bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between patient complexity and healthcare costs in primary care on a Japanese island: a cross-sectional study
Authors: Sugiyama Yoshifumi , Mutai Rieko , Matsushima Masato 
Published: March 2023

ObjectivesThis study aimed to elucidate the relationship between patient complexity and healthcare costs in a primary care setting on a Japanese island.DesignCross-sectional study.SettingTarama Clinic, Okinawa Miyako Hospital, on Tarama Island, Okinawa Prefecture, Japan.ParticipantsPatients who visited Tarama Clinic from 1 April 2018 to 30 June 2018, were aged 20 years or above, were resident in Tarama Village and had decision-making capacity.Outcome measuresPatient complexity scored using Patient Centred Assessment Method (PCAM), healthcare costs per person per year/visit and participant characteristics.ResultsWe included 355 study participants. The means (SD) of the total PCAM scores and healthcare costs per person per year/visit were 21.4 (5.7) and 1056.4 (952.7)/125.7 (86.7) in US dollars, respectively. Spearman’s rank correlation coefficients between the total PCAM scores and healthcare costs per person per year/visit were 0.33 and 0.28 (p values <0.0001 and <0.0001), respectively. The healthcare costs per person tended to be relatively low in the patient groups with the highest complexity. In the groups, the proportion of those with psychological conditions tended to be higher and those with cardiovascular diseases tended to be lower than in the other groups. Multiple regression analysis showed that total PCAM scores were associated with healthcare costs per person per year/visit, which were log-transformed: the regression coefficients were 3.87×10–2 and 2.34×10–2, respectively; the p values were <0.001 and <0.001, respectively.ConclusionsThis study clarified the association between patient complexity and healthcare costs in a primary care setting on a Japanese island. We found that such costs tended to be relatively low in patient groups with the highest complexity. In primary care, healthcare costs probably do not accurately reflect the value of services provided by medical institutions; it may be essential to introduce a system that provides incentives for problem-solving approaches to social issues.
MEDEA randomised intervention study protocol in Cyprus, Greece and Israel for mitigation of desert dust health effects in adults with atrial fibrillation
Authors: Anagnostopoulou Pinelopi , Kouis Panayiotis , Papatheodorou Stefania I , Middleton Nicos , Papasavvas Ilias , Avraamides Panayiotis , Simantirakis Emmanuel , Anastasiou Ioannis , Novack Victor , Stamatelatos Gerasimos , Revvas Efstathios , Kaniklides Christos , Tymvios Filippos , Savvides Chrysanthos , Koutrakis Petros , Yiallouros Panayiotis K 
Published: March 2023

IntroductionMediterranean countries experience frequent desert dust storm (DDS) events originating from neighbouring Sahara and Arabian deserts, which are associated with significant increase in mortality and hospital admissions, mostly from cardiovascular and respiratory diseases. Short-term exposure to ambient air pollution is considered as a trigger for symptomatic exacerbations of pre-existing paroxysmal atrial fibrillation (AF) and other types of heart arrhythmia. The Mitigating the Health Effects of Desert Dust Storms Using Exposure-Reduction Approaches clinical randomised intervention study in adults with AF is funded by EU LIFE+programme to evaluate the efficacy of recommendations aiming to reduce exposure to desert dust and related heart arrhythmia effects.Methods and analysisThe study is performed in three heavily exposed to desert dust regions of the Eastern Mediterranean: Cyprus, Israel and Crete-Greece. Adults with paroxysmal AF and implanted pacemaker are recruited and randomised to three parallel groups: (a) no intervention, (b) interventions to reduce outdoor exposure to desert dust, (c) interventions to reduce both outdoor and indoor exposure to particulate matter during desert dust episodes. Eligible participants are enrolled on a web-based platform which communicates, alerts and makes exposure reduction recommendations during DDS events. Exposure changes are assessed by novel tools (smartwatches with Global Positioning System and physical activity sensors, air pollution samplers assessing air quality inside and outside participant’s homes, etc). Clinical outcomes include the AF burden expressed as the percentage of time with paroxysmal AF over the total study period, the incidence of ventricular arrhythmia episodes as recorded by the participants’ pacemakers or cardioverters/defibrillators and the disease-specific Atrial Fibrillation Effect on QualiTy-of-Life questionnaire.Ethics and disseminationLocal bioethics’ authorities approved the study at all sites, according to national legislations (Cyprus: National Bioethics Committee, Data Protection Commissioner and Ministry of Health; Greece, Scientific Committee and Governing Board of the University General Hospital of Heraklion; Israel: Institutional Review Board (‘Helsinki committee’) of the Soroka University Medical Center). The findings will be publicised in peer-reviewed scientific journals, in international conferences and in professional websites and newsletters. A summary of the results and participants’ interviews will be included in a documentary in English, Greek and Hebrew.Trial registration numberClinicalTrials.gov Identifier;NCT03503812.
Metabolic syndrome and ischaemic stroke in non-anticoagulated atrial fibrillation with low CHA2DS2-VASc scores
Authors: Ahn Hyo-Jeong , Lee So-Ryoung , Choi Eue-Keun , Lee Seung-Woo , Han Kyung-Do , Kwon Soonil , Oh Seil , Lip Gregory Y.H. 
Published: March 2023

ObjectiveConflicting results have been reported on whether metabolic syndrome (MetS) confers an increased risk of ischaemic stroke in atrial fibrillation (AF). We investigated the risk of ischaemic stroke according to MetS in patients with AF who are not indicated for oral anticoagulants.MethodsA total of 76 015 oral anticoagulant-naïve patients with AF with low Congestive Heart Failure, Hypertension, Age ≥75 years (Doubled), Diabetes Mellitus, Stroke (Doubled), Vascular Disease, Age 65–74 years, Sex Category (Female) (CHA2DS2-VASc) score (0 and 1) were included from the National Health Information Database. The risk of ischaemic stroke was evaluated according to MetS, the number of MetS components (metabolic burden), and individual metabolic components defined by health examination data within 2 years of AF diagnosis.ResultsMetS was prevalent among 21 570 (28.4%) of the entire study population (mean age 49.8±11.1 years, mean CHA2DS2-VASc score 0.7±0.5). During a mean follow-up of 5.1 years, ischaemic stroke occurred in 1395 (1.84%) patients. MetS was associated with a higher risk of ischaemic stroke (adjusted HR (aHR) 1.19, 95% CI 1.06 to 1.33, p=0.002). Patients with the highest number of MetS components (4 or 5) showed the greatest aHR of 1.38 (95% CI 1.13 to 1.69), whereas those with a single component had a marginal risk of ischaemic stroke (aHR 1.17, 95% CI 0.97 to 1.40). Elevated blood pressure and increased waist circumference were independent components associated with 1.48-fold and 1.15-fold higher risks of ischaemic stroke, respectively.ConclusionAmong AF patients with CHA2DS2-VASc scores of 0 and 1 with no anticoagulation, MetS is associated with an increased risk of ischaemic stroke. Given the linear incremental association between metabolic burden and ischaemic stroke, the integrated management of metabolic derangements in AF is required.
A class of static spherically symmetric solutions in f(Q)-gravity
Authors: Calzá Marco , Sebastiani Lorenzo 
Published: March 2023

AbstractWe analyze a class of topological static spherically symmetric vacuum solutions in f(Q)-gravity. We considered an Ansatz ensuring that those solutions trivially satisfy the field equations of the theory when the non-metricity scalar is constant. In the specific, we provide and discuss local solutions in the form of black holes and traversable wormholes.
Investigating ultrafast structural dynamics using high repetition rate x-ray FEL radiation at European XFEL
Authors: Tschentscher Th. 
Published: March 2023

AbstractEuropean XFEL is an international facility providing hard and soft x-ray free-electron laser radiation for user experiments with a wide range of scientific applications. Its superconducting linear accelerator enables high repetition rate experiments with a broad range of x-ray pulse delivery patterns. The combination of time-resolved experiments, providing access to the time-domain from sub-femtoseconds to milliseconds, with atomic resolution x-ray geometric and electronic structure determination methods is responsible for the bulk of scientific applications of European XFEL. In addition, the extreme x-ray intensities and coherence properties open new methods for studying matter out of equilibrium. After start of operation in 2017, the facility now harvests scientific applications with impact to the challenge areas climate and energy, health, environment and sustainability, and digitalization. Extensions of European XFEL aim to increase performance and capabilities for new scientific applications. An upgrade of the facility in the early 2030s will increase the applicability of European XFEL to solid materials and provide dedicated instruments for improved conditions in specific research fields.
The use of in situ non-invasive techniques as powerful tools in the investigation of eighteenth century Chinese wallpapers from the National Museum of Ancient Art—Lisbon
Authors: Pressato Miriam , Lança Teresa , Miguel Catarina , Candeias António , Valadas Sara 
Published: March 2023

AbstractThe National Museum of Ancient Art in Lisbon (MNAA) hosts the most important Portuguese public collection of art. Among its different types of artworks, a set of six Chinese wallpaper panels from the eighteenth century is present; they represent the production of porcelain and have been donated to the Museum in 1949. Despite the large interest that has raised around these kinds of artefacts, few technical studies have been carried out to date on Chinese wallpapers. In this study, a non-invasive investigation of the wallpaper panels from the MNAA by means of portable devices is described. More specifically, the combined use of technical photography (namely UVF, Vis and IR photography), Vis-NIR-FORS and EDXRF allowed to carry out a preliminary diagnostic survey, which higlighted an improper handling of the wallpapers prior to their donation to the Museum, and poor conservation conditions of the paper sheets. Furthermore, it allowed for the identification of the painting technique, the main pigments, and their distribution; the presence of inorganic pigments (such as vermilion and lead white) and organic dyes (e.g. anthraquinone-based red dyes and indigo), used both as overlapping layers and mixtures, has been determined.
ConNet: Designing a Fast, Efficient, and Robust Crowd Counting Model Through Composite Compression
Authors: Masilang Regina Marie A. , Benedictos Bianca Joy R. , Tejada Mikayla M. , Marasigan Giann Jericho Mari F. , Antioquia Arren Matthew C. 
Published: March 2023

Counting the number of people in a specific area is crucial in maintaining proper crowd safety and management especially in highly-congested indoor scenarios. Recent convolutional neural network (CNN) approaches integrate auxiliary sub-networks to increase the accuracy of the model in estimating crowd size. However, these models require large computational costs due to additional calculations, resulting in an impractically slow inference speed for real-world applications. In this paper, we propose a fast, efficient, and robust crowd counting model called Condensed Network or ConNet. We utilize a composite technique composed of multiple compression methods to reduce the number of parameters of our proposed model. ConNet attains counting accuracy on par with state-of-the-art crowd counting methods on benchmark datasets featuring indoor scenes, while significantly reducing parameter count and increasing inference speed. Moreover, ConNet still performs accurately even with extreme changes in lighting conditions, image resolutions, and camera orientations. Our smallest model ConNet-04 has 61.0× less parameters and is at most 9.0× faster than the baseline approach. Our code and trained models are publicly available at https://github.com/mikatej/ConNet .
FINITE ELEMENT BIOMECHANICAL MODELING OF PAROTID GLAND MORPHING IN PATIENTS UNDERGOING RADIOTHERAPY FOR HEAD AND NECK TUMORS
Authors: ITTA FRANCESCA , MAFFEI NICOLA , D’ANGELO ELISA , MEDURI BRUNO , LOHR FRANK , GUIDI GABRIELE 
Published: March 2023

Patients treated with radiation therapy (RT) for head and neck cancer are exposed during the course of several weeks of treatment (6–7 weeks) to several physiological processes that can induce inter-fraction deformation of the parotid salivary glands (PGs). Gland morphing tends to make them move towards the high dose region of the dose distribution. As a consequence, parotids may be irradiated more than initially planned, leading to increased toxicity. We implemented a biomechanical model of the parotid morphing process that can serve as the basis to optimize adaptive RT protocols, leading to further reductions of dose to these structures. Raystation[Formula: see text] hybrid deformation algorithms and 3DSlicer[Formula: see text] tools were employed to obtain a mesh representation of PG anatomy and deformation from CT-series of eight patients treated with highly modulated radiotherapy (Tomotherapy[Formula: see text]). The biomechanical model was computationally implemented with the finite element software COMSOL[Formula: see text] multiphysics. Gland tissue was modeled as a linear elastic material with a Poisson ratio of 0.49 and a density value of 1 g/cm3. A radial force field was introduced to mimic parotid shrinkage due to radiation exposure. Fixed constraints were placed taking into account the anatomical barrier effect of parotid-surrounding structures (mandible) during the shrinkage process. The implemented biomechanical model was able to predict PG morphing with a mean volume difference of 1.36% [0.9–2.0] % between real and modeled deformed anatomy for the first half of treatment and 1.5% [0.8–2.1]% for the second half of treatment. Prediction of geometric overlap of observed versus simulated geometry as quantified using DICE was acceptable for the first half of the treatment but still unsatisfactory for the second half. Adding model components taking into account other elements that define PG morphing (facial geometry changes due to general weight loss and — in patients with significant macroscopic tumor load - local tumor volume loss) may accurately predict parotid morphing and thus permit further optimization of frequency and timing of off-line ART protocols in patients undergoing radiotherapy for head and neck cancer. This may result in a further reduction of treatment toxicity and these approaches are becoming even more important as the use of particle therapy with its increased dosimetric sensitivity towards geometric changes of the patient is slowly increasing.
Programming CAR T Cell Tumor Recognition: Tuned Antigen Sensing and Logic Gating
Authors: Hamieh Mohamad , Mansilla-Soto Jorge , Rivière Isabelle , Sadelain Michel 
Published: March 2023

AbstractThe success of chimeric antigen receptor (CAR) T cells targeting B-cell malignancies propelled the field of synthetic immunology and raised hopes to treat solid tumors in a similar fashion. Antigen escape and the paucity of tumor-restricted CAR targets are recognized challenges to fulfilling this prospect. Recent advances in CAR T cell engineering extend the toolbox of chimeric receptors available to calibrate antigen sensitivity and combine receptors to create adapted tumor-sensing T cells. Emerging engineering strategies to lower the threshold for effective antigen recognition, when needed, and enable composite antigen recognition hold great promise for overcoming tumor heterogeneity and curbing off-tumor toxicities.Significance:Improving the clinical efficacy of CAR T cell therapies will require engineering T cells that overcome heterogeneous and low-abundance target expression while minimizing reactivity to normal tissues. Recent advances in CAR design and logic gating are poised to extend the success of CAR T cell therapies beyond B-cell malignancies.
Por uma Semiose cognitiva de infância: Uma poesia contínua
Authors: Palo Maria José 
Published: March 2023

A cognição forma-se na mente do intérprete, ou torna-se um hábito ou torna-se certa forma de comportar-se mentalmente, que lhe oferece modelos mentais sob circunstâncias similares. Suas raízes múltiplas geram matrizes de ideias que nos ensinam a ver e a pensar (Deleuze; Guattari, 2012). Essa atividade cognitiva faz a mediação entre sentimento e volição e a correspondência com o signo na semiose, em exercício de significação em significação. Uma outra práxis surge na cognição dirigida pela percepção que a Literatura e as Artes privilegiam em sua linguagem aberta às coordenações de ações humanas (Maturana, 2001). Na singularidade, a Semiose cognitiva, em sistemas sígnicos e performáticos, agencia a ambivalência e a sobredeterminação do objeto de conhecimento traduzido na aprendizagem. Entende-se que a conjugação desses aspectos cognitivos e estéticos atua como medium de exploração da natureza específica da literatura para criança, denominada poeticidade, que privilegia o movimento de recriação e interpretação das potencialidades do devir (Agamben, 2008). Em resposta, esse movimento metacrítico poético – a Semiose, projeta um modo de construir matrizes do conhecimento, da informação e da aprendizagem com elementos da experiência de linguagem ou de uma poesia contínua de signos ou de uma Semiose cognitiva de infância.
“All’s Well That Starts Well”: An Intralinguistic and Interlinguistic Perspective on the Use and Translation of Well
Authors: Quinci Carla , Musacchio Maria Teresa 
Published: March 2023

Abstract
Well is one of the most widely used, versatile pragmatic markers. Given its multiple functions, it may pose translation challenges, especially in hybrid oral texts translated to be read rather than heard. This paper investigates the presence and function of the pragmatic marker well in a parallel, aligned corpus of English TED Talk transcripts and their Italian translations. All occurrences of well in the English subcorpus were identified and classified to observe whether and how this marker was translated in the Italian transcripts. In the English subcorpus, well is found in sentence-/clause-initial position to introduce (a) rhetorical questions, (b) fictitious turn-takings between the speaker and other fictitious addressees, and (c) quotations. It was generally translated through a limited set of equivalents, which testifies to the standard approach used to transfer the pragmatic meaning of well into Italian, mostly relying on dictionary-based direct equivalents, e.g. beh and its orthographical variants.
Turkana Low-Level Jet Influence on Southwest Ethiopia Climate
Authors: Jury Mark R. , Minda Thomas T. 
Published: March 2023

Abstract
The Turkana Jet in northern Kenya is shown to modulate the climate of southwest Ethiopia’s Omo River Valley using in situ hydrometeorological data, satellite measurements, and atmospheric reanalyses from decadal to diurnal time scales. Temporal statistics from lowland (2.5°–5°N, 35°–38°E) and highland (6°–9°N, 35°–38°E) areas show that 850-hPa westward airflow over Lake Turkana is stronger in March and October but is weakened when western Indian Ocean sea temperatures become warmer than usual at intervals of 2–7 years. A case study on 24 March 2019 reveals how a stronger Turkana Jet induces warming and drying of the Omo Valley. A second case study on 27 September 2018 reveals Hadley cell subsidence over the southern flank of the Turkana Jet. We demonstrate how nocturnal airflow draining off the mountains joins the channelized jet. Satellite and atmospheric reanalyses exhibit realistic diurnal cycles in the east Omo mountains, but some products have incorrect phase and warm bias. Omo Valley soil moisture and runoff exhibit little trend in historical records and model projections; however, unpredictable multiyear wet and dry spells and a growing demand for water are ongoing concerns.
Double-Effect Donation or Bodily Respect? A “Third Way” Response to Camosy and Vukov
Authors: McCarthy Anthony , Watt Helen 
Published: March 2023

Is it possible to donate unpaired vital organs, foreseeing but not intending one's own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on “double effect donation.” Where we disagree with these authors is that we see double-effect donation not as a morally praiseworthy act akin to martyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity goes beyond avoiding the aim to kill: not all side effects of deliberate bodily interventions can be outweighed by intended benefits for another even if the subject fully consents. It is not any necessary intention to kill or harm another or oneself that makes lethal donation/harvesting illicit but the more immediate intention to accept or perform surgery on an (innocent) person combined with the foresight of lethal harm and no health-related good for him or her. Double-effect donation falls foul of the first condition of double-effect reasoning in that the immediate act is wrong in itself. We argue further that the wider effects of such donation would be socially disastrous and corrupting of the medical profession: doctors should retain a sense of nonnegotiable respect for bodily integrity even when they intervene on willing subjects for the benefit of others. Summary: Lethal organ donation (for example, donating one's heart) is not a praiseworthy but a morally impermissible act. This is not because such donation necessarily involves any aim to kill oneself (if one is the donor) or to kill the donor (if one is the surgeon). Respect for bodily integrity goes beyond avoiding any hypothetical aim to kill or harm oneself or another innocent person. ‘Double effect donation’ of unpaired vital organs, defended by Camosy and Vukov, is in our view a form of lethal bodily abuse and would also harm the transplant team, the medical profession and society at large.
Mental Toughness and Resilience in Trail Runner’s Performance
Authors: Gameiro Nuno , Rodrigues Filipe , Antunes Raúl , Matos Rui , Amaro Nuno , Jacinto Miguel , Monteiro Diogo 
Published: March 2023

Our purpose with this study was to analyze trail runners’ psychological variables of mental toughness (MT) and resilience, and their associations with runners’ performances within a quantitative cross-sectional study. In total, we analyzed data from 307 Portuguese trail runners (60 female, 247 male), aged between 20 to 66 years ( M age = 41.98; SD = 7.74). The results showed that the measurement model, including the factors of MT, resilience, and performance variables, exhibited an adequate fit to the data: χ 2 = 150.01 (74); BS-p = .003; CFI= .953; TLI = .942; RMSEA = .058 90% (.045, .071) and SRMR= .042. Standardized direct effects revealed positive associations between these variables. More specifically: (a) MT was significantly associated with resilience; and (b) resilience was significantly associated with performance. The indirect regression paths showed that MT was positively associated with performance, with resilience considered a possible mediator ( β = .09 IC = .010, .168; p = .02). In total, considering direct and indirect effects, the model explained 21% of performance variance among trail runners.