bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wars of Choice: Leaders, Rebellion Legacy, and Domestic Unrest
Authors: Su Ruolin 
Published: October 2021

Abstract
Existing studies suggest that leaders that have earlier been participants in rebellions have a higher propensity for international conflict than leaders with no such experience. This paper examines whether prior involvement in rebellions will induce leaders to initiate international conflicts during domestic strife. I propose a preference modification approach and argue that rebel leaders’ policy choices during domestic unrest are a product of their pre-existing preferences and contextual factors. Specifically, I claim that the greater preference for conflict abroad during domestic unrest that former rebel leaders display than do their fellow leaders is contingent on the severity level of domestic problems. When facing serious internal unrest, rebel leaders are less likely than their non-rebel counterparts to engage in international conflicts due to the effect that critical domestic strife will have on the former’s perceptions and thus their policy preferences. Intense domestic strife predisposes rebel leaders to engage in both international conflict and domestic measures, which to some extent neutralises their original policy preference of international conflict as the sole policy response. By contrast, non-rebel leaders perceive more efficacy in international conflict during severe domestic unrest and are more likely to initiate an international dispute in that case. Statistical analyses of the international militarised dispute initiations of leaders under domestic strife from 1875 to 2000 reveal strong support for these arguments.
Interpretable, not black-box, artificial intelligence should be used for embryo selection
Authors: Afnan Michael Anis Mihdi , Liu Yanhe , Conitzer Vincent , Rudin Cynthia , Mishra Abhishek , Savulescu Julian , Afnan Masoud 
Published: October 2021

AbstractArtificial intelligence (AI) techniques are starting to be used in IVF, in particular for selecting which embryos to transfer to the woman. AI has the potential to process complex data sets, to be better at identifying subtle but important patterns, and to be more objective than humans when evaluating embryos. However, a current review of the literature shows much work is still needed before AI can be ethically implemented for this purpose. No randomized controlled trials (RCTs) have been published, and the efficacy studies which exist demonstrate that algorithms can broadly differentiate well between ‘good-’ and ‘poor-’ quality embryos but not necessarily between embryos of similar quality, which is the actual clinical need. Almost universally, the AI models were opaque (‘black-box’) in that at least some part of the process was uninterpretable. This gives rise to a number of epistemic and ethical concerns, including problems with trust, the possibility of using algorithms that generalize poorly to different populations, adverse economic implications for IVF clinics, potential misrepresentation of patient values, broader societal implications, a responsibility gap in the case of poor selection choices and introduction of a more paternalistic decision-making process. Use of interpretable models, which are constrained so that a human can easily understand and explain them, could overcome these concerns. The contribution of AI to IVF is potentially significant, but we recommend that AI models used in this field should be interpretable, and rigorously evaluated with RCTs before implementation. We also recommend long-term follow-up of children born after AI for embryo selection, regulatory oversight for implementation, and public availability of data and code to enable research teams to independently reproduce and validate existing models.
Was this career shaped by people or by chance?
Authors: Field John G 
Published: October 2021

Abstract
This paper discusses the people and events that influenced my career and the lessons I learnt along the way. In this essay I attempt to pass these lessons on to others. Born and growing up in Cape Town, from my earliest recollections at the age of four I have wanted to be associated with fish and the sea. My first mentor was the Professor of Zoology at the University of Cape Town, who gave me the opportunity to go to sea on the University research ship, and later to join the International Indian Ocean Expedition where I met others who influenced me. Then a postdoctoral fellowship in Nova Scotia led me to meet Ken Mann, a SCOR working group, and a series of wonderful colleagues and friends. The contribution of each of these to my development is discussed, along with the lessons learned. The friends I have made on my journey in marine science and my academic family of former students have enriched my life enormously and if I had my life again, I would have it no other way.
Organizational capacity for patient and family engagement in hospital planning and improvement: interviews with patient/family advisors, managers and clinicians
Authors: Anderson Natalie N , Baker G Ross , Moody Lesley , Scane Kerseri , Urquhart Robin , Wodchis Walter P , Gagliardi Anna R 
Published: October 2021

Abstract

Background
Patient and family engagement (PE) in healthcare planning and improvement achieves beneficial outcomes and is widely advocated, but a lack of resources is a critical barrier. Little prior research studied how organizations support engagement specifically in hospitals.

Objective
We explored what constitutes hospital capacity for engagement.

Methods
We conducted descriptive qualitative interviews and complied with criteria for rigour and reporting in qualitative research. We interviewed patient/family advisors, engagement managers, clinicians and executives at hospitals with high engagement activity, asking them to describe essential resources or processes. We used content analysis and constant comparison to identify themes and corresponding quotes and interpreted findings by mapping themes to two existing frameworks of PE capacity not specific to hospitals.

Results
We interviewed 40 patient/family advisors, patient engagement managers, clinicians and corporate executives from nine hospitals (two &lt; 100 beds, four 100 + beds, three teaching). Four over-arching themes about capacity considered essential included resources, training, organizational commitment and staff support. Views were similar across participant and hospital groups. Resources included funding and people dedicated to PE and technology to enable communication and collaboration. Training encompassed initial orientation and project-specific training for patient/family advisors and orientation for new staff and training for existing staff on how to engage with patient/family advisors. Organizational commitment included endorsement from the CEO and Board, commitment from staff and continuous evaluation and improvement. Staff support included words and actions that conveyed value for the role and input of patient/family advisors. The blended, non-hospital-specific framework captured all themes. Hospitals of all types varied in the availability of funding dedicated to PE. In particular, reimbursement of expenses and compensation for time and contributions were not provided to patient/family advisors. In addition to skilled engagement managers, the role of clinician or staff champions was viewed as essential.

Conclusion
The findings build on prior research that largely focused on PE in individual clinical care or research or in primary care planning and improvement. The findings closely aligned with existing frameworks of organizational capacity for PE not specific to hospital settings, which suggests that hospitals could use the blended framework to plan, evaluate and improve their PE programs. Further research is needed to yield greater insight into how to promote and enable compensation for patient/family advisors and the role of clinician or staff champions in supporting PE.
Anti-Nuclear Antibody Quantitation: Calibration and Harmonization Adjustment via Population Interrogation
Authors: Wener Mark H , Fink Susan L , Morishima Chihiro , Chaudhary Anu , Hutchinson Kathleen 
Published: October 2021

Abstract

Background
The 2019 classification criteria for systemic lupus erythematosus (SLE) includes an initial criterion requiring the presence of an antinuclear antibody (ANA), positive at a titer of at least 1:80 on HEp-2 cells, or equivalent. However, results of ANA tests performed on HEp-2 cells vary when tested in different laboratories. Calibration of ANA assays by achieving a common specificity in healthy control populations offers the possibility of achieving harmonization via population interrogation, but the expected specificity in a healthy control population is not known.

Methods
The studies used to determine the use of ANAs performed by immunofluorescence microscopy on HEp-2 cells as the entry criterion for classification of SLE were reanalyzed by a meta-analysis to determine the expected frequency of positive ANAs in healthy control populations at serum dilutions of 1:40 and 1:80.

Results
Our meta-analysis demonstrated that the expected specificity in a healthy control population of ANA performed using serum diluted 1:80 is 91.3% (CI 86.1–94.7%). The expected specificity of ANA performed at 1:40 serum dilution is 79.2% (CI 72.3–84.8%).

Conclusion
One approach to achieving harmonization of ANA assays from different laboratories with each other and with expected performance would involve adjusting assays so that about 10% of a healthy control population has a positive ANA when tested at 1:80 dilution, and about 20% of the healthy control population has a positive ANA when tested at 1:40 dilution. This pragmatic approach to calibration and harmonization adjustment via population interrogation offers an opportunity for individual laboratories to be aligned with each other and with ANA performance expected for consistent categorization of patients with SLE.
Search for fast radio transients using Arecibo drift-scan observations at 1.4 GHz
Authors: Perera B B P , Smith A J , Vaddi S , Carballo-Rubio R , McGilvray A , Venkataraman A , Roshi D Anish , Manoharan P K , Perillat P , Lieb E , Lorimer D R , McLaughlin M A , Agarwal D , Aggarwal K , Ransom S M 
Published: October 2021

ABSTRACT
We conducted a drift-scan observation campaign using the 305-m Arecibo telescope in 2020 January and March when the observatory was temporarily closed during the intense earthquakes and the initial outbreak of the COVID-19 pandemic, respectively. The primary objective of the survey was to search for fast radio transients, including fast radio bursts (FRBs) and rotating radio transients (RRATs). We used the seven-beam ALFA receiver to observe different sections of the sky within the declination region ∼(10°–20°) on 23 nights and collected 160 h of data in total. We searched our data for single-pulse transients, of covering up to a maximum dispersion measure of 11 000 pc cm−3 at which the dispersion delay across the entire bandwidth is equal to the 13-s transit length of our observations. The analysis produced more than 18 million candidates. Machine learning techniques sorted the radio frequency interference and possibly astrophysical candidates, allowing us to visually inspect and confirm the candidate transients. We found no evidence for new astrophysical transients in our data. We also searched for emission from repeated transient signals, but found no evidence for such sources. We detected single pulses from two known pulsars in our observations and their measured flux densities are consistent with the expected values. Based on our observations and sensitivity, we estimated the upper limit for the FRB rate to be &lt;2.8 × 105 sky−1 d−1 above a fluence of 0.16 Jy ms at 1.4 GHz, which is consistent with the rates from other telescopes and surveys.
Not all peaks are created equal: the early growth of supermassive black holes
Authors: Ni Yueying , Di Matteo Tiziana , Feng Yu 
Published: October 2021

ABSTRACT
In this work, we use the constrained Gaussian realization technique to study the early growth of supermassive black holes (SMBHs) in cosmological hydrodynamic simulations, exploring its relationship with features of the initial density peaks on large scales, ∼ 1 h−1Mpc. Our constrained simulations of volume (20 h−1Mpc)3 successfully reconstruct the large-scale structure as well as the black hole growth for the hosts of the rare 109 M⊙ SMBHs found in the bluetides simulation at z ∼ 7. We run a set of simulations with constrained initial conditions by imposing a $5 \sigma _0(R_\mathrm{G})$ peak on the scale of $\\ R_\mathrm{ G} = 1$ h−1Mpc varying different peak features, such as the shape and compactness as well as the tidal field surrounding the peak. We find that initial density peaks with high compactness and low tidal field induce the most rapid BH growth at early epochs. This is because compact density peaks with a more spherical large-scale matter distribution lead to the formation of the highest gas inflows (mostly radial) in the centres of haloes which boost the early BH accretion. Moreover, such initially compact density peaks in low tidal field regions also lead to a more compact BH host galaxy morphology. Our findings can help explain the tight correlation between BH growth and host galaxy compactness seen in observations.
Membrane nanodomains modulate formin condensation for actin remodeling in Arabidopsis innate immune responses
Authors: Ma Zhiming , Sun Yanbiao , Zhu Xinlu , Yang Liang , Chen Xu , Miao Yansong 
Published: October 2021

Abstract
The assembly of macromolecules on the plasma membrane concentrates cell surface biomolecules into nanometer- to micrometer-scale clusters (nano- or microdomains) that help the cell initiate or respond to signals. In plant–microbe interactions, the actin cytoskeleton undergoes rapid remodeling during pathogen-associated molecular pattern-triggered immunity (PTI). The nanoclustering of formin-actin nucleator proteins at the cell surface has been identified as underlying actin nucleation during plant innate immune responses. Here, we show that the condensation of nanodomain constituents and the self-assembly of remorin proteins enables this mechanism of controlling formin condensation and activity during innate immunity in Arabidopsis thaliana. Through intrinsically disordered region-mediated remorin oligomerization and formin interaction, remorin gradually recruits and condenses formins upon PTI activation in lipid bilayers, consequently increasing actin nucleation in a time-dependent manner postinfection. Such nanodomain- and remorin-mediated regulation of plant surface biomolecules is expected to be a general feature of plant innate immune responses that creates spatially separated biochemical compartments and fine tunes membrane physicochemical properties for transduction of immune signals in the host.
Tranexamic Acid in Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis
Authors: Dionne Joanna C. , Oczkowski Simon J. W. , Hunt Beverley J. , Antonelli Massimo , Wijnberge Marije , Raasveld Senta Jorinde , Vlaar Alexander P. J. ,   for ESICM Transfusion Taskforce and the GUIDE Group
Published: October 2021

OBJECTIVES:
Tranexamic acid is proposed as a treatment for gastrointestinal bleeding. The Haemorrhage Alleviation with Tranexamic Acid-Intestinal System trial evaluated extended-use (24 hr) high-dose tranexamic acid, prompting a reappraisal for tranexamic acid in gastrointestinal bleeding.

DATA SOURCES:
We conducted a systematic review and meta-analysis of randomized controlled trials comparing tranexamic acid with usual care or placebo in adults with gastrointestinal bleeding. We searched MEDLINE, EMBASE, and CENTRAL (inception to September 2019).

Data Selection:
Two reviewers independently screened citations, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool in duplicate. The main outcomes were mortality, bleeding, and adverse events.

DATA EXTRACTION:
Studies were analyzed as high-dose IV tranexamic acid versus all other dosing strategies for tranexamic acid using fixed-effects models. We assessed certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.

DATA SYNTHESIS:
Five randomized controlled trials evaluated extended-use high-dose IV tranexamic acid, seven evaluating low-dose IV or enteral tranexamic acid. Extended-use high-dose IV tranexamic acid did not reduce mortality (relative risk, 0.98%; 95% CI, 0.88–1.09; I
2 = 63%; high certainty) or bleeding (relative risk, 0.92; 95% CI, 0.82–1.04; p = 0.17 and absolute risk differences, –0.7%; 95% CI, –1.5 to 0.3; high certainty) but resulted in a small increase in deep venous thrombosis (relative risk, 2.01; 95% CI, 1.08–3.72; I
2 = 0%), pulmonary embolism (relative risk, 1.78; 95% CI, 1.06–3.0; I
2 = 0%), and seizure (relative risk, 1.73; 95% CI, 1.03–2.93) with high certainty. Low-dose IV/enteral tranexamic acid did not reduce mortality (relative risk, 0.62; 95% CI, 0.36–1.09; I
2 = 0%) but did reduce risk of rebleeding (relative risk, 0.5; 95% CI, 0.33–0.75; I
2 = 9%) and need for surgery (relative risk, 0.58; 95% CI, 0.38–0.88; I
2 = 11%), with moderate certainty.

CONCLUSIONS:
Extended-use high-dose IV tranexamic acid does not improve mortality or bleeding outcomes and increases adverse events. Low-dose/enteral tranexamic acid may be effective in reducing hemorrhage; more evidence is required to demonstrate its safety.
Phalangeal and Metacarpal Fractures of the Hand: Preventing Stiffness
Authors: Neumeister Michael W. , Winters James N. , Maduakolum Erica 
Published: October 2021

Summary:
Fractures of the phalangeal or metacarpal bones of the hand are common. Many of these fractures are treated without surgery. However, both conservative and operative management of fractures of the hand can result in stiffness. Stiffness is the most common complication in the management of hand fractures. The key to preventing stiffness is early range of motion exercises. This article challenges many of the current treatment regimens offered to patients with the so-called unstable fractures. The evaluation of the patients’ function is the primary factor that should determine the course of conservation versus operative management. X-rays do not demonstrate function and therefore act as an adjunct only to the care of the patient. The goal of treating hand fractures is to restore function. Early motion may not only improve healing but may also hasten the return to normal hand function. The tenets of how to prevent stiffness are described in this review.
Paediatric nasal dermoid: evaluation and management
Authors: Adil Eelam , Rahbar Reza 
Published: October 2021

Purpose of review
The aim of this study was to present the evaluation and current management of congenital paediatric nasal dermoid.

Recent findings
There has been a trend towards less invasive surgical excision techniques, including purely endoscopic excision, endoscopic-assisted approaches and midline excision with nasal bone osteotomies and bone flap. These approaches allow adequate access for both total resection and nasal contour and skull base reconstruction. Following resection, if nasal bone osteotomies are insufficient for restoring nasal appearance, free temporoparietal fascial graft and/or conchal cartilage can be considered. For nasal tip deformities, interdomal sutures and free fat grafting are a suitable option.

Summary
Complete surgical excision remains the treatment of choice for nasal dermoid lesions. The surgical approach taken and reconstruction depends on the type of lesion (cyst versus sinus or fistula), location (intranasal versus extranasal), whether or not there is intracranial extension, and experience of the surgical team.
A Prediction Model for Selective Use of Facial Computed Tomography in Blunt Head Trauma Patients
Authors: Huang Li-Kuo , Huang Chih-Sheng , Tu Hsi-Feng , Chiang Kuo-Hsien , Bajani Francesco , Fu Chih-Yuan 
Published: October 2021

Background:
Head trauma patients may have concomitant facial fractures, which are usually underdetected by head computed tomography alone. This study aimed to identify the clinical indicators of facial fractures and to develop a risk-prediction model to guide the discriminative use of additional facial computed tomography in head trauma.

Methods:
The authors retrospectively reviewed head trauma patients undergoing simultaneous head and facial computed tomography at a Level II trauma center from 2015 to 2018. Multivariate logistic regression analysis was used to evaluate independent risk factors for concomitant facial fractures in head trauma patients using data collected from 2015 to 2017, and a risk-prediction model was created accordingly. Model performance was validated with data from 2018.

Results:
In total, 5045 blunt head trauma patients (development cohort, 3534 patients, 2015 to 2017; validation cohort, 1511 patients, 2018) were enrolled. Concomitant facial fractures occurred in 723 head trauma patients (14.3 percent). Ten clinical and head computed tomographic variables were identified as predictors, including age, male sex, falls from elevation, motorcycle collisions, Glasgow Coma Scale scores less than 14, epistaxis, tooth rupture, facial lesions, intracranial hemorrhage, and skull fracture. In the development cohort, the model showed good discrimination (area under the receiver operating characteristic curve = 0.891), calibration (Hosmer-Lemeshow C test, p = 0.691), and precision (Brier score = 0.066). In the validation cohort, the model demonstrated excellent discrimination (area under the receiver operating characteristic curve = 0.907), good calibration (Hosmer-Lemeshow C test, p = 0.652), and good precision (Brier score = 0.083). With this model, 77.1 percent of unnecessary facial computed tomography could be avoided.

Conclusion:
This model could guide the discriminative use of additional facial computed tomography to detect concomitant facial fractures in blunt head trauma.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, III.
Technical Refinement in Three-Dimensional Nipple-Areola Complex Tattooing of the Reconstructed Breast
Authors: Ruffolo Alexis M. , Bruce William J. , Daugherty Timothy H. F. , Lee Jason , Sommer Nicole Z. 
Published: October 2021

Summary:
Three-dimensional nipple-areola complex tattooing has previously been described as an alternative to surgical reconstruction using local flaps and grafts. This technique offers patients an option that can achieve aesthetically pleasing results without a donor site, changes in projection over time, or additional scarring. Plastic surgeons may be limited in their ability to create a realistic-appearing nipple-areola complex because of limited experience with basic tattooing techniques and unfamiliarity with the artistic principles of light and shadow required to create depth on a two-dimensional surface. Consistent results can be achieved with attention to the technical pearls discussed in this article.