bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myocardial Infarction Is Associated With Increased Stroke Severity, In‐Hospital Mortality, and Complications: Insights From China Stroke Center Alliance Registries
Authors: Duan Hongzhou , Li Zixiao , Gu Hong‐Qiu , Zhou Qi , Tong Xu , Ma Gaoting , Wang Bo , Jia Baixue , Wang Yilong , Miao Zhongrong , Wang Yongjun , Mo Dapeng 
Published: October 2021

Background
Prior studies have shown an increased risk of ischemic stroke (IS) after myocardial infarction (MI); however, there are limited studies concerning the characteristics, in‐hospital mortality, and complications of patients with IS with a medical history of MI. We hypothesized that patients with IS with a medical history of MI may experience more severe strokes and have a higher risk of in‐hospital mortality and complications than patients with IS without a medical history of MI.

Methods and Results

Consecutive in‐hospital data were extracted from the China Stroke Center Alliance database from August 2015 to July 2019. Patient characteristics, hospital tests, in‐hospital mortality, and complications were analyzed and compared in patients with IS with or without a history of MI. Of 893 429 patients with IS, we identified 81 646 (9.1%) patients with a history of MI (MI group). Compared with patients with IS without MI, MI group patients were older, had a lower prevalence of current smoking, had a higher prevalence of a relative medical history, and took more medications before admission. Compared with the group with IS without MI, the MI group had a higher National Institute of Health Stroke Scale score after onset (4.0 versus 3.0; Hodges‐Lehmann estimator, 22.5) and a higher proportion of severe strokes (National Institute of Health Stroke Scale score ≥15) (7.1% versus 4.4%; absolute standardized difference=11.6%). In the fully adjusted models, the risk of in‐hospital mortality was higher in the MI group (odds ratio [OR], 1.74; 95% CI, 1.57–1.92;
P
<0.0001). MI group patients also had a higher risk of complications, including urinary tract infection (OR, 1.28; 95% CI, 1.2–1.36;
P
<0.0001), gastrointestinal bleeding (OR, 1.29; 95% CI, 1.19–1.39;
P
<0.0001), pneumonia (OR, 1.24; 95% CI, 1.21–1.28;
P
<0.0001), depression (OR, 1.33; 95% CI, 1.24–1.42;
P
<0.0001), seizure (OR, 1.35; 95% CI, 1.22–1.49;
P
<0.0001), atrial fibrillation (OR, 1.78; 95% CI, 1.71–1.86;
P
<0.0001), and cardiac or respiratory arrest (OR, 1.98; 95% CI, 1.78–2.2;
P
<0.0001).

Conclusions
Patients with IS with a medical history of MI have an increased risk of severe stroke, in‐hospital mortality, and complications. Studies exploring the underlying mechanisms are needed to improve and tailor stroke treatment strategies.
Naive Experience, Religious Root Unity, and Human Identity
Authors: Skillen James W. 
Published: October 2021

Abstract
Resolving Dooyeweerd’s temporal/supratemporal dialectic opens the way to a deeper appreciation of naive experience and human identity as the image of God. This essay makes a case for that proposition, building on my critique of Dooyeweerd’s idea of cosmic time published previously in this journal. There I hypothesized that time—temporality—should be recognized as the first modal aspect rather than as a transaspectual common denominator of the other aspects. The religious root unity of the human community is not a supratemporal, spiritual concentration point but rather humans themselves in their generations answering to God in all that they are and do. Humans are not temporal bodies directed by imperishable souls but whole persons-in-community, subject to all the modal laws and norms (including the temporal), living by faith in the true God or in false gods throughout this age, which opens to creation’s fulfillment in the age to come.
Knowledge and the Fall in American Neo-Calvinism: Toward a Van Til–Plantinga Synthesis
Authors: Békefi Bálint 
Published: October 2021

Abstract
Cornelius Van Til and Alvin Plantinga represent two strands of American Protestant philosophical thought influenced by Dutch neo-Calvinism. This paper compares and synthetizes their models of knowledge in non-Christians given the noetic effects of sin and non-Christian worldview commitments. The paper argues that Van Til’s distinction between the partial realization of the antithesis in practice and its absolute nature in principle correlates with Plantinga’s insistence on prima facie–warranted common-sense beliefs and their ultimate defeasibility given certain metaphysical commitments. Van Til endorsed more radical claims than Plantinga on epistemic defeat in non-Christian worldviews, the status of the sensus divinitatis, and conceptual accuracy in knowledge of the world. Finally, an approach to the use of evidence in apologetics is developed based on the proposed synthesis. This approach seeks to make more room for evidence than is generally recognized in Van Tilianism, while remaining consistent with the founder’s principles.
Using Excavated Slips to Look at Effective Governance of the Northern Frontier during the Han Dynasty—The Lelang Commandery in Han Slips
Authors: Zhang (張德芳) Defang 
Published: October 2021

Abstract
By analyzing “The Record of the Increase and Decrease in the Number of Households in Lelang Commandery by County in Year Four of Chuyuan” 樂浪郡初元四年縣别户口多少[集] 簿 from Han tomb #364, located in Jeongbaekdong 정백동 (貞柏洞), Pyeongyang, this paper shows how population and territory were fundamental to the exercise of power. Complete population figures for Lelang Commandery 樂浪郡 are evidence of the existence of a governing mechanism of commanderies and counties in this region during the Western Han. Furthermore, an assortment of excavated seals in the area are symbols of different levels of official authority. The discovery of impressions on clay from seals of government officials from commandery level to county level, essentially covering every county in Lelang Commandery, indicates the effectiveness of various administrative bodies and officials of all levels in exercising their functions and powers. Wooden slips that refer to Lelang, which were excavated in the Juyan 居延 area, show that Lelang commandery and all other border commanderies were effectively governed during the Western Han down through Wang Mang to the Eastern Han.
Investigation of Machine Learning Using Satellite-Based Advanced Dvorak Technique Analysis Parameters to Estimate Tropical Cyclone Intensity
Authors: Olander Timothy , Wimmers Anthony , Velden Christopher , Kossin James P. 
Published: October 2021

AbstractSeveral simple and computationally inexpensive machine learning models are explored that can use advanced Dvorak technique (ADT)-retrieved features of tropical cyclones (TCs) from satellite imagery to provide improved maximum sustained surface wind speed (MSW) estimates. ADT (version 9.0) TC analysis parameters and operational TC forecast center best track datasets from 2005 to 2016 are used to train and validate the various models over all TC basins globally and select the best among them. Two independent test sets of TC cases from 2017 to 2018 are used to evaluate the intensity estimates produced by the final selected model called the “artificial intelligence (AI)” enhanced advanced Dvorak technique (AiDT). The 2017–18 MSW results demonstrate a global RMSE of 7.7 and 8.2 kt (1 kt ≈ 0.51 m s−1), respectively. Basin-specific MSW RMSEs of 8.4, 6.8, 7.3, 8.0, and 7.5 kt were obtained with the 2017 dataset in the North Atlantic, east/central Pacific, northwest Pacific, South Pacific/south Indian, and north Indian Ocean basins, respectively, with MSW RMSE values of 8.9, 6.7, 7.1, 10.4, and 7.7 obtained with the 2018 dataset. These represent a 30% and 23% improvement over the corresponding ADT RMSE for the 2017–18 datasets, respectively, with the AiDT error reduction significant to 99% in both sets. The AiDT model represents a notable improvement over the ADT performance and also compares favorably to more computationally expensive and complex machine learning models that interrogate satellite images directly while still preserving the operational familiarity of the ADT.
Outcome management of Fournier’s gangrene cases at tertiary hospital: 7 Years experience
Authors: Wirjopranoto Soetojo , Azmi Yufi Aulia 
Published: October 2021

Objective: This study aims to describe the condition of Fournier’s gangrene in Dr. Soetomo General Hospital from January 2014 to December 2020. Material and methods: This study used a retrospective analytic design, by taking data through medical records at Dr. Soetomo General Hospital from January 2014 to December 2020. This study used total sampling with recorded data: age, gender, length of stay, outcome, location, comorbidities, causes, management, culture results, and Fournier’s gangrene severity index (FGSI) score. Result: Of the 135 subjects collected, it was found that 55.56% were individuals over 50 years of age. About 91.11% were male patients, with some sites being in the scrotum 50.37%. Only 25.19% of patients had no comorbids, while the rest had a history of CKD, hypertension, diabetes, or a combination of these diseases. Bacterial cultures obtained were mostly caused by the Enterobacteriaceae bacteria group (32.59%). Of the subjects we studied who experienced mortality, it was found that all were from the group with FGSI >9. Conclusion: From the results of our descriptive study, at a glance, it appears that there is a tendency for the incidence of Fournier’s gangrene in the elderly and individuals with comorbidities. And the mortality rate increases with a high FGSI value. So that FGSI could be used as a predictor of mortality in patients with FG.
Sociodemographic and Geographic Factors Associated With Non-Obstetrical Ultrasound Imaging Utilization: A Population-Based Study
Authors: Adams Scott J. , Yao Shenzhen , Mondal Prosanta , Lim Hyun , Mendez Ivar , Babyn Paul 
Published: October 2021

Objective: Ultrasound is one of the most commonly used imaging modalities, though some populations face barriers in accessing ultrasound services, potentially resulting in disparities in utilization. The objective of this study was to assess the association between sociodemographic and geographic factors and non-obstetrical ultrasound utilization in the province of Saskatchewan, Canada. Methods: All non-obstetrical ultrasound exams performed from 2014 to 2018 in Saskatchewan, Canada were retrospectively identified from province-wide databases. Univariate and multivariate Poisson regression analyses were performed to assess the association between ultrasound utilization and sex, age, First Nations status, Charlson Comorbidity Index, urban vs. rural residence, geographic remoteness, and neighborhood income. Results: A total of 1,324,846 individuals (5,857,044 person-years) were included in the analysis. Female sex (adjusted incidence rate ratio [aIRR], 2.20; 95% confidence interval [CI], 2.19-2.22), age (aIRR, 4.97; 95% CI, 4.90-5.05 for ≥57 years vs. <11 years), comorbidities (aIRR, 4.36 for Charlson Comorbidity Index >10 vs. 0; 95% CI, 3.78-5.03), and higher neighborhood income (aIRR, 1.04; 95% CI, 1.02-1.05 for highest vs. lowest quintile) were associated with higher rates of ultrasound utilization. Individuals who were status First Nations (aIRR, 0.91; 95% CI, 0.90-0.92) or resided in geographically remote areas (aIRR, 0.87 for most vs. least remote; 95% CI, 0.83-0.91) had lower rates of ultrasound utilization. Individuals who lived in a rural area also had lower rates of ultrasound utilization (aIRR, 0.93; 95% CI, 0.92-0.94). Conclusion: Substantial disparities exist in non-obstetrical ultrasound utilization among individuals in low-income neighborhoods, status First Nations individuals, and individuals in rural and remote communities.
Assessment of Progressive Collapsing Foot Deformity Using Semiautomated 3D Measurements Derived From Weightbearing CT Scans
Authors: Krähenbühl Nicola , Kvarda Peter , Susdorf Roman , Burssens Arne , Ruiz Roxa , Barg Alexej , Hintermann Beat 
Published: October 2021

Background: In progressive collapsing foot deformity (PCFD), hind- and midfoot deformities can be hard to characterize based on weightbearing plain radiography. Semiautomated 3-dimensional (3D) measurements derived from weightbearing computed tomography (WBCT) scans may provide a more accurate deformity assessment. In the present study, automated 3D measurements based on WBCT were used to compare hindfoot alignment of healthy individuals to patients with PCFD. Methods: The WBCT scans of 20 patients treated at our institution with either a flexible (N = 10) or rigid (N = 10) PCFD were compared with the WBCT scans of a control group of 30 healthy individuals. Using semiautomated image analysis software, from each set of 3D voxel images, we measured the talar tilt (TT), hindfoot moment arm (HMA), talocalcaneal angle (TCA; axial/lateral), talonavicular coverage (TNC), and talocalcaneal overlap (TCO). The presence of medial facet subluxation as well as sinus tarsi/subfibular impingement was additionally assessed. Results: With the exception of the TCA (axial/lateral), the analyzed measurements differed between healthy individuals and patients with PCFD. The TCA axial correlated with the TNC in patients with PCFD. An increased TCO combined with sinus tarsi impingement raised the probability of predicting a deformity as rigid. Conclusion: Using 3D measurements, in this relatively small cohort of patients, we identified relevant variables associated with a clinical presentation of flexible or rigid PCFD. An increased TCO combined with sinus tarsi impingement raised the probability of predicting a deformity as rigid. Such WBCT-based markers possibly can help the surgeon in decision-making regarding the appropriate surgical strategy (eg, osteotomies vs realignment arthrodesis). However, prospective studies are necessary to confirm the utility of the proposed parameters in the treatment of PCFD. Level of Evidence: Level III, case-control study.
Fecal CEA Has an Advantage in the Diagnosis of Colorectal Cancer at Early Stage
Authors: Li Linfang , Xing Shan , Wu Miantao , Ao Yufeng , Zheng Xin , Cai Rongzeng , Han Runkun , Li Jingcong , Li Xiaohui , Zeng Qiuyao 
Published: October 2021

Purpose Serum carcinoembryonic antigen (SCEA) level is often measured in patients with CRC but suffers from poor sensitivity and specificity as a diagnostic biomarker. CEA is more abundant in stool than in serum, but it has not been widely studied. This study aimed to elucidate the efficacy of fecal CEA (FCEA) as a potential non-invasive biomarker for early diagnosis of CRC. Materials and Methods We retrospectively analyzed the determination of FCEA and SCEA levels by electrochemiluminescence. We evaluated the diagnostic accuracy of FCEA and SCEA levels in early-stage CRC patients and healthy controls using ROC curve. Results A total of 298 people were included: 115 patients with CRC, 35 patients with adenomatous polyp (APC), 46 patients with non-gastrointestinal cancer (NGC), and 102 healthy controls (HC). The FCEA concentrations in CRC and APC patients were significantly higher than that of NGC and HC, and this is different from SCEA expression in APC and NGC. As a diagnostic biomarker of CRC, FCEA had significantly larger AUC compared with SCEA (.802 vs .735, P  < .001). For identifying early-stage colorectal cancer, FCEA showed better diagnostic efficacy (AUC: .831) than SCEA (AUC: .750), and the combination of the 2 biomarkers was even higher (AUC: .896). The sensitivity of FCEA was higher than that of SCEA (78.7% vs 29.8%). When SCEA was negative, 80.3% of CRC and 54.6% of APC cases could be identified by FCEA. Conclusion Compared with SCEA, FCEA has more advantages in the diagnosis of the early stage of colorectal cancer and adenomatous polyps.
Psychosocial indicators of primary congenital glaucoma and filtering surgeries impacts on children and family’s quality of life
Authors: Silva Andrea Oliveira da , Rolim-de-Moura Christiane , Botelho Nara Lúcia Poli , Gracitelli Carolina PB , Ferraz Nívea Nunes 
Published: October 2021

Purpose: To identify psychosocial indicators and evaluate the filtering surgeries impacts on quality of life (QOL) of children with primary congenital glaucoma (PCG) and their family. Methods: Parents of children with bilateral PCG who underwent filtering surgery were included. Data were collected through: (a) psychological inquiry to determine psychosocial indicators; (b) Children’s Visual Function Questionnaire (CVFQ). The associations between the CVFQ scores and visual acuity, intraocular pressure, optic disk cupping, horizontal corneal diameter, axial length, number of surgeries, and hypotensive eye drops were investigated. The statistical significance level was considered as p ⩽ 0.05. Results: The mean age of the nine mothers interviewed and their children (six boys and three girls) was 29 ± 5 years and 35 ± 18 months, respectively. The psychosocial indicators determined were: emotional impact of the diagnosis, disease knowledge, mother and family’s feelings on facing the surgical treatment, surgical result comprehension, treatment adherence, child's emotional and behavioral reactions, social support, and future expectations. In CVFQ analysis, QOL score was strongly associated with visual acuity ( r = −0.79; p = 0.01). Besides the treatment score was correlated to intraocular pressure ( r = −0.68; p < 0.05), optic disk cupping ( r = −0.85; p = 0.03), and corneal diameter ( r = −0.69; p = 0.02). Correlations were not found for number of surgeries and eye drops. Conclusions: This study confirmed the PCG surgical treatment impact on QOL and determined psychosocial indicators which may favor the suitable actions in psychological treatment and follow-up of the children and families.
Should we care about the ocular surface in the anophthalmic patient?
Authors: Volpe Giulio , De Piano Maria , Mazzone Giacomilde , Micera Alessandra , Bonini Stefano , Modugno Alessandra Claudia 
Published: October 2021

Purpose: To assess clinical and biomolecular changes of the conjunctival epithelium in anophthalmic patients wearing an ocular prosthesis. Methods: Thirty-five unilateral anophthalmic patients were enrolled. Patients with blepharitis, lid abnormalities, and topical/systemic medication affecting the ocular surface were excluded. Symptom Assessment in Dry Eye (SANDE) questionnaire and tear function test (Schirmer Test Type I) were recorded. Conjunctival inflammation and meibomian gland dysfunction (MGD) were graded in the anophthalmic side and fellow eye. Impression cytology sampling of the upper, lower tarsal, and posterior/bulbar conjunctiva from the anophthalmic socket were collected and compared to healthy controls. Results: Patients had significantly higher SANDE ( p < 0.001), Schirmer I test ( p = 0.004), conjunctival inflammation ( p < 0.001), and MGD scores ( p < 0.001) on the anophthalmic side compared to the fellow eye. Mucin 5AC, inflammatory markers (MMP-9, ICAM-1) expression ( p < 0.001), and response to oxidative stress (NRF2-KEAP1 signaling pathway) ( p < 0.05) were significantly upregulated in the posterior conjunctival surface in the anophthalmic socket. Conclusions: Anophthalmic patients complained of more pronounced dry eye symptoms and presented more significant signs of inflammation and MGD on the anophthalmic side. The bulbar conjunctiva, behind the prosthesis, showed more significant hyperexpression of mucins, markers of inflammation, and increased response to oxidative stress compared to the tarsal conjunctiva. Patients wearing ocular prosthesis had signs of inflammation resembling dry eye disease.
Measurement of neurofilaments improves stratification of future disease activity in early multiple sclerosis
Authors: Uher Tomas , Havrdova Eva Kubala , Benkert Pascal , Bergsland Niels , Krasensky Jan , Srpova Barbora , Dwyer Michael , Tyblova Michaela , Meier Stephanie , Vaneckova Manuela , Horakova Dana , Zivadinov Robert , Leppert David , Kalincik Tomas , Kuhle Jens 
Published: October 2021

Background: The added value of neurofilament light chain levels in serum (sNfL) to the concept of no evidence of disease activity-3 (NEDA-3) has not yet been investigated in detail. Objective: To assess whether combination of sNfL with NEDA-3 status improves identification of patients at higher risk of disease activity during the following year. Methods: We analyzed 369 blood samples from 155 early relapsing-remitting MS patients on interferon beta-1a. We compared disease activity, including the rate of brain volume loss in subgroups defined by NEDA-3 status and high or low sNfL (> 90th or < 90th percentile). Results: In patients with disease activity (EDA-3), those with higher sNFL had higher odds of EDA-3 in the following year than those with low sNFL (86.5% vs 57.9%; OR = 4.25, 95% CI: [2.02, 8.95]; p = 0.0001) and greater whole brain volume loss during the following year (β = −0.36%; 95% CI = [−0.60, −0.13]; p = 0.002). Accordingly, NEDA-3 patients with high sNfL showed numerically higher disease activity (EDA-3) in the following year compared with those with low sNfL (57.1% vs 31.1%). Conclusion: sNfL improves the ability to identify patients at higher risk of future disease activity, beyond their NEDA-3 status. Measurement of sNfL may assist clinicians in decision-making by providing more sensitive prognostic information.
Hyperacute stroke and the specialist nursing impact: exploring the cause and context of feelings of secondary traumatic stress – a qualitative inquiry
Authors: Wilkinson Mark , Cox Nigel , Witham Gary , Haigh Carol 
Published: October 2021

Background Secondary traumatic stress (STS) has been defined as the stress resulting from helping or wanting to help a traumatised or suffering person. The hyperacute nature of stroke specialist nurses’ work places them at risk of developing STS. Aims To explore the factors that are influential in stroke specialist nurses' experience of STS development within hyperacute practice. Methods This study is qualitative with a narrative design. Data were collected from a purposive sample of stroke specialist nurses (20 female and 2 male) working in hyperacute services during the years 2016 and 2017. Data were analysed using Polkinghorne’s approach. Results This research identified four themes: exposure to acute suffering and death- young presentations; moral distress; interactions with relatives and problematic healthcare systems. Conclusion The findings from this study suggest that stroke specialist nurses are exposed to multiple triggers which are commensurate with the potential for STS development. The findings contribute a new understanding of the emotional burden of hyperacute specialist stroke nursing that has implications for patient safety and satisfaction, services provision and staff well-being.