bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning Automated Detection of Large Vessel Occlusion From Mobile Stroke Unit Computed Tomography Angiography
Authors: Czap Alexandra L. , Bahr-Hosseini Mersedeh , Singh Noopur , Yamal Jose-Miguel , Nour May , Parker Stephanie , Kim Youngran , Restrepo Lucas , Abdelkhaleq Rania , Salazar-Marioni Sergio , Phan Kenny , Bowry Ritvij , Rajan Suja S. , Grotta James C. , Saver Jeffrey L. , Giancardo Luca , Sheth Sunil A. 
Published: December 2021

Background:
Prehospital automated large vessel occlusion (LVO) detection in Mobile Stroke Units (MSUs) could accelerate identification and treatment of patients with LVO acute ischemic stroke. Here, we evaluate the performance of a machine learning (ML) model on CT angiograms (CTAs) obtained from 2 MSUs to detect LVO.

Methods:
Patients evaluated on MSUs in Houston and Los Angeles with out-of-hospital CTAs were identified. Anterior circulation LVO was defined as an occlusion of the intracranial internal carotid artery, middle cerebral artery (M1 or M2), or anterior cerebral artery vessels and determined by an expert human reader. A ML model to detect LVO was trained and tested on independent data sets consisting of in-hospital CTAs and then tested on MSU CTA images. Model performance was determined using area under the receiver-operator curve statistics.

Results:
Among 68 patients with out-of-hospital MSU CTAs, 40% had an LVO. The most common occlusion location was the middle cerebral artery M1 segment (59%), followed by the internal carotid artery (30%), and middle cerebral artery M2 (11%). Median time from last known well to CTA imaging was 88.0 (interquartile range, 59.5–196.0) minutes. After training on 870 in-hospital CTAs, the ML model performed well in identifying LVO in a separate in-hospital data set of 441 images with area under receiver-operator curve of 0.84 (95% CI, 0.80–0.87). ML algorithm analysis time was under 1 minute. The performance of the ML model on the MSU CTA images was comparable with area under receiver-operator curve 0.80 (95% CI, 0.71–0.89). There was no significant difference in performance between the Houston and Los Angeles MSU CTA cohorts.

Conclusions:
In this study of patients evaluated on MSUs in 2 cities, a ML algorithm was able to accurately and rapidly detect LVO using prehospital CTA acquisitions.
Impact of Local Atmospheric Intraseasonal Variability on Mean Sea Ice State in the Arctic Ocean
Authors: Liang Xi , Liu Chengyan , Yu Lejiang , Losch Martin , Zhang Lujun , Li Xichen , Zhao Fu , Tian Zhongxiang 
Published: December 2021

AbstractThe Arctic atmosphere shows significant variability on intraseasonal time scales of 10–90 days. The intraseasonal variability in the Arctic sea ice is clearly related to that in the Arctic atmosphere. It is well known that the Arctic mean sea ice state is governed by the local mean atmospheric state. However, the response of the Arctic mean sea ice state to the local atmospheric intraseasonal variability is unclear. The Arctic atmospheric intraseasonal variability exists in both the thermodynamical and dynamical variables. Based on a sea ice–ocean coupled simulation with a quantitative sea ice budget analysis, this study finds that 1) the intraseasonal atmospheric thermodynamical variability tends to reduce sea ice melting through changing the downward heat flux on the open water area in the marginal sea ice zone, and the intraseasonal atmospheric dynamical variability tends to increase sea ice melting by a combination of modified air–ocean heat fluxes, ice–ocean heat fluxes, and sea ice deformation; 2) the intraseasonal atmospheric dynamical variability increases summertime sea ice concentration in the Beaufort Sea and the Greenland Sea but decreases summertime sea ice concentration along the Eurasian continent in the East Siberia–Laptev–Kara Seas, resulting from the joint effects of the modified air–ocean heat fluxes, ice–ocean heat fluxes, and the sea ice deformation, as well as the mean sea ice advection due to the changes of sea ice drift. The large spread in sea ice in the CMIP models may be partly attributed to the different model performances in representing the observed atmospheric intraseasonal variability. Reliable modeling of atmospheric intraseasonal variability is an essential condition in correctly projecting future sea ice evolution.
Adiabatic and Diabatic Signatures of Ocean Temperature Variability
Authors: Holmes R. M. , Sohail T. , Zika J. D. 
Published: December 2021

AbstractAnthropogenically induced radiative imbalances in the climate system lead to a slow accumulation of heat in the ocean. This warming is often obscured by natural modes of climate variability such as El Niño–Southern Oscillation (ENSO), which drive substantial ocean temperature changes as a function of depth and latitude. The use of watermass coordinates has been proposed to help isolate forced signals and filter out fast adiabatic processes associated with modes of variability. However, how much natural modes of variability project into these different coordinate systems has not been quantified. Here we apply a rigorous framework to quantify ocean temperature variability using both a quasi-Lagrangian, watermass-based temperature coordinate and Eulerian depth and latitude coordinates in a free-running climate model under preindustrial conditions. The temperature-based coordinate removes the adiabatic component of ENSO-dominated interannual variability by definition, but a substantial diabatic signal remains. At slower (decadal to centennial) frequencies, variability in the temperature- and depth-based coordinates is comparable. Spectral analysis of temperature tendencies reveals the dominance of advective processes in latitude and depth coordinates while the variability in temperature coordinates is related closely to the surface forcing. Diabatic mixing processes play an important role at slower frequencies where quasi-steady-state balances emerge between forcing and mixing in temperature, advection and mixing in depth, and forcing and advection in latitude. While watermass-based analyses highlight diabatic effects by removing adiabatic variability, our work shows that natural variability has a strong diabatic component and cannot be ignored in the analysis of long-term trends.Significance StatementQuantifying the ocean warming associated with anthropogenically induced radiative imbalances in the climate system can be challenging due to the superposition with modes of internal climate variability such as El Niño. One method proposed to address this issue is the analysis of temperature changes in fluid-following (or “watermass”) coordinates that filter out fast adiabatic processes associated with these modes of variability. In this study we compare a watermass-based analysis with more traditional analyses of temperature changes at fixed depth and latitude to show that even natural modes of climate variability exhibit a substantial signal in watermass coordinates, particularly at decadal and slower frequencies. This natural variability must be taken into account when analyzing long-term temperature trends in the ocean.
Radiology reporting in rectal cancer using MRI: adherence to national template for structured reporting
Authors: Alvfeldt Gustav , Aspelin Peter , Blomqvist Lennart , Sellberg Nina 
Published: December 2021

Background In 2014, a national workshop program was initiated and a reporting template and manual for rectal cancer primary staging using magnetic resonance imaging (MRI) was introduced and made available by the national Swedish Colorectal Cancer Registry. Purpose To evaluate the effect of the national template program by identify if there was a gap between the content in Swedish MRI reports from 2016 and the national reporting template from 2014. The aim was to explore and compare differences in content in reporting practice in different hospitals in relation to the national reporting template, with focus on: (i) identifying any implementational differences in reporting styles; and (ii) evaluating if reporting completeness vary based on such implementational differences. Material and Methods A total of 250 MRI reports from 10 hospitals in four healthcare regions in Sweden were collected. Reports were analyzed using qualitative content analysis with a deductive thematic coding scheme based on the national reporting template. Results Three different implemented reporting styles were identified with variations of content coverage in relation to the template: (i) standardized and structured protocol (reporting style A); (ii) standardized semi-structured free-text (reporting style B); and (iii) regular free-text (reporting style C). The relative completeness of reporting practice of rectal cancer staging in relation to the national reporting template were 92.9% for reporting style A, 77.5% for reporting style B, and 63.9% for reporting style C. Conclusion The implementation of template-based reporting according to reporting style A is a key factor to conform to evidence-based practice for rectal cancer reporting using MRI.
Effects of nicorandil on systemic inflammation and oxidative stress induced by percutaneous coronary intervention in patients with coronary heart disease
Authors: Zong Yulong , Li Jie , Xu Xinghua , Xu Xingli 
Published: December 2021

Objective The present study investigated the effects of a bolus intracoronary injection of nicorandil on systemic inflammation and oxidative stress induced by percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD). Methods Patients undergoing coronary angiography (CAG) were enrolled into the CAG group (n = 30). Patients undergoing PCI were randomly divided into the PCI (n = 30) and PCI + nicorandil groups (n = 30). Results Blood taken from patients in the placebo group 24 hours after PCI exhibited significant increases in the expression of inflammatory indicators and mild increases in the expression of anti-inflammatory indicators. The intracoronary injection of nicorandil reversed the elevation of inflammatory indicators and significantly increased the levels of anti-inflammatory indicators in the blood of patients with PCI. Blood taken from patients in the placebo group 24 hours after PCI also displayed significant decreased superoxide dismutase levels and increased malondialdehyde levels. Nicorandil treatment reversed these changes of oxidative stress marker levels. Conclusions These results indicated the possible medical application of intracoronary injections of nicorandil for reducing systemic inflammation and oxidative stress in the peripheral blood of patients undergoing PCI.
Selecting from their toolbox of interventions – A realist study of the role of occupational therapists in reablement services
Authors: Dibsdall Lisa 
Published: December 2021

Introduction Reablement services support people to regain skills and increase their independence. This aim resonates with occupational therapy philosophy. This article presents results of a study of the role of occupational therapists in reablement services that involve two organisations. Method Theories on the role of occupational therapists in reablement were identified using a realist synthesis approach and were tested and expanded using a qualitative case study design. Each of the three case studies consisted of one reablement service in England. Methods of the study included observations and interviews with occupational therapists, interviews with managers in both organisations and focus groups and interviews with reablement support workers. Findings Findings conclude that occupational therapists’ education and experience underpin their ability to undertake assessments and person-centred goal setting. They utilise a range of intervention techniques selecting from their toolbox of interventions to support people. Occupational therapists have a role in training reablement support workers to work in an enabling way. Regular communication and co-location support levels of trust and shared purpose between members of the reablement team. Conclusion The conceptual framework developed from the study can be used by organisations when commissioning and developing reablement services to consider the different contextual layers of reablement.
How an idiosyncratic (zero-beta) risk can greatly increase the firm’s cost of capital
Authors: Grant Andrew , Johnstone David , Kwon Oh Kang 
Published: December 2021

The celebrated capital asset pricing model (‘CAPM’) brought numerous appealing insights and spawned a new theory of capital budgeting. One key intuition is that there is ‘no penalty for diversifiable risk’ – that is, any risky payoff that has zero-correlation with the wider economy, and hence zero-beta, is treated as ‘risk-free’. Does that mean that managers can bet the firm on a spin of the roulette wheel without attracting a higher CAPM discount rate? Our re-interpretation of CAPM reveals that potential financial losses which are conventionally regarded as firm-specific ‘unpriced’ risks can bring a large increase in the firm’s beta and CAPM cost of capital, despite having zero-beta and making only negligible difference at the aggregate market level. This mathematical result clashes with textbook expositions but is easily demonstrated and can be traced to authoritative but overlooked parts of the theoretical CAPM literature. JEL Classification: G11, G12
Assessment of Exclusive, Dual, and Polytobacco E-Cigarette Use and COVID-19 Outcomes Among College Students
Authors: Merianos Ashley L. , Russell Alex M. , Mahabee-Gittens E. Melinda , Barry Adam E. , Yang Meng , Lin Hsien-Chang 
Published: December 2021

Purpose This study examined current (past 30-day) dual- and polytobacco use patterns and COVID-19 symptomatology, testing, and diagnosis status among college student electronic cigarette (e-cigarette) users. Design Cross-sectional online questionnaire administered during October–December 2020. Setting Four large, U.S. public universities in geographically diverse locations. Sample College students (N=756) ages 18–24 who reported current e-cigarette use. Measures Current use of e-cigarettes, combustible cigarettes, and cigars, and self-reported COVID-19 symptomatology, testing, and diagnosis status were measured. Analysis Multivariable logistic regression models accounting for students’ demographics, university site, fraternity/sorority membership, and current residence. Results Over half (53.6%) of students were exclusive e-cigarette users, 20.4% were dual e-cigarette and combustible cigarette users, 4.6% were dual e-cigarette and cigar users, and 21.4% were poly users of e-cigarettes, combustible cigarettes, and cigars. Compared to exclusive e-cigarette users, dual users of e-cigarettes and combustible cigarettes (AOR=2.12, 95%CI=1.05–4.27) and poly users of e-cigarettes, combustible cigarettes, and cigars (AOR=3.70, 95%CI=1.78–7.70) had increased odds of COVID-19 symptomatology, even when accounting for covariates. While current tobacco use groups did not differ based on COVID-19 testing, polytobacco users had significantly increased odds (AOR=2.16, 95%CI=1.11–4.20) of having received a positive COVID-19 diagnosis. Conclusion Given use of two or more tobacco products increased COVID-19-related risks, results underscore the need to prevent dual- and polytobacco use behaviors in college student e-cigarette users.
Formulation, optimization, and characterization of amlodipine besylate loaded polymeric nanoparticles
Authors: Chourasiya Vibha , Bohrey Sarvesh , Pandey Archna 
Published: December 2021

The objectives of this work were to formulate and optimize amlodipine besylate loaded polymeric nanoparticles by using factorial design. The emulsion solvent evaporation method was employed successfully to produce the drug loaded polymeric nanoparticles and the optimization was done by the help of the 24 factorial design. The effect of the main preparation variables on the dependent variables such as nanoparticle size and % drug entrapment efficiency was studied for the optimization of the nanoparticles. The characterization of these nanoparticles was done by the different parameters such as interaction between the excipients, size, morphology, zeta potential, % drug entrapment efficiency, % process yield, and in-vitro drug release behavior. FTIR, DLS, TEM, AFM, zeta potential studies, and dialysis bag method were performed for this purpose. The in vitro drug release data were analyzed by different kinetic models to know the release mechanism. The optimized nanoparticles were spherical in shape and showed particle size 91.5 ± 4.3 nm, PDI 0.368 ± 0.014, zeta potential −17.5 mV, % drug entrapment efficiency 74.06 ± 2.1%, and % process yield 78.51 ± 1.8%. The release kinetics studies revealed that drug release from the nanoparticles follow the Korsmeyer–Peppas model.
Production of bacterial cellulose biopolymers in media containing rice and corn hydrolysate as carbon sources
Authors: de Souza Karina C , dos Santos Gabriela R , Trindade Felipe CS , S Costa Andréa Fernanda de , de Almeida Yeda MB , Sarubbo Leonie A , Vinhas Glória M 
Published: December 2021

Bacterial cellulose (BC) is a promising option for ecologically viable processes. In this work, BC was produced using starch hydrolysate (rice and corn flakes) as carbon sources. The starch was hydrolyzed by fungus for glucose production. A maximum yield of 2.80 ± 0.43 g/L of BC was obtained with the hydrolyzed rice medium. Moreover, BC produced in the rice and corn media had crystallinity of around 50%. Fourier-transform infrared spectrometry confirmed the functional groups in BC as well as the absence of contaminants from production process. The thermogravimetric analysis revealed that the polymers formed with alternative media had greater thermal stability. Scanning electron microscopy revealed a morphological structure with the random arrangement of nanofibrils in a non-uniform manner distributed in the weave of both polymeric films. The biofilms produced in different media had similar properties to those of films obtained with a conventional medium, revealing that the polymeric characteristics are not modified.
Colonoscopy may be weak link in organised colorectal cancer screening programme with faecal immunochemical test
Authors: Denis Bernard , Gendre Isabelle 
Published: December 2021

Objective To evaluate the quality of colonoscopies performed after a positive faecal immunochemical test in the French colorectal cancer screening programme. Methods Retrospective analysis of all colonoscopies performed between 2015 and 2019 after a positive quantitative faecal immunochemical test in the population-based colorectal cancer screening programme organised in Alsace, part of the French programme. The following indicators were evaluated: annual colonoscopy volume, caecal intubation rate, adenoma detection rate, proximal serrated lesion detection rate and proportion of patients referred directly to surgery for benign polyp management. Endoscopists who performed <30 faecal immunochemical test positive colonoscopies were non-assessable. Results Overall, 13,455 faecal immunochemical test-positive colonoscopies performed by 116 community gastroenterologists were included, 13,067 of them by 80 assessable endoscopists. The overall caecal intubation, adenoma detection and proximal serrated lesion detection rates were 97.9%, 57.6% and 7.6%, respectively. They were <90%, <45% and <1% for 1.3%, 12.5% and 6.3% of the endoscopists, respectively. Overall, 1028 (7.9%) individuals were examined by 13 low-performing endoscopists and 328 (2.4%) individuals by 33 low-volume non-assessable endoscopists. Among 9133 individuals harbouring polyps, 155 (1.7%) had unwarranted surgery for a benign polyp. Overall, 1487 individuals (11.1%; 95% confidence interval 10.5–11.6) were not given the best possible chances, whereas 5545 individuals (41.2%; 95% confidence interval 40.4–42.0) were offered the best possible chances by 37 endoscopists. Conclusions At programme level, the key performance indicators evaluated largely exceeded the target standards. At individual level, at least one in nine individuals was not given the best possible chances during faecal immunochemical test-positive colonoscopies by a minority of poor-performing and/or low-volume endoscopists.
A critical incident study of ICU nurses during the COVID-19 pandemic
Authors: Rhéaume Ann , Breau Myriam , Boudreau Stéphanie 
Published: December 2021

Background: Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them. Purpose: To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic. Design: Qualitative descriptive component within a larger mixed-methods study. Participants and research context: Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis was used to analyze the data. Ethical considerations: The study was approved by the ethics committee at the researchers’ university in eastern Canada. Results: A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety. Discussion: Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed. Conclusion: Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being.
The Judicial Fix for Forest Loss: The Godavarman Case and the Financialization of India’s Forests
Authors: Menon Manju , Kohli Kanchi 
Published: December 2021

In India, the setting up of large projects in forest areas can be undertaken only after government permission is obtained under the Forest (Conservation) Act (FCA) of 1980. Today, this approval process includes the enumeration and valuation of forest loss, and the financing of compensatory afforestation schemes to offset the loss. These procedures were designed through the orders and judgements of the Supreme Court of India in a set of cases that started in 1995 and continue to this day. These procedures are purportedly aimed to protect and restore forest ecologies in India. In this article we analyse the Supreme Court’s processes and orders between 1996 and 2006 which transformed the political ecology of forests in India. The judicial and expert discourses treated forest regulation and conservation as a techno-managerial exercise, separating it from social-ecological concerns such as historical dispossession of Adivasis and other forest-dependent people, and violent state suppression of diverse forms of forest management. The judicial interventions are instructive to understand the policy processes of green neoliberalism and the implications of the financialization of forests on environmental governance in India.