bluuebunny/crossref_metadata_2025_split huggingface dataset:
Employing Computed Tomography to Assess Clavicle Symmetry in Healthy Adults in the Indian Population of Dakshina Karnataka
Authors: Barde Mustapha Alhaji , Sharma Dolly A. , Yadav Sushil 
Published: June 2024

Abstract
Background The S-shaped collar bone lies horizontally at the root of the neck and is one of the most common bones to fracture. The symmetry of the clavicle bone differs between males and females, so the present study was conducted to assess the symmetry of the clavicle in healthy adults of the Indian population in the Dakshina Karnataka region.
Methods The data for this cross-sectional study were retrospectively collected from 138 adult patients who all underwent chest computed tomography (CT) for clinical reasons. Patients younger than 18 years and those with bony fractures, trauma, or other deformities were excluded. Axial chest CT images were used to trace the anatomy of the clavicle. The curved planar reconstruction technique was used to trace the maximum length of the bilateral clavicle.
Results There were 138 patients of both sexes. Patients ranged in age from 20 to 80 years. The chi-square test was used to investigate whether sex and clavicle symmetry were related. In women, bilateral symmetry and asymmetry were 42.5 and 41.2%, respectively, while in men, they were 57.5 and 58.8%, respectively; hence, there was no significant correlation (p-value = 0.877) between clavicle symmetry and sex. A linear-by-linear association test was performed to ascertain the relationship between the variance in clavicle symmetry and age. It was noted that 51 individuals had asymmetry and 87 had symmetry. The patients were further divided into three age groups. There were 34, 67, and 37 individuals in the 20 to 40, 41 to 60, and 61 to 80 years age groups, respectively. Clavicle symmetry was 27.6% in the 20 to 40 and 61 to 80 age groups and 44.8% in the 41 to 60 age group. The percentages of asymmetry were 19.6, 54.9, and 25.5% in the 20 to 40, 41 to 60, and 61 to 80 years age groups, respectively, with no correlation between age and clavicle length symmetry (p-value = 0.643).
Conclusion Regardless of age or sex, the population under study had symmetric clavicles. As a result, the assumption of symmetry may be accepted in some clinical scenarios, such as simple fractures, but caution should be exercised when designing fixatives and surgical cases.
News media in crisis: a sentiment and emotion analysis of US news articles on unemployment in the COVID-19 pandemic
Authors: Yu Lingli , Yang Ling 
Published: June 2024

AbstractNews media play an indispensable role in disseminating information and shaping public perception during times of crisis. This study, integrating sentiment, emotion, discourse, and timeline analyses together, conducts a corpus-based sentiment analysis of the news articles on unemployment from the New York Times in 2020 to capture the emotional dynamics conveyed by the newspaper as the pandemic-induced unemployment developed in the US. The results reveal that positive sentiment in the news articles on unemployment is significantly higher than negative sentiment. In emotion analysis, “trust” and “anticipation” rank the first and second among the eight emotions, while “fear” and “sadness” top the negative emotions. Complemented with a discourse analysis approach, the study reveals that the change of the sentiments and emotions over time is linked with the evolution of the pandemic and unemployment, the policy response as well as the protests against ethnic inequalities. This study highlights the important role mainstream news media play in information dissemination and solution-focused reportage at the time of severe crisis.
Impact of automated alerts on discharge opioid overprescribing after general surgery
Authors: Rizk Elsie , Kaur Navjot , Duong Phuong Y , Fink Ezekiel , Wanat Matthew A , Douglas Thornton J , Kim Min P 
Published: June 2024

Abstract

Purpose
The objectives of this study were to identify the most performed surgical procedures associated with the highest rates of discharge opioid overprescribing and to implement an electronic health record (EHR) alert to reduce discharge opioid overprescribing.

Methods
This quality improvement, before-and-after study included patients undergoing one of the identified target procedures—laparoscopic cholecystectomy, unilateral open inguinal hernia repair, and laparoscopic appendectomy—at an academic medical center. The alert notified providers when the prescribed opioid quantity exceeded guideline recommendations. The preimplementation cohort included surgical encounters from January 2020 to December 2021. The EHR alert was implemented in May 2022 following provider education via email and in-person presentations. The postimplementation cohort included surgical encounters from May to August 2022. The primary outcome was the proportion of patients with a discharge opioid supply exceeding guideline recommendations (overprescribing).

Results
A total of 1,478 patients were included in the preimplementation cohort, and 141 patients were included in the postimplementation cohort. The proportion of patients with discharge opioid overprescribing decreased from 48% in the preimplementation cohort to 3% in the postimplementation cohort, with an unadjusted absolute reduction of 45% (95% confidence interval, 41% to 49%; P &lt; 0.001) and an adjusted odds ratio of 0.03 (95% confidence interval, 0.01 to 0.08; P &lt; 0.001). Among patients who received opioids, the mean (SD) opioid supply at discharge decreased from 92 (43) oral morphine milligram equivalents (MME) (before implementation) to 57 (20) MME (after implementation) (P &lt; 0.001). The proportion of patients who received additional opioid prescriptions within 1 to 14 days following hospital discharge did not change (P = 0.76).

Conclusion
Implementation of an EHR alert along with provider education can reduce discharge opioid overprescribing following general surgery.
Slit1 inhibits ovarian follicle development and female fertility in mice
Authors: Grudet Florine , Martinot Emmanuelle , Godin Philippe , Bérubé Michael , Chédotal Alain , Boerboom Derek 
Published: June 2024

Abstract
Previous in vitro studies have suggested that SLIT ligands could play roles in regulating ovarian granulosa cell proliferation and gene expression, as well as luteolysis. However, no in vivo study of Slit gene function has been conducted to date. Here, we investigated the potential role of Slit1 in ovarian biology using a Slit1-null mouse model. Female Slit1-null mice were found to produce larger litters than their wild-type counterparts due to increased ovulation rates. Increased ovarian weights in Slit1-null animals were found to be due to the presence of greater numbers of healthy antral follicles with similar numbers of atretic ones, suggesting both an increased rate of follicle recruitment and a decreased rate of atresia. Consistent with this, treatment of cultured granulosa cells with exogenous SLIT1 induced apoptosis in presence or absence of follicle-stimulating hormone, but had no effect on cell proliferation. Although few alterations in the messenger RNA levels of follicle-stimulating hormone-responsive genes were noted in granulosa cells of Slit1-null mice, luteinizing hormone target gene mRNA levels were greatly increased. Finally, increased phospho-AKT levels were found in granulosa cells isolated from Slit1-null mice, and SLIT1 pretreatment of cultured granulosa cells inhibited the ability of both follicle-stimulating hormone and luteinizing hormone to increase AKT phosphorylation, suggesting a mechanism whereby SLIT1 could antagonize gonadotropin signaling. These findings therefore represent the first evidence for a physiological role of a SLIT ligand in the ovary, and define Slit1 as a novel autocrine/paracrine regulator of follicle development.
‘Relocating Adolescents’: The Costs of Out-of-Area Placements as a Response to Extra-Familial Risk/Harm
Authors: Holmes Lisa , Pinto Vânia S , Wroe Lauren Elizabeth , Peace Delphine , Firmin Carlene 
Published: June 2024

Abstract
In the UK, there has been increased awareness of the harm adolescents face beyond their families. There is no national strategy for safeguarding adolescents. One intervention that comes with particularly high costs is relocation placements by children’s social care that move adolescents some distance from their communities. This research aims to contribute to the evidence about the relocation of adolescents exposed to, or at risk of extra-familial risk/harm. The research reported here sought to explore the costs associated with relocation placements. Data were gathered about the time taken to carry out the social work processes associated with relocation placements and about the costs associated with the placements. Two interviews and six focus groups were conducted with twenty-four participants. The findings highlight that each adolescent had a unique context, which was influenced by the type of extra-familial risk/harm. The service response therefore needed to be tailored, and unit costs are presented as a range from £22,000 to £170,000 for six months. There is substantial variability in the use and costs of relocation placements. The findings offer evidence for earlier intervention to avoid extra-familial risk/harm. The financial costs of relocation placements need to be considered within the context of the well-being of adolescents.
Inhumation as Theophanic Encounter: The Eastern Orthodox Rejection of Cremation
Authors: Earl Alexander 
Published: June 2024

Abstract
This essay aims to articulate why the Orthodox have historically, and to the present, opposed cremation. Its primary line of argument is that inhumation is a site of “theophanic encounter”: a manifestation of the Glory of God. This theophanic quality is borne out in the scriptures and the Church’s liturgical experience. In particular, the connections between the funeral service and the entombed Christ on Holy Friday and Saturday properly situate the meaning of the post-mortem body. This intimate connection between the deceased and their body is clear in Orthodoxy’s “hylomorphism,” the soul-body unity, which champions the eschatology of resurrection. Finally, all of the above is concretely experienced in the cult of the saints and their relics, which become vehicles for the divine energies: a theophany of Christ’s ongoing conquest of sin and death. Thus, cremation can only be viewed as a tragic misunderstanding of the dual meaning of “doxa” in Orthodoxy: right-belief and right-glory.
Case report: pseudoaneurysm of left ventricle secondary to infective endocarditis complicated by cardiac rupture—a multimodality imaging approach
Authors: Ruggerini Sara , Venturelli Andrea , Tripodi Alberto Giovanni , Brega Carlotta 
Published: June 2024

Abstract

Background
Pseudoaneurysm (PSA) of the left ventricle (LV) is a rare peri-annular complication of infective endocarditis (IE), and it is associated with high risk of free wall rupture. The diagnosis is challenging because the exact incidence and the pathogenesis are still unclear.

Case summary
A 69-year-old lady underwent prosthetic mitral valve replacement for IE secondary to Staphylococcus aureus sepsis complicated by multiple embolizations. In the post-operative period, the patient developed persistent low-grade fever with negative blood culture. Transoesophageal echocardiography (TOE) revealed complete posterior valve detachment and a PSA sac arising from the antero-lateral commissure; the colour flow Doppler showed massive mitral regurgitation. Thoracic computed tomography (CT) scan confirmed the echo data and the exact localization of the cardiac rupture. The patient underwent reoperation, a pericardial patch was sutured to exclude the PSA sac, and a mechanical prosthesis valve was finally implanted. A follow-up TOE revealed the exclusion of the PSA; two leakages with mild peri-valvular mitral regurgitation were found, with no haemodynamic impact.

Discussion
In our case, the patient developed a PSA of the LV as a consequence of peri-annular extension of IE on the mitral valve. Pseudoaneurysm is a potentially lethal complication, if not promptly treated. Multimodality imaging including echocardiography and CT scan is recommended, in order to plan surgery ad hoc.
Use of decision tree ensembles for crustal structure imaging from receiver functions
Authors: Wang Yitan , Russo R M , Lin Yuanhang 
Published: June 2024

SUMMARY
Mode conversion of P waves at the boundary between Earth's crust and upper mantle, when analysed using receiver functions (RFs), allows characterization of Earth structure where seismic station density is high and earthquake sources are favourably distributed. We applied two ensemble decision tree algorithms—Random Forest (RanFor) and eXtreme Gradient Boost (XGBoost)—to synthetic and real RF data to assess these machine learning techniques' potential for crustal imaging when available data are sparse. The synthetic RFs, entailing both sharp increases in seismic velocity across the Moho and gradational Moho structures, calculated with and without added random noise, correspond to idealized crustal structures: a dipping Moho, Moho offset by crustal-scale faults, anti- and synform Moho structures and combinations of these. The RanFor/XGBoost algorithm recovers input structures well regardless of event-station distributions. Useful crustal and upper mantle seismic velocities can also be determined using RanFor and XGBoost, making it possible to image crustal thickness and P- and S-wave velocities simultaneously from RFs alone. We applied the trained RanFor/XGBoost to RFs determined from real seismic data recorded in the contiguous United States, producing a map of the Moho and P- and S-wave velocities of the lowermost crust and uppermost mantle. Use of XGBoost, which evaluates residuals between input RFs and ground-truth to update the decision tree using the gradient of a penalty function, improves the crustal thickness estimates.
Seafloor topography refinement from multisource data using genetic algorithm—backpropagation neural network
Authors: Wu Chunhong , Su Xinwen , Xu Chuang , Jian Guangyu , Li Jinbo 
Published: June 2024

SUMMARY
During the inversion of seafloor topography (ST) using the backpropagation neural network (BPNN), the random selection of parameters may decrease the accuracy. To address this issue and achieve a more efficient global search, this paper introduces a genetic algorithm-backpropagation (GA-BP) neural network. Benefiting from the global search and parallel computing capabilities of the GA, this study refines the ST of the South China Sea using multisource gravity data. The results indicate that the GA-BP model, with a root mean square (RMS) value of 126.0 m concerning ship-measured water depths. It is noteworthy that when dealing with regions characterized by sparse survey line distributions, the GA-BP neural network stronger robustness compared to BPNN, showing less sensitivity to the distribution of survey data. Furthermore, the paper explores the influence of different data pre-processing methods on the neural network inversion of sea depths. This research introduces an optimization algorithm that reduces instability during BPNN initialization, resulting in a more accurate prediction of ST.
Spatial variation in stress orientation in and around Türkiye: rupture propagation across the stress regime transition in the 2023 Mw 7.8 Kahramanmaraş earthquake
Authors: Yoshida Keisuke 
Published: June 2024

SUMMARY
On 6 February 2023, the Mw 7.8 Kahramanmaraş, Türkiye, earthquake occurred on the East Anatolian Fault Zone (EAFZ). This study examined the spatial variation of the stress field in and around Türkiye, particularly along the EAFZ, better to understand the rupture process of this event. We first combined focal mechanisms around Türkiye, created a data set consisting of 2984 focal mechanisms, and conducted stress tensor inversion. The results showed that the maximum compressional axis near the EAFZ was oriented north–south and slightly varied along the strike. Moreover, the relative magnitude of north–south compressional stress gradually increased from south to north, and the stress regime changes from a normal fault regime to a strike-slip fault regime. The static stress change caused by the 2023 Mw 7.8 and 7.7 events does not explain this lateral pattern, implying that this stress regime transition existed before the main shock. This suggests that shear stress on the EAFZ was low in this southern segment because it was unfavourably oriented to the regional stress field. Dynamic stress changes due to rupture propagation and dynamic weakening may have triggered the slip at the southern segment under low background shear stress. Previous studies have reported that the Mw 7.8 main shock rupture started at a splay fault, first propagated through the central and northern segments and then backpropagated with a time delay towards the southern segment, where it caused a significant but relatively small slip. The pre-existing along-strike shear stress variation on the fault may have contributed to the smaller and delayed coseismic slip in the southern segment than in the central and northern segments. The main shock rupture possibly caused stress rotation locally near the central segment where the magnitudes of the vertical and north–south compressional stresses were almost equal.
Farming, finance and family: factors associated with anxiety, depression and stress among Western Australian farmers
Authors: Riethmuller Micaela L , Newnham Elizabeth A , Dzidic Peta L , McEvoy Peter M 
Published: June 2024

AbstractFarming is a challenging, stressful and rewarding occupation involving many factors that are beyond farmers’ control. The aim of this study was to investigate correlates associated with the anxiety, depression and stress of farmers in Western Australia. Farmers and farm residents (N = 124) completed an online survey assessing anxiety, depression, stress, farming stressors, social supports, coping strategies and sense of belonging. Higher financial/external trade and societal pressures, family/relationship tension, use of coping strategies such as self-blame, venting, disengagement and planning, lack of succession planning and considering selling the farm, and lower social support and sense of belonging, were associated with higher anxiety, depression and/or stress. The findings highlight the specific impacts of financial and family pressures on poorer mental health status among farmers. Clinical and community interventions that build on naturally occurring strengths, such as family support and community connectedness, are needed.
Giving meaning to quality of healthcare in Malaysia
Authors: Nair Narayanan Divya , Awang Samsiah , Agins Bruce , Mohd Ujang Izzatur Rahmi , Zulkifli Nur Wahida , Hamidi Normaizira , Ahmad Shukri Saidatul Sheeda 
Published: June 2024

Abstract
Ensuring quality in healthcare calls for a coordinated, systematic, congruous, and sustained approach. Nevertheless, it demands defining what the quality of healthcare means in the local context. Presently, the Malaysian healthcare system utilizes various definitions of quality of healthcare across the different initiatives and levels of healthcare, which can lead to fragmented or ineffective quality improvement. The study aims to describe the process undertaken in developing an explicit definition of the quality of healthcare tailored to the Malaysian context, which is currently lacking. A pluralistic method was used to explore the different perspectives. Three distinct approaches were used to understand how quality is defined among the different stakeholder groups: (i) interactive policy-makers engagement sessions, (ii) a review of local quality-related documents, and (iii) an online survey engaging the public. The domains depicting quality of healthcare that emerged through these three approaches were mapped against a framework and synthesized to form the local definition of quality. A national quality-related technical working group convened on several sessions to achieve consensus and finalize the definition of quality of healthcare. Quality healthcare in Malaysia is defined as providing high-quality healthcare that is safe, timely, effective, equitable, efficient, people-centred, and accessible [STEEEPA] which is innovative and responsive to the needs of the people, and is delivered as a team, in a caring and professional manner in order to improve health outcomes and client experience. The consensus-driven local definition of healthcare quality will guide policies and ensure standardization in measuring quality, thereby steering efforts to improve the quality of healthcare services delivered in Malaysia.
A comparison of the MPN and pour plate methods for estimating shellfish contamination by Escherichia coli
Authors: Cooper David M , Mannion Finn , Jones Laurence , Pinn Eunice , Sorby Rees , Malham Shelagh K , Le Vay Lewis 
Published: June 2024

Abstract

Aims
Shellfish production areas are classified for suitability for human consumption using counts of Escherichia coli in shellfish samples. Two alternative laboratory methods are approved in the European Union and UK for measuring E. coli in shellfish samples; the most probable number (MPN) and pour plate methods. These methods have inherently different statistical uncertainty and may give different counts for the same sample. Using two approaches: simulated data and spiking experiments, we investigate the theoretical properties of the two methods to determine their reliability for shellfish waters classification.

Methods and results
Assuming a Poisson distribution of E. coli in shellfish samples, we simulate concentrations in 10 000 samples using the MPN and pour plate methods. We show that for higher concentrations of E. coli the pour plate method becomes increasingly more reliable than the MPN method. The MPN method has higher probabilities than pour plate of generating results exceeding shellfish classification thresholds, while conversely having higher probabilities of failing to detect counts that exceed regulatory thresholds. The theoretical analysis also demonstrates that the MPN method can produce genuine extreme outliers, even when E. coli are randomly distributed within the sampled material. A laboratory spiking experiment showed results consistent with the theoretical analysis, suggesting the Poisson assumption used in the theoretical analysis is reasonable.

Conclusion
The large differences in statistical properties between the pour plate and MPN methods should be taken into consideration in classifying shellfish beds, with the pour plate method being more reliable over the crucial range of E. coli concentrations used to determine class boundaries.