bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of a Pediatric Continuity Care Intensivist Program on Patient and Parent Outcomes: An Unblinded Randomized Controlled Trial
Authors: Walter Jennifer K. , Madrigal Vanessa , Shah Parth , Kubis Sherri , Himebauch Adam S. , Feudtner Chris 
Published: December 2021

Abstract
Objectives We studied the impact of a standardized continuity care intensivists (CCIs) program on patient and family outcomes for long-stay patients in the pediatric intensive care unit (PICU), also assessing the intervention's acceptability and feasibility.
Methods A patient-level, unblinded randomized-controlled trial in a PICU at a large children's hospital. Participants included: (1) patients with ≥ 7 days PICU admission and likely to stay another 7 days; (2) their parents; (3) PICU attendings participating as continuity attendings; and (4) PICU attendings providing usual care (UC). We examined a bundled intervention: (1) standardized continuity attending role, (2) communication training course for CCI, and (3) standardized timing of contact between CCI and patient/family.
Results Primary outcome was patient PICU length of stay. Secondary outcomes included patient, parental, and clinician outcomes. We enrolled 115 parent-patient dyads (231 subjects), 58 patients were randomized into treatment arm and 56 into the UC arm. Thirteen attendings volunteered to serve as CCI, 10 as UC. No association was found between the intervention and patient PICU length of stay (p = 0.5), other clinical factors, or parental outcomes. The intervention met a threshold for feasibility of enrollment, retention, and implementation while the majority of providers agreed the intervention was acceptable with more efficient decision making. Thirty percent CCIs felt the role took too much time, and 20% felt time was not worth the benefits.
Conclusion CCI intervention did not impact patient or family outcomes. PICU attendings believed that the implementation of the CCI program was feasible and acceptable with potential benefits for efficiency of decision making.
Radiographic Outcomes following K-Wire Augmentation of Dorsal Spanning Plate Fixation for Intra-Articular Fractures of the Distal Radius
Authors: Shah Harsh A. , Martin Anthony R. , Geller Joseph S. , Iyer Hariharan , Dodds Seth D. 
Published: December 2021

Abstract
Background Restoration of articular surface alignment is critical in treating intra-articular distal radius fractures. Dorsal spanning plate fixation functions as an internal distraction mechanism and can be advantageous in the setting of highly comminuted fracture patterns, polytrauma patients, and patients with radiocarpal instability. The addition of K-wires to support articular surface reduction potentially augments fracture repair stability.
Questions/Purposes We examined the radiographic outcomes and maintenance of reduction in patients with comminuted intra-articular distal radius fractures treated with K-wire fixation of articular fragments followed by dorsal spanning plate application.
Patients and Methods We reviewed 35 consecutive patients with complex intra-articular distal radius fractures treated with dorsal spanning plate and K-wire fixation between April 2016 and October 2019. AO classification was recorded: B1 (3), B3 (2), C2 (2), C3 (28). A two-tailed paired t-test was used to compare findings immediately post-dorsal spanning plate surgery and at final follow-up after dorsal spanning plate removal.
Results Mean patient age was 43.3 years (19–78 years). Mean follow-up was 7.8 months (SD 4.3 months) from surgery and 2.5 months from pin removal (SD 2.6 months). All patients achieved radiographic union. Radial height (mean interval change (MIC) 0.2 mm, SD 2.2, p = 0.63), articular step-off (MIC 0.1 mm, SD 0.6 mm, p = 0.88), and radial inclination (MIC −1.1 degrees, SD 3.7 degrees, p = 0.10) did not change from post-surgery to final follow-up. Ulnar variance (MIC −0.9 mm, SD 2.0 mm, p = 0.02) and volar tilt (MIC −1.5 degrees, SD 4.4 degrees, p = 0.05) were found to have decreased.
Conclusion Dorsal spanning plate augmented with K-wire fixation for comminuted intra-articular distal radius fractures in polytrauma patients allows for immediate weightbearing and maintains articular surface alignment at radiographic union and may provide better articular restoration than treatment with dorsal spanning plate alone.
Level of Evidence This is a Level IV, therapeutic study.
Hyperoxemia among Pediatric Intensive Care Unit Patients Receiving Oxygen Therapy
Authors: Fayazi Azadeh R. , Sesia Matteo , Anand Kanwaljeet J. S. 
Published: December 2021

AbstractSupratherapeutic oxygen levels consistently cause oxygen toxicity in the lungs and other organs. The prevalence and severity of hyperoxemia among pediatric intensive care unit (PICU) patients remain unknown. This was the first study to examine the prevalence and duration of hyperoxemia in PICU patients receiving oxygen therapy. This is a retrospective chart review. This was performed in a setting of 36-bed PICU in a quaternary-care children's hospital. All the patients were children aged <18 years, admitted to the PICU for ≥24 hours, receiving oxygen therapy for ≥12 hours who had at least one arterial blood gas during this time.There was no intervention. Of 5,251 patients admitted to the PICU, 614 were included in the study. On average, these patients received oxygen therapy for 91% of their time in the PICU and remained hyperoxemic, as measured by pulse oximetry, for 65% of their time on oxygen therapy. Patients on oxygen therapy remained hyperoxemic for a median of 38 hours per patient and only 1.1% of patients did not experience any hyperoxemia. Most of the time (87.5%) patients received oxygen therapy through a fraction of inspired oxygen (FiO2)-adjustable device. Mean FiO2 on noninvasive support was 0.56 and on invasive support was 0.37. Mean partial pressure of oxygen (PaO2) on oxygen therapy was 108.7 torr and 3,037 (42.1%) of PaO2 measurements were >100 torr. Despite relatively low FiO2, PICU patients receiving oxygen therapy are commonly exposed to prolonged hyperoxemia, which may contribute to ongoing organ injury.
Bochdalek Hernia and Partial Diaphragmatic Agenesis: Pedicled Intercostal Muscle Flap and Mesh Repair in a Young Adult with Sickle Cell Disease
Authors: Dantis Klein , Rathore Devendra Kumar , Gupta Nilesh , Singha Subrata Kumar 
Published: December 2021

AbstractCongenital Bochdalek hernia (BH) in an adult is rare and has an unusual presentation. They are confined to the pediatric age group with an incidence of 1:3,000 live births. It rarely persists asymptomatic until adulthood. Surgical repair by thoracic, abdominal, or thoraco-abdominal approach is the treatment of choice with diaphragmatic reconstruction in associated diaphragmatic agenesis. With only 10 cases of BH with partial diaphragmatic agenesis reported to date, we discuss the rarity, unusual presentation, and management of BH in a young adult with sickle cell disease that has not been reported in the literature.
Anticancer efficacy of monotherapy with antibodies to SIRPα/SIRPβ1 mediated by induction of antitumorigenic macrophages
Authors: Sakamoto Mariko , Murata Yoji , Tanaka Daisuke , Kakuchi Yuka , Okamoto Takeshi , Hazama Daisuke , Saito Yasuyuki , Kotani Takenori , Ohnishi Hiroshi , Miyasaka Masayuki , Fujisawa Masato , Matozaki Takashi 
Published: December 2021

SignificanceTumor-infiltrating macrophages are involved in tumor development, progression, and metastasis. Much recent attention has focused on the modification of macrophage functions in tumors as a basis for cancer treatments. SIRPα and SIRPβ1 are present in macrophages and function as a regulator for phagocytosis. We found that monotherapy with an anti-SIRPα/SIRPβ1 antibody (Ab) suppresses tumor formation by bladder and mammary cancer cells in mice. This effect is likely mediated by promoting the cytotoxic and phagocytic activity of macrophages against tumor cells. Notably, the antitumor effect of the Ab is largely dependent on its binding to SIRPβ1 on macrophages. Our findings reveal mechanisms of antitumor action of the anti-SIRPα/SIRPβ1 Ab and targeting of SIRPβ1 as a potential strategy for cancer immunotherapy.
Editorial: Military human performance optimization: Contemporary issues for sustained and improved readiness
Authors: Nindl Bradley C. , Kyröläinen Heikki 
Published: December 2021

ABSTRACTThis issue of the European Journal of Sport Science includes 8 invited state‐of‐the‐science narrative reviews by well‐established researchers in the area of military performance focused on (a) physical training; (b) musculoskeletal injury; (c) adaptive bone formation and stress fracture prevention; (d) sex differences in responses to military stress; (e) load monitoring in military settings; (g) circulating biomarkers related to resilience during military stress; (H) military nutrition research; and (I) development of military exoskeletons. Important historical, current and future scientific and research information and guidance within the context of sustained and improved military physical performance and readiness are provided. Conclusions and recommendations for protecting Soldier health and resiliency include: (1) combined physical training emphasizing higher intensity but lower volume; (2) musculoskeletal injury risk factors most supported from the literature include: female sex, prior injury and low fitness; (3) adequate sleep, vitamin D, calcium, and energy availability are all critical for creating a resilient skeleton protecting against stress fractures; (4) differences between men and women when exposed to military stress include cardiovascular strain, fat oxidation, and psychological health risk; (5) biomarkers (cortisol, epi/norepi, ILs 4, 6, 10, 18 and TNF‐alpha, IGF‐I, testosterone, DHEA) offer insight for internal stress; (6) monitoring physiological training load should include consideration for multiple inputs, rather than a single measure; (7) nutrition optimization includes determining operational requirements, nutritional practices and nutrient delivery strategies; and (8) future generation exoskeletons will achieve a better balance of intended movement based on individual user and interactions with internal and external constraints.
Horndeski fermion–boson stars
Authors: Roque Armando A , Ureña-López L Arturo 
Published: December 2021

Abstract
We establish the existence of static and spherically symmetric fermion–boson stars, in a low energy effective model of (beyond) Horndeski theories. These stars are in equilibrium, and are composed by a mixing of scalar and fermionic matters that only interact gravitationally one with each other. Properties such as mass, radius, and compactness are studied, highlighting the existence of two families of configurations defined by the parameter c
4. These families have distinctive properties, although in certain limits both are reduced to their counterparts in general relativity (GR). Finally, by assuming the same conditions used in GR, we find the maximum compactness of these hybrid stars and determine that it remains below the so-called Buchdahl’s limit.
On black hole area quantization and echoes
Authors: Coates Andrew , Völkel Sebastian H , Kokkotas Kostas D 
Published: December 2021

Abstract
In this work we argue that black hole (BH) area quantization of Bekenstein and Mukhanov should not give rise to measurable effects in terms of so-called gravitational wave echoes during BH mergers. We outline that the quantum spectrum of a BH should be washed out during and after BH mergers, and hence one should not expect echoes in this scenario. The extreme broadening of the spectrum is due to the large particle emission rate during ringdown. Our results question key assumptions being made in recent literature on this topic.
An introduction to gravitational waves through electrodynamics: a quadrupole comparison
Authors: Dorsch Glauber Carvalho , Antunes Porto Lucas Emanuel 
Published: December 2021

Abstract
We present a pedagogical introduction to some key computations in gravitational waves via a side-by-side comparison with the quadrupole contribution of electromagnetic radiation. Subtleties involving gauge choices and projections over transverse modes in the tensorial theory are made clearer by direct analogy with the vectorial counterpart. The power emitted by the quadrupole moment in both theories is computed, and the similarities as well as the origins of eventual discrepancies are discussed. Finally, we analyze the stability of bound systems under radiation emission, and discuss how the strength of the interactions can be established this way. We use the results to impose an anthropic bound on Newton’s constant of order G ≲ 3 × 104
G
obs, which is on par with similar constraints from stellar formation.
Thermodynamic approach for the understanding of the kinetics of heat effects induced by structural relaxation of metallic glasses
Authors: Makarov A S , Afonin G V , Aronin A S , Kobelev N P , Khonik V A 
Published: December 2021

Abstract
We present a novel approach to the understanding of heat effects induced by structural relaxation of metallic glasses. The key idea consists in the application of a general thermodynamic equation for the entropy change due to the evolution of a non-equilibrium part of a complex system. This non-equilibrium part is considered as a defect subsystem of glass and its evolution is governed by local thermoactivated rearrangements with a Gibbs free energy barrier proportional to the high-frequency shear modulus. The only assumption on the nature of the defects is that they should provide a reduction of the shear modulus—a diaelastic effect. This approach allows to determine glass entropy change upon relaxation. On this basis, the kinetics of the heat effects controlled by defect-induced structural relaxation is calculated. A very good agreement between the calculation and specially performed calorimetric and shear modulus measurements on three metallic glasses is found.
Study of mode II interlaminar fracture toughness of laminated composites of glass and jute fibres in epoxy for structural applications
Authors: Chandel Pankaj Singh , Tyagi Y K , Jha Kanishk , Kumar Rajeev , Sharma Shubham , Singh Jujhar , Ilyas R A 
Published: December 2021

Abstract
Composites are being used in the place of metals in many industries as they have a lower density and are cheaper than metals. In aerospace industries there is requirement for light weight together with strength, and reinforced fibre composites are superior in some critical properties compared with metals. In this study, laminated composites were fabricated with woven E-glass and jute fibres in an epoxy matrix by a hand layup method. The samples were prepared as per the relevant the America Society for Testing ad Materials (ASTM) standard and tested for mode II interlaminar fracture toughness to investigate delamination resistance. Mode II interlaminar fracture toughness was evaluated by an end-notched flexure test using three-point bending. The fracture toughness G
IIC was calculated for a curing temperature range from 40 °C to 70 °C at intervals of 5 °C for different sets of laminated composites. The investigations revealed that when the curing temperature of laminated composites was increased from 40 °C to 70 °C, the interlaminar fracture toughness G
IIC was increased in neat woven E-glass laminated composites, decreased in neat jute laminated composites, significantly increased in laminated composites with woven E-glass fibres in compression and jute fibres in tension and slightly increased when woven E-glass fibres were kept in tension and jute fibres in compression.
Factors associated with emerging multimodal transportation behavior in the San Francisco Bay Area
Authors: McAuliffe Wells Emily , Small Mitchell , Spurlock C Anna , Wong-Parodi Gabrielle 
Published: December 2021

Abstract
This paper identifies the influence of demographic, local transportation environment, and individual preferences for transportation attributes on multimodal transportation behavior in an urban environment with emergent transportation mode availability. Multimodality is the use of more than one mode of transportation during a given timeframe. Multimodality has been considered a key component of sustainable and efficient transportation systems, as this travel behavior can represent a shift away from personal vehicle use to more sustainable transportation modes, especially in urban environments with diverse transportation systems and emergent shared transportation alternatives (e.g., carsharing, ridehailing, bike sharing). However, it is unclear what factors contribute towards people being more likely to exhibit multimodal transportation behavior in modern urban environments. We assessed commuting behavior based on a survey administered in the San Francisco Bay Area according to whether residents commuted (i) exclusively by vehicle, (ii) by a mix of vehicle and non-vehicle modes, or (iii) exclusively by non-vehicle modes. A classification tree approach identified correlations between commuting classes and demographic variables, preferences for transportation attributes, and location-based information. The characterization of commuting styles could inform regional transportation policy and design that aims to reduce vehicle use by identifying the demographic, preference, and location-based considerations correlated with each commuting style.
CoDNaS-RNA: a database of conformational diversity in the native state of RNA
Authors: González Buitrón Martín , Tunque Cahui Ronaldo Romario , García Ríos Emilio , Hirsh Layla , Parisi Gustavo , Fornasari María Silvina , Palopoli Nicolas 
Published: December 2021

Abstract

Summary
Conformational changes in RNA native ensembles are central to fulfill many of their biological roles. Systematic knowledge of the extent and possible modulators of this conformational diversity is desirable to better understand the relationship between RNA dynamics and function. We have developed CoDNaS-RNA as the first database of conformational diversity in RNA molecules. Known RNA structures are retrieved and clustered to identify alternative conformers of each molecule. Pairwise structural comparisons between all conformers within each cluster allows to measure the variability of the molecule. Additional annotations about structural features, molecular interactions and biological function are provided. All data in CoDNaS-RNA is free to download and available as a public website that can be of interest for researchers in computational biology and other life science disciplines.

Availability and implementation
The data underlying this article are available at http://ufq.unq.edu.ar/codnasrna or https://codnas-rna.bioinformatica.org/.

Supplementary information
Supplementary data are available at Bioinformatics online.
Safety and economic analysis of selective histopathology following cholecystectomy: multicentre, prospective, cross-sectional FANCY study
Authors: Bastiaenen Vivian P. , van Vliet Jaap L. P. , de Savornin Lohman Elise A. J. , Corten Bartholomeus J. G. A. , de Jonge Joske , Kraima Anne C. , Swank Hilko A. , van Acker Gijs J. D. , van Geloven Anna A. W. , in ‘t Hof Klaas H. , Koens Lianne , de Reuver Philip R. , van Rossem Charles C. , Slooter Gerrit D. , Tanis Pieter J. , Terpstra Valeska , Dijkgraaf Marcel G. W. , Bemelman Willem A. ,   for the Dutch Snapshot Research Group
Published: December 2021

Abstract

Background
There is ongoing debate concerning the necessity of routine histopathological examination following cholecystectomy. In order to reduce the pathology workload and save costs, a selective approach has been suggested, but evidence regarding its oncological safety is lacking.

Methods
In this multicentre, prospective, cross-sectional study, all gallbladders removed for gallstone disease or cholecystitis were systematically examined by the surgeon for macroscopic abnormalities indicative of malignancy. Before sending all specimens to the pathologist, the surgeon judged whether histopathological examination was indicated. The main outcomes were the number of patients with hypothetically missed malignancy with clinical consequences (upper limit two-sided 95 per cent c.i. below 3:1000 considered oncologically safe) and potential cost savings of selective histopathological examination.

Results
Twenty-two (2.19:1000) of 10 041 specimens exhibited malignancy with clinical consequences. In case of a selective policy, surgeons would have held back 7846 of 10041 (78.1 per cent) gallbladders from histopathological examination. Malignancy with clinical consequences would have been missed in seven of 7846 patients (0.89:1000, upper limit 95% c.i. 1.40:1000). No patient benefitted from the clinical consequences, while two were harmed (futile additional surgery). Of 15 patients in whom malignancy with clinical consequences would have been diagnosed, one benefitted (residual disease radically removed), two potentially benefitted (palliative systemic therapy), and four experienced harm (futile additional surgery). Estimated cost savings established by replacing routine for selective histopathological examination were €703 500 per 10 000 patients.

Conclusion
Selective histopathological examination following cholecystectomy is oncologically safe and could reduce pathology workload, costs, and futile re-resections.
Long-term oncological prognosis after curative-intent liver resection for hepatocellular carcinoma in the youngversusthe elderly: multicentre propensity score-matching study
Authors: Pu Jia-Le , Chen Zhong , Yao Lan-Qing , Feng Ji-Ye , Diao Yong-Kang , Guan Ming-Cheng , Li Ju-Dong , Chen Zheng-Liang , Zhou Ya-Hao , Wang Hong , Gu Wei-Min , Li Jie , Li Chao , Wang Ming-Da , Zhu Hong , Liang Ying-Jian , Shen Feng , Pawlik Timothy M. , Lau Wan Yee , Yang Tian 
Published: December 2021

AbstractBackgroundHepatocellular carcinoma (HCC) is the most common malignancy in the elderly worldwide, but it is also common among younger individuals in areas with endemic hepatitis B virus infection. The differences in long-term oncological prognosis of young versus elderly patients after R0 liver resection for HCC were explored in this study.MethodsUsing a Chinese multicentre database, consecutive patients who underwent R0 liver resection for HCC between 2007 and 2019 were analysed retrospectively. After excluding middle-aged (36–69 years old) patients, overall survival (OS), cancer-specific survival (CSS), and recurrence were compared between young (35 years or younger) and elderly (70 years or older) patients using propensity score matching (PSM).ResultsAmong 531 enrolled patients, there were 192 (36.2 per cent) and 339 (63.8 per cent) patients categorized as young and elderly respectively. PSM created 140 pairs of matched patients. In the PSM cohort, 5-year OS was comparable for young versus elderly patients (51.7 versus 52.3 per cent, P = 0.533). Young patients, however, had a higher 5-year cumulative recurrence rate (62.1 versus 51.6 per cent, P = 0.011) and a worse 5-year CSS rate (54.0 versus 64.3 per cent, P = 0.034) than elderly patients. On multivariable Cox regression analyses, young patient age remained independently associated with an increased recurrence rate (hazard ratio 1.62, P = 0.016) and a decreased CSS rate (hazard ratio 1.69, P = 0.021) compared with older age.ConclusionFollowing R0 liver resection for HCC, younger patients were at a higher risk of recurrence, and elderly patients had a better CSS rate. Thus, enhanced surveillance for HCC recurrence should be implemented for young patients.