bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ten-Year Trend in Age, Sex, and Racial Disparity in tPA (Alteplase) and Thrombectomy Use Following Stroke in the United States
Authors: Otite Fadar Oliver , Saini Vasu , Sur Nicole Beaton , Patel Smit , Sharma Richa , Akano Emmanuel O. , Anikpezie Nnabuchi , Albright Karen , Schmidt Elena , Hoffman Haydn , Gould Grahame , Khandelwal Priyank , Latorre Julius Gene , Malik Amer M. , Sacco Ralph L. , Chaturvedi Seemant 
Published: October 2021

Background and Purpose:
IV tPA (intravenous thrombolysis with alteplase) and mechanical thrombectomy (MT) utilization increased in acute ischemic stroke hospitalizations in the United States over the last decade. It is uncertain whether this increase occurred equally across all age, sex, and racial groups.

Methods:

Adult acute ischemic stroke hospitalizations (weighted n=4 442 657) contained in the 2008 to 2017 National Inpatient Sample were identified using
International Classification of Diseases
codes. Proportions of hospitalizations with IV tPA and MT were computed according to age, sex, and race. Joinpoint and multivariable-adjusted logistic regression models were used to evaluate trends over time.

Results:

Across this period, 32.4% of all hospitalizations were in patients ≥80 years, and 64.7% of these were women. IV tPA and MT use differed by age with highest proportion of utilization of both treatments in patients aged 18 to 39 years (IV tPA, 12.3%) and lowest percentage in patients aged ≥90 years (IV tPA, 7.9%). Utilization of both procedures increased over time in all age groups, but the pace of increase was faster in patients ≥90 years compared with patients aged 18 to 39 years (MT: odds ratio, 1.25 [95% CI, 1.20–1.35] per unit increase in year,
P
interaction <0.001). Frequency of utilization of IV tPA and MT was lower in Black patients compared with White patients in most age groups. Usage of both procedures increased over time in all races and after 2015, IV tPA utilization was >10% in all demographic subgroups except in Black patients 60 to 79 years and Black patients ≥80 years. Analysis of race-by-time interaction revealed the Black-vs-White treatment gaps for IV tPA (odds ratio, 1.02 [95% CI, 1.01–1.03]) and MT (odds ratio, 1.08 [95% CI,1.05–1.12]) declined over time (both
P
interaction <0.01). Sex-related differences in IV tPA use were noted, but this gap also declined over time.

Conclusions:
Age- and sex-related treatment gaps in IV tPA and MT reduced over the last decade. Racial disparity in IV tPA and MT utilization persists with particularly lower frequency of usage of both acute stroke treatments in Black patients compared with White patients, but race-associated treatment gaps also declined over time.
Risk factors of post-anaesthesia care unit delirium in patients undergoing non-cardiac surgery in Singapore
Authors: Ke Yuhe , Chew Sophia , Seet Edwin , Wong Wan Yi , Lim Vera , Chua Nelson , Zhang Jinbin , Lim Beatrice , Chua Vanessa , Loh Ne-Hooi Will , Ti Lian Kah 
Published: October 2021

Introduction:
Post-anaesthesia care unit (PACU) delirium affects 5%–45% of patients after surgery and is associated with postoperative delirium and increased mortality. Up to 40% of PACU delirium is preventable, but it remains under-recognised due to a lack of awareness of its diagnosis. The nursing delirium screening scale (Nu-DESC) has been validated for diagnosing PACU delirium, but is not routinely used locally. This study aimed to use Nu-DESC to establish the incidence and risk factors of PACU delirium in patients undergoing non-cardiac surgery in the surgical population.

Methods:
We conducted an audit of eligible patients undergoing major surgery in three public hospitals in Singapore over 1 week. Patients were assessed for delirium 30–60 min following their arrival in PACU using Nu-DESC, with a total score of ≥2 indicative of delirium.

Results:
A total of 478 patients were assessed. The overall incidence rate of PACU delirium was 18/478 (3.8%), and the incidence was 9/146 (6.2%) in patients aged > 65 years. Post-anaesthesia care unit delirium was more common in females, patients with malignancy and those who underwent longer operations. Logistic regression analysis showed that the use of bispectral index (P < 0.001) and the presence of malignancy (P < 0.001) were significantly associated with a higher incidence of PACU delirium.

Conclusion:
In this first local study, the incidence of PACU delirium was 3.8%, increasing to 6.2% in those aged > 65 years. Understanding these risk factors will form the basis for which protocols can be established to optimise resource management and prevent long-term morbidities and mortality in PACU delirium.
Feeling Apart: Relations of Belonging in Tibetan Buddhist Lay-Monastic Communities
Authors: Caple Jane 
Published: October 2021

Abstract
Studies of belonging and community formation often emphasize commonality of values, emotions, and feelings. This article highlights the importance of practices that create relations of distance between members as well as closeness. Drawing on fieldwork in institutionalized Tibetan Buddhist communities in northeastern Tibet (Amdo/Qinghai), I focus on everyday practices of respect and faith that materialize community by putting monks, reincarnate lamas, and laity “in their place.” This can include the most quotidian of acts, such as standing when someone enters a room. I argue that such practices of “feeling apart” and their refusal are central to individual negotiations of religious belonging and to the dynamic, ongoing process of community formation. The importance of these practices becomes particularly apparent when, as is the case in northeastern Tibet, seemingly taken-for-granted relations of belonging and the emotional style that enacts and creates these relations are felt to be precarious.
Feeling the Way to Revelation: Patterns of Doubt and Persuasion in Tibetan Buddhist Auto/biographical Treasure Narratives
Authors: Townsend Dominique 
Published: October 2021

Abstract
In the Tibetan Buddhist Treasure (gter ma) tradition, communities cohere around the marking of certain visions as offering insight into the proper method of ritual practices, the veracity of reincarnation claims, decisions about institutional structures, assertions of lineage relationships, and most importantly for the purposes of this article, the phenomenology of Buddhist enlightenment for readers lacking such experience. There is a long and robust history of doubt around such visions and their narrative accounts. Doubters seek to debunk and disenfranchise those whose visions they dispute. This article analyzes the emotional dynamics and aesthetic charge of five exemplary visionary accounts from the 17th–20th century, with a focus on how doubts are overcome through intense positive sensory experiences within their life stories. Such narratives generate a sense of religious belonging in Tibetan Buddhist Treasure communities, beginning with the visionary him- or herself whose successful navigation of doubt is resolved by the persuasive power of intensely positive aesthetic experience.
Law and Justice among the Socratics: Contexts for Plato’s Republic
Authors: Horky Phillip Sidney 
Published: October 2021

Abstract
At the beginning of Republic 2 (358e–359b), Plato has Glaucon ascribe a social contract theory to Thrasymachus and ‘countless others’. This paper takes Glaucon’s description to refer both within the text to Thrasymachus’ views, and outside the text to a series of works, most of which have been lost, On Justice or On Law. It examines what is likely to be the earliest surviving work that presents a philosophical defence of law and justice against those who would prefer their opposites, On Excellence by an anonymous author usually referred to as ‘Anonymus Iamblichi’; the views on these topics among the Socratics, including Crito, Simon the Cobbler, Aristippus of Cyrene, and Antisthenes; and Socrates’ debate with Hippias ‘On Justice’ in Xenophon’s Memorabilia (4.4.5–25). Its main contention is that the ‘countless others’ referred to by Glaucon points chiefly, but not solely, to the members of the circle of Socrates, who themselves espoused a range of views on justice and law, and their relations.
What Aristotle Learned from Plato about Justice and Laws
Authors: Lee Mi-Kyoung 
Published: October 2021

Abstract
In this paper I consider Aristotle’s solutions to two questions about justice and the laws: why think that obeying the law is just? And why think that doing what is just will promote one’s happiness? I analyze Aristotle’s solutions to these two problems in terms of four claims concerning the laws that come from Plato and underwrite Aristotle’s optimism about the potential for politikê epistêmê to issue in laws which are objectively correct.
Spatial and temporal patterns of wound periderm development in Cryptomeria japonica bark
Authors: Iizuka Etsushi , Ohse Megumi , Arakawa Izumi , Kitin Peter , Funada Ryo , Nakaba Satoshi 
Published: October 2021

Abstract
Limited investigations have been carried out on the physiological and growth responses of bark to wounding, even though wound periderms play crucial roles in tree defenses. To understand the mechanisms of wound periderm formation, we studied the growth responses and structural changes of wounded bark of three Cryptomeria japonica individuals. We observed the developmental time frame and morphology of wound periderms around mechanically induced wounds in summer. The wound responses included discoloration, lignification, and suberization in tissues present at the time of wounding, followed by wound periderm formation and secondary metabolite deposition. The trees had developed wound periderms approximately 4 weeks after wounding. The wound periderms were within 3 mm in the axial directions and within 1 mm in the lateral directions from the wound surfaces. The distinct patterns of wound periderm formation in the axial and lateral regions resulted from the arrangement and anatomical features of the cells adjacent to the wounds. The wound phellem cells were tangentially narrower and axially shorter in the side and upper/lower regions, respectively, of the wounds. Therefore, the cell division frequencies in the planes parallel to the wound surface may be greater than those in the other directions. Wound reactions in bark might initially be triggered by microenvironmental changes, such as the spread of desiccation, which depends directly on the morphology of phloem cell complexes.
Migration Infrastructure and Brokerage in Victorian Female Emigration Societies
Authors: Ruiz Marie 
Published: October 2021

Abstract
In the nineteenth century, female mobility was eased by a variety of intermediary structures, which interacted to direct the migration of British women to the Empire. Among these migration infrastructures were female emigration societies such as the Female Middle Class Emigration Society (1861–1886). This organisation was the first to assist gentlewomen in emigrating. It adopted a holistic approach to British female emigration by promoting women’s departure, selecting candidates, arranging their protection on the voyage, as well as their reception in the colonies. Grounded in a multifactorial perspective, this article offers an insight into how female migration brokerage came into being in the Victorian context. It intersects migration with gender and labour perspectives in a trans-sectorial approach of the history of female migration infrastructures in the British Empire, and reveals the diversity of transnational migration intermediaries interacting at meso level between female emigrants, non-state actors, and state institutions.
Leaving a Life Behind: Eliza Binemeciyan’s Encounter with “the Banality of Evil”
Authors: Kadıoğlu Ayşe 
Published: October 2021

Abstract
Among the Armenian actors who were essential in creating and sustaining Istanbul theaters at the turn of the twentieth century, Eliza Binemeciyan (1890-1981) emerged as a prominent one. In the aftermath of taking part in the play Kösem Sultan in 1912, she became the star of Istanbul theaters for more than a decade until she left her beloved city when she was 35 years old. She never returned to Istanbul, the city that was her home and where the remains of her parents, both well known Armenian actors, were buried. Her story as well as the stories of her Armenian colleagues reveal the decline of cosmopolitanism and the rise of nationalism in Istanbul. The change of scene in Istanbul theaters from multi-lingualism and cosmopolitanism to nationalism was like a microcosm of the policies of Turkification during the decline of the Ottoman Empire. In many memoirs about the era, Eliza Binemeciyan’s departure was normalized since she was depicted as an actor whose absence fostered the acting careers of Muslim Turkish women without much regard for her remarkable presence in Istanbul theaters.
Recovery of Screening Mammogram Cancellations During COVID-19
Authors: Pairawan Seyed S. , Olmedo Temich Luis , de Armas Sebastian , Folkerts Andrew , Solomon Naveen , Cora Cherie , Ramalingam Kirithiga , Lum Sharon S. 
Published: October 2021

Background In response to the COVID-19 pandemic, the American Society of Breast Surgeons and American College of Radiology released a joint statement recommending that all breast screening studies be postponed effective March 26, 2020. Study Design A retrospective review of all canceled mammograms at a single tertiary care institution from January 1-August 31, 2020 was performed to evaluate the effect of this recommendation by quantifying both the number and reason for mammogram cancellations before and after March 26, 2020. Utilization of the electronic patient portal for appointment cancellation as a surrogate for telehealth uptake was noted. Results During the study period, 5340 mammogram appointments were kept and 2784 mammogram appointments were canceled. From a baseline of 30 (10.8%) canceled mammograms in January, cancellations peaked in March (576, 20.6%) and gradually decreased to a low in August (197, 7%). Reasons for cancellations varied significantly by month ( P < .0001) and included COVID-19 related (236, 8.5%), unspecified patient reasons (1,210, 43.5%), administrative issues (147, 5.3%), provider requests (46, 1.7%), sooner appointments available (31, 1.1%), and reasons not given (486, 17.5%). In addition, compared to a baseline in January (51, 16.5%), electronic patient portal access peaked in August (67, 34.0%). Conclusion Screening mammogram cancellations have gradually recovered after early COVID-19 restrictions were lifted and increasing use of electronic patient access appears to be sustained. Consequences for future staging at the time of diagnosis remain unknown. Understanding to what extent the pandemic affected screening may help surgeons plan for post-pandemic breast cancer care.
Risk Factors Associated With Driving After Cannabis Use Among Canadian Young Adults
Authors: Huỳnh Christophe , Beaulieu-Thibodeau Alexis , Fallu Jean-Sébastien , Bergeron Jacques , Flores-Aranda Jorge , Jacques Alain , Brochu Serge 
Published: October 2021

This study identifid the most prominent risk factors associated with driving after cannabis use (DACU). 1,126 Canadian drivers (17–35 years old) who have used cannabis in the past 12 months completed an online questionnaire about sociodemographic information, substance use habits, cannabis effect expectancies, driving behaviours and peers’ behaviours and attitudes concerning DACU. A hierarchical logistic regression allowed identifying variables that were associated with DACU. Income (CA$30,000–CA$69,000), weekly-to-daily cannabis use, higher level of cannabis-related problems, expectation that cannabis facilitates social interactions, drunk driving, belief that DACU is safe, general risky driving behaviours, having a few friends who had DACU and injunctive norms predicted past 12-month DACU. Older age, holding negative expectations concerning cannabis, driving aggressively and perceived accessibility of public transportation decreased the probability of DACU. With restricted resources, programmes will be more efficient by targeting Canadian young adults most inclined to DACU by focussing on these risk factors.
The Fragility of Statistical Significance in Patellofemoral Instability Research: A Systematic Review
Authors: Constant Michael , Trofa David P. , Saltzman Bryan M. , Ahmad Christopher S. , Li Xinning , Parisien Robert L. 
Published: October 2021

Background: Fragility analysis is increasingly utilized to evaluate the robustness of results within the orthopaedic literature and has frequently revealed instability of reported outcomes. Purpose/Hypothesis: The purpose of this investigation was to utilize a fragility analysis to evaluate the stability of reported results in the patellofemoral instability (PFI) literature. We hypothesized the demonstration of significant fragility in patellofemoral research to be similar to that identified throughout other areas of the orthopaedic literature. Study Design: Systematic review; Level of evidence, 4. Methods: The PubMed database was queried from January 1, 2000, to October 10, 2020 for comparative trials in 10 prominent orthopaedic journals that reported dichotomous outcomes related to the management of PFI. The fragility index (FI) and the fragility quotient (FQ) were calculated for each individual outcome event, and the overall FI and FQ were determined for all included studies. Results: A total of 22 comparative studies comprising 11 randomized controlled trials and 11 nonrandomized trials were included for the analysis. A total of 75 outcome events underwent a fragility analysis and revealed a median FI and FQ of 3 (interquartile range [IQR], 1-5) and 0.043 (IQR, 0.018-0.081), respectively. Also 27% of included studies reported loss to follow-up greater than the overall FI, therefore suggesting the maintenance of the follow-up may have resulted in the reversal of significance. Conclusion: The result of the comprehensive fragility analysis demonstrated a lack of robustness in PFI research with the alteration of only a few outcome events required to reverse statistical significance. We therefore recommend the triple reporting of the P value, the FI, and the FQ to aid in the interpretation of the statistical integrity of future comparative trials in the PFI literature.
Feelings of not Mattering and Depressive Symptoms From a Temporal Perspective: A Comparison of the Cross-Lagged Panel Model and Random-Intercept Cross-Lagged Panel Model
Authors: Etherson Marianne E. , Smith Martin M. , Hill Andrew P. , Flett Gordon L. 
Published: October 2021

Are feelings of not mattering an antecedent of depressive symptoms, a consequence, or both? Most investigations focus exclusively on feelings of not mattering as an antecedent of depressive symptoms. Our current study examines a vulnerability model, a complication model, and a reciprocal relations model according to a cross-lagged panel model (CLPM) and a random-intercept cross-lagged panel model (RI-CLPM). A sample of 197 community adults completed the General Mattering Scale (GMS), the Anti-Mattering Scale (AMS), and a depression measure at three time points (i.e., baseline, 3 weeks, and 6 weeks). GMS and AMS scores were associated robustly with depressive symptoms at each time point. Other results highlighted the need to distinguish levels of anti-mattering and mattering. CLPM analyses supported a reciprocal relations model of anti-mattering (assessed by the AMS) and depressive symptoms and a complication model linking mattering (assessed by the GMS) and depressive symptoms. The RI-CLPM analyses provided tentative support only for a complication model of anti-mattering and depressive symptoms. Our findings highlight the differences between measures of the mattering construct and the need to adopt a temporal perspective that considers key nuances and the interplay among feelings of mattering, feelings of not mattering, and depression.
Effects of Psychological and Physical Stress on Oxidative Stress, Serotonin, and Fatigue in Young Females Induced by Objective Structured Clinical Examination: Pilot Study of u-8-OHdG, u-5HT, and s-HHV-6
Authors: Iida Tadayuki , Ito Yasuhiro , Kanazashi Miho , Murayama Susumu , Miyake Takashi , Yoshimaru Yuki , Tatsumi Asami , Ezoe Satoko 
Published: October 2021

Background: To establish a method to prevent and manage fatigue caused by psychological and physical stress in young females, early detection factors, such as understanding of fatigue and causes of psychological and physical stress, as well as a review of early management of psychiatric disease, are important. With increasing knowledge regarding the diverse causes of stress, it is important to select biomarkers with consideration of the types of stress burden and mechanisms underlying the development of physical symptoms. The methods used to search for stress characteristics is an issue that needs to be addressed. However, consensus regarding objective assessment methods for impaired mental health is lacking. Methods: We examined the effects of an objective structured clinical examination (OSCE), considered to be a uniform source of psychological and physical stress, on biomarkers of oxidative stress and fatigue in 16 third-year female medical university students (21.3 ± 2.1 years old) in Japan with a normal menstrual cycle. A self-administered questionnaire consisting of Zung’s Self-rating Depression Scale (SDS) and State-Trait Anxiety Inventory (STAI) was used to assess subjective stress. Furthermore, stress-related biomarkers (urinary 8-hydroxy-2ʹ-deoxyguanosine [u-8-OHdG], urinary 5-hydroxytryptamine [u-5-HT], and salivary human herpesvirus-6 [s-HHV-6]) were examined at 1 month, 1 week, and 1 day before, and 1 week after the OSCE. Results: The results indicated that the OSCE did not have effects on u-8-OHdG, a biomarker of oxidative stress. However, u-5-HT and s-HHV-6 were found to be elevated in examinations performed prior to the OSCE. Conclusions: The present findings suggest that u-5-HT and s-HHV-6 levels can be used for objective assessment of mental and physical fatigue in young females, including that produced not only by knowledge regarding an upcoming OSCE, but also by skill and attitude aspects related to that examination.