bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aligning Faithful Interpretations with their Social Attribution
Authors: Jacovi Alon , Goldberg Yoav 
Published: April 2021

Abstract
We find that the requirement of model interpretations to be faithful is vague and incomplete. With interpretation by textual highlights as a case study, we present several failure cases. Borrowing concepts from social science, we identify that the problem is a misalignment between the causal chain of decisions (causal attribution) and the attribution of human behavior to the interpretation (social attribution). We reformulate faithfulness as an accurate attribution of causality to the model, and introduce the concept of aligned faithfulness: faithful causal chains that are aligned with their expected social behavior. The two steps of causal attribution and social attribution together complete the process of explaining behavior. With this formalization, we characterize various failures of misaligned faithful highlight interpretations, and propose an alternative causal chain to remedy the issues. Finally, we implement highlight explanations of the proposed causal format using contrastive explanations.
Recent Climate Variability around the Kerguelen Islands (Southern Ocean) Seen through Weather Regimes
Authors: Pohl Benjamin , Saucède Thomas , Favier Vincent , Pergaud Julien , Verfaillie Deborah , Féral Jean-Pierre , Krasniqi Ylber , Richard Yves 
Published: April 2021

AbstractDaily weather regimes are defined around the Kerguelen Islands (Southern Ocean) on the basis of daily 500-hPa geopotential height anomalies derived from the ERA5 ensemble reanalysis over the period 1979–2018. Ten regimes are retained as significant. Their occurrences are highly consistent across reanalysis ensemble members. Regimes show weak seasonality and nonsignificant long-term trends in their occurrences. Their sequences are usually short (1–3 days), with extreme persistence values above 10 days. Seasonal regime frequency is mostly driven by the phase of the southern annular mode over Antarctica, midlatitude dynamics over the Southern Ocean such as the Pacific–South American mode, and, to a lesser extent, tropical variability, with significant but weaker relationships with El Niño–Southern Oscillation. At the local scale over the Kerguelen Islands, regimes have a strong influence on measured atmospheric and oceanic variables, including minimum and maximum air temperature, mostly driven by horizontal advections, seawater temperature recorded 5 m below the surface, wind speed, and sea level pressure. Relationships are weaker for precipitation amounts. Regimes also modify regional contrasts between observational sites in Kerguelen, highlighting strong exposure contrasts. The regimes allow us to improve our understanding of weather and climate variability and interactions in this region; they will be used in future work to assess past and projected long-term circulation changes in the southern midlatitudes.
Ileal Pouch Excision can Be Performed With Similar Outcomes in Obese Patients Compared to Nonobese Counterparts: An Assessment From American College of Surgeons National Surgical Quality Improvement Program
Authors: Esen Eren , Aytac Erman , Aydinli H. Hande , Grieco Michael J. , Erkan Arman , Kirat Hasan T. , Schwartzberg David M. , Baca Bilgi , Karahasanoglu Tayfun , Remzi Feza H. 
Published: April 2021

Background Failed pouches may tend to be managed with only a loop ileostomy in obese patients due to some safety concerns. The effect of obesity on ileal pouch excision outcomes is poorly studied. In our study, we aimed to assess the short-term outcomes after ileal pouch excision in obese patients compared to their nonobese counterparts. Methods The patients who underwent pouch excision between 2005 and 2017 were included using ACS-NSQIP participant user files. The operative outcomes were compared between obese (BMI ≥30 kg/m2) and nonobese (BMI<30 kg/m2) groups. Results There were 507 pouch excision patients included of which eighty (15.7%) of them were obese. Physical status of the obese patients tended to be worse (ASA>3, 56.3 vs 42.9%, P = .027). There were more patients who had diabetes mellitus (DM) and hypertension (HT) in the obese group (26.3% vs. 11.2%, P = .015; 11.3 vs. 4.4%, P < .001, respectively). Operative time was similar between 2 groups (mean ± SD, 275 ± 111 vs. 252±111 minutes, P = .084). Deep incisional SSI was more commonly observed in the obese group (7.5 vs 2.8%, P = .038). In multivariate analysis, only deep incisional SSI was found to be independently associated with obesity (OR: 2.79, 95% CI: 1.02-7.67). Obese patients were readmitted more frequently than nonobese counterparts (28.3 vs 16%, P = .035). The length of hospital stay was comparable [median (IQR), 7 (4-13.5) vs. 7 (5-11) days, P = .942]. Conclusion Ileal pouch excision can be performed in obese patients with largely similar outcomes compared to their nonobese counterparts although obesity is associated with a higher rate of deep space infection.
A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery
Authors: Patel Samik H. , Battaglia Michael A. , Shanker Beth-Ann , Cleary Robert K. 
Published: April 2021

BackgroundOncologic outcomes for colon cancer are optimal when chemotherapy is started within 6 to 8 weeks after surgery. The study objective was to investigate the impact of operative modality and urgency on the time interval from surgery to adjuvant chemotherapy.MethodsThis is a retrospective institutional tumor registry cohort study of open and laparoscopic/robotic colorectal resections for stage II-IV cancer between April 2010 and January 2018. Primary outcome was time from surgery to chemotherapy. Predictor variables were adjusted for imbalances by propensity score weighting.ResultsA total of 220 patients met inclusion criteria: 171 elective (108 laparoscopic/robotic and 63 open) and 49 urgent colectomies. After propensity score weighting, there was no significant difference in time to chemotherapy between elective minimally invasive and open surgical approaches (48 days vs. 58 days, P = .187). Only 68.9% of minimally invasive and 50.8% of open colectomy patients started chemotherapy within 8 weeks of surgery. There was a significant difference ( P = .037) among surgical sites with rectal resections having the longest (55 days), and right colectomies having the shortest (46 days), time to chemotherapy. Patients who had urgent operations had significantly longer hospital length of stay ( P < .001) and higher post-discharge emergency department visit rates ( P < .001) than the elective operation group. However, there was no significant difference in time to chemotherapy.DiscussionNeither operative modality nor operative urgency resulted in a significant difference in postoperative time to initiating chemotherapy. Future efforts should be focused on identifying postoperative recovery criteria and optimum multidisciplinary communication methods that allow recovered patients to start chemotherapy sooner.
Assessment of factors affecting short-term pulmonary functions following cardiac surgery: A prospective observational study
Authors: Katiyar Neetika , Negi Sandeep , Negi Sunder Lal , Puri Goverdhan Dutt , Thingnam Shyam Kumar Singh 
Published: April 2021

Background Pulmonary complications after cardiac surgery are very common and lead to an increased incidence of post-operative morbidity and mortality. Several factors, either modifiable or non-modifiable, may contribute to the associated unfavorable consequences related to pulmonary function. This study was aimed to investigate the degree of alteration and factors influencing pulmonary function (forced expiratory volume in one second (FEV1) and forced vital capacity), on third, fifth, and seventh post-operative days following cardiac surgery. Methods This study was executed in 71 patients who underwent on-pump cardiac surgery. Pulmonary function was assessed before surgery and on the third, fifth, and seventh post-operative days. Data including surgical details, information about risk factors, and assessment of pulmonary function were obtained. Results The FEV1 and forced vital capacity were significantly impaired on post-operative days 3, 5, and 7 compared to pre-operative values. The reduction in FEV1 was 41%, 29%, and 16% and in forced vital capacity was 42%, 29%, and 19% consecutively on post-operative days 3, 5, and 7. Multivariate analysis was done to detect the factors influencing post-operative FEV1 and forced vital capacity. Discussion This study observed a significant impairment in FEV1 and forced vital capacity, which did not completely recover by the seventh post-operative day. Different factors affecting post-operative FEV1 and forced vital capacity were pre-operative FEV1, age ≥60, less body surface area, lower pre-operative chest expansion at the axillary level, and having more duration of cardiopulmonary bypass during surgery. Presence of these factors enhances the chance of developing post-operative pulmonary complications.
Current Concepts on Tissue Adhesive Use for Meniscal Repair—We Are Not There Yet: A Systematic Review of the Literature
Authors: Marom Niv , Ode Gabriella , Coxe Francesca , Jivanelli Bridget , Rodeo Scott A. 
Published: April 2021

Background: Tissue adhesives (TAs) represent a promising alternative or augmentation method to conventional tissue repair techniques. In sports medicine, TA use has been suggested and implemented in the treatment of meniscal tears. The aim of this review was to present and discuss the current evidence and base of knowledge regarding the clinical usage of TAs for meniscal repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic literature search was performed using the PubMed, Embase, and Cochrane Library databases for studies reporting on clinical outcomes of TA usage for meniscal repair in humans in the English language published before January 2020. Results: Ten studies were eligible for review and included 352 meniscal repairs: 94 (27%) were TA-based repairs and 258 (73%) were combined suture and TA repairs. Concomitant anterior cruciate ligament reconstruction was performed in 224 repairs (64%). All included studies utilized fibrin-based TA. Of the 10 studies, 9 were evidence level 4 (case series), and 8 reported on a cohort of ≤40 meniscal repairs. Rates of meniscal healing were evaluated in 9 of 10 studies, with repair failure seen in 39 repairs (11%). Conclusion: The use of TAs, specifically fibrin-based TAs, for meniscal repair shows good results as either an augmentation or primary repair of various configurations of meniscal tears. However, this review reveals an absence of comparative high-quality evidence supporting the routine use of TAs for meniscal repair and emphasizes the lack of an ideal TA designed for that purpose. Further high-quality research, basic science and clinical, will facilitate the development of new materials and enable testing their suitability for use in meniscal repair.
Dementia Care, Fall Detection, and Ambient-Assisted Living Technologies Help Older Adults Age in Place: A Scoping Review
Authors: Gettel Cameron J. , Chen Kevin , Goldberg Elizabeth M. 
Published: April 2021

Objectives: We aimed to describe recent technologic advances in the three domains of dementia care, falls, and home supports; summarize existing literature on usability; and identify knowledge gaps. Methods: A comprehensive search of five databases for recent peer-reviewed publications was conducted in May 2020. Independent reviewers performed title/abstract review, full-text screening, data extraction, and study characteristic summarization. Results: Out of 2,696 citations, 151 articles were retrieved for full-text evaluation, after which 54 studies were included in this scoping review. For each domain, different technologies are available to enhance the health and well-being of older adults; many users deemed them usable and useful. Technologies targeted improving function, psychosocial and cognitive status, home safety, and caregiver burden. Barriers to widespread uptake include privacy concerns, suboptimal user experience, and willingness to accept assistance. Conclusion: Technologic innovations directed toward dementia care, fall detection, and ambient-assisted living can aid older adults “aging in place.”
Hydroxychloroquine prophylaxis for preeclampsia, hypertension and prematurity in pregnant patients with systemic lupus erythematosus: A meta-analysis
Authors: Duan Jiaoniu , Ma Dan , Wen Xiaoting , Guo Qianyu , Gao Jinfang , Zhang Gailian , Xu Ke , Zhang Liyun 
Published: April 2021

Objectives This meta-analysis aimed to evaluate the effectiveness of HCQ in improving the maternal and fetal outcomes in pregnancies with SLE. Methods A literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane database for relevant English language articles, and Wanfang, CNKI and VIP for Chinese articles, from the databases’ inception to April 30, 2020. These studies compared the maternal and/or fetal outcomes between pregnant patients with SLE who were administered HCQ during pregnancy (HCQ+ group) and those who were not administered HCQ (HCQ− group). Two investigators extracted the data and assessed the quality using the Newcastle-Ottawa Scale (NOS) and GRADE criteria independently. Odds ratio (OR) and 95% confidence intervals (CIs) were calculated. All statistical analyses were conducted using the Stata 12.0 software. Results Nine studies involving 1132 pregnancies were included in the study (3 case controls, 2 prospective cohorts, 4 retrospective cohorts). Preeclampsia, gestational hypertension, and prematurity were significantly lower in the HCQ+ group than in the HCQ− group (OR 0.35, 95% CI 0.21–0.59), (OR 0.41, 95% CI 0.19–0.89) and (OR 0.55, 95% CI 0.36–0.86), respectively. There were no significant differences in the rates of HELLP Syndrome (OR 0.88, 95% CI 0.19–3.96), gestational diabetes (OR 2.3, 95% CI 0.44–12.12), thrombotic events (OR 0.26, 95% CI 0.05–1.51), spontaneous abortion (OR 1.77, 95% CI 0.96–3.26), premature rupture of membranes (OR 0.58, 95% CI 0.24–1.39), oligohydramnios (OR 0.90, 95% CI 0.38–2.14), live birth (OR 1.22, 95% CI 0.60–2.47), stillbirth (OR 1.00, 95% CI 0.50–2.00), congenital malformation (OR 0.53, 95% CI 0.14–2.04), low birth weight (OR 0.77, 95% CI 0.43–1.39), intrauterine distress (OR 1.07, 95% CI 0.41–2.76,), intrauterine growth restriction (OR 0.57, 95% CI 0.06–5.43), or five-minute APGAR score <7 (OR 0.72, 95% CI 0.20–2.58) between the two groups. Conclusions HCQ treatment during pregnancy could reduce the risk of preeclampsia, pregnancy hypertension and prematurity in SLE patients. The certainty of evidence is high but majority of the studies included are retrospective studies and not randomized controlled trials. Therefore, the multidisciplinary management of pregnant patients with SLE should promote HCQ use, irrespective of disease activity or severity.
Increased referrals to an Australian Consultation Liaison Psychiatry service during the COVID-19 pandemic
Authors: Lele Kiran , Cartoon Jodi , Griffiths Alison 
Published: April 2021

Objective: It has been widely predicted that the COVID-19 pandemic will have a detrimental impact on the mental health (MH) of individuals. This has been dubbed as the MH ‘second wave’. In Australia, these impacts have been partly mitigated by institutional responses such as increased access to psychotherapy. Consultation Liaison (CL) psychiatry services provide MH care to acutely unwell patients in general hospitals. It was hypothesised that the number of referrals to the studied service had increased since the start of the pandemic. Methods: From the Electronic medical records (eMRs), the authors collected daily referral numbers, over 3 consecutive years, to a large CL service in metropolitan Sydney. Results: Referrals were significantly increased by 25%, 95% CI [1.14, 1.36], p < .001 since the start of the pandemic. This increase was delayed, and remained elevated despite a reduction in COVID-19 infections. Conclusion: This study adds evidence to the existence of the MH ‘second wave’, highlights a key impact on healthcare workers’ well-being and will assist in guiding resource allocation decisions in the near future.
Determinants of Breast Cancer Screening in Three Arab American Women Subgroups
Authors: Alatrash Manal 
Published: April 2021

Introduction Arab American women (AAW) have significantly low mammography screening (MS) rates; religious and sociocultural factors may serve as facilitators or barriers to screening. Understanding associations with screening practices and attitudes is imperative. The purpose of this study was to examine associations of sociodemographic characteristics with perceived benefits and barriers to MS and explore relationships of MS with sociodemographics, and perceived benefits and barriers in Muslim and Christian AAW from three Arab countries, Jordan, Lebanon, and Egypt. Method In this exploratory, cross sectional study, a convenience sample of 316 AAW completed a survey that combined sociodemographics and the Arab Specific-Culture Barriers instrument. Results Religion was significantly associated with perceived benefits and country of birth had a significant association with perceived barriers. Significant relationships were found between some variables and MS. Discussion This study provided insights into facilitators and barriers influencing behaviors and attitudes regarding MS in AAW. Additional efforts are to be made to overcome barriers within a religious and cultural context to empower these women.
Virtual Study-Abroad Through Web Conferencing: Sharing Knowledge and Building Cultural Appreciation in Nursing Education and Practice
Authors: King Tara Spalla , Bochenek Jeanie , Jenssen Unni , Bowles Wendy , Morrison-Beedy Dianne 
Published: April 2021

Background: With a focus on building global citizens, a U.S. and Norwegian academic collaborative partnership fostered clinical learning experiences addressing cultural and health care comparisons. High-impact educational practices integrated into international clinical experiences, combined with virtual global learning classrooms, highlighted the Sustainable Development Goals. Problem: Given nursing education’s requirements, devising innovative strategies expanded global learning in brief but transformative experiences while integrating nontraveling students, especially relevant considering current pandemic-related travel restrictions. Approach: We developed an educational experience pairing U.S. students (17 in person; 64 through web conference) and Norwegian students (50 in person; 3 for web conference) in population health experiences, providing required clinical hours and a shared cultural exchange. Integration of nontraveling students in joint virtual global experiences broadened the global learning opportunity for all. Conclusion: This work offers insight into how faculty used a virtual global learning experience as a synergistic tool with traditional study abroad.
Research-Based Game Design for Serious Games
Authors: Watt Keith , Smith Tamarah 
Published: April 2021

Background: Research into serious games has produced confusing and sometimes conflicting results regarding the effectiveness of using games in education. This confusion can make designing an effective serious game challenging if one wishes to follow the recommendations found in the literature. When we examine these recommendations in light of theoretical models of cognitive and social development along with Universal Design for Learning principles, many of these apparent contradictions can be resolved. Aim: In reviewing the literature we identified social learning and motivation factors that when considered in designing serious games can improve their effectiveness. Using these factors, we provide a concise set of guidelines for developing serious games. Conclusion: The research-informed guidelines presented here can be utilized by all game designers wishing to maximize serious game effectiveness.
Biweekly DoceAqualip in mCRPC patients beyond 20 cycles: A case series
Authors: Tiwari Srikant , Bisaria Abhaya , Kaur Harmeet , Joshi Nisarg , Sejpal Jaykumar , Khan Mujtaba A 
Published: April 2021

Introduction Docetaxel 75 mg/m2 every 3 weeks for up to 10 cycles is an accepted standard regimen in metastatic castration-resistant prostate cancer (mCRPC). We report our experience with >20 cycles of biweekly nanosomal docetaxel lipid suspension (NDLS) treatment in patients with mCRPC. Case reports Cases with long-term treatment of NDLS treatment in mCRPC patients were identified from the medical records of Jawaharlal Nehru Cancer Hospital & Research Centre Bhopal, India. A total of three cases with >20 cycles of NDLS are presented here. Management and outcomes Overall, the 3 patients received biweekly NDLS at a dose of 45 mg/m2 for 22, 36, and 40 cycles, respectively, except for one patient where NDLS was initiated at 50 mg/m2 and later reduced to 45 mg/m2. All the 3 patients reported prostate-specific antigen (PSA) response (>50% decline in PSA levels from baseline). The time to treatment failure (TTF) was 14.8, 18.2, and 20.6 months in these 3 patients, respectively. PSA nadir occurred after 14, 6 and 13 cycles, respectively. The OS was 21.6, 22.2 and 25.8 months, respectively. Anemia, lymphopenia, and neutropenia were the most common adverse events. NDLS treatment was overall well-tolerated without any new safety concerns. Conclusions Biweekly NDLS for >20 cycles was effective and well-tolerated in patients with mCRPC. NDLS can potentially be used for long-term management, which may be a requirement for most patients with mCRPC.
Detecting the prevalence of bacterial colonization on tunneled cuffed hemodialysis catheters using quantitative PCR targeting 16S rRNA and scanning electron microscopy
Authors: Onder Ali Mirza , Cuff Christopher F , Liang Xiaobing , Billings Anthony A , Onder Songul , Yu Jing Jie , King Judy Ann 
Published: April 2021

Background and objectives: Tunneled cuffed hemodialysis catheters (TCC) get colonized by microorganisms, increasing risk for catheter related bacteremia (CRB). Our objective was to detect the prevalence of bacterial colonization of TCC by using quantitative PCR (qPCR) targeting 16S rRNA and by determining the intraluminal adherent biological material (ABM) coverage. Methods: A total of 45 TCC were investigated. The 16S rRNA qPCR technique was used to detect bacterial colonization after scraping the intraluminal ABM. Proximal, middle, and distal TCC were evaluated by scanning electron microscopy (SEM) to determine the percentage (%) of intraluminal ABM coverage. All catheters were cultured following sonication. Results: A total of 45 TCC were removed: 7 due to CRB, 3 for suspected CRB and 35 were removed for non-infectious etiologies. Bacterial colonization was detected in 27 TCC by documenting 16S rRNA qPCR (+) results (60%). Seven of these 16S rRNA qPCR (+) catheters were removed due to CRB. There was no difference in demographic, clinical, or laboratory values between the 16S rRNA (+) versus (−) TCC. The 16S rRNA qPCR (−) outcome was highly associated with CRB-free status with negative predictive value of 100%. Bacterial colonization was documented in 10 TCC using catheter cultures (22%), which was significantly less compared to qPCR method ( p = 0.0002). ABM were detected in all catheter pieces, with mean intraluminal surface coverage (ABMC) of 68.4 ± 26.1%. ABM was unlikely to be microbial biofilm in at least 36% of removed TCC as their 16S rRNA qPCR and catheter culture results were both negative. Conclusions: Detecting bacterial colonization of TCC was significantly higher with 16S rRNA qPCR compared to catheter cultures. The 16S rRNA qPCR (−) cannot be predicted and was strongly associated with absence of CRB. Intraluminal ABM was not associated with microbial presence in about 1/3 of the TCC. These pieces of evidence may help to improve prophylactic strategies against CRB.