bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex Differences in Rupture Risk and Mortality in Untreated Patients With Intact Abdominal Aortic Aneurysms
Authors: Talvitie Mareia , Stenman Malin , Roy Joy , Leander Karin , Hultgren Rebecka 
Published: February 2021

Background
Studies on intact abdominal aortic aneurysms mainly focus on treated patients, and data on untreated patients are sparse. The objective was to investigate sex differences among untreated patients regarding rupture and mortality rates and to determine predictors for these events. Sex‐specific causes of death were evaluated.

Methods and Results

All patients ≥40 years diagnosed from 2001 to 2015 (n=32 393) with intact abdominal aortic aneurysms were identified in national registries; 60% (n=19 569) were untreated. Comorbid loads, crude rupture, and mortality rates were assessed. Predictors of 5‐year rupture and mortality were analyzed in Cox models (sex, age, comorbidities, income, and marital status). The proportion of men and women with multiple comorbidities was similar. Within 5 years, 798 ruptures occurred (9.7% women versus 6.9% men,
P
<0.001). Ruptures were independently predicted by female sex (hazard ratio [HR], 1.23; 95% CI, 1.07–1.42;
P
=0.004), chronic obstructive pulmonary disease (HR, 1.36; 95% CI, 1.15–1.62;
P
<0.001), age (HR, 11.49; 95% CI, 5.68–23.25 for ≥80 years;
P
<0.001), and income (HR, 0.63; 95% CI, 0.53–0.75 for highest tertile;
P
<0.001). After 5 years, 56.5% women and 50.4% men were deceased. Mortality was not independently predicted by female sex. Rupture was the third most common cause of death (11.9% women versus 8.7% men;
P
<0.001). The median time‐to‐events was 2.8 years.

Conclusions
A considerable proportion of patients with intact abdominal aortic aneurysms in surveillance remain untreated. Despite surveillance algorithms, the healthcare system fails to prevent a high number of ruptures, especially among women. The time‐to‐event data highlight the urgency to develop more individualized surveillance.
The Practitioner’s Perspective: R2P at 15
Authors: Pawnday Savita , Streitfeld-Hall Jaclyn 
Published: February 2021

Abstract
In this contribution the authors reflect on the Forum topic ‘R2P 15 Years after the World Summit: Progress, Problems and Prospects’ and provide their perspective as advocates on the normative and practical progress made towards implementation of R2P. They discuss how R2P has created a greater consciousness regarding atrocity crimes within multilateral decision-making, the challenges inherent in cultivating norm champions, and how to transform R2P from a boutique foreign policy initiative into a domestic policy imperative.
Europe’s Progress and the Road Ahead at R2P’s 15th Anniversary
Authors: Stefan Cristina G. , Newman Edward 
Published: February 2021

Abstract
This contribution examines the European Union’s engagement with the R2P framework and showcases various examples of progress in support of R2P from the past 15 years. It also illustrates some lingering ambivalence within the EU towards the principle and the divisions which exist across the EU membership regarding some aspects of the R2P agenda, and in particular the role of military force in pursuit of human protection. With the EU currently facing a range of internal and global challenges, its ability to improve policy coherence across the broad range of programmes and activities in support of the R2P agenda, and its ability to shape norms internationally, remain uncertain.
Differentiated Government Control for Conformity: Government-NGO Relations in China
Authors: Wang Qun 
Published: February 2021

Abstract
This study examines differentiated government control over foundations in China. The distinct patterns of “Harmonious Society” and “obeying the law” in foundation mission statements indicate a two-dimensional control mechanism in which the government intends to seek functional conformity and behavioral conformity from foundations. Using the multinomial logistic regression method on the mission statement of 2,498 foundations from 2004 to 2013, this article finds that foundations’ funding-sufficiency leads to the government’s strong intention for functional conformity and weak intention for behavioral conformity. The article implies that the Chinese government has eased some institutional constraints on foundations for the purpose of seeking financial contributions from foundations. It suggests that the Chinese government can adapt to the socioeconomic conditions and calculate its relations with nongovernmental organizations.
The Public’s Supportive Attitude towards the Social Inclusion of Children with Special Needs: Theory and Experience
Authors: Song Chengcheng , Zhang Chao 
Published: February 2021

Abstract
Using hierarchical linear models, this article examines how factors at individual and policy levels influence public attitudes towards the social inclusion of children with special needs based on data collected from 1,602 samples and second-hand data in five cities. It is found that individual and policy factors have varying impacts on relationship support, social support, and public support for the social inclusion of children with special needs: (1) individuals who once gave help to children with special needs express strong support; (2) government policies may have a crowding out effect, that is, greater intensity of child policies may lower public support for the social inclusion of children with special needs; (3) different policies may interfere with each other, that is, child policies and disability policies may have the opposite effects on people’s attitudes towards public support for the social inclusion of children with special needs.
The Mystery of Cicada 3301: Constructing Gnosis in Cyberspace
Authors: Andjelkovic Filip 
Published: February 2021

Abstract
This article examines the ways in which gnostic ideas of spiritual growth, enlightenment, and transcendence resonate with the “cyber-gnostic” ideology presented through the viral “Cicada 3301” internet mystery. The content of the mystery situates traditionally spiritual enlightenment in the libertarian concerns of freedom of information and privacy, and in the tiered cosmology of the “surface/deep/dark” web. Additionally, this article evaluates the potential for classifying the Cicada 3301 mystery and its surrounding community as an online form of religious expression. Ultimately, it is argued that the mystery offers an insight into how philosophical notions of identity and communication interface with spiritual notions of enlightenment and transcendence through the experience of cybertechnology.
Convective-Storm Environments in Subtropical South America from High-Frequency Soundings during RELAMPAGO-CACTI
Authors: Schumacher Russ S. , Hence Deanna A. , Nesbitt Stephen W. , Trapp Robert J. , Kosiba Karen A. , Wurman Joshua , Salio Paola , Rugna Martin , Varble Adam C. , Kelly Nathan R. 
Published: February 2021

AbstractDuring the Remote Sensing of Electrification, Lightning, and Mesoscale/Microscale Processes with Adaptive Ground Observations-Cloud, Aerosol, and Complex Terrain Interactions (RELAMPAGO-CACTI) field experiments in 2018–19, an unprecedented number of balloon-borne soundings were collected in Argentina. Radiosondes were launched from both fixed and mobile platforms, yielding 2712 soundings during the period 15 October 2018–30 April 2019. Approximately 20% of these soundings were collected by highly mobile platforms, strategically positioned for each intensive observing period, and launching approximately once per hour. The combination of fixed and mobile soundings capture both the overall conditions characterizing the RELAMPAGO-CACTI campaign, as well as the detailed evolution of environments supporting the initiation and upscale growth of deep convective storms, including some that produced hazardous hail and heavy rainfall. Episodes of frequent convection were characterized by sufficient quantities of moisture and instability for deep convection, along with deep-layer vertical wind shear supportive of organized or rotating storms. A total of 11 soundings showed most unstable convective available potential energy (MUCAPE) exceeding 6000 J kg−1, comparable to the extreme instability observed in other parts of the world with intense deep convection. Parameters used to diagnose severe-storm potential showed that conditions were often favorable for supercells and severe hail, but not for tornadoes, primarily because of insufficient low-level wind shear. High-frequency soundings also revealed the structure and evolution of the boundary layer leading up to convection initiation, convectively generated cold pools, the South American low-level jet (SALLJ), and elevated nocturnal convection. This sounding dataset will enable improved understanding and prediction of convective storms and their surroundings in subtropical South America, as well as comparisons with other heavily studied regions such as the central United States that have not previously been possible.
Accounting for Geographic Basis Risk in Heat Index Insurance: How Spatial Interpolation Can Reduce the Cost of Risk
Authors: Leppert Daniel , Dalhaus Tobias , Lagerkvist Carl-Johan 
Published: February 2021

AbstractExtreme heat events cause periodic damage to crop yields and may pose a threat to the income of farmers. Weather index insurance provides payouts to farmers in the case of measurable weather extremes to keep production going. However, its viability depends crucially on the accuracy of local weather indices to predict yield damages from adverse weather conditions. So far, extreme heat indices are poorly represented in weather index insurance. In this study, we construct indices of extreme heat using observations at the nearest weather station and estimates for each county using three interpolation techniques: inverse-distance weighting, ordinary kriging, and regression kriging. Applying these indices to insurance against heat damage to corn in Illinois and Iowa, we show that heat index insurance reduces relative risk premiums by 27%–29% and that interpolated indices outperform the nearest-neighbor index by around 2%–3% in terms of relative risk reduction. Further, we find that the advantage of interpolation over a nearest-neighbor index in terms of relative risk reduction increases as the sample of weather stations is reduced. These findings suggest that heat index insurance can work even when weather data are spatially sparse, which delivers important implications for insurance practice and policy makers. Further, our public code repository provides a rich toolbox of methods to be used for other perils, crops, and regions. Our results are therefore not only replicable but also constitute a cornerstone for projects to come.
Gastrointestinal stromal tumors: relationship between preoperative CT features and pathologic risk stratification
Authors: Grazzini Giulia , Guerri Sara , Cozzi Diletta , Danti Ginevra , Gasperoni Silvia , Pradella Silvia , Miele Vittorio 
Published: February 2021

Objective: To investigate a relationship between contrast-enhanced computed tomography (CECT) features of gastrointestinal stromal tumors (GISTs) and risk of relapse according to Miettinen stratified risk classifications. Methods: After ethical committee approval, a retrospective analysis was conducted on the preoperative CECT of patients with pathologically proven GIST undergoing surgery between June 2009 and December 2019. Chi-square analysis was used to evaluate the correlation between Miettinen stratified risk categories and the following imaging features: tumor size and location, growth pattern, margins, type and degree of contrast enhancement, presence of calcifications, necrosis, signs of ulceration/fistulation, internal hemorrhagic foci, enlarged feeding or draining vessels (EFDV), ascites, peritoneal implants, lymphadenopathy, or metastasis. Results: A total of 54 patients (mean age 65 ± 11, 29 men) were included in the study with a total of 56 GISTs. Necrosis, ulceration/fistulation, hemorrhage, margins, enlarged vessels, type of contrast enhancement, and metastasis turned out to be associated with Miettinen risk categories ( p < 0.005). Logistic regression analysis identified the presence of necrosis and EFDV as predictors of pathologic risk of relapse (overall accuracy of 89.3%). Conclusion: Preoperative CECT may be helpful in predicting pathologic risk categories of GISTs, as determined by the Miettinen classification system.
A Framework for Revisiting Brain Death: Evaluating Awareness and Attitudes Toward the Neuroscientific and Ethical Debate Around the American Academy of Neurology Brain Death Criteria
Authors: Chatterjee Krishanu , Rady Mohamed Y. , Verheijde Joseph L. , Butterfield Richard J. 
Published: February 2021

Background: There remains a lack of awareness around the American Academy of Neurology (AAN) procedural criteria for brain death and the surrounding controversies, leading to significant practice variability. This survey study assessed for existing knowledge and attitude among healthcare professionals regarding procedural criteria and potential change after an educational intervention. Methods: Healthcare professionals with increased exposure to brain injury at Mayo Clinic hospitals in Arizona and Florida were invited to complete an online survey consisting of 2 iterations of a 14-item questionnaire, taken before and after a 30-minute video educational intervention. The questionnaire gathered participants’ opinion of (1) their knowledge of the AAN procedural criteria, (2) whether these criteria determine complete, irreversible cessation of brain function, and (3) on what concept of death they base the equivalence of brain death to biological death. Results: Of the 928 people contacted, a total of 118 and 62 participants completed the pre-intervention and post-intervention questionnaire, respectively. The results show broad, unchanging support for the concept of brain death (86.8%) and that current criteria constitute best practice. While 64.9% agree further that the loss of consciousness and spontaneous breathing is sufficient for death, contradictorily, 37.6% believe the loss of additional integrated bodily functions such as fighting infection is necessary for death. A plurality trusts these criteria to demonstrate loss of brain function that is irreversible (67.6%) and complete (43.6%) at baseline, but there is significantly less agreement on both at post-intervention. Conclusion: Although there is consistent support that AAN procedural criteria are best for clinical practice, results show a tenuous belief that these criteria determine irreversible and complete loss of all brain function. Despite support for the concept of brain death first developed by the President’s Council, participants demonstrate confusion over whether the loss of consciousness and spontaneous breath are truly sufficient for death.
Treatment of headache disorders with acupuncture: a 6-year retrospective study
Authors: Mata Javier , Sanchís Pilar , Valentí Pedro , Hernández Beatriz , Aguilar Jose Luis 
Published: February 2021

Objective: Existing systematic reviews and meta-analyses indicate that acupuncture has similar clinical effectiveness in the prevention of headache disorders (HDs) as drug therapy, but with fewer side effects. As such, examining acupuncture’s use in a pragmatic, real-world setting would be valuable. The purpose of this study was to compare the effects of acupuncture and prophylactic drug treatment (PDT) on headache frequency in patients with HDs, under real-world clinical conditions. Methods: Retrospective cohort study of patients with HDs referred to a pain clinic, using electronic health record data. Patients continued with tertiary care (treatment of acute headache attacks and lifestyle, meditation, exercise and dietary instructions) with PDT, or received 12 sessions of acupuncture over 3 months, instead of PDT under conditions of tertiary care. The primary outcome data were the number of days with headache per month, and groups were compared at baseline and at the end of the third month of treatment. Results: Data were analysed for 482 patients with HDs. The number of headache days per month decreased by 3.7 (standard deviation (SD) = 2.9) days in the acupuncture group versus 2.9 (SD = 2.3) in the PDT group (p = 0.007). The proportion of responders was 39.5% versus 16.3% (p < 0.001). The number needed to treat was 4 (95% confidence interval = 3–7). Conclusion: Our study has shown that patients with HDs in tertiary care who opted for treatment with acupuncture appeared to receive similar clinical benefits to those that chose PDT, suggesting these treatments may be similarly effective of the prevention of headache in a real-world clinical setting.
Retrospective survey from vascular access team Lombardy net in COVID-19 era
Authors: Gidaro Antonio , Vailati Davide , Gemma Marco , Lugli Francesca , Casella Francesco , Cogliati Chiara , Canelli Antonio , Cremonesi Nadia , Monolo Davide , Cordio Giuseppe , Frosi Chiara , Destefanis Riccardo , Rossi Anna , Alemanno Maria Chiara , Valenza Franco , Luisoni Mara Dina , Elli Stefano , Caldarini Andrea , Lucchini Alberto , Paglia Stefano , Baroni Monica , Giustivi Davide 
Published: February 2021

Background: Venous Access Devices (VADs) are the most used devices in COVID-19 patients. Objective: Identify VADs implanted, catheter related thrombosis (CRT), catheter-related bloodstream infection (CRBSI), and accidental remove of VADs in both COVID-19 positive and COVID-19 free patients. Successive analysis was conducted comparing COVID-19 positive patients with COVID-19 free with inverse probability propensity score weights using simple regression to account for these two confounders (peripheral tip as central/peripheral and hospitalization as no/yes). Methods: This multicenter, retrospective cohort study collected data from seven hospitals in Lombardy during the pandemic period from February 21st to May 31st 2020. Results: A total of 2206 VADs were evaluated, 1107 (50.2%) of which were inserted in COVID-19 patients. In COVID-19 cohort the first choice was Long Peripheral Cannula in 388 patients (35.1%) followed by Midline Catheter in 385 (34.8%). The number of “central tip” VADs inserted in COVID-free inpatients and COVID-19 positive were similar (307 vs 334). We recorded 42 (1.9%) CRT; 32 (79.2%) were observed in COVID-19 patients. A total of 19 CRBSI were diagnosed; 15 (78.95%) were observed in COVID-19. Accidental removals were the more represented complication with 123 cases, 85 (69.1%) of them were in COVID-19. COVID-19 significantly predicted occurrence of CRT (OR = 2.00(1.85–5.03); p < 0.001), CRSB (OR = 3.82(1.82–8.97); p < 0.001), and Accidental Removal (OR = 2.39(1.80–3.20); p < 0.001) in our propensity score weighted models. Conclusions: CRT, CRBSI, and accidental removal are significantly more frequent in COVID-19 patients. Accidental removals are the principal complication, for this reason, the use of subcutaneously anchored securement is recommended for a shorter period than usual.
Safety and Efficacy of Endovascular Treatment of Portal Vein Stenosis in Liver Transplant Recipients: A Systematic Review
Authors: Sare Antony , Chandra Vishnu , Shanmugasundaram Srinidhi , Shukla Pratik A. , Kumar Abhishek 
Published: February 2021

Purpose: To evaluate the efficacy of Angioplasty and Stent Placement for the treatment of Portal Vein Stenosis in Liver Transplant Recipients by performing a systematic review. Materials and Methods: The PubMed Database was extensively searched for articles describing Portal Vein Stenosis (PVS) as a complication in Liver Transplant (LT) patients. The initial database search yielded 488 unique records published in the PubMed Database, 19 of which were deemed to meet the inclusion criteria. Outcomes were separated into 2 groups (Group A included patients with primary angioplasty, Group B included patients with primary stent placement), and further subdivided into Adult and Pediatric populations. Results: Group A included a total of 282 LT patients with portal vein stenosis. The population was predominantly pediatric (n = 243). Group B included a total of 111 LT patients with portal vein stenosis. This population was predominantly adult (n = 66). Technical success was significantly higher in both Group B pediatric (100%) and adults (97%) compared to Group A (69.5%) and (66.7%) respectively. Re-stenosis rates were significantly lower in Group B pediatric group compared to Group A (2.3% vs 29.7%, χ2 = 13.9; p < 0.001). Overall major (3.1%) and minor complications rates (1.5%) were low. Conclusion: Primary stent placement appears to have higher technical success in both populations and lower re-stenosis rates for treatment of PVS in pediatric populations.
Efficacy of oral vancomycin prophylaxis for prevention of Clostridioides difficile infection: a systematic review and meta-analysis
Authors: Tariq Raseen , Laguio-Vila Maryrose , Tahir Muhammad Waqas , Orenstein Robert , Pardi Darrell S. , Khanna Sahil 
Published: February 2021

Background: Prevention of recurrent Clostridioides difficile infection (CDI) is a challenge in clinical practice, particularly in patients who need systemic antimicrobial therapy. We aimed to evaluate the role of oral vancomycin prophylaxis (OVP) in prevention of primary or future CDI in patients on systemic antimicrobial therapy. Methods: A systematic search of MEDLINE, Embase, and Web of Science was performed from 2000 to January 2020. We included case-control or cohort studies that included patients on systemic antimicrobial therapy who did or did not receive oral vancomycin prophylaxis (OVP) and were evaluated for development of CDI. Odds ratio (OR) estimates with 95% confidence intervals (CI) were calculated. Results: Four studies including 1352 patients evaluated OVP for primary CDI prevention, with CDI occurring in 29/402 patients on OVP (7.4%) compared with 10.4% (99/950) without OVP. Meta-analysis revealed no significant decrease in risk of CDI in patients who received OVP (OR, 0.18; 95% CI, 0.03–1.03; p = 0.06). There was significant heterogeneity with I2 = 76%. Ten studies including 9258 patients evaluated OVP for secondary CDI prevention. Future CDI occurred in 91/713 patients on OVP (13.3%) compared with 21.9% (1875/8545) who did not receive OVP. Meta-analysis revealed a statistically significant decreased risk of future CDI (OR, 0.34; 95% CI, 0.20–0.59; p < 0.00001). Significant heterogeneity was seen with I2 = 59%. Discussion: Based on observational data, OVP appears to decrease the risk of future CDI in patients with prior CDI who require systemic antimicrobial therapy. However, OVP was not effective for primary prevention of CDI.
Effect of immunotherapy on overall survival in limited-stage small cell lung carcinoma: a national cancer database analysis
Authors: Bilani Nadeem , Alley Evan , Elson Leah , Nahleh Zeina , Arteta-Bulos Rafael 
Published: February 2021

Background: While immune-based therapies have been approved for extensive-stage small cell lung cancer, there is limited data on the efficacy of immunotherapy in patients with limited-stage disease. Methods: We used the National Cancer Database to first evaluate factors associated with the inclusion of immunotherapy as part of the initial therapeutic course in patients diagnosed with limited-stage small cell lung cancer (LS-SCLC). Consequently, we evaluated the impact of this immunotherapy on 2-year and 5-year overall survival (OS). We did this by performing 1:1 matching for controls that did not receive immunotherapy, and comparing survival between cohorts using the Kaplan–Meier method. Results: A total of 98 patients with LS-SCLC received immunotherapy as part of their initial therapeutic regimen. Age and facility type were the only significant predictors of the use of immunotherapy. There was no statistically significant difference between matched case-control cohorts in median OS ( p = 0.985), 2-year OS ( p = 0.747), and 5-year OS ( p = 0.934). Conclusion: In this study using a large national database, we found that the inclusion of immunotherapy as part of the initial systemic therapy regimen was not significantly associated with improved OS in a cohort of LS-SCLC patients.