bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Prehospital Stroke Diagnosis Using Natural Language Processing of Paramedic Reports
Authors: Mayampurath Anoop , Parnianpour Zahra , Richards Christopher T. , Meurer William J. , Lee Jungwha , Ankenman Bruce , Perry Ohad , Mendelson Scott J. , Holl Jane L. , Prabhakaran Shyam 
Published: June 2021

Background and Purpose:
Accurate prehospital diagnosis of stroke by emergency medical services (EMS) can increase treatments rates, mitigate disability, and reduce stroke deaths. We aimed to develop a model that utilizes natural language processing of EMS reports and machine learning to improve prehospital stroke identification.

Methods:
We conducted a retrospective study of patients transported by the Chicago EMS to 17 regional primary and comprehensive stroke centers. Patients who were suspected of stroke by the EMS or had hospital-diagnosed stroke were included in our cohort. Text within EMS reports were converted to unigram features, which were given as input to a support-vector machine classifier that was trained on 70% of the cohort and tested on the remaining 30%. Outcomes included final diagnosis of stroke versus nonstroke, large vessel occlusion, severe stroke (National Institutes of Health Stroke Scale score >5), and comprehensive stroke center-eligible stroke (large vessel occlusion or hemorrhagic stroke).

Results:

Of 965 patients, 580 (60%) had confirmed acute stroke. In a test set of 289 patients, the text-based model predicted stroke nominally better than models based on the Cincinnati Prehospital Stroke Scale (
c
-statistic: 0.73 versus 0.67,
P
=0.165) and was superior to the 3-Item Stroke Scale (
c
-statistic: 0.73 versus 0.53,
P
<0.001) scores. Improvements in discrimination were also observed for the other outcomes.

Conclusions:
We derived a model that utilizes clinical text from paramedic reports to identify stroke. Our results require validation but have the potential of improving prehospital routing protocols.
Five new species of Western Atlantic stardrums, Stellifer (Perciformes: Sciaenidae) with a key to Atlantic Stellifer species
Authors: CHAO NING LABBISH , CARVALHO-FILHO ALFREDO , SANTOS JONAS DE ANDRADE 
Published: June 2021

Five new species of Stellifer are described from the Caribbean Sea and tropical southwestern Atlantic. Among the previously recognized stelliferine genera, Stellifer is unique by having a pair of variably developed appendages on the posterior margin of the anterior gas chamber, which is lacking in Bairdiella, Corvula, Elattarchus, Odontoscion and Ophioscion. However, recent genetic studies indicated that Stellifer and Ophioscion are not monophyletic. The genus Ophioscion Gill, 1863 is recognized herein as a junior synonym of Stellifer Oken, 1817. Of the five new species described, Stellifer cervigoni n. sp., S. collettei n. sp., and S. musicki n. sp. have a pair of knob-like diverticula along the posterior margin of the anterior gas chamber, which is absent in S. macallisteri n. sp., and S. menezesi n. sp. Stellifer cervigoni n. sp. is found along the southern Caribbean coast of Colombia and Venezuela; it can be distinguished from other species by having a jet-black roof of mouth and inner opercular lining. Stellifer collettei n. sp. is found from Surinam to southeastern Brazil, while S. musicki n. sp. is endemic to northern Brazil. Stellifer macallisteri n. sp. has an oblique, terminal mouth and it is found in Colombia, Venezuela and Dominican Republic. Stellifer menezesi n. sp. has a subterminal mouth and is found from northeastern to southeastern Brazil. These results bring the number of valid species of Stellifer in the Atlantic to 18, and a key to the identification of these species is included.
Doppler Radar Analysis of the Eyewall Replacement Cycle of Hurricane Matthew (2016) in Vertical Wind Shear
Authors: Cha Ting-Yu , Bell Michael M. , DesRosiers Alexander J. 
Published: June 2021

AbstractHurricane Matthew (2016) was observed by ground-based polarimetric radars in Miami (KAMX), Melbourne (KMLB), and Jacksonville (KJAX) and a NOAA P3 airborne tail Doppler radar near the coast of the southeastern United States during an eyewall replacement cycle (ERC). The radar observations indicate that Matthew’s primary eyewall was replaced with a weaker outer eyewall, but unlike a classic ERC, Matthew did not reintensify after the inner eyewall disappeared. Triple Doppler analysis was calculated from the NOAA P3 airborne fore and aft radar scanning combined with the KAMX radar data during the period of secondary eyewall intensification and inner eyewall weakening from 19 UTC 6 October to 00 UTC 7 October. Four flight passes of the P3 aircraft show the evolution of the reflectivity, tangential winds, and secondary circulation as the outer eyewall became well-established. Further evolution of the ERC is analyzed from the ground-based single Doppler radar observations for 35 hours with high temporal resolution at a 5-minute interval from 19 UTC 6 October to 00 UTC 8 October using the Generalized Velocity Track Display (GVTD) technique. The single-Doppler analyses indicate that the inner eyewall decayed a few hours after the P3 flight, while the outer eyewall contracted but did not reintensify and the asymmetries increased episodically. The analysis suggests that the ERC process was influenced by a complex combination of environmental vertical wind shear, an evolving axisymmetric secondary circulation, and an asymmetric vortex Rossby wave damping mechanism that promoted vortex resiliency despite increasing shear.
“We got in the pilot program to learn from it:” Features of Social Learning in Drought Contexts Along the Arkansas River in Colorado
Authors: Henderson Jen , Dilling Lisa , Morss Rebecca , Wilhelmi Olga , Rick Ursula 
Published: June 2021

AbstractUnintended consequences from decisions made in one part of a social-ecological system (SES) in response to climate hazards can magnify vulnerabilities for others in the same system. Yet anticipating or identifying these cascades and spillovers in real time is difficult. Social learning is an important component of adaptation that has the ability to facilitate adaptive capacity by mobilizing multiple actors around a common resource to manage collectively in ways that build local knowledge, reflective practices, and a broader understanding of contexts for decisions. While the foundations of social learning in resource management have been theorized in the literature, empirical examples of unintended consequences that trigger social learning are few. This article analyzes two cases of drought decisions made along the Arkansas River Basin in Colorado; in each, social learning occurred after actors experienced unanticipated impacts from others’ decisions. Methods include interviews with actors, both individual and institutional representatives of different sectors (e.g. recreation, agriculture, etc.), and a review of relevant historical and policy documents. The study identifies four features of social learning that aided actors’ responses to unanticipated consequences: first, governance structures that facilitated more holistic river management; second, relationship boundaries that expanded beyond small scale decisions to capture interactions and emergent problems; third, knowledge of others’ previous experience, whether direct or indirect; and fourth, creation of spaces for safer experimentation with adaptation changes. Results identify empirical examples of actors who successfully learned to adapt together to unexpected consequences and thus may provide insight for others collectively managing drought extremes.
The Effects of Perioperative Peripheral Nerve Blocks on Peri- and Postoperative Opioid Use and Pain Management
Authors: Cardwell Taylor W. , Zabala Vanessa , Mineo Jocelyn , Ochner Christopher N. 
Published: June 2021

Introduction The amount of peri- and post-operative use of opioids for pain management, and the duration in which they are used following surgery, are positively associated with the likelihood of subsequent opioid use and addiction. Aware of this issue, many clinicians are seeking ways to reduce opioid use while maintaining adequate pain management. Recent evidence suggests that peripheral nerve block utilization may present a viable mechanism by which clinicians can accomplish this goal. Methods Ovid MEDLINE and Pubmed databases were searched to identify relevant articles. Using the advanced search option, the key terms “opioid,” “morphine,” “nerve block,” “peripheral anesthesia,” “pain management,” “preoperative,”, “intraoperative,” and “postoperative” were used and combined with the Boolean terms “AND” and “OR.” This review examines the extant literature surrounding the use of peripheral nerve blocks in relation to patient-reported pain scores, intraoperative opioids, postoperative opioids, patient-controlled analgesic with opioids, and opioid consumption once the patient has left the hospital. Further, the effect peripheral nerve blocks have on postoperative physical therapy, surgery related complications, and overall patient satisfaction are briefly discussed. Results The use of perioperative peripheral nerve blocks decreases opioid consumption not only in the postoperative period, but also intraoperatively as well. The most significant decrease in opioid consumption is seen in the first 24-72 hours postoperatively. Patient reported pain scores were also lower in patients who received peripheral nerve blocks. Discussion Despite relatively robust efficacy data, utilization of peripheral nerve blocks is not ubiquitous; the potential reasons for which are also discussed. Lastly, clinical recommendations based on the available data are provided.
Squamous-cell carcinoma due to mesh infection after umbilical hernia operation: third case of the literature
Authors: Duymus Mehmet Esat , Ipci Ozlem 
Published: June 2021

Introduction Polypropylene (PP) meshes are safe synthetic products used for hernia repairs and associated with minimal complication. Chronic inflammation is thought to play a pathophysiological role in the development of cancer. Case presentation: We present a 67-year-old female case of squamous cell-cancer (SCC) that developed due to mesh after umbilical hernia operation. The mass in the anterior abdominal wall was totally resected. Pathology was reported as T2N0, moderately differentiated acantholytic type SCC. No recurrence or complication was detected in the fourth-month follow-up. Conclusion Cancer development after mesh is very rare and our case is the third case in the literature. Cancer development should be kept in mind in patients presenting with ulcerated masses if do not regress with infection treatment after mesh application.
Emerson’s abolitionist perfectionism
Authors: Ritter Eric 
Published: June 2021

This article aims to rewrite Emerson’s moral perfectionism – his anti-foundationalist pursuit of an always more perfect state of self and society – onto his moral and intellectual participation in the abolitionist movement. I argue that Cavell artificially separated Emerson’s moral perfectionism from his extensive, decades-long abolitionism. The source of Cavell’s oversight is his participation in the long-standing norm of dichotomizing Emerson’s work into the theoretical ‘essays’ and the ‘anti-slavery writings’ or the philosophical and the polemical. Recent scholars of Emerson have questioned and even dismissed this dichotomy, however, while recentring Emerson’s politics in his oeuvre as a whole. They find much to praise, and also plenty to criticize, in Emerson’s abolitionist writings. I follow and extend that scholarly trend here and introduce what I call Emerson’s abolitionist perfectionism as an expansion of Cavell’s influential work on moral perfectionism.
Cyclin-dependent kinase 15 upregulation is correlated with poor prognosis for patients with breast cancer
Authors: Zhang Xiquan , Wang Qin , Luo Yijun , Song Meijiao , Zhou Zhiyong , Zeng Lin , Hu Meng , Yang Chuyan 
Published: June 2021

Objective To investigate the clinical significance of cyclin-dependent kinase (CDK) 15 in breast cancer. Methods This prospective observational study enrolled 154 patients with breast cancer. Tumor tissues and paired paracancerous normal tissues were collected. Additionally, 85 samples of benign breast lesions were obtained from patients with mammary gland hyperplasia. Patient characteristics were recorded, and CDK15, human epidermal growth factor receptor (HER)2, estrogen receptor, progesterone receptor, and Ki67 immunohistochemical expression were determined. Results The rate of strong CDK15 expression was 63.6% (98/154) in breast cancer tissues, which was remarkably higher than that in benign breast lesions (34.1%, 29/85). Similarly, the ratio of strong CDK15 expression was markedly higher in tumor tissues (63.6%, 98/15) than in paracancerous normal tissues (27.3%, 42/154). Pearson’s analysis showed that the CDK15 expression score was positively correlated with HER2 and Ki67. Patients with high CDK15 expression showed markedly higher ratios of TNM stage III to IV, lymph node metastasis, and increased tumor diameters but a significantly lower rate of ductal carcinoma in situ. The median survival time of these patients was significantly shorter. Kaplan–Meier curve analysis showed that low CDK15 expression predicted longer survival times. Conclusion Upregulated CDK15 predicted poor clinical outcomes in breast cancer.
Prevention and management of acute esophageal toxicity during concomitant chemoradiotherapy for locally advanced lung cancer
Authors: Borghetti Paolo , Imbrescia Jessica , Volpi Giulia , Costantino Gianluca , Cossali Gianluca , Greco Diana , Pastorello Edoardo , La Mattina Salvatore , Bonù Marco Lorenzo , Tomasini Davide , Buglione Michela 
Published: June 2021

Background: Standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC) is concomitant chemoradiotherapy. The survival benefit of combined treatment is partially counterbalanced by an increased rate of acute esophageal toxicity. Several pharmaceutical products are available for prevention and management of esophagitis, including Faringel Plus. Aim: To assess the incidence and the grade, identify the correlations with clinical, dosimetric, and therapeutic variables, and analyse the role of Faringel Plus as a pharmaceutical preventive measure against acute esophageal toxicity. Methods: Patients with LA-NSCLC treated with concomitant radiochemotherapy were retrospectively reviewed. Acute esophagitis and dysphagia were graded according to Common Terminology Criteria for Adverse Events version 5.0. Clinical, dosimetric, and therapeutic correlations were investigated using χ2 test. Results: Among the 23 analysed patients, 18 (78.3%) and 1 (4.3%) developed G2 and G3 esophagitis, respectively; G1–2 dysphagia were reported in 11 cases (47.8%). No statistically significant correlation between the variables considered and acute esophageal toxicity was identified. In the group of patients who received Faringel Plus as preventive treatment (10 subjects, 43.5%), dysphagia presentation time was significantly longer ( p = 0.038); esophagitis onset time was longer and symptoms duration was shorter. Faringel Plus allowed a reduction in the use of analgesic drugs. Conclusions: Acute mild esophageal toxicity was confirmed to be a common side effect in this setting. No clinical-dosimetric parameter has been demonstrated to be effective in predicting acute esophageal toxicity. The use of Faringel Plus appears effective as a therapeutic and prophylactic tool to manage acute esophageal toxicity.
Explosive sound without external stimuli following electroencephalography kappa rhythm fluctuation: A case report
Authors: Sumi Yukiyoshi , Miyamoto Towa , Sudo Satoshi , Kadotani Hiroshi , Ozeki Yuji , Imai Makoto 
Published: June 2021

Background The pathology underlying exploding head syndrome, a parasomnia causing a loud sound/sense of explosion, is not well understood. Kappa rhythm is a type of electroencephalogram alpha band activity with maximum potential between contralateral temporal electrodes We report a case of preceding kappa activity before exploding head syndrome attacks. Case report A 57-year-old woman complained of explosive sounds for 2 months; a loud sound would transpire every day before sleep onset. She was diagnosed with exploding head syndrome. During polysomnography and the multiple sleep latency test, the exploding head syndrome attacks occurred six times. A kappa wave with activity disappearing a few seconds before most exploding head syndrome attacks was observed. The alpha band power in T3-T4 derivation gradually waxed followed by termination around the attacks. Conclusion This case demonstrated that the dynamics of kappa activity precede exploding head syndrome attacks. Finding ways to modulate electroencephalogram oscillation could elucidate their causality and lead to therapeutic intervention.
Migraine and the development of additional psychiatric and pain disorders in the transition from adolescence to adulthood
Authors: Gerstl Lucia , Tadych Natalie , Heinen Florian , Kainz Christine , Bonfert Michaela V , Hannibal Iris , Huss Kristina , Ruscheweyh Ruth , Straube Andreas , Obermeier Viola , von Kries Rüdiger , Landgraf Mirjam N 
Published: June 2021

Introduction The transition from childhood to adolescence and from adolescence to adulthood are vulnerable phases in life. In these phases, late or insufficient treatment of diseases may lead to chronification and favor development of additional disorders. In adolescents, migraine often has a highly negative impact on school performance and everyday life. The hypothesis of the present study was that adolescents with migraine have a higher risk for developing additional disorders such as psychiatric disorders or other pain syndromes in the course of the disease. Materials and methods In this study, we analyzed health insurance data of 56,597 German adolescents at the age of 15 years in the year 2006. By using the International Classification of Diseases (ICD 10), we determined a group with migraine diagnosis in the year 2006 and a control group without any headache diagnosis in 2006. We then compared both groups regarding the development of additional disorders (based on the ICD 10) during the following 10 years (2007 to 2016). Results Adolescents with migraine had a 2.1 fold higher risk than persons without migraine diagnosis to develop an additional affective or mood disorder, a 1.8 fold higher risk to obtain neurotic, stress-related and somatoform disorders, a 1.8 fold higher risk to subsequently suffer from behavioral syndromes, a 1.6 higher risk to get back pain and a 1.5 fold higher risk for irritable bowel syndrome during the next 10 years. Conclusion Adolescents with migraine are at risk for developing additional disorders later. Considering and addressing the patient’s risks and potential medical and psychosocial problems might improve the long-term outcome significantly.
Risk Exposures, Risk Perceptions, Negative Attitudes Toward General Vaccination, and COVID-19 Vaccine Acceptance Among College Students in south Carolina
Authors: Qiao Shan , Tam Cheuk Chi , Li Xiaoming 
Published: June 2021

Purpose: The current study investigated how risk exposures, risk perceptions of COVID-19, and negative attitudes toward general vaccination were related to COVID vaccine acceptance among college students. Design: Cross-sectional study. Setting: Data was collected by online survey using RedCap among college students in South Carolina between September 2020 and October 2020. Sample: 1062 college students in South Carolina. Measures: risk exposures to COVID-19, perceived severity of COVID-19, perceived susceptibility of COVID-19, negative attitude toward general vaccination, vaccine acceptance of COVID-19. Analysis: Hierarchical linear regression was used to examine the association of these factors with COVID-19 vaccine acceptance controlling for key demographics. Results: Perceived severity of COVID-19 was positively associated with vaccine acceptance (ß = 0.19, p < 0.001). Higher level of risk exposures (ß = −0.08, p = 0.007) and negative attitude toward general vaccination (ß = −0.38, p < 0.001) were associated with low vaccine acceptance. Conclusion: We need tailored education messages for college students to emphasize the severity of COVID-19, address the concerns of side effects of general vaccines by dispelling the misconception, and target the most vulnerable subgroups who reported high level of risk exposures while showed low intention to take the vaccine.
Lactation Consultation by an International Board Certified Lactation Consultant Improves Breastfeeding Rates for Mothers With Gestational Diabetes Mellitus
Authors: Griffin Laurie Beth , Ding Jia Jennifer , Has Phinnara , Ayala Nina , Kole-White Martha B. 
Published: June 2021

Background In patients with gestational diabetes, breastfeeding decreases the lifetime risk of Type 2 diabetes by half. Lactation consultation has been shown to increase breastfeeding rates in the general population but has not been assessed in a gestational diabetes population. Research Aims To determine if (1) a postpartum International Board Certified Lactation Consultant (IBCLC) consultation during delivery hospitalization improved inclusive (any) or exclusive breastfeeding rates at hospital discharge and 3 months postpartum in participants with GDM; and if (2) obstetrical providers’ acknowledgement of maternal feeding preference affected the rates of IBCLC consultation for patients. Methods This was a retrospective, comparative, secondary analysis of a prospective cohort ( N = 517) study of women gestational diabetes. Participants who received a IBCLC consultation ( n = 386; 74.5%) were compared to those who did not ( n = 131; 25.5%). Baseline demographics, antepartum characteristics, neonatal information, mode of infant feeding at hospital discharge and 3 months postpartum, and IBCLC consultation during postpartum hospitalization were measured. Results After adjusting for baseline differences, participants who received an IBCLC consultation were more likely to report any breastfeeding at postpartum discharge (aOR 4.87; 95% CI [2.67, 8.86]) and at 3 months postpartum (aOR 5.39; 95% CI [2.61, 11.16]) compared to participants who did not. However, there was no difference in exclusive breastfeeding rates between those who did and did not receive IBCLC consultation. Conclusion Inpatient IBCLC consultation during the immediate postpartum period was associated with improved rates of any breastfeeding in participants with GDM.