bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cross‐Sectional Network Analysis Study Applied to the Depression Anxiety Stress Scale‐21 (DASS‐21): A New Factor Revealed
Authors: Alvarenga Marco Antônio Silva , Ali Amira Mohammed , Guilhermino Carollina Souza , de Azevedo Tiago Geraldo , Olímpio Kelly Fernandes , Kersul Camila , da Cunha Glacithane Lins , Alvares-Teodoro Juliana , Ribeiro Pricila Cristina Correa , Mansur-Alves Marcela , Teodoro Maycoln Lêoni Martins , Bandeira Paulo Felipe Ribeiro 
Published: September 2024

Background: The Depression Anxiety Stress Scale‐21 (DASS‐21) has been widely studied in different populations as a brief screening tool to assess features of psychological distress. Because of its multidimensionality, this scale is better addressed within a complex system.Objective: Therefore, this research is aimed at investigating the psychometric properties of the scale using network analysis and other statistical analysis to evidence validity of the scale based on its internal structure, since only two studies using classical methods have previously tested it on Brazilian samples.Methods: In this cross‐sectional study, an online survey was used to recruit a sample of 4017 (Mage = 31.16; SD = 10.31 years), of whom 70.3% were college students, 69.5% were assigned female at birth, 60.8% declared themselves to be White, and 22.6% reported they lived in the southeastern region of the country. The DASS‐21 was analyzed using uni‐, bi‐, and multivariate analyses, including exploratory graph analysis (EGA) and bootstrap EGA.Results: EGA and BootEGA generated and confirm a model with four factors, which expressed a better fit than other replications (χ2 (183) = 899.09, Comparative Fit Index [CFI] = 1.00, Tucker–Lewis Index [TLI] = 1.00, root mean square error of approximation [RMSEA] = 0.03, and standardized root mean square residual [SRMR] = 0.03). The new four‐factor model has excellent composite reliability (rho_C range = 0.84–0.90), which indicates a high level of accuracy of the measured factor. It is also invariant across genders and type of activity performed.Conclusion: The classic structure of the DASS‐21 (three factors) was replicated, but a four‐factor model proved to be the one with the best statistical indices for nonclinical sample, providing new insight into the internal structure of this scale. In addition, there was factorial invariance between the groups compared. Implications for the use of the new structure are discussed.
Genetic Variance in Heparan Sulfation Is Associated With Salt Sensitivity
Authors: Oppelaar Jetta J. , Ferwerda Bart , Romman Mohamed A. , Sahebdin Ghazalah N. , Zwinderman Aeilko H. , Galenkamp Henrike , Boekholdt S. Matthijs , van den Born Bert-Jan H. , Olde Engberink Rik H.G. , Vogt Liffert 
Published: September 2024

BACKGROUND:
High heritability of salt sensitivity suggests an essential role for genetics in the relationship between sodium intake and blood pressure (BP). The role of glycosaminoglycan genes, which are crucial for salinity tolerance, remains to be elucidated.

METHODS:
Interactions between 54 126 variants in 130 glycosaminoglycan genes and daily sodium excretion on BP were explored in 20 420 EPIC-Norfolk (European Prospective Investigation Into Cancer in Norfolk) subjects. The UK Biobank (n=414 132) and the multiethnic HELIUS study (Healthy Life in an Urban Setting; n=2239) were used for validation. Afterward, the urinary glycosaminoglycan composition was studied in HELIUS participants (n=57) stratified by genotype and upon dietary sodium loading in a time-controlled crossover intervention study (n=12).

RESULTS:

rs2892799 in
NDST3
(heparan sulfate N-deacetylase/N-sulfotransferase 3) showed the strongest interaction with sodium on mean arterial pressure (false discovery rate 0.03), with higher mean arterial pressure for the C allele in high sodium conditions. Also, rs9654628 in
HS3ST5
(heparan sulfate-glucosamine 3-sulfotransferase 5) showed an interaction with sodium on systolic BP (false discovery rate 0.03). These interactions were multiethnically validated. Stratifying for the rs2892799 genotype showed higher urinary expression of N-sulfated heparan sulfate epitope D0S0 for the T allele. Conversely, upon dietary sodium loading, urinary D0S0 expression was higher in participants with stable BP after sodium loading, and sodium-induced effects on this epitope were opposite in individuals with and without BP response to sodium.

CONCLUSIONS:

The C allele of rs2892799 in
NDST3
exhibits higher BP in high sodium conditions when compared with low sodium conditions, whereas no differences were detected for the T allele. Concomitantly, both alleles demonstrate distinct expressions of D0S0, which, in turn, correlates with sodium-mediated BP elevation. These findings underscore the potential significance of genetic glycosaminoglycan variation in human BP regulation.
Affluence, Vividness, and Blame
Authors: McElwee Brian , Gabriel Iason 
Published: September 2024

Abstract
Most affluent people do little to aid those living in severe poverty. In this paper, we consider the extent to which such people are blameworthy for their inaction. We argue for three main claims. First, we cannot convincingly appeal to the phenomenon of non-culpable moral ignorance to argue that the affluent are not seriously blameworthy for their inaction: affluent people are either not ignorant, or else they are culpably ignorant. Second, however, a parallel phenomenon of non-culpable lack of vivid awareness does have some purchase in mitigating blame. Although this diminishes blame to some degree, significant blame is still appropriate, given that vivid awareness is to some extent under our control. Thirdly, there is good reason to believe that expressions of appropriate blame, which could alert us to moral wrongdoing, are systematically suppressed regarding global poverty. Therefore, the absence of blame doesn’t indicate the absence of blameworthy behaviour.
Cumulonimbus Clouds Convert a Smaller Fraction of CAPE into Kinetic Energy in a Warmer Atmosphere
Authors: Peters John M. , Chavas Daniel R. , Lebo Zachary J. , Su Chun-Yian 
Published: September 2024

Abstract
This study investigates how entrainment’s diluting effect on cumulonimbus updraft buoyancy is affected by the temperature of the troposphere, which is expected to increase by the end of the century. A parcel model framework is constructed that allows for independent variations in the temperature (T), the entrainment rate ε, the free-tropospheric relative humidity (RH), and the convective available potential energy (CAPE). Using this framework, dilution of buoyancy is evaluated with T and RH independently varied and with CAPE either held constant or increased with temperature. When CAPE is held constant, buoyancy decreases as T increases, with parcels in warmer environments realizing substantially smaller fractions of their CAPE as kinetic energy (KE). This occurs because the increased moisture difference between an updraft and its surroundings at warmer temperatures drives greater updraft dilution. Similar results are found in midlatitude and tropical conditions when CAPE is increased with temperature. With the expected 6%–7% increase in CAPE per kelvin of warming, KE only increases at 2%–4% K−1 in narrow updrafts but tracks more closely with CAPE at 4%–6% in wider updrafts. Interestingly, the rate of increase in the KE with T becomes larger than that of CAPE when the later quantity increases at more than 10% K−1. These findings emphasize the importance of considering entrainment in studies of moist convection’s response to climate change, as the entrainment-driven dilution of buoyancy may partially counteract the influence of increases in CAPE on updraft intensity.

Significance Statement
Cumulonimbus clouds mix air with their surrounding environment through a process called entrainment, which controls how efficiently environmental energy is converted into upward speed in thunderstorm updrafts. Our research shows that warmer temperatures will exacerbate the moisture difference between cumulonimbus updrafts and their surroundings, leading to greater mixing and less efficient conversion of environmental energy into updraft speeds. This effect should be considered in future research that investigates how climate change will affect cumulonimbus clouds.
Assessing the Spurious Impacts of Ice-Constraining Methods on the Climate Response to Sea Ice Loss Using an Idealized Aquaplanet GCM
Authors: Lewis Neil T. , England Mark R. , Screen James A. , Geen Ruth , Mudhar Regan , Seviour William J. M. , Thomson Stephen I. 
Published: September 2024

Abstract
Coupled climate model simulations designed to isolate the effects of Arctic sea ice loss often apply artificial heating, either directly to the ice or through modification of the surface albedo, to constrain sea ice in the absence of other forcings. Recent work has shown that this approach may lead to an overestimation of the climate response to sea ice loss. In this study, we assess the spurious impacts of ice-constraining methods on the climate of an idealized aquaplanet general circulation model (GCM) with thermodynamic sea ice. The true effect of sea ice loss in this model is isolated by inducing ice loss through reduction of the freezing point of water, which does not require additional energy input. We compare the results of freezing point modification experiments with experiments where sea ice loss is induced using traditional ice-constraining methods and confirm the result of previous work that traditional methods induce spurious additional warming. Furthermore, additional warming leads to an overestimation of the circulation response to sea ice loss, which involves a weakening of the zonal wind and storm-track activity in midlatitudes. Our results suggest that coupled model simulations with constrained sea ice should be treated with caution, especially in boreal summer, where the true effect of sea ice loss is weakest, but we find the largest spurious response. Given that our results may be sensitive to the simplicity of the model we use, we suggest that devising methods to quantify the spurious effects of ice-constraining methods in more sophisticated models should be an urgent priority for future work.

Significance Statement
The potential effects of Arctic sea ice loss on midlatitude weather have been investigated using climate models where sea ice loss is artificially induced, without increasing greenhouse gas concentrations. Recently, this approach has been challenged because the artificial heating used to melt sea ice may also have direct effects on climate, which are not caused by sea ice loss. We run simulations with a simplified climate model that allows us to separate the “spurious” direct effects of the artificial heating from the “true” effect of sea ice loss. In our simulations, the responses of temperature and atmospheric circulation are amplified by spurious effects. Consequently, we argue that previous studies using more complex climate models may overestimate the effect of sea ice loss on climate.
Analysis of BRAF Gene Mutation in Hashimoto’s Thyroiditis With Multifocal Papillary Thyroid Carcinoma
Authors: Wang Feng , Su Yanling , Yao Xiyu , Liu Jie , Ke Qingxian 
Published: September 2024

Background Thyroid cancer (TC) is a highly prevalent malignant tumor of the head and neck. Papillary thyroid carcinoma (PTC) is the primary pathological type of TC, accounting for more than 80% of all TCs. BRAF mutations are closely associated with PTC. However, the relationship among HT, PTC, and BRAF mutations has not yet been clarified. We aimed to investigate the BRAF mutation in Hashimoto’s thyroiditis (HT) with PTC. Methods A total of 72 patients with multifocal PTC were included and grouped based on surgical pathology examination. Group A (n = 32) had pure multifocal PTC and Group B (n = 40) had HT with multifocal PTC. Various features were compared: BRAF mutation, multifactorial analysis of BRAF mutations, pathological features in patients with HT and multifocal PTC, and multifactorial analysis of factors affecting HT with multifocal PTC. Results Significant differences were seen in thyroid peroxidase antibody levels, central lymph node metastasis, extra-thyroidal invasion, main and non-main lesion diameters, and BRAF mutation positivity ( P < 0.05). Patients with the BRAF mutation had significantly higher rates of extra-thyroidal invasion and lymph node metastasis than those without the BRAF mutation ( P < 0.05). Logistic regression analysis showed that BRAF mutation and main lesion nodule diameter were independent risk factors affecting extra-thyroidal invasion and central lymph node metastasis in patients with HT and multifocal PTC ( P < 0.05). Discussion BRAF mutations were more prevalent and closely associated with extra-thyroidal invasion and central lymph node metastasis in patients with HT and multifocal PTC.
Emergency laparotomy and endoscopic gastrostomy in patients on extra-corporeal membrane oxygenation (ECMO) support
Authors: Gómez Gonzalo A , Vinck Eric E , Matallana Rogelio , Tobón Marcela P , Orrego Ana M , Cardona-Bernal Susana , Rivas Ubaldo E , Quintero Alejandro , Escobar José J , Uribe Juan D , Giraldo Nelson D 
Published: September 2024

Introduction An infrequent yet known complication of ECMO is abdominal compartment syndrome requiring emergency laparotomy. Also, the need for prolonged enteral nutrition while on ECMO may require endoscopic gastrostomy to maintain adequate nutritional status. Here we describe our experience with emergency laparotomy and endoscopic gastrostomy in patients on ECMO support. Methods We retrieved patient histories from our clinical archives and performed a retrospective description of all patients taken to an emergency laparotomy or endoscopic gastrostomy while on ECMO support at our cardiovascular referral center from July 2019 through June 2024. Results During the research period of 5 years a total of 401 patients were placed on ECMO support for either cardiogenic shock or respiratory failure. A total of 27 (7%) patients required an abdominal intervention while on ECMO. 14 (3.5%) patients required emergency laparotomy and 13 (3.2%) of patients required endoscopic gastrostomy tube placement. Overall 30-day mortality of all patients requiring a general surgery procedure while on ECMO support was 33%. Conclusion ECMO support can result in many complications despite its many benefits. Patients who require emergency laparotomy while on ECMO have lower survival-to-discharge and higher mortality at 30 days. Endoscopic gastrostomy however, can be safely performed on ECMO with little to no bleeding complications despite anticoagulation.
Monocentric prospective study to valid multidisciplinary diagnostic and therapeutic approach for Nutcracker syndrome
Authors: John Gwenaël , Wilhelm Frederic , Magnus Louis , Burgaud Mathilde , Leterrier Tristan , Rouyer Olivier , Thiel Hélène , Nicolini Philippe , Chabrot Pascal , Thaveau Fabien 
Published: September 2024

Background: Nutcracker syndrome (NCS) is defined as left renal vein (LRV) compression by the superior mesenteric artery. NCS diagnosis is rendered complex by confounding symptoms. The study objective was to perform a prospective observational analysis of the diagnostic and therapeutic criteria of the patients with suspected NCS. When NCS diagnosis was confirmed, transposition of the LRV was carried out by mini-invasive robotic surgery (MIRS). Method: All patients addressed to the vascular surgery department for suspicion of NCS between January 2022 and June 2023 were included in the study. Patients were subsequently assessed by means of a computed tomography scan, dynamic duplex ultrasound and phlebography associated with an occlusion test of the left gonadic vein (LGV). Diagnostic criteria included aorto-mesenteric angle, LGV diameter and reflux, velocity ratios and diameters and the reno-caval gradient. Result: Thirty two patients aged 37 ± 14 years had suspicion of NCS. Twenty presented an aorto-mesenteric angle below 20°, twenty three had a LGV diameter greater than 5 mm and twenty two of the latter patients also had LGV reflux. A significant reno-caval gradient greater than 5 mmHg was found in ten cases, thereby consolidating NCS diagnosis. Overall, thirteen patients neither presented NCS or pelvic varicosities; eight had pelvic congestion syndrome without NCS and were successfully treated by embolization. Eleven patients with confirmed NCS underwent LRV transposition in the inferior vena cava (IVC). Eight of the latter patients received a complementary pelvic varicosity embolization 2 days later. Two months post-operation 100% of transposed LRV were permeable as assessed by duplex ultrasound controls and all of these patients reported an improvement of symptoms. Conclusion: An innovative multidisciplinary decisional algorithm establishes certitude in NCS diagnosis which can subsequently be treated radically by MIRS.
A 2-Day Postpartum CBT-Based Training for Nurses
Authors: Campbell Madisyn , Haber-Evans Erika , Hicks Amanda , Van Lieshout Ryan J 
Published: September 2024

Background Public health nurses (PHNs) are often a first point of contact for postpartum individuals seeking mental health support, but report limited training related to mental health. Purpose To determine whether a two-day cognitive behavioral therapy (CBT)-based training program focused on postpartum maternal mental health can improve PHN perceptions of their ability to deliver CBT techniques, their confidence working with distressed clients, and with managing client resistance to treatment recommendations. Methods A convenience sample of 45 PHNs working in the Family Health Division of Niagara Region Public Health in Ontario, Canada were assessed before and after they received a two-day CBT-based training program. Before attending training, PHNs reported their current professional position, years of experience working in public health, and any previous mental health training. Their confidence in delivering CBT techniques, working with distressed clients, and with managing client resistance to treatment recommendations was assessed pre- and post-training. Participants also rated their satisfaction with the training. Results Statistically significant improvements were seen in confidence using CBT techniques, and in supporting and managing distressed or resistant clients. The two-day training was highly rated overall by participants. Medium to large effect sizes were found for changes in confidence-related questions. Conclusions Providing PHNs with brief CBT-based mental health-related training can increase their confidence in this aspect of their practice, and could potentially improve the quality of care they provide.
Effect of Compliance to Ventilator Bundle Care in Decreasing Ventilator-associated Pneumonia Rates in a Neonatal Intensive Care Unit: A Quality Improvement Initiative
Authors: Suman Sunistha , Singh Srijan 
Published: September 2024

Purpose Prevention of ventilator-associated pneumonia (VAP) can be achieved by a group of evidence-based interventions known as the “VAP bundle.” In this study, we observed the effect of increasing compliance to bundle care in reducing VAP rates. Methods We did a quality improvement (QI) study in an outborn level 3 neonatal intensive care unit (NICU) enrolling 95 neonates less than 28 days of life; and receiving ventilator care for more than 2 days of hospitalization in NICU. A standardized VAP bundle was implemented with the goal of decreasing VAP rates in NICU. A total of 45 neonates were enrolled in the pre-bundle study group (Group I) and 50 in post-bundle study group (Group II). Results Average bundle compliance increased to 62.26 ± 8.31% in Group II from a baseline compliance value of 52.6 ± 6.87% in Group I ( P < .05). VAP rate was reduced from 37.6 per 1000 MV days (Mechanical Ventilation days) to 25.5 per 1000 MV days ( P < .05). Conclusion Increased compliance to ventilator bundle care leads to a decreased VAP rate resulting in shortening of the MV days per case, decreasing duration of hospital stay, and reducing antibiotic course duration, thereby better employing the health care resources in neonatal care.
Characteristics and control of impact vibration and noise in rail belt conveyor
Authors: Zhang Yuan , Wang Zhuang , Sun Changzheng , Chang Xin , Jia Xianghui 
Published: September 2024

The rail belt conveyor is an innovative energy-saving belt conveyor. Revolutionizing the traditional roller support, it utilizes interval-spaced carriages to support the conveyor belt. The study of impact vibrations in rail belt conveyors remains underexplored in current research. This paper investigates the impact vibration and noise characteristics of the wheel–rail-steel structure coupling system, as well as their control and optimization strategies. First, vibration and noise measurements were conducted along the track. Results indicate that impact vibrations and noise originating from expansion joints and inserted joints fall within the frequency range of 1.5 kHz–5 kHz. Particularly noteworthy is the pronounced impact noise near inserted joints, with dominant frequencies ranging from 1.5 kHz to 2.5 kHz. Further investigation has revealed that the impacts on inserted joints encompass interactions between the wheel and rail, as well as between different sections of the rail itself. Next, the characteristics of filler materials such as polyurethane rubber, silicone, polyurethane resin, and epoxy resin were analyzed and compared. The experimental results show that filling rubber in expansion joints can reduce lateral impact vibrations by 61% and vertical impact vibrations by 66%. Additionally, the sound pressure level was reduced by approximately 1.7 dBA. Finally, welding the guiding rail to its preceding rail and grinding the welded surface effectively eliminated the composite impact vibrations and sharp noise at the inserted joint, resulting in a decrease of approximately 3 dBA in the sound pressure level. This paper provides guidance on the structural improvement and acoustic optimization of rail belt conveyors.
Progression independent of relapse activity can be predicted by passively acquired tapping speed through a smartphone for 1 month: A prospective study
Authors: Chico-Garcia Juan Luis , Sainz Amo Raquel , Monreal Enric , Sainz de la Maza Susana , Rodriguez Jorge Fernando , Masjuan Jaime , Costa-Frossard Lucienne , Villar Luisa María 
Published: September 2024

Background: Tapping speed (TS) correlates with baseline disability scales in people with multiple sclerosis (pwMS) Objective: The study aimed to address if progression independent of relapse activity (PIRA) could be predicted by first-month measurement of TS. Methods: Prospective study including pwMS in one referral MS center. Consecutive patients were included and keys/second (Keys/s) were passively measured each day using an in-house smartphone application for 1 month. Median, mean, and maximum keys/s were obtained. Multivariate logistic regression models (including keys/s, age, sex, and baseline disability scores) were obtained for prediction of a PIRA event after 1 year. Results: Overall, 59 patients were included in the final analysis (64.4% women, median age of 44.5 years). However, 10 patients presented a PIRA event, without differences regarding baseline characteristics between PIRA and no-PIRA groups. PIRA group presented lower median keys/s (2 vs 4 keys/s, p = 0.002) and mean keys/s (2.8 vs 4.6, p = 0.008), while maximum keys/s were similar ( p = 0.32). A median ⩽ 3 keys/s was independently associated with PIRA (aOR = 16.8, p = 0.03), as did a mean ⩽ 3.7 keys/s (aOR = 17, p = 0.02). These differences were not detected regarding other variables analyzed. Conclusion: Low median or mean keys/s obtained during initial month of assessment were indicative of a PIRA event within the next year.