bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher clinical acuity and 7-day hospital mortality in non-COVID-19 acute medical admissions: prospective observational study
Authors: Lyall Marcus J , Lone Nazir I 
Published: March 2021

ObjectivesTo understand the effect of COVID-19 lockdown measures on severity of illness and mortality in non-COVID-19 acute medical admissions.DesignA prospective observational study.Setting3 large acute medical receiving units in NHS Lothian, Scotland.ParticipantsNon-COVID-19 acute admissions (n=1682) were examined over the first 31 days after the implementation of the COVID-19 lockdown policy in the UK on 23 March 2019. Patients admitted over a matched interval in the previous 5 years were used as a comparator cohort (n=14 954).Main outcome measuresPatient demography, biochemical markers of clinical acuity and 7-day hospital inpatient mortality.ResultsNon-COVID-19 acute medical admissions reduced by 44.9% across all three sites in comparison with the mean of the preceding 5 years (p<0.001). Patients arriving during this period were more likely to be male, of younger age and to arrive by emergency ambulance transport. Non-COVID-19 admissions during lockdown had a greater incidence of acute kidney injury, lactic acidaemia and an increased risk of hospital death within 7 days (4.2% vs 2.5%), which persisted after adjustment for confounders (OR 1.87, 95% CI 1.43 to 2.41, p<0.001).ConclusionsThese data demonstrate a significant reduction in non-COVID-19 acute medical admissions during the early weeks of lockdown. Patients admitted during this period were of higher clinical acuity with a higher incidence of early inpatient mortality.
Relativistic corrections to the rotation curves of disk galaxies
Authors: Deur Alexandre 
Published: March 2021

AbstractWe present a method to investigate relativistic effects arising from large masses. The method is non-perturbative and employs a mean-field approximation and gravitational lensing. Using this method and a basic model of disk galaxy, we find that relativistic corrections to the rotation curves of disk galaxies are significant at large galactic radii. The model predicts a strong correlation between the inferred galactic dark mass and the galactic disk thickness, which we verified using two separate sets of observational data.
Refactoring Cost Estimation for Architectural Technical Debt
Authors: Deeb Samir , BenIdris Mrwan , Ammar Hany , Dzielski Dale 
Published: March 2021

Paying-off the Architectural Technical Debt by refactoring the flawed code is important to control the debt and to keep it as low as possible. Project Managers tend to delay paying off this debt because they face difficulties in comparing the cost of the refactoring against the benefits gained. These managers need to estimate the cost and the efforts required to conduct these refactoring activities as well as to decide which flaws have higher priority to be refactored. Our research is based on a dataset used by other researchers that study the technical debt. It includes more than 18,000 refactoring operations performed on 33 apache java projects. We applied the COCOMO II:2000 model to calculate the refactoring cost in person-months units per release. Furthermore, we investigated the correlation between the refactoring efforts and two static code metrics of the refactored code. The research revealed a weak correlation between the refactoring efforts and the size of the project, and a moderate correlation with the code complexity. Finally, we applied the DesigniteJava tool to verify our research results. From the analysis we found a significant correlation between the ranking of the architecture smells and the ranking of refactoring efforts for each package. Using machine learning practices, we took the architecture smells level and the code metrics of each release as an input to predict the levels of the refactoring effort of the next release. We calculated the results using our model and found that we can predict the ‘High’ and ‘Very High’ levels, the most significant levels from managers’ perspective, with [Formula: see text] accuracy.
A Values-Based Explanation of the Resilience of Family Firms: Evidence from Tunisia After the 2011 Jasmine Revolution
Authors: Hammouda Amira , Basly Sami 
Published: March 2021

While the goals of long term sustainability and survival were thoroughly studied in family firms’ literature, to the best of our knowledge, rare studies had investigated the influence of values on the capacity of family firms to be resilient. In addition, this likely relationship is highly contingent on cultural and national contexts, as family values – on which family business values are dependent – are not the same across countries and World regions. These theoretical and empirical gaps motivated the present research which aims at investigating the probable influence of family firms’ values on the resilience of these firms in the unique context of Tunisia. This qualitative research is based on a body of discourse collected from nine managers belonging to five Tunisian family businesses. Our research allowed us to highlight some key family business values in a new underexplored setting that is an oriental country with a culture driven by Islamic and Arab values. More importantly, our analysis shows that family values underlie both community and business values. Finally, our results underscore the importance of business values, community values and family values in the resilience of the firms studied.
Shared Neural Circuits for Visuospatial Working Memory and Arithmetic in Children and Adults
Authors: Matejko Anna A. , Ansari Daniel 
Published: March 2021

AbstractVisuospatial working memory (VSWM) plays an important role in arithmetic problem solving, and the relationship between these two skills is thought to change over development. Even though neuroimaging studies have demonstrated that VSWM and arithmetic both recruit frontoparietal networks, inferences about common neural substrates have largely been made by comparisons across studies. Little work has examined how brain activation for VSWM and arithmetic converge within the same participants and whether there are age-related changes in the overlap of these neural networks. In this study, we examined how brain activity for VSWM and arithmetic overlap in 38 children and 26 adults. Although both children and adults recruited the intraparietal sulcus (IPS) for VSWM and arithmetic, children showed more focal activation within the right IPS, whereas adults recruited the bilateral IPS, superior frontal sulcus/middle frontal gyrus, and right insula. A comparison of the two groups revealed that adults recruited a more left-lateralized network of frontoparietal regions for VSWM and arithmetic compared with children. Together, these findings suggest possible neurocognitive mechanisms underlying the strong relationship between VSWM and arithmetic and provide evidence that the association between VSWM and arithmetic networks changes with age.
Retrosplenial Cortical Connectivity with Frontal Basal Ganglia Networks
Authors: Monko Megan E. , Heilbronner Sarah R. 
Published: March 2021

Abstract
Previous studies of the retrosplenial cortex (RSC) have focused on its role in navigation and memory, consistent with its well-established medial temporal connections, but recent evidence also suggests a role for this region in reward and decision making. Because function is determined largely by anatomical connections, and to better understand the anatomy of RSC, we used tract-tracing methods to examine the anatomical connectivity between the rat RSC and frontostriatal networks (canonical reward and decision-making circuits). We find that, among frontal cortical regions, RSC bidirectionally connects most strongly with the anterior cingulate cortex, but also with an area of the central–medial orbito-frontal cortex. RSC projects to the dorsomedial striatum, and its terminal fields are virtually encompassed by the frontal-striatal projection zone, suggestive of functional convergence through the basal ganglia. This overlap is driven by anterior cingulate cortex, prelimbic cortex, and orbito-frontal cortex, all of which contribute to goal-directed decision making, suggesting that the RSC is involved in similar processes.
The Neural Codes Underlying Internally Generated Representations in Visual Working Memory
Authors: Yu Qing , Postle Bradley R. 
Published: March 2021

AbstractHumans can construct rich subjective experience even when no information is available in the external world. Here, we investigated the neural representation of purely internally generated stimulus-like information during visual working memory. Participants performed delayed recall of oriented gratings embedded in noise with varying contrast during fMRI scanning. Their trialwise behavioral responses provided an estimate of their mental representation of the to-be-reported orientation. We used multivariate inverted encoding models to reconstruct the neural representations of orientation in reference to the response. We found that response orientation could be successfully reconstructed from activity in early visual cortex, even on 0% contrast trials when no orientation information was actually presented, suggesting the existence of a purely internally generated neural code in early visual cortex. In addition, cross-generalization and multidimensional scaling analyses demonstrated that information derived from internal sources was represented differently from typical working memory representations, which receive influences from both external and internal sources. Similar results were also observed in intraparietal sulcus, with slightly different cross-generalization patterns. These results suggest a potential mechanism for how externally driven and internally generated information is maintained in working memory.
Wood anatomy, fire wounds and dendrochronological potential of Prosopis pugionata Burkart (Fabaceae) in arid Argentine Chaco
Authors: Bravo Sandra , Bogino Stella , Leiva Marta , Lepiscopo Martín , Cendoya María Alicia , Kunst Carlos , Biurrun Fernando 
Published: March 2021

Abstract
Prosopis pugionata (Fabaceae) is a halophyte tree species that grows exclusively in Argentina’s arid environments, whose woodlands are mainly affected by fires and overgrazing. Here, we describe the wood anatomy and fire wounds of P. pugionata and their relationship with plant size and bark thickness. Besides, we attempt to determine the potential of P. pugionata for dendrochronological studies in order to date fire events throughout time. We tested the hypothesis that P. pugionataforms datable fire wounds, allowing its use for dendrochronological studies. The study area is located in the arid Argentine Chaco region. Seventeen individuals, varying from 15 to 65 years of age, were randomly sampled and bole disks were taken at 0.3, 1.3 and 2.3 m high. P. pugionatais a diffuse and semi-ring-porous hardwood species with growth rings delimited by marginal parenchyma bands. The bark is longitudinally fissured, with an average thickness of 0.19 cm, and a scarce increase with age. Seventy-seven percent of the samples showed fire wounds (). We identified fire scars (70%) and marks (30%), and differentiated them by wood growth interruption in the former. Sixty-one percent of fire wounds affected less than 20% of the cambial perimeter and there were no significant effects of age, bole diameter, bole height and bark thickness on the cambial damage percentage. After cross-dating, P. pugionata showed a mean correlation value between series of 0.5, which represents an accurate potential for dendrochronological studies. Twenty wildfires were dated from 1943 to 2007 in the study area with a fire frequency of 0.40 fires/year and a mean fire interval of 2.5 years. Wildfires frequency increased from 1980 to 0.48 fires/year and a mean fire interval of 2 years. Our results indicate that P. pugionata has the potential to date fires, considering its potential for dendrochronological studies, its ability to survive recurrent fires and forms identifiable wound scars in the wood.
Diurnal Cycle of Coastal Convection in the South China Sea Region and Modulation by the BSISO
Authors: Xu Weixin , Rutledge Steven A. , Chudler Kyle 
Published: March 2021

AbstractUsing 17-yr spaceborne precipitation radar measurements, this study investigates how diurnal cycles of rainfall and convective characteristics over the South China Sea region are modulated by the boreal summer intraseasonal oscillation (BSISO). Generally, diurnal cycles change significantly between suppressed and active BSISO periods. Over the Philippines and Indochina, where the low-level monsoon flows impinge on coast lines, diurnal cycles of rainfall and many convective properties are enhanced during suppressed periods. During active periods, diurnal variation of convection is still significant over land but diminishes over water. Also, afternoon peaks of rainfall and MCS populations over land are obviously extended in active periods, mainly through the enhancement of stratiform precipitation. Over Borneo, where the prevailing low-level winds are parallel to coasts, diurnal cycles (both onshore and offshore) are actually stronger during active periods. Radar profiles also demonstrate a pronounced nocturnal offshore propagation of deep convection over western Borneo in active periods. During suppressed periods, coastal afternoon convection over Borneo is reduced, and peak convection occurs over the mountains until the convective suppression is overcome in the late afternoon or evening. A major portion (>70%) of the total precipitation over the Philippines and Indochina during suppressed periods falls from afternoon isolated to medium-sized systems (<10 000 km2), but more than 70% of the active BSISO rainfall is contributed by nocturnal (after 1800 LT) broad precipitation systems (>10 000 km2). However, offshore total precipitation is dominated by large precipitation systems (>10 000 km2) regardless of BSISO phases and regions.
Arctic Cyclone Activity and the Beaufort High
Authors: Kenigson Jessica S. , Timmermans M.-L. 
Published: March 2021

AbstractThe Beaufort high (BH) and its accompanying anticyclonic winds drive the Arctic Ocean’s Beaufort Gyre, the major freshwater reservoir of the Arctic Ocean. The Beaufort Gyre circulation and its capacity to accumulate or release freshwater rely on the BH intensity. The migration of Nordic seas cyclones into the Arctic has been hypothesized to moderate the strength of the BH. We explore this hypothesis by analyzing reanalysis sea level pressure fields to characterize the BH and identify and track cyclones north of 60°N during 1948–2019. A cluster analysis of Nordic seas cyclone trajectories reveals a western pathway (through the Arctic interior) associated with a relatively weak BH and an eastern pathway (along the Arctic periphery) associated with a relatively strong BH. Furthermore, we construct cyclone activity indices (CAIs) in the Arctic and Nordic seas that take into account multiple cyclone parameters (number, strength, and duration). There are significant correlations between the BH and the CAIs in the Arctic and Nordic seas during 1948–2019, with anomalously strong cyclone activity related to an anomalously weak BH, and vice versa. We show how the Arctic and Nordic seas CAIs experienced a regime shift toward increased cyclone activity between the first four decades analyzed (1948–88) and the most recent three decades (1989–2019). Over the same two time periods, the BH exhibits a weakening. Increased cyclone activity and an accompanying weakening of the BH may be consistent with expectations in a warming Arctic and have implications for Beaufort Gyre dynamics and freshwater.
Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: A Randomized Controlled Trial
Authors: Martin Scott D. , Abraham Paul F. , Varady Nathan H. , Nazal Mark R. , Conaway William , Quinlan Noah J. , Alpaugh Kyle 
Published: March 2021

Background: Previous observational studies have suggested poor results of arthroscopic surgery for the treatment of acetabular labral tears in patients older than 40 years. Purpose: To compare hip arthroscopy versus nonoperative management for symptomatic labral tears in patients older than 40 years who have limited radiographic osteoarthritis. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In this single-surgeon, parallel randomized controlled trial, patients older than 40 years who had symptomatic, MRI-confirmed labral tears and limited radiographic osteoarthritis (Tönnis grades 0-2) were randomized 1:1 to arthroscopic surgery with postoperative physical therapy (SPT) or physical therapy alone (PTA) using an electronic randomization program. PTA patients who achieved unsatisfactory improvement were permitted to cross over to SPT after completing ≥14 weeks of physical therapy. The primary outcomes were International Hip Outcome Tool (iHOT-33) and modified Harris Hip Score (mHHS) at 12 months after randomization, and secondary outcomes included other patient-reported outcome measures and the visual analog scale. Outcomes were assessed at baseline and at 3, 6, and 12 months after randomization. Primary analysis was performed on an intention-to-treat basis using linear mixed-effect models. Sensitivity analyses included modified as-treated analysis and treatment-failure analysis. Due to infeasibility, patients and health care providers were both unblinded. Results: The study enrolled 90 patients (46 [51.1%] SPT; 44 [48.9%] PTA); of these, 81 patients (42 [51.9%] SPT; 39 (48.1%) PTA) completed 12-month follow-up. A total of 28 of the 44 PTA patients crossed over to SPT within the study period (63.6% crossover). Intention-to-treat analysis revealed significantly greater iHOT-33 scores (+12.11; P = .007) and mHHS scores (+6.99 points; P = .04) in the SPT group than the PTA group at 12 months. Modified as-treated analysis revealed that these differences exceeded the minimal clinically important difference of 10.0 points (SPT-PTA iHOT-33, +11.95) and 8.0 points (SPT-PTA mHHS, +9.76), respectively. Conclusion: In patients older than 40 years with limited osteoarthritis, arthroscopic acetabular labral repair with postoperative physical therapy led to better outcomes than physical therapy alone. Thus, age over 40 years should not be considered a contraindication to arthroscopic acetabular labral repair. Registration: NCT03909178 (ClinicalTrials.gov identifier)
Effect of Early Residual Laxity After Anterior Cruciate Ligament Reconstruction on Long-term Laxity, Graft Failure, Return to Sports, and Subjective Outcome at 25 Years
Authors: Lindanger Line , Strand Torbjørn , Mølster Anders Odd , Solheim Eirik , Inderhaug Eivind 
Published: March 2021

Background: In spite of supposedly successful surgery, slight residual knee laxity may be found at follow-up evaluations after anterior cruciate ligament reconstruction (ACLR), and its clinical effect is undetermined. Purpose: To investigate whether a 3- to 5-mm increase in anterior translation 6 months after ACLR affects the risk of graft failure, rate of return to sports, and long-term outcome. Study Design: Cohort study; Level of evidence, 2. Methods: From a cohort of 234 soccer, team handball, and basketball players undergoing ACLR using bone–patellar tendon–bone graft, 151 athletes were included who attended 6-month follow-up that included KT-1000 arthrometer measures. A tight graft was defined as <3-mm side-to-side difference between knees (n = 129), a slightly loose graft as 3 to 5 mm (n = 20), and a loose graft as >5 mm (n = 2). Graft failure was defined as ACL revision surgery, >5-mm side-to-side difference, or anterolateral rotational instability 2+ or 3+ at 2-year follow-up. Finally, a 25-year evaluation was performed, including a clinical examination and questionnaires. Results: The rate of return to pivoting sports was 74% among athletes with tight grafts and 70% among those with slightly loose grafts. Also, return to preinjury level of sports was similar between those with slightly loose and tight grafts (40% vs 48%, respectively), but median duration of the sports career was longer among patients with tight grafts: 6 years (range, 1-25 years) vs 2 years (range, 1-15 years) ( P = .01). Five slightly loose grafts (28%) and 6 tight grafts (5%) were classified as failures after 2 years ( P = .002). Thirty percent (n = 6) of patients with slightly loose grafts and 6% (n = 8) with tight grafts had undergone revision ( P = .004) by follow-up (25 years, range, 22-30 years). Anterior translation was still increased among the slightly loose grafts as compared with tight grafts at long-term follow-up ( P < .05). In patients with tight grafts, 94% had a Lysholm score ≥84 after 24 months and 58% after 25 years, as opposed to 78% ( P = .02) and 33% ( P = .048), respectively, among patients with slightly loose grafts. Conclusion: A slightly loose graft at 6 months after ACLR increased the risk of later ACL revision surgery and/or graft failure, reduced the length of the athlete’s sports career, caused permanent increased anterior laxity, and led to an inferior Lysholm score.
Creating a Competency-Based Medical Education Curriculum for Canadian Diagnostic Radiology Residency (Queen’s Fundamental Innovations in Residency Education)-Part 2: Core of Discipline Stage
Authors: Mishra Siddharth , Chung Andrew , Rogoza Christina , Islam Omar , Mussari Benedetto , Wang Xi , Dagnone Damon , Cofie Nicholas , Dalgarno Nancy , Kwan Benjamin Y. M. 
Published: March 2021

Purpose: All postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) model divided into 4 stages of training. Queen’s University has been the first Canadian institution to mandate transitioning to CBME across all residency programs, including Diagnostic Radiology. This study describes the implementation of CBME with a focus on the third developmental stage, Core of Discipline, in the Diagnostic Radiology residency program at Queen’s University. We describe strategies applied and challenges encountered during the adoption and implementation process in order to inform the development of other CBME residency programs in Diagnostic Radiology. Methods: At Queen’s University, the Core of Discipline stage was developed using the Royal College of Physicians and Surgeons of Canada’s (RCPSC) competence continuum guidelines and the CanMEDS framework to create radiology-specific entrustable professional activities (EPAs) and milestones for assessment. New committees, administrative positions, and assessment strategies were created to develop these assessment guidelines. Currently, 2 cohorts of residents (n = 6) are enrolled in the Core of Discipline stage. Results: EPAs, milestones, and methods of evaluation for the Core of Discipline stage are described. Opportunities during implementation included tracking progress toward educational objectives and increased mentorship. Challenges included difficulty meeting procedural volume requirements, inconsistent procedural tracking, improving feedback mechanisms, and administrative burden. Conclusion: The transition to a competency-based curriculum in an academic Diagnostic Radiology residency program is significantly resource and time intensive. This report describes challenges faced in developing the Core of Discipline stage and potential solutions to facilitate this process.