SAs versus an IS for the femoral fixation of a semitendinosus autograft in MPFL reconstruction. Study Design: Controlled laboratory study. Methods: Based on a priori power analysis, a total of 6 matched pairs of cadaveric knees were included. Specimens in each pair were randomly assigned to receive either SA or IS fixation. After an appropriate reconstruction procedure, the looped end of the MPFL graft was pulled laterally at a rate of 6 mm/s until construct failure. The best-fit slope of the load-displacement curve was then used to calculate the stiffness (N/mm) in a post hoc fashion. A paired t test was used to compare the mean load to failure and the mean stiffness between groups. Results: No significant difference in load to failure was observed between the IS and the SA fixation groups (294.0 ± 61.1 vs 250.0 ± 55.9; P = .352), although the mean stiffness was significantly higher in IS specimens (34.5 ± 9.6 vs 14.7 ± 1.2; P = .004). All IS reconstructions failed by graft pullout from the femoral tunnel, whereas 5 of the 6 SA reconstructions failed by anchor pullout. Conclusion: In this biomechanical study using a cadaveric model of MPFL reconstruction, SA femoral fixation was not significantly different from IS fixation in terms of load to failure. The mean load-to-failure values for both reconstruction techniques were greater than the literature-reported values for the native MPFL. Clinical Relevance: These results suggest that SAs are a biomechanically viable alternative for femoral-sided graft fixation in MPFL reconstruction.