bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns, Transport, and Anisotropy of Salt Fingers in Shear
Authors: Brown Justin M. , Radko Timour 
Published: October 2023

Abstract
Through an expansive series of simulations, we investigate the effects of spatially uniform shear on the transport, structure, and dynamics of salt fingers. The simulations reveal that shear adversely affects the heat and salt fluxes of the system, reducing them by up to an order of magnitude. We characterize this in detail across a broad range of Richardson numbers and density ratios. We demonstrate that the density ratio is strongly related to the amount of shear required to disrupt fingers, with larger density ratio systems being more susceptible to disruption. An empirical relationship is proposed that captures this behavior that could be implemented into global ocean models. The results of these simulations accurately reproduce the microstructure measurements from North Atlantic Tracer Release Experiment (NATRE) observations. This work suggests that typical salt finger fluxes in the ocean will likely be a factor of 2–3 less than predicted by models not taking the effects of shear on double-diffusive systems into account.

Significance Statement
The purpose of this work is to measure how large-scale (>1 m) motion affects specific small-scale (∼1 cm) mixing in the ocean. We approach this topic using simulations of meter-scale boxes of fluid containing both temperature and salt concentration with an applied background flow. We measure how this background flow changes the mixing of temperature and salt as the strength of the applied flow increases. We find that current estimates may overpredict mixing at this scale throughout the World Ocean by about a factor of 2–3, on average. This could have consequences for estimates of climate in addition to heat, salt, nutrient, and pollutant transport.
A Web-Based Prediction Tool to Improve Identification of Patients With Undersized Hamstring Tendon Autograft in Anterior Cruciate Ligament Reconstruction
Authors: Xu Wennan , Liu Chengxiao , Peng Huaming , Wang Jingsong , Zhang Zhengzheng , Song Bin , Li Weiping , Jiang Chuan 
Published: October 2023

Background: An undersized hamstring tendon (HT) autograft is significantly associated with a higher graft failure rate in anterior cruciate ligament reconstruction (ACLR) surgery. The ability to accurately predict inadequate HT graft diameter is critical, as it could assist surgeons in making better graft choices and surgical plans. Purpose: To develop a web-based prediction tool to better assess the size of HT autograft and to help clinicians accurately identify patients with potentially undersized HT grafts in order to make appropriate clinical decisions. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 588 patients who received primary arthroscopic single-bundle ACLR surgery with gracilis tendon (GT) and semitendinosus tendon (ST) autograft were retrospectively reviewed. According to the size of 4-strand HT graft, patients were divided into diameter ≥8 mm and <8 mm groups. The least absolute shrinkage and selection operator method and logistic regression were used to identify the independent factors associated with HT graft diameter and establish the models. The prediction performance of the model was evaluated by concordance index and calibration combined with external validation. The diagnostic performance of the prediction model was assessed by sensitivity, specificity, predictive values, and likelihood ratios. Decision curve analysis was used to evaluate the clinical utility of the model. Results: Among the numerous indicators, sex, weight, height, thigh length, and ST-GT diameter (measured on plane 1 of a magnetic resonance imaging scan) were identified to be highly correlated predictors that could provide satisfactory prediction performance in determining the HT graft diameter. Based on these predictors, a prediction model named the HTD model was developed with satisfactory discrimination (concordance index, 0.932) and calibration (mean absolute error, 0.039). When the probability calculated by the HTD model was >65%, the sensitivity and specificity of predicting 4-strand HT graft diameter ≥8 mm were 86.7% and 90.2%, respectively. Conclusion: As a useful supplementary prediction tool, the HTD model could accurately predict the diameter of HT autograft during preoperative planning.
Effect of low-calcium and standard-calcium dialysate on serum calcium, phosphorus and full-segment parathyroid hormone in patients on peritoneal dialysis: A retrospective observational study
Authors: An Ning , Zhou Haishan , Li Xianhui , Yu Xinyin , Yang Haijuan , Zhai Liping , Huang Yuhua , Yao Cuiwei 
Published: October 2023

Objective: To investigate the effects of low-calcium and standard-calcium dialysate in patients with chronic kidney disease on peritoneal dialysis, and find out which dialysate has less vascular calcification effect. Methods: A total of 141 patients who had undergone peritoneal dialysis (PD) for 2 years in the PD centre from January 2012 to December 2017 were included and divided into two groups according to the calcium concentration of the PD fluid used. There were 79 cases in the low-calcium group, with a dialysate calcium concentration of 1.25 mmol/L and 62 cases in the standard-calcium group, with a dialysate calcium concentration of 1.75 mmol/L. The demographic characteristics and clinical information before initiation of PD were collected and compared between the two groups. Information on the serum calcium, phosphorus and PTH, systolic and diastolic blood pressures and the use of antihypertensive and phosphate-lowering drugs in the second year of dialysis was also collected and compared between the two groups. Vascular calcification was assessed in patients on PD treatment. Results: The mean serum calcium concentrations before initiation of PD in the low- and standard-calcium groups were 1.94 ± 0.27 and 1.89 ± 0.28 mmol/L, respectively. The serum calcium concentrations after PD were 2.30 ± 0.21 and 2.41 ± 0.23 mmol/L, respectively. After PD, the serum calcium concentration in both groups was significantly increased ( p < 0.05). The serum calcium concentration in the low-calcium group after PD treatment was lower than that in the standard-calcium group, and the difference was statistically significant ( p < 0.05). Compared with the standard-calcium group, patients in the low-calcium group had significantly higher parathyroid hormone concentrations ( p < 0.05). More types of phosphate-lowering drugs were used (59.49%) in the low-calcium group than that in the standard-calcium group (35.48%; p < 0.05). The number of antihypertensive drug usage were also higher in the low-calcium group, and the difference was statistically significant ( p < 0.05). As for the vascular calcification effect, the two groups have shown no statistical difference in abdominal aortic calcification rate, carotid arteriosclerosis rate and aortic arch calcification rate ( p < 0.05). Conclusion: We found that low-calcium PD fluid may increase the PTH level and the proportion of CKD patients using antihypertensive drug and phosphorus-lowering drug, but the vascular calcification effect of the low and standard calcium PD fluid needs further exploration. This paper provides new evidence for the choice of dialysate for PD, low-calcium dialysate has no outstanding advantages for long term dialysis.
Use of prostaglandin and cyclophosphamide for pediatric lupus with digital gangrene: Back to safety before hitting the axe!
Authors: Jain Hritvik , Mittal Aliza , Didel Siyaram , Kumar Prawin , Singh Kuldeep 
Published: October 2023

Digital gangrene is a rare presenting feature of childhood lupus and only a reported incidence of 1.3%. We describe two cases of pediatric onset systemic lupus erythematosus (SLE), both 16 years old, presenting with digital gangrene and the successful salvage of the digits after using intravenous cyclophosphamide for immunosuppression and use of intravenous prostaglandin E1 infusions for limb reperfusion. Both of the patients responded exceptionally to the infusions with resolution of gangrene and near-total preservation of the functionality of toes.
Mental Time Travel as Self-Affirmation
Authors: Stephan Elena , Sedikides Constantine 
Published: October 2023

Academic Abstract This article integrates and advances the scope of research on the role of mental time travel in bolstering the self. We propose that imagining the self in the future (prospection) or in the past (retrospection) highlights central and positive self-aspects. Thus, bringing to mind one’s future or past broadens the perceived bases of self-integrity and offers a route to self-affirmation. In reviewing corresponding research programs on self-prospection and nostalgia, we illustrate that mental time travel serves to affirm the self in terms of self-esteem, coherence, and control. Mental time travel could be implemented as a source of self-affirmation for facilitating coping and behavior change in several domains such as relationships, health, education, and organizational contexts. Public Abstract People can mentally travel to their future or to their past. When people imagine what they will be like in the future, or what they were like in the past, they tend to think about themselves in terms of the important and positive attributes that they possess. Thinking about themselves in such an affirming way expands and consolidates their self-views. This broader image of themselves can increase self-esteem (the extent to which one likes who they are), coherence (the extent to which one perceives life as meaningful), and control (the extent to which one feels capable of initiating and pursuing goals or effecting desirable outcomes). Mental time travel, then, has favorable or affirming consequences for one’s self-views. These consequences can be harnessed to modify one’s behavior in such life domains as relationships, health, education, and work.
In Vitro Antioxidant and Inhibitory Study of Picrorhiza kurroa (Kutki), Syzygium aromaticum (Loung), Lawsonia inermis (Henna), Rheum emodi (Revand Chini), Curcuma longa (Haldi) Against Lipid Per-Oxidation in Mice Brain and Liver
Authors: Hassan Farooq , Khan Asmat Ullah , Zaidi Syed Zahoor ul Hassan , Niazi Madiha Khan , ismail Muhammad Amjed 
Published: October 2023

The aerobic organisms not only need oxygen for survival, but oxygen is also fundamentally malignant to the aerobic organism on the grounds of free radical generation and their affiliation with free oxidative stress. This study was done to evaluate the antioxidant and protective properties of P kurroa, S aromaticum, L inermis, R emodi, and C longa against lipid peroxidation induced by different pro-oxidants. The aqueous extracts of these medicinal plants showed inhibition against thiobarbituric acid reactive species (TBARS) induced by different pro-oxidants (10 mM FeSO4 and 5 mM sodium nitroprusside) in the brain and liver of mice. Moreover, the free radical scavenging activities of the extracts were evaluated by the scavenging of the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical. L inermis, S aromaticum, and R emodi showed higher inhibitory effects, which could be attributed to their significantly reduced ability and free radical scavenging activities. Therefore, the oxidative stress in the brain and liver could be potentially managed or prevented by the dietary intake of L inermis, S aromaticum, and R emodi plants, which justifies the use of these plants in various degenerative diseases. C longa and P kurroa showed relatively weak antioxidant activities.
Moving scope technique improves technical success rate of device insertion during EUS-guided hepaticogastrostomy (with video)
Authors: Bessho Kimi , Ogura Takeshi , Ueno Saori , Okuda Atsushi , Nishioka Nobu , Sakamoto Jun , Yamamoto Yoshitaro , Uba Yuki , Tomita Mitsuki , Hattori Nobuhiro , Nakamura Junichi , Nishikawa Hiroki 
Published: October 2023

Background: Technical tips for device insertion during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) have not been reported. To improve the technical success rate of device insertion without unnecessary tract dilation, the pushing force should be transmitted directly from the channel of the echoendoscope to the intrahepatic bile duct. Objectives: We developed a novel technique, termed the ‘moving scope technique’, the feasibility of which during EUS-HGS is described. Design: Retrospective study. Methods: The primary outcome of this study was the technical success rate of dilation device insertion without electrocautery dilation after the moving scope technique. The initial technical success rate of dilation device insertion was defined as successful insertion into the biliary tract. If dilation device insertion failed, the moving scope technique was attempted. Results: A total of 143 patients were enrolled in this study. The initial technical success rate for device insertion was 80.4% (115/143). The moving scope technique was therefore attempted in 28 patients. The mean angle between the intrahepatic bile duct and the guidewire was improved to 141.0° and resulted in a technical success rate of 100% (28/28). The area under the ROC curve (AUC) was 0.88, and 120° predicted successful dilation device insertion with sensitivity of 88.0% and specificity of 78.8%. Bile peritonitis ( n = 8) and cholangitis ( n = 2) were observed as adverse events, but were not severe. Conclusion: In conclusion, the moving scope technique may be helpful during EUS-HGS to achieve successful insertion of the dilation device into the biliary tract. These results should be evaluated in a prospective randomized controlled trial.
Using AI Tools to Develop Training Materials for Aviation: Ethical, Technical, and Practical Concerns
Authors: Nguyen Blake , Sonnenfeld Nathan , Finkelstein Lindsay , Alonso Alex , Gomez Caroline , Duruaku Fiona , Jentsch Florian 
Published: October 2023

A key potential advantage of modern training technologies relates to the ability to use them to automate aspects of training. Although in the early stages of adoption within the aviation industry, artificial intelligence (AI) tools and methods have many promises for training design, development, delivery, and assessment. We applied the use-case technology-mapping framework (UCTM) to identify and analyze how automation and AI technologies may be used within the flightcrew training design pipeline, integrating perspectives from relevant literature, informal discussions with stakeholders, and workshops with domain experts. Our preliminary findings highlight current/near-future applications of AI methods and tools in the training design pipeline. Here, we discuss ethical/legal, technical, and practical considerations for flightcrew training. We urge practitioners and researchers in the aviation human factors community to engage in this discussion and to conduct empirical research that will allow for a positive use of the technology across applications, including in aviation training. Practical Takeaways/Applications. • We present a wide range of potential use cases of AI in flightcrew training. • We discuss the ethical/legal, technical, and practical implications of automation and AI. • This information may inform future training processes and practices in the aviation domain.
Clinical Reasoning Curricula in Health Professions Education: A Scoping Review
Authors: Elvén Maria , Welin Elisabet , Wiegleb Edström Desiree , Petreski Tadej , Szopa Magdalena , Durning Steven J. , Edelbring Samuel 
Published: October 2023

OBJECTIVES This scoping review aimed to explore and synthesize current literature to advance the understanding of how to design clinical reasoning (CR) curricula for students in health professions education. METHODS Arksey and O’Malley's 6-stage framework was applied. Peer-reviewed articles were searched in PubMed, Web of Science, CINAHL, and manual searches, resulting in the identification of 2932 studies. RESULTS Twenty-six articles were included on CR in medical, nursing, physical therapy, occupational therapy, midwifery, dentistry, and speech language therapy education. The results describe: features of CR curriculum design; CR theories, models, and frameworks that inform curricula; and teaching content, methods, and assessments that inform CR curricula. CONCLUSIONS Several CR theories, teaching, and assessment methods are integrated into CR curricula, reflecting the multidimensionality of CR among professions. Specific CR elements are addressed in several curricula; however, no all-encompassing CR curriculum design has been identified. These findings offer useful insights for educators into how CR can be taught and assessed, but they also suggest the need for further guidance on educational strategies and assessments while learners progress through an educational program.
Case report: Primary stabbing headache treated with melatonin in Saethre-Chotzen syndrome
Authors: Frank Florian , Filippi Vera , Kaltseis Katharina , Broessner Gregor 
Published: October 2023

Background: Primary stabbing headache (PSH) is a rare primary headache presenting with short, stabbing pain sensations of unknown etiology. Owed to the rare prevalence of the disease, only limited data exists on possible treatment options. The most cumulative expertise exists for indomethacin as a potential treatment in PSH. However, known side effects and long-term tolerability issues have urged the FDA to restrict the use of indomethacin as long-term medication. In about 35% of the cases indomethacin does not provide sufficient relieve, demanding for efficacious and well tolerable alternatives. Case: Herewith we report a case of a young female adult presenting with PSH treated with melatonin resulting in an outstanding and long-lasting response. The patient has a rare underlying genetic disorder leading to facial dysmorphia, which according to the scarce literature, is not associated with PSH so far, but requires extensive exclusion of secondary causes of headaches. Conclusion: Given the exceptional tolerability of melatonin with low concern even on a long-term use, we discuss an indomethacin trial in PSH might be a diagnostic approach rather than a therapeutic one in the future.
PF4 activates the c-Mpl–Jak2 pathway in platelets
Authors: Buka Richard J. , Montague Samantha J. , Moran Luis A. , Martin Eleyna M. , Slater Alexandre , Watson Steve P. , Nicolson Phillip L. R. 
Published: October 2023

Abstract
Platelet factor 4 (PF4) is an abundant chemokine that is released from platelet α-granules on activation. PF4 is central to the pathophysiology of vaccine-induced immune thrombocytopenia and thrombosis (VITT) in which antibodies to PF4 form immune complexes with PF4, which activate platelets and neutrophils through Fc receptors. In this study, we show that PF4 binds and activates the thrombopoietin receptor, cellular myeloproliferative leukemia protein (c-Mpl), on platelets. This leads to the activation of Janus kinase 2 (JAK2) and phosphorylation of signal transducer and activator of transcription (STAT) 3 and STAT5, leading to platelet aggregation. Inhibition of the c-Mpl–JAK2 pathway inhibits platelet aggregation to PF4, VITT sera, and the combination of PF4 and IgG isolated from VITT patient plasma. The results support a model in which PF4-based immune complexes activate platelets through binding of the Fc domain to FcγRIIA and PF4 to c-Mpl.
Anti-PF4 immunothrombosis without proximate heparin or adenovirus vector vaccine exposure
Authors: Schönborn Linda , Esteban Olga , Wesche Jan , Dobosz Paulina , Broto Marta , Puig Sara Rovira , Fuhrmann Jessica , Torres Raquel , Serra Josep , Llevadot Roser , Palicio Marta , Wang Jing Jing , Gordon Tom Paul , Lindhoff-Last Edelgard , Hoffmann Till , Alberio Lorenzo , Langer Florian , Boehme Christian , Biguzzi Eugenia , Grosse Leonie , Endres Matthias , Liman Thomas , Thiele Thomas , Warkentin Theodore E. , Greinacher Andreas 
Published: October 2023

Abstract
Platelet-activating anti-platelet factor 4 (PF4)/heparin antibodies and anti-PF4 antibodies cause heparin-induced thrombocytopenia (HIT) and vaccine-induced immune thrombocytopenia and thrombosis (VITT), respectively. Diagnostic and treatment considerations differ somewhat between HIT and VITT. We identified patients with thrombocytopenia and thrombosis without proximate heparin exposure or adenovirus-based vaccination who tested strongly positive by PF4/polyanion enzyme-immunoassays and negative/weakly positive by heparin-induced platelet activation (HIPA) test but strongly positive by PF4-induced platelet activation (PIPA) test (ie, VITT-like profile). We tested these patients by a standard chemiluminescence assay that detects anti-PF4/heparin antibodies found in HIT (HemosIL AcuStar HIT-IgG(PF4-H)) as well as a novel chemiluminescence assay for anti-PF4 antibodies found in VITT. Representative control sera included an exploratory anti-PF4 antibody-positive but HIPA-negative/weak cohort obtained before 2020 (n = 188). We identified 9 patients with a clinical-pathological profile of a VITT-like disorder in the absence of proximate heparin or vaccination, with a high frequency of stroke (arterial, n = 3; cerebral venous sinus thrombosis, n = 4), thrombocytopenia (median platelet count nadir, 49 × 109/L), and hypercoagulability (greatly elevated D-dimer levels). VITT-like serological features included strong reactivity by PIPA (aggregation &lt;10 minutes in 9/9 sera) and positive testing in the novel anti-PF4 chemiluminescence assay (3/9 also tested positive in the anti-PF4/heparin chemiluminescence assay). Our exploratory cohort identified 13 additional patient sera obtained before 2020 with VITT-like anti-PF4 antibodies. Platelet-activating VITT-like anti-PF4 antibodies should be considered in patients with thrombocytopenia, thrombosis, and very high D-dimer levels, even without a proximate exposure to heparin or adenovirus vector vaccines.
CRTC2 activates the epithelial–mesenchymal transition of diabetic kidney disease through the CREB-Smad2/3 pathway
Authors: Li Yujie , Zhang Yufeng , Shi Hongshuo , Liu Xuemei , Li Zifa , Zhang Jiayi , Wang Xiuge , Wang Wenbo , Tong Xiaolin 
Published: October 2023

Abstract
Background
Epithelial–mesenchymal transition (EMT) plays a key role in tubulointerstitial fibrosis, which is a hallmark of diabetic kidney disease (DKD). Our previous studies showed that CRTC2 can simultaneously regulate glucose metabolism and lipid metabolism. However, it is still unclear whether CRTC2 participates in the EMT process in DKD.

Methods
We used protein‒protein network (PPI) analysis to identify genes that were differentially expressed during DKD and EMT. Then, we constructed a diabetic mouse model by administering STZ plus a high-fat diet, and we used HK-2 cells that were verified to confirm the bioinformatics research results. The effects that were exerted by CRTC2 on epithelial-mesenchymal transition in diabetic kidney disease through the CREB-Smad2/3 signaling pathway were investigated in vivo and in vitro by real-time PCR, WB, IHC and double luciferase reporter gene experiments.

Results
First, bioinformatics research showed that CRTC2 may promote EMT in diabetic renal tubules through the CREB-Smad2/3 signaling pathway. Furthermore, the Western blotting and real-time PCR results showed that CRTC2 overexpression reduced the expression of E-cadherin in HK-2 cells. The CRTC2 and α-SMA levels were increased in STZ-treated mouse kidneys, and the E-cadherin level was reduced. The luciferase activity of α-SMA, which is the key protein in EMT, was sharply increased in response to the overexpression of CRTC2 and decreased after the silencing of CREB and Smad2/3. However, the expression of E-cadherin showed the opposite trends. In the real-time PCR experiment, the mRNA expression of α-SMA increased significantly when CRTC2 was overexpressed but partially decreased when CREB and Smad2/3 were silenced. However, E-cadherin expression showed the opposite result.

Conclusion
This study demonstrated that CRTC2 activates the EMT process via the CREB-Smad2/3 signaling pathway in diabetic renal tubules.