bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of Atrial Fibrillation Burden Trends for Stroke Risk Stratification
Authors: Piccini Jonathan P. , Stanelle Evan J. , Johnson Cody C. , Hylek Elaine M. , Kanwar Rahul , Lakkireddy Dhanunjaya R. , Mittal Suneet , Peacock James , Russo Andrea M. , Soderlund Dana , Hills Mellanie True , Passman Rod S. 
Published: October 2024

BACKGROUND:
Atrial fibrillation (AF) is associated with an increased risk of stroke, yet the limitations of conventional monitoring have restricted our understanding of AF burden risk thresholds. Predictive algorithms incorporating continuous AF burden measures may be useful for predicting stroke. This study evaluated the performance of temporal AF burden trends as predictors of stroke from a large cohort with insertable cardiac monitors.

METHODS:
Using deidentified data from Optum Clinformatics Data Mart (2007–2019) linked with the Medtronic CareLink insertable cardiac monitor database, we identified patients with an insertable cardiac monitor for AF management (n=1197), suspected AF (n=1611), and cryptogenic stroke (n=2205). Daily AF burden was transformed into simple moving averages, and temporal AF burden trends were defined as the comparison of unique simple moving average pairs. Classification trees were used to predict ischemic stroke, and AF burden significance was quantified using bootstrapped mean variable importance.

RESULTS:

Of 5013 patients (age, 69.2±11.7 years; 50% male; CHA
2
DS
2
-VASc, 3.7±1.9) who met inclusion criteria, 869 had an ischemic stroke over 2 409 437 days total follow-up. Prior stroke or transient ischemic attack (variable importance, 13.13) was the number 1 predictor of future stroke followed by no prior diagnosis of AF (7.35) and AF burden trends in follow-up (2.59). Temporal proximity of AF and risk of stroke differed by device indication (simple moving averages: AF management, <8 days and suspected AF and cryptogenic stroke, 8–21 days). Together, baseline characteristics and AF burden trends performed optimally for the area under the receiver operating characteristic curve (0.73), specificity (0.70), and relative risk (5.00).

CONCLUSIONS:
AF burden trends may provide incremental prognostic value as leading indicators of stroke risk compared with conventional schemes.
Using Atrial Fibrillation Burden Trends and Machine Learning to Predict Near-Term Risk of Cardiovascular Hospitalization
Authors: Peacock James , Stanelle Evan J. , Johnson Lawrence C. , Hylek Elaine M. , Kanwar Rahul , Lakkireddy Dhanunjaya R. , Mittal Suneet , Passman Rod S. , Russo Andrea M. , Soderlund Dana , Hills Mellanie True , Piccini Jonathan P. 
Published: October 2024

BACKGROUND:
Atrial fibrillation is associated with an increased risk of cardiovascular hospitalization (CVH), which may be triggered by changes in daily burden. Machine learning of dynamic trends in atrial fibrillation burden, as measured by insertable cardiac monitors (ICMs), may be useful in predicting near-term CVH.

METHODS:
Using Optum’s deidentified Clinformatics Data Mart Database (2007–2019), linked with the Medtronic CareLink ICM database, we identified patients with >1 days of ICM-detected atrial fibrillation. ICM-detected diagnostic parameters were transformed into simple moving averages over different periods for daily follow-up. A diagnostic trend was defined as the comparison of 2 simple moving averages of different periods for each diagnostic parameter. CVH was defined as any hospital, emergency department, or ambulatory surgical center encounter with a cardiovascular diagnosis-related group or diagnosis code. Machine learning was used to determine which diagnostic trends could best predict patient risk 5 days before CVH.

RESULTS:

A total of 2616 patients with ICMs met the inclusion criteria (71±11 years; 55% male). Among them, 1998 (76%) had a planned or unplanned CVH over 605 363 days. Machine learning revealed distinct groups: (A) sinus rhythm (reference), (B) below-average burden, (C) above-average burden, and (D) above-average burden with decreasing patient activity. The relative risk was increased in all groups versus the reference (B, 4.49 [95% CI, 3.74–5.40]; C, 8.41 [95% CI, 7.00–10.11]; D, 11.15 [95% CI, 9.10–13.65]), including a 21% increase in CVH detection over prespecified burden thresholds of duration (≥1 hour) and quantity (≥5%). The area under the receiver operating characteristic curve increased from 0.55 when using hourly burden amounts to 0.66 when using burden trends and decreasing patient activity (
P
<0.001), a 20% increase in predictive power.

CONCLUSIONS:
Trends in atrial fibrillation were strongly associated with near-term CVH, especially above-average burden coupled with low patient activity. This approach could provide actionable information to guide treatment and reduce CVH.
The Institutionalisation of Power-Sharing in Zanzibar: Strengths and Challenges
Authors: Haji Moh’d J. 
Published: October 2024

Abstract
In 2010, Zanzibar presented a distinctive example of power-sharing in Africa. The introduction of power-sharing governance system was preceded by a referendum, which set the stage for a subsequent constitutional amendment to facilitate this governance approach on the Island. This model was adopted to address the region’s longstanding and entrenched political issues. Despite the strong base of its adoption, power sharing has shown ups and downs throughout its life, passing through the boycott from 2015 to 2020 and the 2020 electoral violence. This study examines the strengths and challenges of power-sharing in Zanzibar, focusing on its potential path for its institutionalization. The study used a qualitative research design, with interviews and documentary reviews as data collection methods. The findings indicate that while power-sharing in Zanzibar benefits from robust public support, which complicates efforts to eliminate or alter it, the system encounters various institutional and behavioral challenges that impede its full institutionalization.
Reflections on Forty Years of Muqarnas: The Broadened Range of Publication Venues for Islamic Art and Architectural History
Authors: Necipoğlu Gülru 
Published: October 2024

Abstract
On the occasion of the fortieth anniversary of Muqarnas, I examine the place of this groundbreaking publication in a changing scholarly landscape. Even though the field of Islamic/Islamicate studies has burgeoned—as evidenced by the establishment in recent years of many specialized series and journals—Muqarnas continues to fulfill the enduring need for a global perspective open to all subjects and critical methods. My “Reflections” combine a historiography of the journal with an overview of more specialized new publication venues, while highlighting the reasons for the revised title: Muqarnas: An Annual on Visual, Material, and Architectural Cultures of the Islamic World.
Stem and root anatomy of Zanonia indica L. (Cucurbitaceae) and significant adaptations of the aerial roots
Authors: Lekhak Manoj M. , Gondaliya Amit D. , Yadav S.R. , Ghane S.G. , Rajput Kishore S. 
Published: October 2024

Summary
The physiological and ecological adaptions of higher plants are driven by anatomical changes that contribute to the evolution of the climbing habit. This not only makes them able to survive in a dry environment but also supports them to undergo secondary growth and complete their reproduction. Some plants even form aerial roots as a survival strategy. In the present study, the anatomy of both aerial and underground roots and stems in Zanonia indica L. (Cucurbitaceae) is investigated. In young stems, vascular bundles (VB) had sieve elements on the inner margin of the protoxylem elements (i.e., bicollateral VB). In stems as well as aerial and underground roots, the axial elements of the secondary xylem were arranged in radial plates separated by wide medullary rays. Aerial and underground roots shared similar features in having exarch protoxylem and distinct narrow piths. Structurally, the secondary xylem was composed of vessels, tracheids, fibres, axial and ray parenchyma cells while extra-fascicular sieve elements were observed only in stems and aerial roots. The formation of aerial roots is a survival mechanism whose significance is discussed with reference to the available literature.
On the Generating Mechanisms of Daily Precipitation in the Conterminous United States: Climatology, Trends, and Associated Marginal and Extreme Distributions
Authors: Alshehri Mohammed , Mascaro Giuseppe , Kunkel Kenneth E. 
Published: October 2024

Abstract
A critical task to better quantify changes in precipitation (P) mean and extreme statistics due to global warming is to gain insights into the underlying physical generating mechanisms (GMs). Here, the dominant GMs associated with daily P recorded at 2861 gauges in the conterminous United States from 1980 to 2018 were identified from atmospheric reanalyses and publicly available datasets. The GMs include fronts (FRTs), extratropical cyclones (ETCs), atmospheric rivers (ARs), tropical cyclones (TCs), and North American monsoon (NAM). Climatologies of the GM occurrences were developed for the nonzero P (NZP) and annual P maxima (APM) samples, characterizing the marginal and extreme P distributions, respectively. FRT is everywhere the most frequent (45%–75%) GM of NZP followed by ETC (12%–33%). The FRT contribution declines for APM (19%–66%), which are dominated by AR (50%–65%) in western regions and affected by TC (10%–18%) in southern and eastern regions. The GM frequencies exhibit trends with the same signs over large regions, which are not statistically significant except for an increase in FRT (TC) frequency in the northeast (central region). Two-sample tests showed well-defined spatial patterns with regions where 1) both the marginal and extreme P distributions of the two dominant GMs likely belong to different statistical populations and 2) only the marginal or extreme distributions could be considered statistically different. These results were interpreted through L-moments and parametric distributions that adequately model NZP and APM frequency. This work provides useful insights to incorporate mixed populations and nonstationarity in P frequency analyses.
National Trends in the Creation of Diverting Ileostomy at the Time of Ileal Pouch-Anal Anastomosis in Adults With Ulcerative Colitis
Authors: Adams Ursula C. , Agala Chris B. , Barnes Edward L. , Stem Jonathan M. , Charles Anthony G. , Phillips Michael R. 
Published: October 2024

Introduction The impact of diverting ileostomy in adults with ulcerative colitis (UC) undergoing ileal pouch-anal anastomosis (IPAA) is unclear. This study uses a novel approach with population-level data to identify patients with diverting ileostomy at the time of IPAA and determine the impact of diverting ileostomy on postoperative outcomes. Methods Using the International Business Machines (IBM) MarketScan® database, adults (18-64 years old) with a diagnosis of UC who underwent IPAA between 2000 and 2019 were examined. Patients were assigned to the diverting ileostomy (DI) cohort or no-DI cohort based on the presence of an ostomy closure code in the 1-year following their IPAA. Rates of ileostomy formation and readmissions were quantified and outcomes between cohorts compared. Results There were 540 patients in the no-DI and 2494 in the DI cohort. There were regional differences in the rate of ostomy creation, but the overall rate of ostomy creation remained stable across years. Patients with no-DI vs DI had a longer index length of stay (LOS) (7 vs 6 days, P = .001). Adverse postoperative outcomes did not differ between cohorts. Diversion did not independently affect the likelihood of a 30-day readmission, and since 2000, readmission rates have declined for all IPAA patients. Discussion This is the first study to capture population-level data on the effect of diversion at the time of IPAA for adult UC patients. This study demonstrates that the rate of fecal diversion at the time of IPAA has remained stable over time, but readmission rates have declined.
Fault diagnosis of floating offshore wind turbine based on bidirectional long short-term memory networks with sliding window
Authors: Wu Ping , Huo Yifei , Ni Yuxuan , Wang Yixuan , Wu Zhenquan , Zhang Xujie , Wang Lin , Liu Yichao 
Published: October 2024

Owing to its ability to harvest more power in deeper waters than other types of offshore wind turbines, the floating offshore wind turbine (FOWT) has attracted significant interest from both academics and industry. However, deterioration in system performance and unscheduled shutdowns will significantly increase operation and maintenance costs. To avoid system damage and ensure operation safety, there is a great demand for developing FOWT fault diagnosis to detect and identify faults as early as feasible. Due to the enormous complexity of FOWT including dynamics and nonlinearity, effective FOWT fault diagnosis poses a significant challenge. This paper develops a novel FOWT fault diagnosis method using bidirectional long short-term memory (BiLSTM) with sliding window. Firstly, the dynamics are embedded by stacking time-dependent measurements using the sliding window technique. Then, the augmented data is fed into a BiLSTM network to exploit the nonlinearity of FOWT. Consequently, a softmax classifier is used for fault diagnosis. A high-fidelity 10 MW spar FOWT benchmark based on the NREL Fatigue, Aerodynamics, Structures, and Turbulence (FAST) model is used to validate the capability and effectiveness of the proposed method. Experimental results show that the proposed method outperforms other related methods in diagnosing critical faults in FOWTs under various operating conditions.
A Study to Assess Personality, Psychological Distress, and Adjustment Difficulties Among Undergraduate Nursing Students in the National Capital
Authors: Anita  , Khakha Deepika C , Bhargava Rachna 
Published: October 2024

Background There has been growing concern about stress in nursing. It is acknowledged as a major part of the student experience and linked to psychological distress and other adverse consequences on student’s health and well-being. Psychological stress depends on students’ personality traits and may lead to adjustment issues. Aim To assess personality, psychological distress, and adjustment difficulties among nursing students at All India Institute of Medical Sciences (AIIMS), New Delhi. Materials and Methods This cross-sectional descriptive study included 292 participants enrolled in a BSc (Hons) nursing course at the College of Nursing, AIIMS, New Delhi. Data were collected using a questionnaire comprising the big five inventory, general health questionnaire, and adjustment inventory for college students. The reliability of the tools was 0.79, 0.82, and 0.94, respectively. Data were analyzed using descriptive and inferential statistics. Results Extrovert and neuroticism were found to be the most dominant type of personality trait among the nursing students. A high level of distress was experienced by 56.2% of the participants with a mean score of 4.8 ± 2.72 while a low level of psychological distress was experienced by 43.8% of the subjects with a mean score of 0.3 ± 0.48. No participant was in the excellent adjustment category while 2.1% of the participants were in the overall good adjustment category. Average overall adjustment was seen in 10.3% of the participants and unsatisfactory and very unsatisfactory overall adjustment was seen in 40.7% and 46.9% of the participants respectively. There was a significant association between neuroticism personality traits and psychological distress ( p < .05). There was a significant association between psychological distress and adjustment and between personality and adjustment ( p < .05). A significant association was also found between neurotic and conscientiousness personality traits with father’s education. Home, health, and educational adjustment were found to be positively correlated with mother’s education. Neuroticism and openness to experience personality traits and educational adjustment were found to have a statistically significant relationship with the duration of sleep. A significant relationship was also seen between psychological distress and health adjustment with the number of close friends. Conclusion Extrovert and neuroticism personalities are dominant among nursing students. Psychological distress and unsatisfactory adjustment categories are faced by the majority of the participants. Therefore, a student-friendly environment is needed in the colleges to decrease the level of distress faced by the students and to help them in easy adjustment.
Narrowband Ultraviolet B Phototherapy for Generalized Granuloma Annulare: Real-Life Experience and Review of the Literature
Authors: Acer Ersoy , Kaya Erdoğan Hilal , Ağaoğlu Esra , Bilgin Muzaffer , Saraçoğlu Zeynep Nurhan 
Published: October 2024

Introduction: Generalized granuloma annulare (GA) is an uncommon noninfectious granulomatous dermatitis. Phototherapy is often considered first-line therapy, with more evidence for psoralen ultraviolet A than narrowband ultraviolet B (NB-UVB). We aimed to evaluate the effectiveness and safety of NB-UVB in generalized GA and to review the literature. Materials and Methods: In this observational, retrospective study, 11 patients with generalized GA who received NB-UVB between 2013 and 2023 were evaluated. Data from the patients were obtained from the phototherapy unit and clinical follow-up forms. Results: Eleven patients, 10 (90.9%) female and 1 (9.1%) male were included in the study. The mean age of the patients was 57.6 ± 7.9 years. The mean disease duration was 26.9 ± 27.9 weeks. Three (27.2%) of the patients had interstitial GA. All patients showed improvement: NB-UVB therapy resulted in complete response in 18.2% of the patients and partial response in 81.8%. The mean number of NB-UVB sessions was 36.4 ± 13.8. The mean cumulative dose was 37.1 ± 25.6 J/cm2. There was no significant difference in the mean number of sessions and cumulative dose according to clinical response ( P > .05). NB-UVB was extremely well tolerated. After phototherapy, patients were followed for at least 6 months; no relapses were observed. Conclusion: NB-UVB is an effective and safe treatment option in generalized GA.
Explainable machine learning for modeling predictors of unintended pregnancy among married/in-union women in sub-Saharan Africa, a multi-country analysis of MICS 6 survey
Authors: Kebede Shimels Derso , Abera Kaleab M , Abeje Eyob Tilahun , Bekele Enyew Ermias , Daba Chala , Asmare Lakew , Demeke Bayou Fekade , Arefaynie Mastewal , Mohammed Anissa , Tareke Abiyu Abadi , Keleb Awoke , Kebede Natnael , Tsega Yawkal , Endawkie Abel 
Published: October 2024

Introduction Unintended pregnancy is defined as a pregnancy that is either mistimed (wanted at a later time) or unwanted (not wanted at all). It has been a concerning issue for reproductive health and public health, with significant negative effects on the mother, child, and the public at large. It is a worldwide public health issue that can have a major impact on the health of pregnant women and newborns. Methods The study was conducted using secondary data from IPUMS Multiple Indicator Cluster Surveys round 6. The analysis was based on a data merged from six sub-Saharan Africa countries such as Gambia, Ghana, Lesotho, Malawi, Nigeria, and Sierra Leone. A total weighted sample of 28,027married/in-union reproductive-age women was included in the study. Seven machine learning algorithms were trained and their performance compared in predicting unintended pregnancy. Finally, Shapley Additive exPlanations model explanation technique was used to identify the predictors of unintended pregnancy. Results XGBoost was the top-performing model, achieved the highest area under receiver operating characteristic curve (0.62) and accuracy (65.92%), surpassing all other models. SHAP global feature importance identified top predictors of unintended pregnancy, with women from Malawi, Ghana, and Lesotho, women having primary education and secondary education, with parity of more than three, have higher likelihood of unintended pregnancy. In the other hand, women from Nigeria and Sierra Leone, whose husband/partner has more wives or partners (polygamy relation), and women who owns mobile phone had lower risk of unintended pregnancy. Conclusion These findings highlight the importance of considering contextual factors, such as country-specific sociocultural norms and individual characteristics, in understanding and addressing unintended pregnancies. By strategically addressing the identified predictors, policymakers, and healthcare providers can develop impactful programs that address the root causes of unintended pregnancies, ultimately contributing to improved reproductive health outcomes worldwide.
Arthrography for Sports Injuries
Authors: Setiawati Rosy 
Published: October 2024

Arthrography is an X-ray examination using a contrast agent to examine a joint, such as the knee or shoulder. In arthrography, serial X-rays are taken of the joint being examined in various positions after a contrast agent is injected into the joint. This examination is most often used to examine the knee and shoulder joints, but can also be used for other joints, such as the wrist, ankle, hip, or elbow. Similarly, direct MR arthrography also involves the injection of contrast material into the joint. The contrast material used for MR evaluation is different from that used for x-rays; it contains the substance gadolinium, which affects the local magnetic field in the MRI channel and shows up on the MR image. As in conventional direct arthrography, the contrast material outlines anatomical structures within the joint, such as cartilage, labrum, ligaments, and bones, and allows them to be evaluated after the MR image is produced. Direct CT arthrography uses the same type of contrast material as conventional direct arthrography using x-rays and can be supplemented with air to produce double-contrast CT arthrograms. CT creates cross-sectional images that are processed by a computer using x-rays.