bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex-specific diagnostic efficacy of MRI in axial spondyloarthritis: challenging the ‘One Size Fits All’ notion
Authors: Ulas Sevtap Tugce , Proft Fabian , Diekhoff Torsten , Rios Valeria , Rademacher Judith , Protopopov Mikhail , Greese Juliane , Eshed Iris , Adams Lisa C , Hermann Kay Geert A , Ohrndorf Sarah , Poddubnyy Denis , Ziegeler Katharina 
Published: October 2023

ObjectivesSex-specific differences in the presentation of axial spondyloarthritis (axSpA) may contribute to a diagnostic delay in women. The aim of this study was to investigate the diagnostic performance of MRI findings comparing men and women.MethodsPatients with back pain from six different prospective cohorts (n=1194) were screened for inclusion in this post hoc analysis. Two blinded readers scored the MRI data sets independently for the presence of ankylosis, erosion, sclerosis, fat metaplasia and bone marrow oedema. Χ2tests were performed to compare lesion frequencies. Contingency tables were used to calculate markers for diagnostic performance, with clinical diagnosis as the standard of reference. The positive and negative likelihood ratios (LR+/LR–) were used to calculate the diagnostic OR (DOR) to assess the diagnostic performance.ResultsAfter application of exclusion criteria, 526 patients (379 axSpA (136 women and 243 men) and 147 controls with chronic low back pain) were included. No major sex-specific differences in the diagnostic performance were shown for bone marrow oedema (DOR m: 3.0; f: 3.9). Fat metaplasia showed a better diagnostic performance in men (DOR 37.9) than in women (DOR 5.0). Lower specificity was seen in women for erosions (77% vs 87%), sclerosis (44% vs 66%), fat metaplasia (87% vs 96%).ConclusionThe diagnostic performance of structural MRI markers is substantially lower in female patients with axSpA; active inflammatory lesions show comparable performance in both sexes, while still overall inferior to structural markers. This leads to a comparably higher risk of false positive findings in women.
Entrepreneurial Migration
Authors: Bryan Kevin A. , Guzman Jorge 
Published: October 2023

Abstract
We track the movement of high-potential startups using cross-state business registrations and estimate the utility of cities to moving startups using a revealed preference approach. 6.6% of these startups move across state borders during their first five years. Startup hubs like Silicon Valley and Boston tend to lose startups to other cities. Our findings show that startups prefer traditional hubs when they move soon after being founded, but later prefer cities with lower taxes. This pattern is not due to vertical sorting or industrial specialization.
Nose-picking in Vietnam
Authors: Arai Yuko 
Published: October 2023

Abstract
This study focuses on nose picking, an observable occurrence in Vietnam. Elias (2010) said that in the civilizing process, self-regulation is a gathering force and the act of nose picking is not performed in public. To better understand the reasons why nose picking is an observable occurrence in Vietnam, the author analyzes content from Thanh Nghị, a magazine published from 1941–1945 during the French colonial era and created by Vietnamese intellectuals to further the spread of French civilizational ideals. This study has two purposes: first, it clarifies the role of Thanh Nghị as an intellectual proponent of French colonialism. Second, it explores different aspects of the civilizing process. By achieving these aims, the study illustrates the effectiveness of the civilizing process in colonial society.
The Siren’s Seed
Authors: Frojmovic Eva 
Published: October 2023

Abstract
In two liturgical Pentateuchs from Northern Europe from around 1300, images of sirens appear unexpectedly and in ways that vary from common siren iconography. Perhaps these human–animal hybrids, or mixta, in their elusive sexuality and transgressive boundary-crossing articulate Jewish cultural concerns with gender politics. Feminist bestiary studies and feminist studies of vocality (the siren’s song) provide new insights into medieval gender politics and its subversions.
Indo-Pacific Strategy: Korea and the World
Authors: Choi Won-Mog 
Published: October 2023

Abstract
On December 28, 2022, the Korean version of the Indo-Pacific Strategy (“In-Tae Strategy”), which will be the foundation for Korean foreign diplomacy for decades to come, was announced. The Strategy focuses on promoting its vision of freedom, peace, and prosperity through the establishment of the following three principles: inclusivity, trust, and reciprocity. The key to the successful implementation of Korea’s Indo-Pacific Strategy is to strengthen comprehensive cooperation with neighboring countries that have shared values and establish an “inclusive approach” that does not exclude China based on the approach of mutually beneficial pragmatism. Recovery of “trust” is also essential for the improvement of relations with Japan. Management of risks arising from any United States-China conflicts is an unavoidable task for Korea. In this light, policy makers and the people of Korea need to understand that the participation in the United States-led Indo-Pacific Economic Cooperation Framework (IPEF) is not merely to take sides with the United States in the system of competition between the United States and China. While attempting to remove the legacy of ideological diplomacy under President Moon Jae-in’s administration, the current administration of Korea should not pursue another ideological diplomacy under the name of “value alliance.” The process of materializing abstract principles of Korea’s Indo-Pacific Strategy into concrete policies must be thoroughly rooted in good neighbor and practical diplomacy in the true sense.
Practicing Medicine on Shaky Grounds
Authors: Lentz Sarah 
Published: October 2023

Abstract
The aim of this article is to reveal for the first time a broader participation of craft surgeons from German-speaking Central Europe in the enslavement trade. Using the Dutch and Danish enslavement trades as examples, the patterns and structures behind the recruitment of such ship’s surgeons will be illuminated. That this activity also had repercussions for the German-speaking hinterland will be illustrated using the example of a Prussian surgeon who published a manual for aspiring medical personnel on practicing aboard slaving vessels, based on his own experiences. His case demonstrates that in Germany, too, some medical practices were first tested aboard slaving vessels and subsequently found their way into general medical discourse.
LSTM-Based Data Integration to Improve Snow Water Equivalent Prediction and Diagnose Error Sources
Authors: Song Yalan , Tsai Wen-Ping , Gluck Jonah , Rhoades Alan , Zarzycki Colin , McCrary Rachel , Lawson Kathryn , Shen Chaopeng 
Published: October 2023

Abstract
Accurate prediction of snow water equivalent (SWE) can be valuable for water resource managers. Recently, deep learning methods such as long short-term memory (LSTM) have exhibited high accuracy in simulating hydrologic variables and can integrate lagged observations to improve prediction, but their benefits were not clear for SWE simulations. Here we tested an LSTM network with data integration (DI) for SWE in the western United States to integrate 30-day-lagged or 7-day-lagged observations of either SWE or satellite-observed snow cover fraction (SCF) to improve future predictions. SCF proved beneficial only for shallow-snow sites during snowmelt, while lagged SWE integration significantly improved prediction accuracy for both shallow- and deep-snow sites. The median Nash–Sutcliffe model efficiency coefficient (NSE) in temporal testing improved from 0.92 to 0.97 with 30-day-lagged SWE integration, and root-mean-square error (RMSE) and the difference between estimated and observed peak SWE values dmax were reduced by 41% and 57%, respectively. DI effectively mitigated accumulated model and forcing errors that would otherwise be persistent. Moreover, by applying DI to different observations (30-day-lagged, 7-day-lagged), we revealed the spatial distribution of errors with different persistent lengths. For example, integrating 30-day-lagged SWE was ineffective for ephemeral snow sites in the southwestern United States, but significantly reduced monthly-scale biases for regions with stable seasonal snowpack such as high-elevation sites in California. These biases are likely attributable to large interannual variability in snowfall or site-specific snow redistribution patterns that can accumulate to impactful levels over time for nonephemeral sites. These results set up benchmark levels and provide guidance for future model improvement strategies.
Comparison of four risk assessment scales in predicting the risk of intraoperative acquired pressure injury in adult surgical patients: a prospective study
Authors: Chen Yuan , Wang Wei , Qian QianJian , Wu BeiWen 
Published: October 2023

Objective To develop and compare four predictive models for intraoperative acquired pressure injury (IAPI) in surgical patients. Methods One hundred patients undergoing various surgeries (hepatobiliary, pancreas, spleen, gastrointestinal, and cardiac surgeries) at Ruijin Hospital from November 2021 to September 2022 were included in this prospective cohort study. Four pressure injury risk assessment scales were used to measure the pressure injury risk: the Braden scale, Munro Pressure Injury Risk Assessment Scale, Scott Triggers tool, and CORN Intraoperative Acquired Pressure Injury Risk Assessment Scale. The patients were divided into the IAPI group and non-IAPI group. Results In total, 37% of patients (37/100) developed class I/stage pressure injury (erythema) after surgery, which resolved within 2 hours after surgery in 86.49% of cases and further progressed to class II/stage or higher pressure injury within 6 days in 15.63% of cases. The application effects of the four commonly used risk assessment tools were compared with the sensitivity, specificity, and area under the receiver operating characteristic curve. The Munro Scale showed the best sensitivity and area under the receiver operating characteristic curve among the four tools for postoperative assessment, but its specificity was only 20.63. Conclusions More appropriate assessment tools are required for IAPI risk evaluation.
Hedgehog Activation for Enhanced Rotator Cuff Tendon-to-Bone Healing
Authors: Luzzi Andrew J. , Ferrer Xavier , Fang Fei , Golman Mikhail , Song Lee , Marshall Brittany P. , Lee Andy J. , Kim Jieon J. , Hung Clark T. , Thomopoulos Stavros 
Published: October 2023

Background: Rotator cuff repair is a common orthopaedic procedure, yet the rate of failure to heal after surgery is high. Repair site rupture is due to poor tendon-to-bone healing and lack of regeneration of the native fibrocartilaginous enthesis. During development, the enthesis is formed and mineralized by a pool of progenitors activated by hedgehog signaling. Furthermore, hedgehog signaling drives regenerative enthesis healing in young animals, in contrast to older animals, in which enthesis injuries heal via fibrovascular scar and without participation of hedgehog signaling. Hypothesis: Hedgehog activation improves tendon-to-bone healing in an animal model of rotator cuff repair. Study Design: Controlled laboratory study. Methods: A total of 78 adult Sprague-Dawley rats were used. Supraspinatus tendon injury and repair were completed bilaterally, with microsphere-encapsulated hedgehog agonist administered to right shoulders and control microspheres administered to left shoulders. Animals were sacrificed after 3, 14, 28, or 56 days. Gene expression and histological, biomechanical, and bone morphometric analyses were conducted. Results: At 3 days, hedgehog signaling pathway genes Gli1 (1.70; P = .029) and Smo (2.06; P = .0173), as well as Runx2 (1.69; P = .0386), a transcription factor of osteogenesis, were upregulated in treated relative to control repairs. At 14 days, transcription factors of tenogenesis, Scx (4.00; P = .041), and chondrogenesis, Sox9 (2.95; P = .010), and mineralized fibrocartilage genes Col2 (3.18; P = .031) and Colx (1.85; P = .006), were upregulated in treated relative to control repairs. Treatment promoted fibrocartilage formation at the healing interface by 28 days, with improvements in tendon-bone maturity, organization, and continuity. Treatment led to improved biomechanical properties. The material property strength (2.43 vs 1.89 N/m2; P = .046) and the structural property work to failure (29.01 vs 18.09 mJ; P = .030) were increased in treated relative to control repairs at 28 days and 56 days, respectively. Treatment had a marginal effect on bone morphometry underlying the repair. Trabecular thickness (0.08 vs 0.07 mm; P = .035) was increased at 28 days. Conclusion: Hedgehog agonist treatment activated hedgehog signaling at the tendon-to-bone repair site and prompted increased mineralized fibrocartilage production. This extracellular matrix production and mineralization resulted in improved biomechanical properties, demonstrating the therapeutic potential of hedgehog agonism for improving tendon-to-bone healing after rotator cuff repair. Clinical Relevance: This study demonstrates the therapeutic potential of hedgehog agonist treatment for improving tendon-to-bone healing after rotator cuff injury and repair.
Development and evaluation of biodegradable starch-based films containing cellulose nanocrystals/titanium dioxide nanoparticles as an alternative for food packaging
Authors: Picolotto Aluisie , Rossa Beltrami Lilian Vanessa , Dallé Danielli , Ornaghi Júnior Heitor Luiz , Zattera Ademir José , Catto Andre Luis , Borsoi Cleide 
Published: October 2023

Biodegradable starch-based films are an environmentally friendly solution to reduce the use of petroleum-derived polymers. Thus, this work aims to obtain corn starch films by incorporating 5% w/w of cellulose nanocrystals (CNC), different concentrations of titanium dioxide nanoparticles (TiO2) (0, 0.25, 0.5, 1, and 2% w/w), and 40% w/w of glycerol and sorbitol (plasticizers), in a 1:1 ratio. The films showed a high potential for UV-light barrier, with an increase of 307% incorporating only 2 wt% of TiO2 in relation to the film without incorporation of TiO2. The use of TiO2 increased the white pigmentation capacity of the samples and decreased the lower water solubility – a reduction of approximately 28% using 0.5 wt% TiO2 compared to the CNC control sample was observed. The incorporation of TiO2 nanoparticles increased the tensile strength by adding 1 wt% of TiO2 nanoparticles with 34% increase in the tensile strength of the film without incorporation of TiO2. The thermal stability of the films with 1 wt% TiO2 and 5 wt% CNC increased by 85°C. Thus, the addition of CNC and TiO2 enabled an improvement in the physical/thermal/chemical properties of the films, making them possible alternatives for use in food packaging.
Real-World Experience With CMV inSIGHT T Cell Immunity Testing in High-Risk Kidney and Pancreas Transplant Recipients
Authors: Descourouez Jillian L. , Smith Jeannina A. , Saddler Christopher M. , Mandelbrot Didier A. , Odorico Jon S. , Jorgenson Margaret R. 
Published: October 2023

Background: Cytomegalovirus (CMV)-specific cell-mediated immunity is important for control of CMV after transplant. Assays exist to measure this, but their place in therapy is unclear, particularly in CMV high-risk recipients, without pretransplant exposure. Objective: The objective of this study was to evaluate predictive potential of a positive assay to determine freedom from DNAemia and describe subsequent 3-month CMV outcomes. Methods: Adult CMV high-risk kidney and/or pancreas transplant recipients were included if a CMV inSIGHT T Cell Immunity Panel (TCIP, Eurofins Viracor) was ordered and resulted between 1 August, 2019 and 30 July, 2022. Results: Seventy-six patients were included in our study; 49 tested during prophylaxis and 27 during treatment. Most TCIP assays obtained in the prophylaxis cohort were negative (n = 46, 93.9%). Rate of post-TCIP CMV infection was 10.2%. In those tested during treatment, 33.3% were positive and rate of post-TCIP CMV recurrence was 22.2%. The positive predictive value of the assay to successfully predict immunity was 66.7% during both prophylaxis and treatment. There were 4 cases of TCIP predictive failure with progressive CMV replication. At time of replication, 2 patients had concomitant clinical confounders thought to influence immune control of viral replication. All patients had intensification of immunosuppression prior to recurrent replication, but after TCIP was collected. Conclusion and Relevance: The data obtained from the TCIP are not static, immune control of CMV in latency can change and must be evaluated in clinical context. Timing of TCIP after transplant is significant, and patient-specific factors remain important to assess the likelihood of CMV in each unique patient-specific scenario. A CMV stewardship program can aid in application and interpretation of results.
Telemedicine Use Following Onset of the COVID-19 Pandemic Was Associated With Youth and White Race but Not With Socioeconomic Deprivation: A Retrospective Cohort Study of Orthopedic Patients
Authors: Navarro Brendan J. , Chen Ling , Dy Christopher J. 
Published: October 2023

Background: The use of telemedicine increased greatly following the onset of the COVID-19 pandemic. It is unclear whether and how sociodemographic factors have affected orthopedics patients’ use of this technology in the pandemic. Purpose: The aim of this study was to determine how patient demographic variability in telemedicine use is influenced by the Area Deprivation Index (ADI) and distance to clinical site among patients seeking care for hip and knee arthritis from orthopedic surgeons. Methods: Demographic data and visit type were collected from the electronic medical record for patients seen in our academic medical center either before or during the COVID-19 pandemic by orthopedic surgeons who specialize in hip and knee arthroplasty. Univariate and multivariate analyses were performed regarding age, race, insurance status, ADI, and distance to a clinical site. Results: In the COVID era, among 4901 visits with 3124 unique patients, those using telemedicine were younger and more likely to be White compared to those who did not use telemedicine. There was no significant difference in telemedicine use based on ADI, distance to a clinical site, or insurance status. Conclusions: This retrospective analysis suggests that orthopedic patients who were White and of younger age were more likely to use telemedicine in the first year of the COVID-19 pandemic. There was no statistically significant relationship between distance from a clinical site or ADI and telemedicine use, suggesting that factors other than these are greater contributors to telemedicine utilization in our cohort. Further information is needed to determine how telemedicine may disproportionately limit access to orthopedic care according to these and other patient factors.
Combining Culinary Medicine With Integrative Medicine in Medical Curriculum: A Novel Community-Centric Approach
Authors: Nguyen An-Thu , Faraj Merwan , Ward Gabriel , Hopkins Elijah , DeMutis Alyssa , Stroupe Amber , DiMucci-Ward JuliSu 
Published: October 2023

Context Historically, medical school curriculums have not addressed applications of medical nutrition therapy (MNT) in patient care plans. In 2020, an elective pilot lifestyle medicine course, “Food and Nutrition as Medicine (FANAM),” was implemented at Edward Via College of Osteopathic Medicine Carolinas (VCOM-Carolinas) using a community-centric model. Objective Teach medical students skills in nutrition education, culinary techniques, patient-centered care through intersectional lenses of culture, available resources, and health literacy. Methods FANAM’s founders were a multidisciplinary team of physicians, a registered dietitian, a nurse and a dietetic technician. Twenty students were in the initial cohort. FANAM utilized physicians and community leaders as mentors who taught through hands-on and didactic exercises. Pre- and post-Likert scales assessed FANAM’s impact on students’ confidence in implementing patient-centered nutrition education. Wilcoxon Signed Rank Tests analyzed survey results with calculated P-value <.05. Results Qualitative assessments demonstrated that 100% of participants believed nutrition education beyond the standard curriculum was necessary. 95% of participants felt confident in their understanding of nutrition and ability to counsel standardized patients after course completion. Conclusion These results indicate that FANAM provided opportunities for students to enhance both knowledge of MNT and practical applications of nutrition education to benefit patients.
Usability of a mobile phone application to enhance activities of daily living in occupational therapy services for breast cancer survivors
Authors: Romero-Ayuso Dulce , García-López Raquel , Lozano-Villena Carmen , Martínez José R , Parga-Amado Paula , García-Ferreiro Paula , Gallud José A , Lozano María , Triviño-Juárez José-Matías 
Published: October 2023

Background/Objective: The use of new technologies in rehabilitation to evaluate and improve occupational performance and quality of life is increasing. Technological applications in the health field could help meet the needs of patients, including those of women breast cancer survivors. The main aim of this study was to design a mobile phone application “MAIA” focused on the perceived needs of women who have had breast cancer to achieve optimal performance in their daily lives in a meaningful way. Methods: A cross-sectional usability study using an online questionnaire was designed. Sociodemographic and occupational performance data were collected. System Usability Scale, Engagement in Meaningful Activities Survey, Occupational Balance Questionnaire, General Self-Efficacy Scale, Functional Assessment of Cancer Therapy - General and Disabilities of the Arm, Shoulder and Hand were administered. Descriptive statistics were used to describe categorical (frequencies and percentages) and quantitative variables (mean and standard deviation). Results: The sample was composed of seventy-eight women diagnosed with breast cancer. Nine activities of daily living were affected in more than 20% of women with breast cancer. The most affected were sleep and rest and functional mobility. Conclusions: Women survivors of breast cancer showed difficulties in daily life performance and participation. The MAIA App could be useful as a new online resource in occupational therapy for the rehabilitation of breast cancer survivors.