bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sudden Cardiac Arrests During the 2021 Taipei Marathon after COVID-19 Confinement in Taiwan
Authors: Chiu Yu-Hui , Chen Chun , Chien Ding-Kuo , Chang Kuo-Song 
Published: June 2023

Introduction:Large-scale mass-sporting events pose unique challenges for emergency health teams. Data is limited in athletes with sudden cardiac arrests (SCAs) and the emergency medical services (EMS) in major sporting events that took place after the coronavirus pandemic.Method:This retrospective observational study describes data from the Taipei Marathon event that took place on December 19, 2021, in Taiwan. The temperature was about 15.2–19.3°C. Four SCAs among 18,144 half-marathoners and the EMS were enrolled.A medical command center was set up 100 meters from the finish line. Ten medical tents, one first-aid station, and nine event ambulances were distributed along the course, and one medical tent was placed near the baggage storage area. Each medical tent comprised: 1 doctor, 1–3 nurses, and 1–3 paramedics. The in-event EMS also comprised a mobile first-aid team. Thirty paramedics rode motorcycles and carried automated external defibrillators and emergency medical kits throughout the racecourse.Results:Among the 7,811 full- and 18,144 half-marathoners, the total number of SCAs was four male half-marathoners. Three runners (75%) stated that they decreased their weekly running volume during the pandemic restrictions’ period. Two runners (50%) experienced cardiac arrest in the final quarter of the race. The median interval of time between SCA occurrence and EMS arrival was 2.5 minutes (interquartile range, 0.5–4 minutes). Electric shocks were delivered to all the four runners (100%) experiencing ventricular fibrillation, and all of them were successfully resuscitated in the field. The median interval of cardiopulmonary resuscitation duration before return of spontaneous circulation was 8.5 minutes (interquartile range, 6–9.5 minutes).Conclusion:4/18144 is a significantly high number of SCA compared to data from the annual Taipei Half-Marathon between 2016 and 2020 and past half-marathons worldwide. The high prevalence rate of SCA (22 per 100,000) may be due to inadequate acclimation and training volumes.
Considerations for Pediatric Mass Shooting Triage Training: A Qualitative Analysis
Authors: Davis Morgan , Cayer Suzanne , Cicero Mark 
Published: June 2023

Introduction:Accurate triage is crucial for pediatric patients because their physiological differences make them more vulnerable to traumatic injury and mortality. However, pediatric trauma patients are challenging for EMS personnel for several reasons including infrequent clinical encounters and inadequate training. Despite the need for increased training, little is known about EMS readiness to perform triage and lifesaving interventions during pediatric mass casualty incidents (MCIs). Simulation skills assessment correlates with EMS performance in the field and can be used to determine MCI readiness.Pediatric patients are often omitted from MCI training and protocols. Feedback from EMS clinicians who participate in pediatric MCI simulations may be useful for educators seeking to optimize pediatric mass shooting triage training.Method:This was an observational study assessing EMS clinician accuracy in triaging eight children and two adults in a mass shooting simulation involving intimate partner violence (IPV) set at a private residence. Participating EMS clinicians were attendees of continuing education classes at Yale New Haven Health Centers for EMS. Participants worked in pairs, and triage decisions were documented during the simulation with an evaluation tool and video recording. After the simulation, pairs completed the demographic survey and completed a semi-structured debriefing. Facilitator prompts included correct triage level for each patient, the role IPV plays in mass shootings, and the participants feedback. Recordings of the debriefings were transcribed and analyzed using grounded theory. During the evaluation process, the major themes will be identified and coded. The transcriptions will be re-evaluated and any additional sub-themes will be identified and coded.Results:As of November 2022, eight paramedics have participated with more sessions scheduled for spring 2023. A preliminary review indicates potential themes will fall under the categories of simulation implementation and clinical approach to triage.Conclusion:These findings may assist EMS agencies with their pediatric MCI training and response.
Improving Hospital Preparedness for Pediatric Abductions
Authors: Pandya Jay , Guzman Jennifer , Roblin Patricia , Daniel Pia 
Published: June 2023

Introduction:In the United States, 840,000 children are reported missing annually. While no concise data is available on the incidence from healthcare facilities, infant and child abductions and elopement events pose a high risk to infants and hospital staff. Following an update on the missing child and missing infant policy at a tertiary care hospital in New York, the hospital’s emergency preparedness team conducted a full-scale hospital drill. The drill included input and participation from administration, nursing, hospital police, and the pediatric department.Method:New updates in the policy which had not been tested before were evaluated during this drill, including plain language verbiage to activate a code, the process of alerting hospital police of the missing pediatric patient, hospital police response, and the response of hospital staff in their work areas. Inpatient pediatric wards, the emergency department, and outpatient clinics were given teaching about the new policy and their responsibilities in the event of a missing child or infant. Evaluators were pre-selected and placed throughout the hospital. Afterward, controllers de-briefed with each of the evaluators as well as with hospital personnel in areas that did not receive teaching on the policy.Results:The areas that did not receive in-person training on the policy update wanted to assist but did not know how to respond and did not follow protocol for securing their areas. Furthermore, areas of the hospital were identified where the overhead paging system did not work as well as gaps in hospital police staffing to cover key hospital exit points.Conclusion:This drill revealed that all hospital personnel need dedicated and personalized training on policy updates highlighting their roles in response, communication lines need to be tested, and plans to address concurrent clinical emergencies need to be formulated.
Fire in the Hole: Modeling the Thermal Effects of a Nuclear Detonation in an Urban Environment
Authors: Taylor Morgan , Bell William , Harris Curt 
Published: June 2023

Introduction:In general, models for thermal effects of nuclear weapons are not as well developed as models for blast and radiation effects, yet casualties resulting from fires and burns in a nuclear detonation would significantly impact civil defense and emergency healthcare. Previous studies have conducted in-depth analysis of the various atmospheric conditions that affect the thermal radiation transmissivity. However, such models have yet to consider the role that buildings play in the urban environment to estimate the casualties from the thermal effect more accurately.Method:A three-dimensional model of the area within a three-mile radius of the detonation site in Atlanta, Georgia, USA was created in Blender. To represent the thermal energy resulting from a 15 kiloton, near-surface burst, a point light was created with a power of 96,725 gigawatts and a radius of 81 meters. Using the Cycles render engine, the resulting light/shadow was orthographically captured directly above the scene.Results:The rendered model demonstrated the attenuating effects of the built, urban environment. Nearly half (46.82%) of the pixels in the resulting raster were black, or regions that were not exposed to any thermal energy. Slightly less than a quarter (22.32%) of the pixels were white or light gray, or regions that received mostly direct thermal energy. The remaining regions (30.86% of the pixels) were dark gray, or regions that were initially in shadow from the thermal pulse but received thermal energy via reflection from nearby buildings.Conclusion:As the thermal pulse travels at the speed of light, it arrives at a location before the blast wave. As such, the built urban environment offers protection from the thermal energy released during a nuclear detonation. Future studies that incorporate this thermal model may more accurately determine the quantity and geospatial distribution of burn casualties in the aftermath of a nuclear detonation.
Screening for depression as part of annual diabetic review using PHQ-9 scores: a pilot study
Authors: Asim Rabeeah , Asim Muhammad , Reddy Rajah , Chepulis Lynne , Lawrenson Ross 
Published: June 2023

Abstract
Diabetes mellitus is associated with an increased risk of depression. Appropriate screening and treatment of depression may therefore support diabetes management in primary care. Study aim was to review the efficacy of using a Patient Health Questionnaire – (PHQ-9) tool to screen for depression in patients with type 2 diabetes mellitus (T2DM) in New Zealand.
It was a cross-sectional study that included 100 consecutive patients with T2DM from two urban practices in Hamilton, New Zealand. Patients were screened using PHQ-9 scores.
Using the PHQ-9, the overall prevalence of depression was 29% including 11 patients under active management/prescribing for depression and 18 undiagnosed patients. By ethnicity, depression affected 41.3%, 33.0%, 25.0% and 13.3% of NZ European, Māori, Pacific and other ethnicities, respectively. PHQ-9 scoring is an easy to administer tool that can be used to screen for unrecognized depression in patients with diabetes as a part of an annual diabetic review.
Creation Stories: What Were the First Resource Churches?
Authors: Shepherd Jack 
Published: June 2023

AbstractThis article builds on the first in the trilogy, ‘What’s in a Name? An Examination of Current Definitions of Resource Churches’, by evaluating narratives in current literature about the origins of resource churches. These will be assessed according to the criteria, highlighted through the perspective of Foucault and Arendt on origin stories, of believability in their depiction of historical events, application to the manifest properties of contemporary resource churches, teleological purpose, and attentiveness to conflict. The origin, or creation, stories to be examined particularly consider the formation and development of resource churches in relation to the first century and Anglo-Saxon England, as well as following the start of the parish system.
Causal mechanisms of common barriers to national adaptation policy processes and practical solutions in South Korea and the UK
Authors: Lee Seunghan , Paavola Jouni , Dessai Suraje 
Published: June 2023

Non-technical SummaryAs adaptation deficits become increasingly evident and widespread, barriers to adaptation draw more attention as a key reason. However, the current understanding of the barriers is limited, making it challenging to provide practical solutions for real-world adaptation policy processes. This study aims to identify the origins, influences, and relationships of common barriers to national adaptation policy processes, and to analyse their causal mechanisms. The findings present a barrier map that illustrates potential causal mechanisms of common barriers to national adaptation policy processes and, based on it, suggest a systematic approach for practical solutions.Technical SummaryDespite progress in national adaptation policies in the last two decades, the adaptation deficit is getting wider and barriers to adaptation are regarded as a key reason for it. However, our understanding of barriers to adaptation does not help improve real adaptation processes. Based on South Korean and UK cases, this study identified 17 common barriers to national adaptation policy processes and placed them in four categories. It also identified the barriers' origins and influences, drew a common barrier map underlying national adaptation policy processes and identified causal mechanisms of the common barriers, which were limitedly addressed in the earlier literature. The results highlight that understanding the causal mechanisms of barriers to national adaptation policy processes is important to devise practical solutions to overcome barriers and improve the effectiveness of real adaptation processes. The findings also offer a practical understanding of common barriers to national adaptation policy, which can help adaptation policy stakeholders and practitioners to diagnose policy problems, analyse what barriers and origins are related to the problems, decide what should be addressed first to solve the problems, and ultimately make efforts to reduce the current adaptation deficit.Social Media SummaryNew study identifies causal mechanisms of 17 common barriers to national adaptation policy processes & suggests a systematic approach to overcome the barriers.
Well Advised
Authors: Perry Julia , Brose Julia , Radenbach Katrin 
Published: June 2023

Abstract: Societal and scientific interest in the prediction and early diagnosis of Alzheimer’s disease is growing. However, decisions regarding early diagnosis must be well-considered. The decision-making process requires specific counseling for concerned individuals, which is currently missing. In our project “Well Advised”, we investigate the needs and expectations of people concerned about their memory regarding counseling services in Germany. Using a mixed-methods approach, we analyze the evaluative interviews from telephone counseling ( n = 44) and one expert focus group with 4 participants. Our evaluation shows a great need for information; the low-threshold telephone counseling service is appreciated. The topics of interest of those seeking advice concern medical-ethical issues of autonomy, the right (not) to know, and risk-benefit considerations. From these findings, we developed a training module and counseling guideline.
Forecasting Magnitude and Frequency of Seasonal Streamflow Extremes Using a Bayesian Hierarchical Framework
Authors: Ossandón Álvaro , Rajagopalan Balaji , Kleiber William 
Published: June 2023

AbstractWe develop a space‐time Bayesian hierarchical modeling (BHM) framework for two flood risk attributes—seasonal daily maximum flow and the number of events that exceed a threshold during a season (NEETM)—at a suite of gauge locations on a river network. The model uses generalized extreme value (GEV) and Poisson distributions as marginals for these flood attributes with non‐stationary parameters. The rate parameters of the Poisson distribution and location, scale, and shape parameters of the GEV are modeled as linear functions of suitable covariates. Gaussian copulas are applied to capture the spatial dependence. The best covariates are selected using the Watanabe‐Akaike information criterion (WAIC). The modeling framework results in the posterior distribution of the flood attributes at all the gauges and various lead times. We demonstrate the utility of this modeling framework to forecast the flood risk attributes during the summer peak monsoon season (July‐August) at five gauges in the Narmada River basin (NRB) of West‐Central India for several lead times (0–3 months). As potential covariates, we consider climate indices such as El Niño–Southern Oscillation (ENSO), the Indian Ocean Dipole (IOD), and the Pacific Warm Pool Region (PWPR) from antecedent seasons, which have shown strong teleconnections with the Indian monsoon. We also include new indices related to the East Pacific and West Indian Ocean regions depending on the lead times. We show useful long lead skill from this modeling approach which has a strong potential to enable robust risk‐based flood mitigation and adaptation strategies 3 months before flood occurrences.
Variations in Global Soil Moisture During the Past Decades: Climate or Human Causes?
Authors: Liu Yangxiaoyue , Yang Yaping , Song Jia 
Published: June 2023

AbstractAs a sensitive climate change indicator, global multi‐depth soil moisture (SM) has undergone great variation due to warming trends during the past decades. Here, we investigate the evolutionary pattern of SM and then carry out an attribution analysis from climate and human perspectives. The results reveal an unbalanced surface and rootzone variation trend during 1980–2020. The surface soil had approximately equal proportions of drying and wetting. Nonetheless, the percentage of the wetting region is significantly higher than that of the drying region for rootzone soil. The significantly drying region is mainly distributed in habitable areas, while the remarkably wetting region is usually located in the harsh climate and tropical humid zones. According to the attribution analysis using the Feature Importance Index of the Random Forest model, Pearson correlation coefficient, Maximum information coefficient, Spearman rank correlation coefficient, and Granger causality with 99% statistical significance, both climatic and human factors presented significant impacts on SM. Specifically, air temperature and evaporation are thought to be the primary climatic factors affecting the seasonal and long‐term variability of SM, respectively. Irrigation water withdrawal is regarded as the dominant driving force of SM variation among six human water withdrawals, and domestic and electricity water withdrawals play indispensable roles in SM fluctuation. Additionally, SM also provides profound feedbacks on climatic factors and human water withdrawals. The global spatial‐temporal SM variation along with warming temperatures could seriously risk food security and sustainable development, which needs to be addressed.
Tbit/s line-rate satellite feeder links enabled by coherent modulation and full-adaptive optics
Authors: Horst Yannik , Bitachon Bertold Ian , Kulmer Laurenz , Brun Jannik , Blatter Tobias , Conan Jean-Marc , Montmerle-Bonnefois Aurélie , Montri Joseph , Sorrente Béatrice , Lim Caroline B. , Védrenne Nicolas , Matter Daniel , Pommarel Loann , Baeuerle Benedikt , Leuthold Juerg 
Published: June 2023

AbstractFree-space optical (FSO) communication technologies constitute a solution to cope with the bandwidth demand of future satellite-ground networks. They may overcome the RF bottleneck and attain data rates in the order of Tbit/s with only a handful of ground stations. Here, we demonstrate single-carrier Tbit/s line-rate transmission over a free-space channel of 53.42 km between the Jungfraujoch mountain top (3700 m) in the Swiss Alps and the Zimmerwald Observatory (895 m) near the city of Bern, achieving net-rates of up to 0.94 Tbit/s. With this scenario a satellite-ground feeder link is mimicked under turbulent conditions. Despite adverse conditions high throughput was achieved by employing a full adaptive optics system to correct the distorted wavefront of the channel and by using polarization-multiplexed high-order complex modulation formats. It was found that adaptive optics does not distort the reception of coherent modulation formats. Also, we introduce constellation modulation – a new four-dimensional BPSK (4D-BPSK) modulation format as a technique to transmit high data rates under lowest SNR. This way we show 53 km FSO transmission of 13.3 Gbit/s and 210 Gbit/s with as little as 4.3 and 7.8 photons per bit, respectively, at a bit-error ratio of 1 ∙ 10−3. The experiments show that advanced coherent modulation coding in combination with full adaptive optical filtering are proper means to make next-generation Tbit/s satellite communications practical.
Global branches and local states of the human gut microbiome define associations with environmental and intrinsic factors
Authors: Tap Julien , Lejzerowicz Franck , Cotillard Aurélie , Pichaud Matthieu , McDonald Daniel , Song Se Jin , Knight Rob , Veiga Patrick , Derrien Muriel 
Published: June 2023

AbstractThe gut microbiome is important for human health, yet modulation requires more insight into inter-individual variation. Here, we explored latent structures of the human gut microbiome across the human lifespan, applying partitioning, pseudotime, and ordination approaches to >35,000 samples. Specifically, three major gut microbiome branches were identified, within which multiple partitions were observed in adulthood, with differential abundances of species along branches. Different compositions and metabolic functions characterized the branches’ tips, reflecting ecological differences. An unsupervised network analysis from longitudinal data from 745 individuals showed that partitions exhibited connected gut microbiome states rather than over-partitioning. Stability in the Bacteroides-enriched branch was associated with specific ratios of Faecalibacterium:Bacteroides. We also showed that associations with factors (intrinsic and extrinsic) could be generic, branch- or partition-specific. Our ecological framework for cross-sectional and longitudinal data allows a better understanding of overall variation in the human gut microbiome and disentangles factors associated with specific configurations.
Disentangling the impact of Atlantic Niño on sea-air CO2 flux
Authors: Koseki Shunya , Tjiputra Jerry , Fransner Filippa , Crespo Lander R. , Keenlyside Noel S. 
Published: June 2023

AbstractAtlantic Niño is a major tropical interannual climate variability mode of the sea surface temperature (SST) that occurs during boreal summer and shares many similarities with the tropical Pacific El Niño. Although the tropical Atlantic is an important source of CO2 to the atmosphere, the impact of Atlantic Niño on the sea-air CO2 exchange is not well understood. Here we show that the Atlantic Niño enhances (weakens) CO2 outgassing in the central (western) tropical Atlantic. In the western basin, freshwater-induced changes in surface salinity, which considerably modulate the surface ocean CO2 partial pressure (pCO2), are the primary driver for the observed CO2 flux variations. In contrast, pCO2 anomalies in the central basin are dominated by the SST-driven solubility change. This multi-variable mechanism for pCO2 anomaly differs remarkably from the Pacific where the response is predominantly controlled by upwelling-induced dissolved inorganic carbon anomalies. The contrasting behavior is characterized by the high CO2 buffering capacity in the Atlantic, where the subsurface water mass contains higher alkalinity than in the Pacific.