bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Core Difference! The Varying Hoplite Shield Designs and their Effects on Economic Value, Performance and Combat Effectiveness
Authors: De Groote Kevin Rowan 
Published: June 2021

Abstract
Despite the vast research undertaken on hoplite warfare, surprisingly little is known about how hoplite shields were made, the very technology underpinning the transformative military reforms of hoplite warfare. The few forays that have explored the manufacturing process have been isolated and unintegrated studies leading to an often simplistic and superficial uniformity of production model which does not reflect the evidence. This article analyses the physical remains of extant hoplite shields and finds a plurality of different designs in concurrent use with core compositional differences that likely impacted combat performance and economic value with some designs performing better than others. Moreover, the use and availability of different shield designs of variable quality and economic value suggests a wider range of socioeconomic diversity in hoplite armies and among hoplites than is generally assumed.
Seasonal Forecast of Non-monsoonal Winter Precipitation over the Eurasian Continent using Machine Learning Models
Authors: Qian QiFeng , Jia XiaoJing , Lin Hai , Zhang Ruizhi 
Published: June 2021

AbstractIn this study, four machine learning (ML) models (gradient boost decision tree (GBDT), light gradient boosting machine (LightGBM), categorical boosting (CatBoost) and extreme gradient boosting (XGBoost)) are used to perform seasonal forecasts for non-monsoonal winter precipitation over the Eurasian continent (30-60°N, 30-105°E) (NWPE). The seasonal forecast results from a traditional linear regression (LR) model and two dynamic models are compared. The ML and LR models are trained using the data for the period of 1979-2010, and then, these empirical models are used to perform the seasonal forecast of NWPE for 2011-2018. Our results show that the four ML models have reasonable seasonal forecast skills for the NWPE and clearly outperform the LR model. The ML models and the dynamic models have skillful forecasts for the NWPE over different regions. The ensemble means of the forecasts including the ML models and dynamic models show higher forecast skill for the NWEP than the ensemble mean of the dynamic-only models. The forecast skill of the ML models mainly benefits from a skillful forecast of the third empirical orthogonal function (EOF) mode (EOF3) of the NWPE, which has a good and consistent prediction among the ML models. Our results also illustrate that the sea ice over the Arctic in the previous autumn is the most important predictor in the ML models in forecasting the NWPE. This study suggests that ML models may be useful tools to help improve seasonal forecasts of the NWPE.
Tornadoes in Hurricane Harvey
Authors: Nowotarski Christopher J. , Spotts Justin , Edwards Roger , Overpeck Scott , Woodall Gary R. 
Published: June 2021

AbstractTropical cyclone tornadoes pose a unique challenge to warning forecasters given their often marginal environments and radar attributes. In late August 2017 Hurricane Harvey made landfall on the Texas coast and produced 52 tornadoes over a record-breaking seven consecutive days. To improve warning efforts, this case study of Harvey’s tornadoes includes an event overview as well as a comparison of near-cell environments and radar attributes between tornadic and nontornadic warned cells. Our results suggest that significant differences existed in both the near-cell environments and radar attributes, particularly rotational velocity, between tornadic cells and false alarms. For many environmental variables and radar attributes, differences were enhanced when only tornadoes associated with a tornado debris signature were considered. Our results highlight the potential of improving warning skill further and reducing false alarms by increasing rotational velocity warning thresholds, refining the use of near-storm environment information, and focusing warning efforts on cells likely to produce the most impactful tornadoes.
Dissemination and Acceptance of COVID-19 Misinformation in Iran: A Qualitative Study
Authors: Taghipour Faezeh , Ashrafi-rizi Hasan , Soleymani Mohammad Reza 
Published: June 2021

Introduction Misinformation refers to unclear information from unreliable resources, and it is a common phenomenon of society; it can even constitute a part of family and social conversations due to the relative damages. Misinformation dissemination under the circumstances of the COVID-19 pandemic can be considered a cause of health-related anxieties and severe harm to the countries. The present study aims to explain factors related to the dissemination and acceptance of coronavirus misinformation in Iran. Material and Methods This qualitative study was carried out through content analysis in the year 2020. The population included Iranian experts in Information and Communication Sciences, among whom 19 experts were selected through the purposive sampling method. The data were collected through semi-structured interviews and analyzed through Continuous Thematic Analysis. Such criteria authenticated data trustworthiness as credibility, confirmability, dependability, and transferability proposed by Guba and Lincoln. Findings Based on the experiences of participants, six major categories and 18 subcategories were identified regarding the major theme. The major categories included the official news and informing system, misinformation nature, users, media, misinformation source, and social determinants. Conclusion Concurrent with the Covid-19 outbreak, a sort of information tsunami occurs. Unavoidably, a significant amount of misinformation regarding the various aspects of the virus, such as its origin, transmission methods, control, and treatment, are published. In many cases, the spreading information is not checked and verified in terms of accuracy and authenticity. The spread and acceptance of Covid-19 related misinformation happen under the impact of various factors. Being familiar with these factors will boost the culture of health and pave the path toward establishing evidence-based information public awareness schemes.
Choosing a Metamodel of a Simulation Model for Uncertainty Quantification
Authors: de Carvalho Tiago M. , van Rosmalen Joost , Wolff Harold B. , Koffijberg Hendrik , Coupé Veerle M. H. 
Published: June 2021

Background Metamodeling may substantially reduce the computational expense of individual-level state transition simulation models (IL-STM) for calibration, uncertainty quantification, and health policy evaluation. However, because of the lack of guidance and readily available computer code, metamodels are still not widely used in health economics and public health. In this study, we provide guidance on how to choose a metamodel for uncertainty quantification. Methods We built a simulation study to evaluate the prediction accuracy and computational expense of metamodels for uncertainty quantification using life-years gained (LYG) by treatment as the IL-STM outcome. We analyzed how metamodel accuracy changes with the characteristics of the simulation model using a linear model (LM), Gaussian process regression (GP), generalized additive models (GAMs), and artificial neural networks (ANNs). Finally, we tested these metamodels in a case study consisting of a probabilistic analysis of a lung cancer IL-STM. Results In a scenario with low uncertainty in model parameters (i.e., small confidence interval), sufficient numbers of simulated life histories, and simulation model runs, commonly used metamodels (LM, ANNs, GAMs, and GP) have similar, good accuracy, with errors smaller than 1% for predicting LYG. With a higher level of uncertainty in model parameters, the prediction accuracy of GP and ANN is superior to LM. In the case study, we found that in the worst case, the best metamodel had an error of about 2.1%. Conclusion To obtain good prediction accuracy, in an efficient way, we recommend starting with LM, and if the resulting accuracy is insufficient, we recommend trying ANNs and eventually also GP regression.
High retinoic acid receptor-related orphan receptor A gene expression in peripheral blood leukocytes may be related to acute myocardial infarction
Authors: Meng Heyu , Ruan Jianjun , Tian Xiaomin , Li Lihong , Chen Weiwei , Meng Fanbo 
Published: June 2021

Objective This study aimed to investigate whether differential expression of the retinoic acid receptor-related orphan receptor A ( RORA) gene is related to occurrence of acute myocardial infarction (AMI). Methods This was a retrospective study. White blood cells of 93 patients with acute myocardial infarction and 74 patients with stable coronary artery disease were collected. Reverse transcription quantitative polymerase chain reaction and western blotting were used to measure RORA mRNA and protein expression, respectively. Results RORA mRNA expression levels in peripheral blood leukocytes in patients with AMI were 1.57 times higher than those in patients with stable coronary artery disease. Protein RORA levels in peripheral blood of patients with AMI were increased. Binary logistic regression analysis showed that high expression of RORA was an independent risk factor for AMI, and it increased the risk of AMI by 2.990 times. Conclusion RORA expression levels in patients with AMI is significantly higher than that in patients with stable coronary artery disease. High expression of RORA is related to AMI and it may be an independent risk factor for AMI.
Minimum 10-Year Outcomes of Primary Arthroscopic Transosseous-Equivalent Double-Row Rotator Cuff Repair
Authors: Johannsen Adam M. , Arner Justin W. , Elrick Bryant P. , Nolte Philip-C. , Rakowski Dylan R. , Horan Marilee P. , Millett Peter J. 
Published: June 2021

Background: Modern rotator cuff repair techniques demonstrate favorable early and midterm outcomes, but long-term results have yet to be reported. Purpose: To determine 10-year outcomes and survivorship after arthroscopic double-row transosseous-equivalent (TOE) rotator cuff repair. Study Design: Case series; Level of evidence 4. Methods: The primary TOE rotator cuff repair procedure was performed using either a knotted suture bridge or knotless tape bridge technique on a series of patients with 1 to 3 tendon full-thickness rotator cuff tears involving the supraspinatus. Only patients who were 10 years postsurgery were included. Patient-reported outcomes were collected pre- and postoperatively, including American Shoulder and Elbow Surgeons (ASES), 12-Item Short Form Health Survey (SF-12), Single Assessment Numeric Evaluation (SANE), shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), and satisfaction. Kaplan-Meier survivorship analysis was performed. Failure was defined as progression to revision surgery. Results: A total of 91 shoulders (56 men, 31 women) were included between October 2005 and December 2009. Mean follow-up was 11.5 years (range, 10.0-14.1 years). Of 91 shoulders, 5 (5.5%) failed and required revision surgery. Patient-reported outcomes for patients who survived were known for 80% (69/86). Outcomes scores at final follow-up were as follows: ASES, 93.1 ± 10.8; SANE, 87.5 ± 14.2; QuickDASH, 11.1 ± 13.5; and SF-12 physical component summary (PCS), 49.2 ± 10.1. There were statistically significant declines in ASES, SANE, and SF-12 PCS from the 5-year to 10-year follow-up, but none of these changes met the minimally clinically important difference threshold. Median satisfaction at final follow-up was 10 (range, 3-10). From this cohort, Kaplan-Meier survivorship demonstrated a 94.4% survival rate at a minimum of 10 years. Conclusion: Arthroscopic TOE rotator cuff repair demonstrates high patient satisfaction and low revision rates at a mean follow-up of 11.5 years. This information may be directly utilized in surgical decision making and preoperative patient counseling regarding the longevity of modern double-row rotator cuff repair.
Characterization of Prophylactic Antimicrobial Therapy Practices for Patients With Marine-Associated Injuries in the Emergency Department
Authors: Byrkit Britany N. , LaScala Elizabeth C. , MenkinSmith Lacey , Hall Gregory A. , Weant Kyle A. 
Published: June 2021

Background: Centers for Disease Control and Prevention (CDC) recommendations for the treatment of marine-associated wound infections include empiric coverage for Vibrio species with a combination of a third-generation cephalosporin and doxycycline. These recommendations are based on limited data and it remains unclear if this regimen is also indicated for prophylaxis. Objective: The purpose of this analysis was to assess the antibiotic regimens used in the emergency department (ED) for prophylaxis of marine-associated injuries relative to the CDC recommendations and evaluate any clinical impact. Methods: A retrospective review evaluated adult patients discharged from the ED over a 4-year period with an antibiotic prescription following an injury with marine exposure. Results: 114 patients were included in the analysis. The majority of patients were < 40 years of age with no previous medical history and presented after sustaining a laceration secondary to oyster shells. 97.4% received prophylactic antibiotic therapy that did not match the CDC recommendations, with the majority receiving doxycycline monotherapy (82%). A 1.8% 30-day ED revisit rate was noted with 2 patients returning for therapy failure. No patients were admitted to the hospital within 30 days and no documented adverse effects related to antibiotic therapy were noted. Conclusion: Current prophylactic antibiotic prescribing practices diverge from the current CDC recommendations for the treatment of marine-associated infections, however, an effect secondary to these variations was not observed. Further investigations of prophylaxis against Vibrio infections in low-risk patients is warranted to limit collateral damage and improve antimicrobial stewardship in the ED.
The timed 25-foot walk in a large cohort of multiple sclerosis patients
Authors: Kalinowski Anissa , Cutter Gary , Bozinov Nina , Hinman Jessica A , Hittle Michael , Motl Robert , Odden Michelle , Nelson Lorene M 
Published: June 2021

Background: The timed 25-foot walk (T25FW) is a key clinical outcome measure in multiple sclerosis patient management and clinical research. Objectives: To evaluate T25FW performance and factors associated with its change in the Multiple Sclerosis Outcome Assessments Consortium (MSOAC) Placebo Database ( n = 2465). Methods: We created confirmed disability progression (CDP) variables for T25FW and Expanded Disability Status Scale (EDSS) outcomes. We used intraclass correlation coefficients (ICCs) and Bland Altman plots to evaluate reliability. We evaluated T25FW changes and predictive validity using a mixed-effects model, survival analysis, and nested case–control analysis. Results: The mean baseline score for the T25FW in this study population was 9.2 seconds, median = 6.1 (standard deviation = 11.0, interquartile range (IQR) = 4.8, 9.0). The T25FW measure demonstrated excellent test–retest reliability (ICC = 0.98). Walk times increased with age, disability, disease type, and disease duration; relapses were not associated with an increase. Patients with T25FW progression had a faster time to EDSS-CDP compared to those without (hazards ratio (HR): 2.6; confidence interval (CI): 2.2, 3.1). Changes in the T25FW were more likely to precede changes in EDSS. Conclusion: This research confirms the association of the T25FW with disability and provides some evidence of predictive validity. Our findings support the continued use of the T25FW in clinical practice and clinical trials.
Quality of life of postmenopausal women in rural area, Nepal
Authors: Thapa Pratima , Thebe Prabha 
Published: June 2021

Background Menopause is one of the natural phenomena in every woman’s life. The transition phase gradually brings lots of changes in the life of women, both physically and mentally. In Nepal, these changes are often viewed as the symptoms of old age. This study aims to determine the prevalence of menopausal symptoms and their quality of life (QOL). Methods A descriptive cross-sectional study was conducted in a rural municipality of Jhapa district, Nepal, with study samples of 215 collected using purposive sampling technique. Semistructured questionnaire and MENQOL questionnaire were used for data collection. Descriptive (mean, standard deviation, frequency and percentage) and inferential statistics (t-test and ANOVA test) were used for data analysis. The confidence interval was taken as 95% and probability of significance at p < 0.05. Results The study showed that the mean age of the respondents was 53.51 ± 4.42 years with the mean age at menopause being 47.18 ± 6.16 years. The most prevalent symptoms among postmenopausal women were feeling tired or worn out (98.8%), followed by decrease in stamina (94%), decrease in physical strength (91.2%) and lack of energy (90%). The highest mean score was seen in physical domain (2.88 ± 1.61) followed by sexual (2.77 ± 1.93), vasomotor (2.65 ± 1.84) and psychosocial (2.45 ± 1.55). The overall mean score of QOL was found to be 80.06 ± 24.52. Marital status, number of children, educational status, occupational status and health seeking behaviour had significant association with the QOL score. Conclusion The most common symptoms experienced by the postmenopausal women were the physical symptoms followed by sexual, vasomotor and psychosocial. Presence of these symptoms certainly affects the QOL. Hence, effective awareness and education programme regarding the symptoms and ways to minimize those symptoms should be planned and provided both at individual and community levels.
Concussion reporting behaviors in student athletes across sexes and levels of contact
Authors: Chizuk Haley M , Haider Mohammad N , Solomito Matthew , Kostyun Regina , Willer Barry S , Leddy John J , Wang David 
Published: June 2021

Context Sport-related concussions (SRC) are common in student athletes. However, current literature suggests that many athletes do not accurately report their symptoms. The under-reporting of concussion symptoms can result in an increased risk of further injury and an underestimation of concussion prevalence. Objective This study aims to identify perspectives on concussion reporting behaviors in student athletes across levels of contact and by sex. Design Cross-sectional study. Setting Elementary and high school, college. Patients or other participants: 1126 female (52%) and male (48%) athletes, mean age 16.6 years. Main outcome measure(s): Standardized questionnaire on concussion reporting during a series of hypothetical scenarios. Results Student athletes participating in sports with higher levels of contact had more education about concussions, yet professed they were less likely to report a concussion. The most common reasons athletes chose not to report were ‘not wanting to miss the game’ and ‘not wanting to let the coach down.’ Minimal differences were found between sexes, with females being just as unlikely, or sometimes more unlikely, to report a concussion than males. Lastly, females playing contact and non-contact sports appear to be more concerned about not wanting to let their coach down than males. Conclusions Although perspective on concussion reporting behavior varied across sports of different levels of contact, we did not find any conclusive evidence of differences in willingness to report a concussion between sexes when compared within the same level of contact.
PENs in the PENis: a case report and brief review of the literature
Authors: Bonatsos Vasileios , Batura Deepak 
Published: June 2021

Abstract
Background
According to the literature, there have been reports of introduction of foreign bodies into the urethra predominantly in males, both adults and children. Erotic stimulation, intoxication, assault and psychiatric conditions are the most frequent contributors.

Case presentation
A 70-year-old male presented with difficulty in passing urine for one week after having inserted two plastic ballpoint pens into his urethra. The patient had a failed attempt at removal using a rigid cystoscope and biopsy forceps. A Liga-clip applicator allowed successful blind removal of both pens while the patient was under a general anaesthetic.

Conclusions
Removal of urethral foreign bodies can be challenging as endoscopic removal may fail, and open or blind procedures may be required. Moreover, complications can be significant. On occasions, improvisations in techniques may be helpful, such as in our patient. A psychiatric review is vital to try and ensure the prevention of repeat incidents.
Unravelling population structure heterogeneity within the genome of the malaria vector Anopheles gambiae
Authors: Campos Melina , Rona Luisa D. P. , Willis Katie , Christophides George K. , MacCallum Robert M. 
Published: June 2021

Abstract
Background
Whole genome re-sequencing provides powerful data for population genomic studies, allowing robust inferences of population structure, gene flow and evolutionary history. For the major malaria vector in Africa, Anopheles gambiae, other genetic aspects such as selection and adaptation are also important. In the present study, we explore population genetic variation from genome-wide sequencing of 765 An. gambiae and An. coluzzii specimens collected from across Africa. We used t-SNE, a recently popularized dimensionality reduction method, to create a 2D-map of An. gambiae and An. coluzzii genes that reflect their population structure similarities.

Results
The map allows intuitive navigation among genes distributed throughout the so-called “mainland” and numerous surrounding “island-like” gene clusters. These gene clusters of various sizes correspond predominantly to low recombination genomic regions such as inversions and centromeres, and also to recent selective sweeps. Because this mosquito species complex has been studied extensively, we were able to support our interpretations with previously published findings. Several novel observations and hypotheses are also made, including selective sweeps and a multi-locus selection event in Guinea-Bissau, a known intense hybridization zone between An. gambiae and An. coluzzii.

Conclusions
Our results present a rich dataset that could be utilized in functional investigations aiming to shed light onto An. gambiae s.l genome evolution and eventual speciation. In addition, the methodology presented here can be used to further characterize other species not so well studied as An. gambiae, shortening the time required to progress from field sampling to the identification of genes and genomic regions under unique evolutionary processes.