bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toward Dynamic Risk Prediction of Outcomes After Coronary Artery Bypass Graft: Improving Risk Prediction With Intraoperative Events Using Gradient Boosting
Authors: Mori Makoto , Durant Thomas J.S. , Huang Chenxi , Mortazavi Bobak J. , Coppi Andreas , Jean Raymond A. , Geirsson Arnar , Schulz Wade L. , Krumholz Harlan M. 
Published: June 2021

Background:
Intraoperative data may improve models predicting postoperative events. We evaluated the effect of incorporating intraoperative variables to the existing preoperative model on the predictive performance of the model for coronary artery bypass graft.

Methods:
We analyzed 378 572 isolated coronary artery bypass graft cases performed across 1083 centers, using the national Society of Thoracic Surgeons Adult Cardiac Surgery Database between 2014 and 2016. Outcomes were operative mortality, 5 postoperative complications, and composite representation of all events. We fitted models by logistic regression or extreme gradient boosting (XGBoost). For each modeling approach, we used preoperative only, intraoperative only, or pre+intraoperative variables. We developed 84 models with unique combinations of the 3 variable sets, 2 variable selection methods, 2 modeling approaches, and 7 outcomes. Each model was tested in 20 iterations of 70:30 stratified random splitting into development/testing samples. Model performances were evaluated on the testing dataset using the C statistic, area under the precision-recall curve, and calibration metrics, including the Brier score.

Results:
The mean patient age was 65.3 years, and 24.7% were women. Operative mortality, excluding intraoperative death, occurred in 1.9%. In all outcomes, models that considered pre+intraoperative variables demonstrated significantly improved Brier score and area under the precision-recall curve compared with models considering pre or intraoperative variables alone. XGBoost without external variable selection had the best C statistics, Brier score, and area under the precision-recall curve values in 4 of the 7 outcomes (mortality, renal failure, prolonged ventilation, and composite) compared with logistic regression models with or without variable selection. Based on the calibration plots, risk restratification for mortality showed that the logistic regression model underestimated the risk in 11 114 patients (9.8%) and overestimated in 12 005 patients (10.6%). In contrast, the XGBoost model underestimated the risk in 7218 patients (6.4%) and overestimated in 0 patients (0%).

Conclusions:
In isolated coronary artery bypass graft, adding intraoperative variables to preoperative variables resulted in improved predictions of all 7 outcomes. Risk models based on XGBoost may provide a better prediction of adverse events to guide clinical care.
Representing the Cosmos and Transforming the Human: The Onto-hermeneutic Visions of Chung-ying Cheng’s The Primary Way: Philosophy of Yijing
Authors: Ng On-cho 
Published: June 2021

Abstract
The review essay critically evaluates, synoptically presents, and admiringly celebrates Chung-ying Cheng latest work, The Primary Way: Philosophy of Yijing. It sees the book’s publication as an emblem of an intellectual jubilee – a half-centenary of scholarly lucubration and achievement in Chinese and comparative philosophy by Cheng, who was trained at Harvard in American pragmatism and analytic philosophy. The essay reveals why Cheng returns to the Yijing time and again. The principal reason is that this ancient classic, to his way of thinking, offers us “the primary Way,” the anchoring normative criteria, perspectives, and values in a nutshell, whereby reality may be deciphered, discerned, and distinguished. To put it in metaphoric terms, the Yijing is the fount of Chinese philosophy. Whether interpreting Chinese thoughts in general or reading the Yijing in particular, Cheng brings western theoretical perspectives to bear on the understanding of the Chinese texts, which are, in and of themselves, replete with deep philosophical meanings. Cheng appropriates the Yijing for his own primary end, which is to disclose, via his onto-hermeneutic reading, a living, transformative ethico-moral philosophy that is onto-cosmologically alive and onto-generatively fecund: the primary Way. In doing so, he not only offers us innovative scholarship on the ancient classic but also opens up a theoretical and methodological frontier, an onto-hermeneutic one, where Chinese thought and philosophy may be explored anew.
Advancing Economic and Social Rights, Including Education in the Context of European Minorities—2019
Authors: Riekkinen Mariya 
Published: June 2021

This article reviews international developments which took place in 2019 with a focus on economic and social rights of members of European minorities, including the right to education. The developments are reviewed based on the practice of the UN, CoE, as well as EU organizations and their bodies whose activities relate to human rights issues. This review also covers the documents of the said bodies adopted in 2018 yet having remained non- promulgated until 2019.
In a nutshell, probably the most significant developments— in terms not only of the greater number of cases resolved but also of new rules proclaimed— occurred within the European Court of Human Rights (ECtHR). In particular, the ECtHR used the notion of ‘institutional racism’ in connection with police violence against Roma individuals in the case Lingurar v. Romania. The Court also articulated an extremely limited ratione materiae right to obtaining psychiatric treatment in a minority language in Rooman v. Belgium. Advancements include developments at unesco which adopted the first- ever international treaty on higher education and continued efforts in approximating diversity in education by elaborating on multi- language education.
Language Rights of European Minorities in the Administration of Justice, Public Administration and Public Services
Authors: Nagy Noémi 
Published: June 2021

This article provides an overview of European minorities’ language rights in the administration of justice, public administration, and public services in 2019. Relevant legal developments are presented in the activities of the major international organizations, i.e. the United Nations, the Organization for Security and Cooperation in Europe, the European Union, and the Council of Europe. Since the most relevant treaties on the language rights of minorities in Europe are the European Charter for Regional or Minority Languages and the Framework Convention for the Protection of National Minorities, special attention is paid to the implementation thereof.
Whereas international monitoring mechanisms devoted to the effective protection of minorities are abundant, language rights of national minorities receive less attention, especially in the fields of official language use, that is, in public administration and justice. The regulation of these areas has been traditionally considered as almost exclusively belonging to the states’ competence, and international organizations are consequently reluctant to interfere. As a result, the official use of minority languages differs in the various countries of Europe, with both good practices (e.g. the Netherlands, Spain, Finland) and unbalanced situations (e.g. Estonia, Ukraine, Azerbaijan).
The Manitoba Agriculture Mesonet: Technical Overview
Authors: RoTimi Ojo E. , Manaigre Lynn 
Published: June 2021

AbstractEstablished primarily to improve weather monitoring across the agricultural regions of the province, the Manitoba Agriculture Weather Program (MAWP) began officially in 2005 with funding from the provincial government for the establishment of a network of 28 automated weather monitoring stations. The network steadily grew to 46 stations between 2007 and 2014 as a result of partnership with local commodity and research groups. In response to the Manitoba flood of 2011, more stations were installed and the network grew to 108 weather stations in 2019. The stations are solar powered, and scheduled maintenance is conducted at each station twice per year. Weather parameters monitored include air temperature, barometric pressure, precipitation, relative humidity, soil moisture, soil temperature, solar radiation, wind speed, and wind direction using research-grade sensors. The observations are transmitted via cellular telemetry every 15 min in the spring, summer, and fall but hourly in the winter to conserve energy supply due to reduced daylight and below-freezing temperatures. The data can be viewed by the public within 1 min of data collection. The data are used to generate agronomic-related maps such as thermal unit computation of growing degree-days and corn heat units as well as disease risk maps such as Fusarium head blight. Beyond agriculture, the data have been used for aviation investigation and for undergraduate course instruction among other applications.
The Climatology and the Midwinter Suppression of the Cold Season North Pacific Storm Track in CMIP6 Models
Authors: Yang Minghao , Li Chongyin , Chen Xiong , Tan Yanke , Li Xin , Zhang Chao , Chen Guiwan 
Published: June 2021

AbstractThe reproducibility of climatology and the midwinter suppression of cold season North Pacific storm track (NPST) in historical runs of 18 CMIP6 models is evaluated against the NCEP reanalysis data. The results show that the position of the climatological peak area of 850 hPa meridional eddy heat flux (v′t′850) is well captured by these models. The spatial patterns of climatological v′t′850 are basically consistent with the NCEP reanalysis. Generally, NorESM2-LM and CESM2-WACCM present a relatively strong capability to reproduce the climatological amplitude of v′t′850 with lower RMSE than the other models. Compared with CMIP5 models, the inter-model spread of v′t′850 climatology among the CMIP6 models is smaller, and their multi-model ensemble is closer to the NCEP reanalysis. The geographical distribution in more than half of the selected models is further south and east. For the subseasonal variability of v′t′850, nearly half of the models exhibit a double-peak structure. In contrast, the apparent midwinter suppression in the NPST represented by the 250 hPa filtered meridional wind variance (v′v′250) is reproduced by all the selected models.In addition, the present study investigates the possible reasons for simulation biases regarding climatological NPST amplitude. It is found that a higher model horizontal resolution significantly intensifies the climatological v′v′250. There is a significant in-phase relationship between climatological v′t′250 and the intensity of the East Asian winter monsoon (EAWM). However, the climatological v′t′850 is not sensitive to the model grid spacing. Additionally, the climatological low-tropospheric atmospheric baroclinicity is uncorrelated with climatological v′v′250. The stronger climatological baroclinic energy conversion is associated with the stronger climatological v′t′850.
Safety and Efficacy of Prophylactic Enoxaparin Adjusted by Anti-Factor Xa Peak Levels in Pancreatic Surgery
Authors: Kramme Katherine , Sarraf Paya , Shebrain Saad , Munene Gitonga 
Published: June 2021

Background Recommended prophylactic doses of enoxaparin (Lovenox) are associated with subprophylactic anti-Factor Xa (anti-Xa) levels. This study examines the safety and efficacy of anti-Xa-guided dosing of enoxaparin in pancreatic surgery. Methods Prospectively enrolled patients undergoing pancreatic surgery received enoxaparin dosing adjusted based on peak anti-Xa levels and were compared to a historical cohort of patients. Results Baseline characteristics were similar between the intervention and control groups. In the intervention group, 73.9% initially had subprophylactic peak anti-Xa levels. There were no differences in the venous thromboembolism (VTE) rates between the intervention and control groups (0% vs. 7.69%; P = .084), major bleeding events (4.35% vs. 2.56%; P = .627), RBC transfusion (15.2% vs. 25.6%; P = .257), or Hgb on discharge (9.82 vs. 9.44 g/dL; P = .244). Subtherapeutic anti-Xa levels were correlated with a higher BMI ( P = .033), longer OR time ( P = .011), and length of stay ( P = .018). Conclusions Enoxaparin 40 mg once daily is associated with subprophylactic peak anti-Xa levels. Dose adjustment based on anti-Xa levels trended toward a lower rate of in-hospital VTE without an increase in bleeding or transfusion requirement.
Mitigating the Costs of Spatial Transformations With a Situation Awareness Augmented Reality Display: Assistance for the Joint Terminal Attack Controller 3-17
Authors: Wickens Christopher D. , Mifsud Domenick , Rodriguez Richi , Ortega Francisco R. 
Published: June 2021

Objective Evaluate and model the advantage of a situation awareness (SA) supported by an augmented reality (AR) display for the ground-based joint terminal attack Controller (JTAC), in judging and describing the spatial relations between objects in a hostile zone. Background The accurate world-referenced description of relative locations of surface objects, when viewed from an oblique slant angle (aircraft, observation post) is hindered by (1) the compression of the visual scene, amplified at a lower slang angle, (2) the need for mental rotation, when viewed from a non-northerly orientation. Approach Participants viewed a virtual reality (VR)-simulated four-object scene from either of two slant angles, at each of four compass orientations, either unaided, or aided by an AR head-mounted display (AR-HMD), depicting the scene from a top-down (avoiding compression) and north-up (avoiding mental rotation) perspective. They described the geographical layout of four objects within the display. Results Compared with the control condition, that condition supported by the north-up SA display shortened the description time, particularly on non-northerly orientations (9 s, 30% benefit), and improved the accuracy of description, particularly for the more compressed scene (lower slant angle), as fit by a simple computational model. Conclusion The SA display provides large, significant benefits to this critical phase of ground-air communications in managing an attack—as predicted by the task analysis of the JTAC. Application Results impact the design of the AR-HMD to support combat ground-air communications and illustrate the magnitude by which basic cognitive principles “scale up” to realistically simulated real-world tasks such as search and rescue.
Rectal Staphylococcus aureus Carriage and Recurrence After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps: A Prospective Cohort Study
Authors: Peng Yue , Liu Zhao , Yu Zhijian , Lu Aiwu , Zhang Tao 
Published: June 2021

Objective: Chronic rhinosinusitis with nasal polyps (CRSwNPs) remains a major challenge due to its high recurrence rate after endoscopic sinus surgery (ESS). We aimed to investigate the risk factors of recurrence among patients who underwent ESS for Chronic rhinosinusitis (CRS). Methods: Prospective cohort study including 391 cases in a single institution receiving ESS were included for analysis from 2014 and 2017. Baseline characteristics including rectal Staphylococcus aureus ( S aureus) carriage in patients receiving ESS for CRSwNPs. The primary outcome was the recurrence of CRSwNPs. Multivariate regression model was established to identify independently predictive factors for recurrence. Results: Overall, 142 (36.3%) cases with recurrence within 2 years after ESS were observed in this study. After variable selection, multivariate regression model consisted of 4 variables including asthma (odds ratio [OR] = 3.41; P < .001), nonsteroidal anti-inflammatory drug allergy (OR = 2.27; P = .005), previous ESS (OR = 3.64; P < .001), and preoperative carriage of S aureus in rectum (OR = 2.34; P = .001). Conclusions: Based on our results, surgeons could predict certain groups of patients who are at high risk for recurrence after ESS. Rectal carriage of S aureus is more statistically related to the recurrence of CRSwNP after ESS compared with skin and nasal carriage.
Influence of cardiopulmonary bypass set-up and management on clinical outcomes after minimally invasive aortic valve surgery
Authors: Cammertoni Federico , Bruno Piergiorgio , Pavone Natalia , Farina Piero , Mazza Andrea , Iafrancesco Mauro , Nesta Marialisa , Chiariello Giovanni A , Spalletta Claudio , Cavaliere Franco , Calabrese Maria , D’Angelo Gianluca A , Sanesi Valerio , Conti Francesco , D’Errico Denise , Massetti Massimo 
Published: June 2021

Introduction: Minimally invasive aortic valve replacement (MIAVR) requires changes in cannulation strategy and cardiopulmonary bypass (CPB) management when compared to the conventional approach (CAVR). We aimed at evaluating if these differences could influence perfusion-related quality parameters and impair postoperative outcomes. Methods: Overall, 339 consecutive patients underwent MIAVR or CAVR between 2014 and 2020 and were analyzed retrospectively. To account for baseline differences, a propensity-matching analysis was performed, obtaining two groups of 97 patients each. Results: MIAVR group had longer CPB time [107 (95–120) vs 95 (86–105) min, p = .003] than CAVR group. Of note, average pump flow rate index [2.4 (2.2–2.5) vs 2.7 (2.4–2.8) l/min/m2, p = .004] was lower in the MIAVR group. Mean arterial pressure was 73 = 9 mmHg vs 62 = 11 mmHg for the MIAVR and CAVR group, respectively (p < .001). Cell-salvaged blood was most commonly used in the MIAVR group (25.8% vs 11.3%, p = .02). Finally, CPB temperature was 32.8°C (32.1–34.8) for MIAVR group vs 34.9°C (33.2–36.1) for the CAVR group (p = .02). Postoperative complications were similar between groups. Conclusions: In conclusion, despite differences in CPB parameters in patients undergoing CAVR and MIAVR, the incidences of adverse outcomes were similar. However, compared to CAVR, MIAVR was associated with shorter durations of mechanical ventilation and hospital stay as well as less transfusion of blood products.
Intranasal dexmedetomidine: Procedural sedation in palliative care: A case report
Authors: Ferguson Lana , Wilson Matthew 
Published: June 2021

Background: This report describes the use of intranasal dexmedetomidine to control incident pain and facilitate daily change of dressing in a patient with cutaneous breast cancer. Case presentation: A 45-year-old woman with extensive thoracic cutaneous metastatic bilateral breast cancer requiring daily 2-hour dressing changes to manage significant exudate. Pain during change of dressing was severe and unresponsive to usual analgesics. Deeper sedation was not an option as the patient was required to change position 1 hour into dressing change. Case management: Intranasal dexmedetomidine was administered 40 minutes prior to dressing change and provided effective rousable sedation and analgesia for the duration of the procedure. Case outcome: Dexmedetomidine provided rousable sedation, allowing the patient to follow commands and mobilise during the procedure. Pain was controlled. No adverse cardiovascular effects were noted with the use of intranasal dexmedetomidine. Conclusion: Intranasal dexmedetomidine is a potentially useful medication for procedural sedation in the management of complex wound dressings. It provides rousable short-term sedation, anxiolysis and analgesia. Further research into the role of intranasal dexmedetomidine to facilitate challenging dressing changes in a community setting is warranted.
Ultrapurified Alginate Gel Containing Bone Marrow Aspirate Concentrate Enhances Cartilage and Bone Regeneration on Osteochondral Defects in a Rabbit Model
Authors: Xu Liang , Urita Atsushi , Onodera Tomohiro , Hishimura Ryosuke , Nonoyama Takayuki , Hamasaki Masanari , Liang Dawei , Homan Kentaro , Gong Jian Ping , Iwasaki Norimasa 
Published: June 2021

Background: Ultrapurified alginate (UPAL) gel implantation has been demonstrated as effective in cartilage repair for osteochondral defects; however, cell transplantation within UPAL gels would be required to treat larger defects. Hypothesis: The combination of UPAL gel and bone marrow aspirate concentrate (BMAC) would enhance cartilage repair and subchondral bone repair for large osteochondral defects. Study Design: Controlled laboratory study. Methods: A total of 104 osteochondral defects (1 defect per knee) of 52 rabbits were randomly divided into 4 groups (26 defects per group): defects without any treatment (Defect group), defects treated using UPAL gel alone (UPAL group), defects treated using UPAL gel containing allogenic bone marrow mesenchymal stromal cells (UPAL-MSC group), and defects treated using UPAL gel containing BMAC (UPAL-BMAC group). At 4 and 16 weeks postoperatively, macroscopic and histologic evaluations and measurements of repaired subchondral bone volumes of reparative tissues were performed. Collagen orientation and mechanical properties of the reparative tissue were assessed at 16 weeks. Results: The defects in the UPAL-BMAC group were repaired with hyaline-like cartilage with well-organized collagen structures. The histologic scores at 4 weeks were significantly higher in the UPAL-BMAC group (16.9 ± 2.0) than in the Defect group (4.7 ± 1.9; P < .05), the UPAL group (10.0 ± 3.3; P < .05), and the UPAL-MSC group (12.2 ± 2.9; P < .05). At 16 weeks, the score in the UPAL-BMAC group (24.4 ± 1.7) was significantly higher than those in the Defect group (9.0 ± 3.7; P < .05), the UPAL group (14.2 ± 3.9; P < .05), and the UPAL-MSC group (16.3 ± 3.6; P < .05). At 4 and 16 weeks, the macroscopic evaluations were significantly superior in the UPAL-BMAC group compared with the other groups, and the values of repaired subchondral bone volumes in the UPAL-BMAC group were significantly higher than those in the Defect and UPAL groups. The mechanical properties of the reparative tissues were significantly better in the UPAL-BMAC group than in the other groups. Conclusion: The implantation of UPAL gel containing BMAC-enhanced hyaline-like cartilage repair and subchondral bone repair of osteochondral defects in a rabbit knee model. Clinical Relevance: These data support the potential clinical application of 1-step treatment for large osteochondral defects using biomaterial implantation with cell transplantation.
Identity narrative, group and individual narratives and their role in social stability: A multidisciplinary approach
Authors: Novac Andrei , Zahn Christine , Blinder Barton J. 
Published: June 2021

Major social political changes over the past decades have stimulated an interest in both individual (i.e., personal) and group narratives as they relate to the decision-making process. In previous contributions, we have proposed the term Identity Narrative (IdN) to define a cognitive and emotional framework that serves as an implicit (unconscious) scaffold of human autobiography. IdN is a form of implicit memory, the acquisition of which begins with the first human nonverbal interactions. It serves as a framework for a person’s identity and creates relative stability and constancy for conscious, explicit, autobiographical memory. In this contribution we are presenting a multi-system exploration of the relationship between personal narratives as influenced by IdN and group narratives and their impact on social stability. We are presenting multi-disciplinary data from a variety of fields, including group psychoanalysis, memory research, the neuroscience of error prediction and free energy, and social science. We propose that in order to maintain social stability, the ratio between the entropy of personal narratives and group narratives in society also remains relatively stable. Based on the literature on group analysis, we are proposing a further investigation of the interchange between group narratives (group psychology, history, the humanities, culture in a society) and individual narratives (autobiography and IdN), and their impact at a societal level. By doing so, we are reiterating that the study of group analysis is of special socio-political significance in these historical times.