bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Photographer’s Visual Grammar: Visual Rightness and Aesthetics of Artistic Photographs
Authors: Vissers Nathalie , Wagemans Johan 
Published: May 2023

Abstract
We are living in a world where photography is everywhere, and almost everyone is a photographer (in the sense of producing photographs with some aesthetic aspiration). Yet, despite the democratic nature of the medium, which suggests that anyone can make great photographs, there are large differences in the aesthetic quality of photographs. Scientifically, we do not yet grasp very well what differentiates aesthetic from non-aesthetic photographs, and how this results in a different viewer experience. In this study, we explored the visual rightness of 21 high-quality artistic photographs, compared with their ecologically valid less-than-optimal variants (one to four alternatives). The high-quality photographs were selected from an online contemporary photography competition which is judged by experts (http://www.life-framer.com). The alternatives were variants provided by the photographers themselves. Participants () preferred the original photograph significantly more than chance level for the majority of the sets (13 out of 21), and significantly less than chance level for a minority of sets (three out of 21). This is in line with the visual rightness theory of picture perception, maintaining that artists are experts in creating visually right images, and that this is salient to nonexpert viewers. Yet, the preference for the original differed greatly between sets (range: 9.63–79.68%) and the original photograph was also the most preferred one in ‘only’ 12 out of 21 sets. Qualitative content analysis showed that preferences were influenced by many levels of photographic information (color, contrast, sharpness, composition, emotional expression, etc.), which were often working together. The most aesthetically powerful photographs reveal a skillful combination of medium, form, and subject matter levels, to produce an optimal visual message. Results have implications for empirical aesthetics, the photography practice, and for our understanding of photography literacy, a key topic in a world where there are many more photographs than humans that can appreciate them.
Stochastic Bifurcation of the North Atlantic Circulation under a Midrange Future Climate Scenario with the NASA-GISS ModelE
Authors: Romanou Anastasia , Rind David , Jonas Jeff , Miller Ron , Kelley Maxwell , Russell Gary , Orbe Clara , Nazarenko Larissa , Latto Rebecca , Schmidt Gavin A. 
Published: May 2023

Abstract
A 10-member ensemble simulation with the NASA GISS-E2-1-G climate model shows a clear bifurcation in the Atlantic meridional overturning circulation (AMOC) strength under the SSP2–4.5 extended scenario. At 26°N, the bifurcation leads to 8 strong AMOC and 2 much weaker AMOC states, while at 48°N, it leads to 8 stable AMOC-on and 2 nearly AMOC-off states, the latter lasting approximately 800 years. A variety of fully coupled models have demonstrated tipping points in AMOC through hosing experiments, i.e., prescribing sufficient freshwater inputs in the subpolar North Atlantic. In the GISS simulations, there are no external freshwater perturbations. The bifurcation arises freely in the coupled system and is the result of stochastic variability (noise-induced bifurcation) associated with sea ice transport and melting in the Irminger Sea after a slowing of the greenhouse gas forcing. While the AMOC strength follows the near shutdown of the Labrador Sea deep convection initially, the Irminger Sea salinity and deep mixing determine the timing of the AMOC recovery or near collapse at 48°N, which varies widely across the ensemble members. Other feedbacks such as ice-albedo, ice-evaporation, E − P, and the overturning salt-advection feedback play a secondary role that may enhance or reduce the primary mechanism which is ice melt. We believe this is the first time that a coupled climate model has shown such a bifurcation across an initial condition ensemble and might imply that there is a chance for significant and prolonged AMOC slow down due to internal variability of the system.

Significance Statement
We believe this is the first time that divergent AMOC behavior has been reported for an ensemble of Earth system model simulations using identical climate forcing and no prescribed freshwater perturbations. This response is a manifestation of noise-induced bifurcation, enhanced by feedbacks, revealing the role stochastic (or intrinsic) variability may play in AMOC stability.
Rapidly Increasing Number and Cost of Residency Applications in Surgery
Authors: Singh Nikhi P. , Boyd Carter J. 
Published: May 2023

Background Surgical specialties represent the most competitive residency positions to obtain, and applicants for these spots may apply to increasingly more programs in an attempt to match. We describe trends in residency applications across all surgical specialties from 2017 to 2021 application cycles. Materials and Methods This review of the 2017, 2018, 2019, 2020, and 2021 surgical residency application cycles used the American Association of Medical Colleges’ Electronic Residency Application Service (ERAS) databases. Data from a total of 72,171 applicants to United States surgical residencies during the study’s time period were included. The 2021 ERAS fee schedule was used to calculate the cost of applications. Results The number of applicants across the study interval remains unchanged. Trends suggest more women and underrepresented minorities in medicine are applying to surgical residencies today compared to 5 years ago. The mean number of applications per applicant increased 32.0% from 39.3 in 2017 to 51.8 in 2021, resulting in an increased application fee cost of $329 per applicant. Mean total cost for application fees alone in 2021 were $1211 per applicant. In 2021, the cost of applying to surgical residency for all applicants was over $26 million, a nearly $8 million increase from 2017. Conclusions There has been an increase in the number of applications per applicant in the past 5 residency application cycles. Increased applications create barriers and burdens for applicants, and residency program personnel. These rapid increases are unsustainable and require intervention, although a viable solution has yet to be elucidated.
Cytoreductive Surgery and Hyperthermic Peritoneal Chemotherapy in Appendiceal and Colorectal Cancer: Outcomes and Survival
Authors: Djadou Teresa Moreno , Poh Keat Seong , Yellinek Shlomo , Fayazzadeh Hana , El-Hayek Kevin , Simpfendorfer Conrad H. , DaSilva Giovanna , Wexner Steven D. 
Published: May 2023

Background We reviewed outcomes following cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with appendiceal or colorectal neoplasms and evaluated key prognostic indicators for treatment. Methods All patients who underwent cytoreductive surgery/HIPEC for appendiceal and colorectal neoplasms were identified from an IRB-approved database. Patient demographics, operative reports, and postoperative outcomes were reviewed. Results 110 patients [median age 54.5 (18-79) years, 55% male] were included. Primary tumor location was colorectal (58; 52.7%) and appendiceal (52; 47.3%). 28.2%, .9%, and 12.7% had right, left, and sigmoid tumors, respectively; 11.8% had rectal tumors. 12/13 rectal cancer patients underwent preoperative radiotherapy. Mean Peritoneal Cancer Index was 9.6 ± 7.7; complete cytoreduction was achieved in 90.9%. 53.6% developed postoperative complications. Reoperation, perioperative mortality, and 30-day readmission rates were 1.8%, .09%, and 13.6%, respectively. Recurrence at a median of 11.1 months was 48.2%; overall survival at 1 and 2 years was 84% and 56.8%, respectively; disease-free survival was 60.8% and 33.7%, respectively, at a median follow-up of 16.8 (0-86.8) months. Univariate analysis of preoperative chemotherapy, primary malignancy location, primary tumor perforated or obstructive, postoperative bleeding complication, and pathology of adenocarcinoma, mucinous adenocarcinoma and negative lymph nodes were identified as possible predictive factors of survival. Multivariate logistic regression analysis showed that preoperative chemotherapy ( P < .001), perforated tumor ( P = .003), and postoperative intra-abdominal bleeding ( P < .001) were independent prognostic indicators for survival. Conclusions Cytoreductive surgery/HIPEC for colorectal and appendiceal neoplasms has low mortality and high completeness of cytoreduction score. Preoperative chemotherapy, primary tumor perforation, and postoperative bleeding are adverse risk factors for survival.
Identifying Risk Factors for AMA Discharge After Injury at a Level 1 Trauma Center
Authors: Ugarte Chaiss , Schellenberg Morgan , Gallagher Shea , Park Stephen , Epstein Larissa , Matsushima Kazuhide , Martin Matthew J. , Inaba Kenji 
Published: May 2023

Background Discharging a patient against medical advice (AMA) is used to describe when a patient opts to leave the hospital prior to a physician’s recommendation while acknowledging the risks of doing so. There are limited published data that identify risk factors for patients leaving AMA, particularly after trauma. Objective This study sought to delineate risk factors for AMA discharge after trauma. Methods Trauma patients who left AMA at our ACS-verified level 1 trauma center were retrospectively included (2021-2022) without exclusions. Demographics, clinical/injury data, and outcomes were collected. The primary outcome was patient-stated reason for leaving AMA. Study variables were summarized with descriptive statistics. Results During the study period, 262 (8%) of 3218 admitted trauma patients left AMA. Psychiatric disease was present in most patients (n = 197, 75%), including substance abuse (n = 146, 56%), and alcohol abuse (n = 95, 36%). Common patient-stated reasons for leaving AMA were inability/unwillingness to wait for procedure, imaging, or placement (n = 56, 22%); and psychiatric disease other than alcohol/substance abuse (n = 39, 15%). Of the patients who left AMA, 29% (n = 77) returned to the hospital 30 days, and 13% (n = 35) were readmitted. Conclusion Patients who leave AMA are at elevated risk of returning to the hospital, which incurs additional costs in already resource-constrained systems. These findings provide impetus for early identification of high-risk patients and efforts to decrease wait times for imaging, procedures, and placement. These actions may mitigate AMA discharges and their resultant impact on patients and hospitals.
A review and meta-analysis of conventional sternotomy versus minimally invasive mitral valve surgery for degenerative mitral valve disease focused on the last decade of evidence
Authors: Hussain Sajad , Swystun Alexander G , Caputo Massimo , Angelini Gianni D , Vohra Hunaid A 
Published: May 2023

Objectives Early meta-analyses comparing minimally invasive mitral valve surgery (MIMVS) with conventional sternotomy (CS) have determined the safety of MIMVS. We performed this review and meta-analysis based on studies from 2014 onwards to examine the differences in outcomes between MIMVS and CS. Specifically, some outcomes of interest included renal failure, new onset atrial fibrillation, mortality, stroke, reoperation for bleeding, blood transfusion and pulmonary infection. Methods A systematic search was performed in six databases for studies comparing MIMVS with CS. Although the initial search identified 821 papers in total, nine studies were suitable for the final analysis. All studies included compared CS with MIMVS. The Mantel – Haenszel statistical method was chosen due the use of inverse variance and random effects. A meta-analysis was performed on the data. Results MIMVS had significantly lower odds of renal failure (OR: 0.52; 95% CI 0.37 to 0.73, p < 0.001), new onset atrial fibrillation (OR: 0.78; 95% CI 0.67 to 0.90, p < 0.001), reduced prolonged intubation (OR: 0.50; 95% CI 0.29 to 0.87, p = 0.01) and reduced mortality (OR: 0.58; 95% CI 0.38 to 0.87, p < 0.01). MIMVS had shorter ICU stay (WMD: −0.42; 95% CI −0.59 to −0.24, p < 0.001) and shorter time to discharge (WMD: −2.79; 95% CI −3.86 to −1.71, p < 0.001). Conclusion In the modern era, MIMVS for degenerative disease is associated with improved short-term outcomes when compared to the CS.
Moderating Effects of Student Engagement on the Relationship Between Weight Bias Internalization and Depressive Symptoms Among Adolescent Girls With Higher Weight
Authors: Ra Jin Suk 
Published: May 2023

This study aimed to examine the moderating effect of student engagement between weight bias internalization and depressive symptoms in Korean adolescent girls with higher weight. Ninety-nine girls with higher weight (≥85th body mass index percentile) in early adolescence (aged 12–14 years) participated in this cross-sectional study. Weight bias internalization, student engagement, and the interaction between these variables were significantly associated with depressive symptoms. Furthermore, a simple slope analysis indicates that higher student engagement was associated with more significant relief in depressive symptoms. Thus, promoting higher student engagement with family and school support may help reduce depressive symptoms related to weight bias internalization in adolescent girls with higher weight. Therefore, family- and school-based programs are required to enhance student engagement in adolescent girls with higher weight.
End-of-Life transfusion support at hospice and pediatric oncology unit: Bridging the gap between benefits and therapeutic alliance
Authors: Nigro Olga , Podda Marta G , Pellegatta Federico , Schiavello Elisabetta , Clerici Carlo A , Catalano Igor , Visconti Giovanna , Albarini Marco , Luksch Roberto , Terenziani Monica , Ferrari Andrea , Casanova Michela , Biassoni Veronica , Meazza Cristina , Spreafico Filippo , Gattuso Giovanna , Sironi Giovanna , Puma Nadia , Bergamaschi Luca , Chiaravalli Stefano , Massimino Maura 
Published: May 2023

Objectives: Although transfusion support is commonly used in oncological palliative care, there is still a paucity of literature. We examined the transfusion support provided in the terminal stage of the disease and compared the approach at a pediatric oncology unit and a pediatric hospice. Case description This case series analyzed patients treated at the Fondazione IRCCS Istituto Nazionale dei Tumori di Milano (INT)’s pediatric oncology unit who died between January 2018 and April 2022. We compared these with those who died at the VIDAS hospice and analyzed the number of complete blood counts taken in a patient’s last 14 days of life, and the number of transfusions performed in the same period. We analyzed 44 patients (22 in pediatric oncology unit; 22 in hospice) in total. Twenty-eight complete blood counts were performed (7/22 patients at the hospice; 21/22 patients at the pediatric oncology unit). Nine patients were given transfusions, three at the hospice, six at our pediatric oncology unit (24 transfusions in total): 20 transfusions at the pediatric oncology unit, four at the hospice. In total 17/44 patients were given active therapies in the last 14 days of life: 13 at the pediatric oncology unit, four at the pediatric hospice. Ongoing cancer treatments did not correlate with a greater likelihood of receiving a transfusion (p=0.91). Conclusions: The hospice’s approach was more conservative than the pediatric oncology one. In the in-hospital setting, the need for a transfusion cannot always be decided on by a combination of numerical values and parameters alone. The family’s emotional-relational response must be considered too.
Weight Gain, Lifestyle, and Cognition During the COVID-19 Pandemic in Southern Brazil
Authors: Vargas Liziane da Silva de , Jantsch Jeferson , Varela Ana Paula Muterle , Dorneles Gilson Pires , Zanini Roberta de Vargas , Peres Alessandra , Guedes Renata Padilha 
Published: May 2023

Background: During the COVID-19 pandemic, the world experienced social distancing that resulted in changes in habits and lifestyle. Such changes can compromise healthy eating habits and the practice of physical activities, known risk factors for developing weight gain and obesity. Objective: The main objective of this study was to describe the change in eating habits, lifestyle, and cognition of the population of Rio Grande do Sul, a state in Southern Brazil, during social distancing due to COVID-19. Methods: The study was conducted from July 21 to August 10, 2020, through a structured online questionnaire that asked for sociodemographic information (age, gender, and education), anthropometric (reported weight and height), change in eating habits, lifestyle (sleep quality and physical activity), and cognition. Chi-square, McNemar tests, and univariate and multivariate analysis were used to evaluate the variables. Confidence intervals were calculated with a significance level of 5%. Results: Of a total of 1072 participants, 57.3% of respondents reported weight gain, and an increased percentage of people were classified as obese. Nearly half of the participants (46%) reported changes in their eating habits for the worse. Body mass index (BMI) was significantly associated with increased consumption of unhealthy foods. Our results identified high physical inactivity (46.9%) and obesity (19%) during social distancing. The changes in eating habits and lifestyle also increased the risk for decreased cognition. Conclusions: These findings highlighted that social distancing impacted eating habits and lifestyle, which increased obesity rates and might predispose to decreased cognition.
Emission and time-resolved migration rates of aromatic diamines from two flexible polyurethane foams
Authors: Karlsson Daniel , Spence Mark W , Plehiers Patrick M 
Published: May 2023

Performing risk assessments (RA) on household use of flexible polyurethane (PU) foams requires access to reliable data about emission and migration of potential diamine impurities. A toluene diisocyanate (TDI) and a methylene diphenyl diisocyanate (MDI) based foam were thermally treated to enable measurements on samples with defined concentrations of the corresponding diamines, toluene diamine (TDA), and methylene dianiline (MDA). The thermally treated foams used for emission testing contained up to 15 mg.kg−1 of TDA and 27 mg.kg−1 of MDA. Those used for migration testing contained 5.1 mg.kg−1 of TDA and 14.1 mg.kg−1 of MDA. Stability of the thermally generated diamines was sufficient for testing over a 37-day period. Analytical techniques that did not decompose the polymer matrix were applied. Emission rates for TDA and MDA isomers were less than the limit of quantitation (LOQ) of 0.008–0.07 μg.m−2.h−1. Migration was studied using samples of the same thermally treated foams over a 35-day period. Quantifiable migration of MDA from the MDI-based foam was only observed on Days 1 and 2. From Day 3 onward, migration rates were less than the LOQ. Quantifiable migration of TDA from the TDI-based foam rapidly decreased with time and was only observed on Days 1 thru 3. From Day 4 onward, migration rates were less than the LOQ. Theoretically, the migration rate should be inversely proportional to the square root of time (t) as t−0.5. This relationship was confirmed by the experimental data and enables extrapolating migration values to more extended time periods to conduct RAs.
New Electrically Conducting Polymeric Fillers
Authors: Bandara A.J. , Curley J. 
Published: May 2023

Conducting polymers have been known since the early 1940s. They have been made by incorporating a randomly dispersed conducting filler into a polymer matrix to form conducting composites. The traditional fillers are carbon black, graphite, and metal powders etc. Over the past two decades, a multitude of intrinsically conducting polymers have been developed, such as poly(p-phenylene vinylene), poly(p-phenylene sulfide), polypyrrole, polythiophene, and polyquinoline (ladder polymers). The structural features which endow conductivity also cause processing problems which make the direct use of these polymers difficult. It is essential to overcome these problems and one solution is to use the conducting polymers as particulate fillers for otherwise insulating plastics. A variety of novel intrinsically conducting polymers have been synthesised and this paper reports the electrical conductivity of the filled systems. Another method of producing conducting composites has been investigated, involving immersing polymer films containing monomers such as pyrrole or aniline into various aqueous oxidant solutions. One advantage of this method is that highly transparent conducting films can be prepared.
Protective effect of additional cathelicidin antimicrobial peptide PR-39 on prosthetic-joint infections
Authors: Zhu Yongjun , Weng Xuan , Zhang Jian , Mao Jingxin 
Published: May 2023

Background Prosthetic-joint infection (PJI) is one of the severest complications after arthroplasty. However, antibiotics are not effective in the bacteria in biofilm outside the prosthetic-joint. Antimicrobial peptides have an efficient antimicrobial activity in staphylococcus aureus compared with conventional antibiotics. Methods Bone marrow stem cells (BMSCs) were isolated, cultured and transfected with cathelicidins antimicrobial peptides proline-arginine-rich 39 amino acid peptide (PR-39) lentivirus. The expression of PR-39 gene in BMSCs was detected by RT-PCR, and the antibacterial activity of PR-39 was measured by agar diffusion method. The transfection efficiency was detected by fluorescence microscopy. The infection model of artificial knee joint in rabbits were established. Kirschner wire was used as the knee joint implant to implant the distal femur through the femoral intercondylar fossa of rabbits. 24 rabbits were randomly divided into 2 groups for the above operations: group A was inoculated 0.5 mL into the joint cavity immediately after the incision was sutured 1 × 107 Staphylococcus aureus of colony forming unit (CFU), group B was inoculated with Staphylococcus aureus and PR-39. After operation, the wound conditions and histological changes were observed by X-ray and optical microscope respectively, CRP and erythrocyte sedimentation rate were measured by test assay. Results The transfection efficiency of lentivirus vectortransfected BMSCs was 74.09%. The supernatant of lentivirus vector had obvious inhibitory effect on Staphylococcus aureus, and the antibacterial rate was 98.43%. 100% infection observed in group A while few infection observed in group B; serum CRP and ESR at a high level in group A while decreased in group B after operation. There were no significant difference in CRP and ESR between the pLV/PR-39 group and pLV/EGFP group at day 1 and 3 respectively after surgery. However, CRP and ESR in the pLV/PR-39 groupwere significantly lower than the pLV/EGFP group at day 7 and 14 respectively after operation. Conclusions Rabbits planted BMSCs expressing PR-39 were significantly increased resistance to Staphylococcus aureus in PJI than control group thus showing great potential for preventing implant-associated infection. It will provide a potential new therapeutic agent for implant-associated infection.