bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unpacking the Complexity of Gurān Identity
Authors: Gholami Saloumeh 
Published: June 2023

Abstract
This study aims to explore the complexity of the term Gurān and how its meaning has evolved over time. The research poses several research questions, including the historical and cultural context of the term, different perspectives on whether Gurān people should be considered a distinct ethnic group or part of the larger Kurdish population, and the role of the term in shaping social, cultural, and political dynamics among different social groups. Additionally, the study seeks to explore the perceptions and experiences of Gurān people regarding the use of the term and their understanding of their own identity. Through a methodical analysis of historical and cultural texts, interviews, as well as contemporary discussions in social media, this research demonstrates a method for studying complex topics such as the Gurān identity and provides insight into the complexities of endonyms and exonyms and their relation to broader issues of identity and conflict.
Regression-Based Ensemble Perturbations for the Zero-Gradient Issue Posed in Lightning-Flash Data Assimilation with an Ensemble Kalman Filter
Authors: Honda Takumi , Sato Yousuke , Miyoshi Takemasa 
Published: June 2023

Abstract
Lightning flash observations are closely associated with the development of convective clouds and have a potential for convective-scale data assimilation with high-resolution numerical weather prediction models. A main challenge with the ensemble Kalman filter (EnKF) is that no ensemble members have nonzero lightning flashes in the places where a lightning flash is observed. In this situation, different model states provide all zero lightning, and the EnKF cannot assimilate the nonzero lightning data effectively. This problem is known as the zero-gradient issue. This study addresses the zero-gradient issue by adding regression-based ensemble perturbations derived from a statistical relationship between simulated lightning and atmospheric variables in the whole computational domain. Regression-based ensemble perturbations are applied if the number of ensemble members with nonzero lightning flashes is smaller than a prescribed threshold (Nmin). Observing system simulation experiments for a heavy precipitation event in Japan show that regression-based ensemble perturbations increase the ensemble spread and successfully induce the analysis increments associated with convection even if only a few members have nonzero lightning flashes. Furthermore, applying regression-based ensemble perturbations improves the forecast accuracy of precipitation although the improvement is sensitive to the choice of Nmin.

Significance Statement
This study develops an effective method to use lightning flash observations for weather prediction. Lightning flash observations include precious information of the inner structure of clouds, but their effective use for weather prediction is not straightforward since a weather prediction model often misses observed lightning flashes. Our new method uses ensemble-generated statistical relationships to compensate for the misses and successfully improves the forecast accuracy of heavy rains in a simulated case. Our future work will test the method with real observation data.
Impact of Trade Liberalisation on Wage Inequality and Skill Formation: A Theoretical Analysis
Authors: Dutta Priya Brata , Saha Niladri 
Published: June 2023

We consider a small open economy with three sector and four factors. Agricultural sector produces output with unskilled labour and land. Manufacturing sector and skill formation sector produce output with skilled labour and capital. Skill formation sector transforms the unskilled labour into skilled labour. We also consider an extended version of this model where agricultural sector also uses capital. So capital is mobile between all three sectors. Both change in the price of manufacturing sector and capital stock alter skill formation in a similar direction. But change in the price of manufacturing sector leads to change in skilled–unskilled wage inequality in the same direction whereas due to change in capital stock it changes in opposite direction. In our extended study, where capital is mobile between all three sectors, the results of the basic model are unaltered. JEL Codes: F13, J31
The influence of different sub-bandage pressure values in the prevention of recurrence of venous ulceration—A ten year follow-up
Authors: Milic Dragan J , Zivic Sasa S , Bogdanovic Dragan C , Lazarevic Milan V , Ademi Bekim N , Milic Isidora D 
Published: June 2023

Objective The aim of this study was to establish the efficacy of three different strengths of compression systems in the prevention of venous leg ulcer (VLU) recurrences during a 10-year follow up period. Methods An open, prospective, randomized, single-center study included 477 patients (240 men, 237 women; mean age 59 years). Patients were randomized into three groups: Group A) 149 patients (allocated to wear elastic stocking 18–25 mmHg). Group B) 167 patients (wearing compression device exerting 25–35 mmHg), and Group C) 161 patients (treated with multilayer compression system exerting 35–50 mmHg). Results Overall, 65% (234/360) of patients had recurrent VLU within 10 years. Recurrence occurred in 120 (96%) of 125 in group A, in 89 (66.9%) of 133 patients in group B and in 25 (24.5%) of 102 patients in group C ( p < 0.05) Conclusion Compression systems with the higher compression class provide lower recurrence rate.
Activation of the mTOR pathway promotes neurite growth through upregulation of CD44 expression
Authors: Zhang Jiwei , Gan Wenjuan , Peng Ru , Lu Lei , Lu Weiqing , Liu Jiamei 
Published: June 2023

Objective To explore the intrinsic mechanism of the mammalian target of rapamycin (mTOR) pathway activation and promotion of neuronal axon growth. Methods Human neuroblastoma cells, SH-SY5Y, were induced with all-trans retinoic acid (ATRA; 10 μM for three days) which differentiated the cell line into a neuronal-like state. Immunohistochemical staining was used to detect the differentiation status of the neuronal-like cells. Phosphatase and tensin homolog (PTEN) RNA interference (RNAi) experiments were performed on the differentiated cells; reverse transcription-polymerase chain reaction (RT-PCR) detected transcriptional levels of PTEN following 24 h of interference. After 36 h, western blot assay was used to detect expression levels of ribosomal protein S6 kinase (pS6k) and mTOR. To downregulate the expression of PTEN and cluster of differentiation 44 (CD44), a cell-surface glycoprotein, simultaneously, PTEN siRNA and CD44 siRNA sequences were mixed in equal proportions in co-interference experiments. RT-PCR detected the transcription level of CD44, and the relationship between the CD44 and axonal growth was observed after 48 h of interference. Results Microtubule-associated protein 2 (MAP2) expression was enhanced after three days of induction in SH-SY5Y cells. RT-PCR showed the transcription level of PTEN was significantly downregulated after 24 h of PTEN knockdown. mTOR and pS6k protein expression levels were significantly upregulated after 36 h of interference. CD44 transcription levels were upregulated after PTEN gene interference. The neurite length of the cells in the experimental interference group was significantly longer than that in the control group, and the expression level of CD44 was positively correlated with neurite growth. The neurite length of the PTEN-only interference group was significantly greater than that of the co-interference and ATRA groups. Conclusion Activation of the mTOR pathway promoted neurite growth through upregulation of CD44 expression, thus promoting neuronal regeneration.
Clinical and pathological predictors of persistent T1 HG at second resection
Authors: Gobbo Andrea , Fasulo Vittorio , Contieri Roberto , Uleri Alessandro , Avolio Pier Paolo , Frego Nicola , Lughezzani Giovanni , Saitta Cesare , Taverna Gianluigi , Zanoni Matteo , Mancon Stefano , Colombo Piergiuseppe , Valeri Marina , Saita Alberto , Lazzeri Massimo , Buffi Nicolò M , Hurle Rodolfo , Casale Paolo 
Published: June 2023

Background: T1 high-grade (HG) non-muscle invasive bladder cancer (NMIBC) has a significant risk of recurrence and progression, and the European Association of Urology recommends a second transurethral resection of the bladder (ReTUR). Stage at ReTUR has been shown to be a reliable predictor of survival, therefore, we sought to assess clinical and pathological predictors associated with the persistence of T1 at ReTUR in our retrospective multicentric cohort. Methods: This is a retrospective multicentric study of T1 HG patients at transurethral resection of the bladder (TURB) who underwent subsequent ReTUR. All histological samples were sub-classified according to Rete Oncologica Lombarda (ROL) T1 sub-staging system. Results: One hundred and sixty-six patients were enrolled. Forty-four (26.5%) had T1 HG tumor at ReTUR while 93 (56%) had residual tumor of any stage. Lesion size was significantly greater in T1 HG patients at ReTUR, as well as the prevalence of multifocality. The multivariable logistic regression model showed lesion dimension and multifocality as predictors of T1 HG at ReTUR, after adjusting for significant covariables (CIS and detrusor muscle presence). ROL sub-staging system was not a significant predictor, but ROL2 prevalence was higher in the T1 HG at ReTUR group. Conclusions: Lesion size and multifocality were independent predictors of T1 HG persistence at ReTUR, and patients at risk should be promptly identified and treated accordingly. Our results could help physicians make patient-tailored decisions by identifying those most likely to benefit from a second resection.
Comparison of simultaneous versus staged bilateral total hip arthroplasty via the direct anterior approach: A propensity score matched analysis
Authors: Okazaki Tomoya , Imagama Takashi , Tanaka Hiroshi , Shiigi Eiichi , Hirata Kenji , Kaneoka Takehiro , Kawakami Takehiro , Sakai Takashi 
Published: June 2023

Purpose It remains unclear whether simultaneous bilateral total hip arthroplasty (SimBTHA) or staged bilateral total hip arthroplasty (StaBTHA) is clinically superior. No study has compared these two procedures matching surgical approach and patient background. This study aimed to clarify the differences between SimBTHA using direct anterior approach (SimBTHA-DAA) and StaBTHA using the direct anterior approach (StaBTHA-DAA). Methods Patients who underwent THA between 2012 and 2020 were enrolled, resulting in a total of 1658 hips of 1388 patients. After propensity score matching for patient background, 204 hips of 102 patients (51 patients in each group) were examined. Clinical and radiographic outcomes, complications, intraoperative blood loss and blood transfusions (BT) were evaluated. In complications, we evaluated periprosthetic fractures, pulmonary embolism, deep venous thrombosis, surgical site infection and dislocation. Results At the final follow-up, clinical and radiographic outcomes and complications were not significantly different between the groups. Intraoperative blood loss was equivalent for SimBTHA and the sum in the first- and second-stage StaBTHA. The total-BT rate was significantly higher for SimBTHA-DAA than for StaBTHA-DAA ( p < .0001). The allogeneic BT rate was significantly higher in SimBTHA-DAA in the supine position (32.3%) than in StaBTHA-DAA (8.3%) ( p = .007). However, no patient who received autologous BT required allogeneic BT. Conclusions Clinical and radiographic outcomes were equivalent between SimBTHA-DAA and StaBTHA-DAA. The allogeneic BT rate was significantly higher in SimBTHA-DAA than in StaBTHA-DAA. Autologous BT reduced the use of allogeneic BT in SimBTHA-DAA. Auto-BT may be useful for avoiding allo-BT in SimBTHA.
Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer
Authors: McGarrah Patrick , Hubbard Joleen , Novotny Paul J. , Branda Megan E. , Sargent Daniel S. , Morton Roscoe F. , Fuchs Charles S. , Benson Al B. , Williamson Stephen K. , Findlay Brian P. , Alberts Steven R. , Goldberg Richard M. , Sloan Jeff A. 
Published: June 2023

Background Previous studies have established that higher baseline quality of life (QOL) scores are associated with improved survival in patients with metastatic colorectal cancer (mCRC). We examined the relationship between overall survival (OS) and baseline QOL. Patients and Methods A total of 1 247 patients with mCRC participating in N9741 (comparing bolus 5-FU/LV, irinotecan [IFL] vs infusional 5-FU/leucovorin [LV]/oxaliplatin [FOLFOX] vs. irinotecan/oxaliplatin [IROX]) provided data at baseline on overall QOL using a single-item linear analogue self-assessment (LASA) 0–100 point scale. The association of OS according to clinically deficient (defined as CD-QOL, score 0–50) vs not clinically deficient (nCD-QOL, score 51–100) baseline QOL scores was tested. A multivariable analysis using Cox proportional hazards modeling was performed to adjust for the effects of multiple baseline factors. An exploratory analysis was performed evaluating OS according to baseline QOL status among patients who did or did not receive second-line therapy. Results Baseline QOL was a strong predictor of OS for the whole cohort (CD-QOL vs nCD-QOL: 11.2 months vs 18.4 months, P < .0001), and in each arm IFL 12.4 vs 15.1 months, FOLFOX 11.1 months vs 20.6 months, and IROX 8.9 months vs 18.1 months. Baseline QOL was associated with baseline performance status (PS) ( P < .0001). After adjusting for PS and treatment arm, baseline QOL was still associated with OS ( P = .017). Conclusions Baseline QOL is an independent prognostic factor for OS in patients with mCRC. The demonstration that patient-assessed QOL and PS are independent prognostic indicators suggests that these assessments provide important complementary prognostic information.
Bar continuity and strain compatibility for high-strength steel reinforcement in reinforced concrete structures
Authors: Zhao Ming-Shan , Ding Miao , Chiew Singping 
Published: June 2023

High-strength steel reinforcement in grade B600 with yield strength of 600 N/mm2 is gaining popularity for its potential to reduce the total amount of reinforcement used and improve construction productivity. However, longer lapped length is required by the conventional lap splicing method for bar continuity. Besides, the conventional design methods are limiting the strength of reinforcement due to strain compatibility issue which suggest that the concrete would fail before B600 rebar yield. This study investigated the reliability of mechanical couplers as alternative splicing method. Statistical analysis showed that the performance of permanent elongation is well within the specified limit of <0.1 mm and the mean tensile strengths are 15.7%–22.1% higher than the requirement. This study also investigated the effectiveness of confinement on enhancing the strain compatibility between B600 rebars and normal concrete through finite element analysis. Results showed with adequately close stirrups, the B600 bars are able to yield and the overall load resistance could be improved by 24%–27% compared to the unconfined models.
Basic assessment of chronic cough in primary care and referral pathways of patients to different specialists
Authors: Domingo Christian , Gonzálvez Jaime , Dávila Ignacio , del Cuvillo Alfonso , Sánchez-Jareño Marta , Cea-Calvo Luis , Naberán Karlos 
Published: June 2023

Background: Chronic cough (CC; cough that lasts 8 weeks or longer) poses major effective assessment challenges. Assessment of CC may vary considerably among medical specialists. Objectives: The aim was to evaluate similarities and consistency of responses across different specialists when performing a basic assessment of CC patients in primary care, and referring patients based on clinical findings or test results. Methods: A modified Delphi approach was used. A survey with 74 statements on initial assessment of CC and referral pathways was addressed to a panel of different specialists, who voted the statements in two rounds. Results: Seventy-seven physicians [18 primary care physicians (PCPs), 24 pulmonologists, 22 allergists, and 13 ear, nose, and throat specialists] from the National Healthcare System of Spain answered the questionnaire. After two rounds, the panel reached a consensus on 63 out of the 74 proposed items (85.1%). Consensus was not reached among the panelists of at least one specialty on 15 out of these 63 agreed items. The panel agreed on those clinical aspects that should be evaluated by PCPs in all patients with CC including the impact of CC on quality of life. Agreement was reached on initial actions to be taken in primary care, including substitution of drugs that may induce cough, performing a chest X-ray, introduction of anti-reflux measures, initiation of empirical anti-reflux pharmacological therapy in some cases, and performing a spirometry with bronchodilator test and hemogram if an etiological diagnosis was not reached. The panelists agreed on a list of diseases that PCPs should assess before referring CC patients. Algorithms were developed for initial assessment and targeted referral of patients with CC from primary care. Conclusion: This study provides the perspective of different medical specialists on how to perform a basic assessment of CC patients in primary care and how and when to refer patients to other specialists.
Survival outcomes of beta-blocker usage in HER2-positive advanced breast cancer patients: a retrospective cohort study
Authors: Hsieh Hui-Hsia , Wu Tien-Yuan , Chen Chi-Hua , Kuo Yu-Hung , Hour Mann-Jen 
Published: June 2023

Background: Clinical trials investigating the effects of beta-blockers (BBs) on cancer are underway. Evidence from preclinical research suggests that BBs could serve as anticancer agents and immune boosters. There is conflicting evidence regarding the effect of BB use on clinical outcomes in patients with breast cancer. Objectives: The study aimed to determine whether BB use is associated with progression-free survival (PFS) and overall survival (OS) in patients receiving anti-human epidermal growth factor receptor 2 (HER2) treatment for advanced breast cancer. Design: Retrospective hospital-based study. Methods: The participants enrolled were breast cancer patients with advanced HER2-positive status who initiated trastuzumab monotherapy or concomitant therapy with trastuzumab and any dose of BB. The patients were enrolled between January 2012 and May 2021 and divided into three groups based on whether they received a BB or not in the therapeutic regimen: BB−/trastuzumab+, BB+ (non-selective)/trastuzumab+, and BB+ (selective)/trastuzumab+. PFS and OS were the primary and secondary endpoints, respectively. Results: The estimated median PFS in the BB−/trastuzumab+, BB+ (non-selective)/trastuzumab+, and BB+ (selective)/trastuzumab+ groups was 51.93, 21.50, and 20.77 months, respectively. The corresponding OS was 56.70, 29.10, and 27.17 months. The intergroup differences in these durations were significant. Both PFS [adjusted hazard ratio (HR): 2.21, 95% confidence interval (CI): 1.56–3.12; p < 0.001]) and OS (adjusted HR: 2.46, 95% CI: 1.69–3.57; p < 0.001) were worse when BBs were used. Conclusion: Our study provides important evidence that BB use potentially has a negative effect on patients with HER2-positive advanced breast cancer. Nevertheless, despite the study’s results, cardiovascular disease (CVD) should be appropriately treated in patients with HER2-positive advanced breast cancer. Other types of drugs can be used to treat CVD, but BB use should be avoided. Large real-world database and prospective studies should be conducted to validate the results of this study.
Ethnic diversity in the English urology workforce and BAUS leadership 2009–2020: A longitudinal study
Authors: Adasonla Kelvin , Newman Thomas , Ellis Ricky , Parry Matthew , Shrotri Nitin , Cresswell Joanne , Green James SA 
Published: June 2023

Objectives: To assess the impact of existing strategies to promote equitable progression, with respect to ethnicity, in the English urology workforce and British Association of Urological Surgeons (BAUS) leadership between 2009 and 2020. Subjects and Methods: A Freedom of Information (FOI) Act request was made to NHS Digital regarding demographic data of clinicians working in urology between 2009 and 2020. Data were collected on urology consultants, specialist registrars and specialty and associate specialist (SAS) doctors over this period. The ethnicities of British Association of Urological Surgeons (BAUS) Trustees and Council Members were determined over the same period, by review of public profiles. Results: The proportion of consultant urologists identified as White decreased from 65.5% to 53.6% ( p < 0.0001), while the proportion of Asian/Asian British consultants increased over the same period (26.9%–36.6%, p < 0.0001). There was a significant increase in Black/Black British trainees (3.0%–11.0%, p < 0.0001) but a decrease in the proportion of Asian/Asian British trainees. Over half of SAS doctors were Asian/British Asian, but this decreased over time as the proportion of white surgeons increased in this group. There was a decrease in the proportion of White urologists occupying BAUS leadership positions (80.6% to 67.6%, p = 0.5). Conclusion: Trends towards increased ethnic diversity were seen across all groups. This was most marked among consultant and SAS doctors. More limited change was observed in the urology leadership. The significance of this is unclear but may reflect a need to address barriers to progression in the highest echelons of urology leadership. The BAUS Widening Participant Group strategy aims to continue this progress, with its 10-point plan designed to support current trainees and tomorrow’s leaders with their career aims. Level of evidence: Not applicable
Adverse Gastrointestinal Events With Sodium Polystyrene Sulfonate Use in Patients on Maintenance Hemodialysis: An International Cohort Study
Authors: Farfan Ruiz Ana Cecilia , Malick Ranjeeta , Rhodes Emily , Clark Edward , Hundemer Greg , Karaboyas Angelo , Robinson Bruce , Pecoits Roberto , Sood Manish M. 
Published: June 2023

Background: There are concerns regarding the gastrointestinal (GI) safety of sodium polystyrene sulfonate (SPS), a medication commonly used in the management of hyperkalemia. Objective: To compare the risk of GI adverse events among users versus non-users of SPS in patients on maintenance hemodialysis. Design: International prospective cohort study. Setting: Seventeen countries (Dialysis Outcomes and Practice Patterns Study [DOPPS] phase 2-6 from 2002 to 2018). Patients: 50 147 adults on maintenance hemodialysis. Measurements: An adverse GI event defined by a GI hospitalization or GI fatality with SPS prescription compared with no SPS prescription. Methods: Overlap propensity score–weighted Cox models. Results: Sodium polystyrene sulfonate prescription was present in 13.4% of patients and ranged from 0.42% (Turkey) to 20.6% (Sweden) with 12.5% use in Canada. A total of 935 (1.9%) adverse GI events (140 [2.1%] with SPS, 795 [1.9%] with no SPS; absolute risk difference 0.2%) occurred. The weighted hazard ratio (HR) of a GI event was not elevated with SPS use compared with non-use (HR = 0.93, 95% confidence interval = 0.83-1.6). The results were consistent when examining fatal GI events and/or GI hospitalization separately. Limitations: Sodium polystyrene sulfonate dose and duration were unknown. Conclusions: Sodium polystyrene sulfonate use in patients on hemodialysis was not associated with a higher risk of an adverse GI event. Our findings suggest that SPS use is safe in an international cohort of maintenance hemodialysis patients.