bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors for Prolonged Drain Use Following Autologous Breast Reconstruction
Authors: Dinis Jacob , Allam Omar , Junn Alexandra , Park Kitae Eric , Mozaffari Mohammad Ali , Shah Rema , Avraham Tomer , Alperovich Michael 
Published: July 2021

AbstractBackground Surgical drains are routinely used following autologous reconstruction, but are often cited as the leading cause of peri-operative discomfort. This study defined routine drain use duration and assessed the risk factors for prolonged breast and abdominal drain use during microvascular breast reconstruction, measures which have never previously been defined.Methods Patients who underwent an abdominal microvascular free flap were included. Demographics, comorbidities, and operation-related characteristics were retrospectively collected in a prospectively maintained database. Statistical analysis utilized chi-square independent t-test, and linear regression analyses.Results One hundred forty-nine patients comprising 233 breast flaps were included. Average breast and abdominal drain duration were 12.9 ± 3.9 and 17.7 ± 8.2 days, respectively. Prolonged breast and abdominal drain duration were defined as drain use beyond the 75th percentile at 14 and 19 days, respectively. Multivariable regression revealed hypertension was associated with an increased breast drain duration by 1.4 days (p = 0.024), axillary dissection with 1.7 days (p = 0.026), African-American race with 3.1 days (p < 0.001), Hispanic race with 1.6 days (p = 0.029), return to the OR with 3.2 days (p = 0.004), and each point increase in BMI with 0.1 days (p = 0.028). For abdominal drains, each point increase in BMI was associated with an increased abdominal drain duration by 0.3 days (p = 0.011), infection with 14.4 days (p < 0.001), and return to the OR with 5.7 days (p = 0.007).Conclusion Elevated BMI, hypertension, and axillary dissection increase risk for prolonged breast drain requirement in autologous reconstruction. African-American and Hispanic populations experience prolonged breast drain requirement after controlling for other factors, warranting further study.
The Association between Implementation of an Enhanced Recovery after Cesarean Pathway with Standardized Discharge Prescriptions and Opioid Use and Pain Experience after Cesarean Delivery
Authors: McCoy Jennifer A. , Gutman Sarah , Hamm Rebecca F. , Srinivas Sindhu K. 
Published: July 2021

Objective This study was aimed to evaluate opioid use after cesarean delivery (CD) and to assess implementation of an enhanced recovery after CD (ERAS-CD) pathway and its association with inpatient and postdischarge pain control and opioid use.
Study Design We conducted a baseline survey of women who underwent CD from January to March 2017 at a single, urban academic hospital. Patients were called 5 to 8 days after discharge and asked about their pain and postdischarge opioid use. An ERAS-CD pathway was implemented as a quality improvement initiative, including use of nonopioid analgesia and standardization of opioid discharge prescriptions to ≤25 tablets of oxycodone of 5 mg. From November to January 2019, a postimplementation survey was conducted to assess the association between this initiative and patients' pain control and postoperative opioid use, both inpatient and postdischarge.
Results Data were obtained from 152 women preimplementation (PRE) and 137 women post-implementation (POST); complete survey data were obtained from 102 women PRE and 98 women POST. The median inpatient morphine milligram equivalents consumed per patient decreased significantly from 141 [range: 90–195] PRE to 114 [range: 45–168] POST (p = 0.002). On a 0- to 10-point scale, median patient-reported pain scores at discharge decreased significantly (PRE: 7 [range: 5–8] vs. POST 5 [range: 3–7], p < 0.001). The median number of pills consumed after discharge also decreased significantly (PRE: 25 [range: 16–30] vs. POST 17.5 [range: 4–25], p = 0.001). The number of pills consumed was significantly associated with number prescribed (p < 0.001). The median number of leftover pills and number of refills did not significantly differ between groups. Median patient-reported pain scores at the week after discharge were lower in the POST group (PRE: 4 [range: 2–6] vs. POST 3[range: 1–5], p = 0.03).
Conclusion Implementing an ERAS-CD pathway was associated with a significant decrease in inpatient and postdischarge opioid consumption while improving pain control. Our data suggest that even fewer pills could be prescribed for some patients.
Key Points
Assisted Reproductive Technology and Perinatal Mortality: Selected States (2006–2011)
Authors: Chang Jeani , Zhang Yujia , Boulet Sheree L. , Crawford Sara B. , Copeland Glenn E. , Bernson Dana , Kirby Russell S. , Kissin Dmitry M. , Barfield Wanda D. ,   for States Monitoring Assisted Reproductive Technology (SMART) Collaborative
Published: July 2021

Objective This study aimed to compare trends and characteristics of assisted reproductive technology (ART) and non-ART perinatal deaths and to evaluate the association of perinatal mortality and method of conception (ART vs. non-ART) among ART and non-ART deliveries in Florida, Massachusetts, and Michigan from 2006 to 2011.
Study Design Retrospective cohort study using linked ART surveillance and vital records data from Florida, Massachusetts, and Michigan.
Results During 2006 to 2011, a total of 570 ART-conceived perinatal deaths and 25,158 non-ART conceived perinatal deaths were identified from the participating states. Overall, ART perinatal mortality rates were lower than non-ART perinatal mortality rates for both singletons (7.0/1,000 births vs. 10.2/1,000 births) and multiples (22.8/1,000 births vs. 41.2/1,000 births). At <28 weeks of gestation, the risk of perinatal death among ART singletons was significantly lower than non-ART singletons (adjusted risk ratio [aRR] = 0.46, 95% confidence interval [CI]: 0.26–0.85). Similar results were observed among multiples at <28 weeks of gestation (aRR = 0.64, 95% CI: 0.45–0.89).
Conclusion Our findings suggest that ART use is associated with a decreased risk of perinatal deaths prior to 28 weeks of gestation, which may be explained by earlier detection and management of fetal and maternal conditions among ART-conceived pregnancies. These findings provide valuable information for health care providers, including infertility specialists, obstetricians, and pediatricians when counseling ART users on risk of treatment.
Key Points
The Effect of Social Determinants and Socioeconomic Status on Laparoscopic Roux-En-Y Gastric Bypass for Weight Loss: An Analysis of the National Inpatient Sample
Authors: Singh Supreet , Guerra Jarot J. , Lazar Paige , Merchant Aziz M. 
Published: July 2021

Abstract
Objective In the United States, Black and Hispanic patients have a higher prevalence of obesity than Whites (49.6 vs. 44.8 vs. 42.2%, respectively). Despite higher rates of obesity among minority populations, bariatric surgery is performed at higher obesity levels in minorities than in Whites. This study examines the effects of various socioeconomic factors such as race, payer type, and income on the likelihood of undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) at class II versus class III obesity and their associated complications.
Materials and Methods National Inpatient Sample (NIS) from 2016 to 2017 was queried to identify patients at least 18 years of age with a concomitant diagnosis of class II or class III obesity who underwent LRYGB. We analyzed obesity level at the time of LRYGB (class II vs. class III), postoperative intestinal obstruction during the admission, and occurrence of any noninfectious complication related to the surgery as our main outcomes. A multivariate logistic regression model was utilized to assess the association between our outcomes and socioeconomic factors associated with the admission.
Results A total of 76,405 LRYGB operations were included. Out of this total, 83% (63,640) LRYGB operations were in class III obesity. Black patients had a lower rate (11.6%) of LRYGB procedures at class II obesity than White (17.6%) and Hispanic (18%) patients (p < 0.001). Medicare, Medicaid, and lower income quartiles also showed lower rates of operation at class II obesity (p < 0.001). Black patients were 29% (95% confidence interval [CI]: 0.61–0.83, p < 0.001) less likely than Whites to have a LRYGB procedure at class II obesity, they were 119% (95% CI: 1.17–4.11, p = 0.0014) more likely to suffer a postoperative intestinal obstruction, and they were 93% (95% CI: 1.31–2.84, p < 0.001) more likely to suffer a noninfectious complication.
Conclusion Socioeconomic disparities in the surgical management of severe obesity persist in the United States, especially for LRYGB. This study highlights multiple demographic factors that led to LRYGB at later obesity levels. Black patients were also more likely to be associated with postoperative complications during the admission. The determinants of health disparities in obese patients need to be examined further to reduce potential long-term morbidity and mortality in minorities. Further research is also required to identify the adverse effects of health disparities in patients with severe obesity and obesity-related comorbidities.
Nitrogen and phosphorus enrichments alter the dynamics of the plankton community in Daya Bay, northern South China Sea: results of mesocosm studies
Authors: Song Xingyu , Li Yao , Xiang Chenhui , Su Xinying , Xu Ge , Tan Meiting , Huang Yadong , Liu Jihua , Ma Zengling , Huang Liangmin , Li Gang 
Published: July 2021

Eutrophication is threatening coastal ecosystems globally. Using 15 mesocosms, we explored how nitrogen (N) and phosphorus (P) enrichment affects the dynamics of plankton communities over 15-day (winter) and 10-day (summer) experimental enrichments in Daya Bay, a mesotrophic bay in the northern South China Sea. P enrichment had no obvious effect on the plankton community, whereas N or N+P enrichment stimulated two phytoplankton blooms, with the dominant species shifting from diatoms to dinoflagellates across enrichment periods in both winter and summer. Coinciding with increases in phytoplankton (i.e. chlorophyll-a concentrations and cell abundance), the N+P enrichment enhanced primary productivity on Experimental Day 6 by a maximum of ~8.0-fold (i.e. from a mean ± s.d., 4.49 ± 0.31 to 36.5 ± 8.4 μg C L–1 h–1) in winter and ~7.5-fold (i.e. from 8.16 ± 0.22 to 60.6 ± 10.1 μg C L–1 h–1) in summer. The N+P enrichment increased the abundance of heterotrophic bacteria in both seasons, as well as bacterial productivity. Moreover, the N+P enrichment increased both community respiration and the variation in net community production in both winter and summer, indicating that the marine ecosystems in Daya Bay may become more fragile in the future with continuing inputs of land-derived nutrients.
Dynamic chromatin regulatory landscape of human CAR T cell exhaustion
Authors: Gennert David G. , Lynn Rachel C. , Granja Jeff M. , Weber Evan W. , Mumbach Maxwell R. , Zhao Yang , Duren Zhana , Sotillo Elena , Greenleaf William J. , Wong Wing H. , Satpathy Ansuman T. , Mackall Crystal L. , Chang Howard Y. 
Published: July 2021

Significance
T cell exhaustion is a major barrier to cancer immunotherapy. T cell exhaustion is the state of T cell dysfunction after chronic stimulation, and recent studies indicate that exhaustion is epigenetically controlled and associated with unique chromatin profiles. This work reports the genome-wide map of active DNA regulatory elements and their connection to genes in the time course of human chimeric antigen receptor T cell exhaustion. Early chromatin events establish the later program of gene expression, active elements are often human-specific, and exhaustion-associated enhancers can be manipulated to precisely control the level of inhibitory receptors on T cells.
MICROSCOPE instrument description and validation
Authors: Liorzou Françoise , Touboul Pierre , Rodrigues Manuel , Métris Gilles , André Yves , Bergé Joel , Boulanger Damien , Bremer Stefanie , Chhun Ratana , Christophe Bruno , Danto Pascale , Foulon Bernard , Hagedorn Daniel , Hardy Emilie , Huynh Phuong-Anh , Lämmerzahl Claus , Lebat Vincent , List Meike , Löffler Frank , Rievers Benny , Robert Alain , Selig Hanns 
Published: July 2021

Abstract
This paper focuses on the dedicated accelerometers developed for the MICROSCOPE mission taking into account the specific range of acceleration to be measured on board the satellite. Considering one micro-g and even less as the full range of the instrument with an objective of one femto-g resolution, that leads to a customized concept and a high-performance electronics for the sensing and servo-actuations of the accelerometer test-masses. This range and performance directed the payload development plan. In addition to a very accurate geometrical sensor core, a high performance electronics architecture provides the measurement of the weak electrostatic forces and torques applied to the test-masses. A set of capacitive detectors delivers the position and the attitude of the test-mass with respect to a very steady gold-coated cage made in silica. The voltages applied on the electrodes surrounding each test-mass are finely controlled to generate the adequate electrical field and so the electrostatic pressures on the test-mass. This field maintains the test-mass motionless with respect to the instrument structure. Digital control laws are implemented in order to enable instrument operation flexibility and a weak position detector noise. These electronics provide both the scientific data for MICROSCOPE’s test of the weak equivalence principle and the input for the satellite drag-free and attitude control system.
Keeping the ICRP recommendations fit for purpose
Authors: Clement C , Rühm W , Harrison J , Applegate K , Cool D , Larsson C-M , Cousins C , Lochard J , Bouffler S , Cho K , Kai M , Laurier D , Liu S , Romanov S 
Published: July 2021

Abstract
The International Commission on Radiological Protection (ICRP) has embarked on a review and revision of the system of Radiological Protection that will update the 2007 general recommendations in ICRP Publication 103. This is the beginning of a process that will take several years, involving open and transparent engagement with organisations and individuals around the world. While the system is robust and has performed well, it must adapt to address changes in science and society to remain fit for purpose. The aim of this paper is to encourage discussions on which areas of the system might gain the greatest benefit from review, and to initiate collaborative efforts. Increased clarity and consistency are high priorities. The better the system is understood, the more effectively it can be applied, resulting in improved protection and increased harmonisation. Many areas are identified for potential review including: classification of effects, with particular focus on tissue reactions; reformulation of detriment, potentially including non-cancer diseases; re-evaluation of the relationship between detriment and effective dose, and the possibility of defining detriments for males and females of different ages; individual variation in the response to radiation exposure; heritable effects; and effects and risks in non-human biota and ecosystems. Some of the basic concepts are also being considered, including the framework for bringing together protection of people and the environment, incremental improvements to the fundamental principles of justification and optimisation, a broader approach to protection of individuals, and clarification of the exposure situations introduced in 2007. In addition, ICRP is considering identifying where explicit incorporation of the ethical basis of the system would be beneficial, how to better reflect the importance of communications and stakeholder involvement, and further advice on education and training. ICRP invites responses on these and other areas relating to the review of the System of Radiological Protection.
High-reliability graphene-wrapped nanoprobes for scanning probe microscopy
Authors: Cao Liang , Liu Ri , Zhang Wenxiao , Wang Ying , Wang Guoliang , Song Zhengxun , Weng Zhankun , Wang Zuobin 
Published: July 2021

Abstract
The nanoprobe is a powerful tool in scanning probe microscopy (SPM) that is used to explore various fields of nanoscience. However, the tips can wear out very fast due to the low stability of conventional probes, especially after the measurement of high currents or lateral friction, which results in image distortion and test imprecision. Herein, a novel functional nanoprobe is presented using graphene sheets in a high-quality graphene solution wrapped round a plasma-treated conventional Pt-Ir coated nanoprobe, which shows highly stability and resistance to degradation, leading to a significantly increased lifetime. Furthermore, we show that the graphene-wrapped nanoprobes have the advantages of enhanced electrical conductivity and reduced tip–sample friction, compared with Pt-Ir coated nanoprobes. The simplicity and low cost of this method make it valuable to various functional graphene-wrapped nanoprobes and applications.
Hyperfine-mediated transitions between electronic spin-1/2 levels of transition metal defects in SiC
Authors: Gilardoni Carmem M , Ion Irina , Hendriks Freddie , Trupke Michael , van der Wal Caspar H 
Published: July 2021

Abstract
Transition metal defects in SiC give rise to localized electronic states that can be optically addressed in the telecom range in an industrially mature semiconductor platform. This has led to intense scrutiny of the spin and optical properties of these defect centers. For spin-1/2 defects, a combination of the defect symmetry and the strong spin–orbit coupling may restrict the allowed spin transitions, giving rise to defect spins that are long lived, but hard to address via microwave spin manipulation. Here, we show via analytical and numerical results that the presence of a central nuclear spin can lead to a non-trivial mixing of electronic spin states, while preserving the defect symmetry. The interplay between a small applied magnetic field and hyperfine coupling opens up magnetic microwave transitions that are forbidden in the absence of hyperfine coupling, enabling efficient manipulation of the electronic spin. We also find that an electric microwave field parallel to the c-axis can be used to manipulate the electronic spin via modulation of the relative strength of the dipolar hyperfine term.
Flavor-specific interaction favors strong neutrino self-coupling in the early universe
Authors: Das Anirban , Ghosh Subhajit 
Published: July 2021

Abstract
Flavor-universal neutrino self-interaction has been shown to ease the tension between the values of the Hubble constant measured from early and late Universe data. We introduce a self-interaction structure that is flavor-specific in the three active neutrino framework. This is motivated by the stringent constraints on new secret interactions among electron and muon neutrinos from several laboratory experiments. Our study indicates the presence of a strongly interaction mode which implies a late-decoupling of the neutrinos just prior to matter radiation equality. Using the degeneracy of the coupling strength with other cosmological parameters, we explain the origin of this new mode as a result of better fit to certain features in the CMB data. We find that if only one or two of the three active neutrino flavors are interacting, then the statistical significance of the strongly-interacting neutrino mode increases substantially relative to the flavor-universal scenario. However, the central value of the coupling strength for this interaction mode does not change by any appreciable amount in the flavor-specific cases. We also briefly analyze a scenario with more than three neutrino species of which only one is self-interacting.	In none of the cases, we find a large enough Hubble constant that could resolve the so-called Hubble tension.
SMBH seeds from dissipative dark matter
Authors: Xiao Huangyu , Shen Xuejian , Hopkins Philip F. , Zurek Kathryn M. 
Published: July 2021

Abstract
The existence of supermassive black holes (SMBHs) with masses greater than ∼ 109
M
☉ at high redshift (z ≳ 7) is difficult to accommodate in standard astrophysical scenarios. We study the possibility that (nearly) totally dissipative self-interacting dark matter (tdSIDM)–in rare, high density dark matter fluctuations in the early Universe — produces SMBH seeds through catastrophic collapse. We use a semi-analytic model, tested and calibrated by a series of N-body simulations of isolated dark matter halos, to compute the collapse criteria and timescale of tdSIDM halos, where dark matter loses nearly all of its kinetic energy in a single collision in the center-of-momentum frame. Applying this model to halo merger trees, we empirically assign SMBH seeds to halos and trace the formation and evolution history of SMBHs. We make predictions for the quasar luminosity function, the M
BH-σv
* relation, and cosmic SMBH mass density at high redshift and compare them to observations. We find that a dissipative dark matter interaction cross-section of σ/m ∼ 0.05 cm2/g is sufficient to produce the SMBHs observed in the early Universe while remaining consistent with ordinary SMBHs in the late Universe.
Multi-scale neural decoding and analysis
Authors: Lu Hung-Yun , Lorenc Elizabeth S , Zhu Hanlin , Kilmarx Justin , Sulzer James , Xie Chong , Tobler Philippe N , Watrous Andrew J , Orsborn Amy L , Lewis-Peacock Jarrod , Santacruz Samantha R 
Published: July 2021

Abstract

Objective. Complex spatiotemporal neural activity encodes rich information related to behavior and cognition. Conventional research has focused on neural activity acquired using one of many different measurement modalities, each of which provides useful but incomplete assessment of the neural code. Multi-modal techniques can overcome tradeoffs in the spatial and temporal resolution of a single modality to reveal deeper and more comprehensive understanding of system-level neural mechanisms. Uncovering multi-scale dynamics is essential for a mechanistic understanding of brain function and for harnessing neuroscientific insights to develop more effective clinical treatment. Approach. We discuss conventional methodologies used for characterizing neural activity at different scales and review contemporary examples of how these approaches have been combined. Then we present our case for integrating activity across multiple scales to benefit from the combined strengths of each approach and elucidate a more holistic understanding of neural processes. Main results. We examine various combinations of neural activity at different scales and analytical techniques that can be used to integrate or illuminate information across scales, as well the technologies that enable such exciting studies. We conclude with challenges facing future multi-scale studies, and a discussion of the power and potential of these approaches. Significance. This roadmap will lead the readers toward a broad range of multi-scale neural decoding techniques and their benefits over single-modality analyses. This Review article highlights the importance of multi-scale analyses for systematically interrogating complex spatiotemporal mechanisms underlying cognition and behavior.