bluuebunny/crossref_metadata_2025_split huggingface dataset:
Black hole feeding and feedback in a compact galaxy
Authors: Di Yihuan , Li Yuan , Yuan Feng , Shi Fangzheng , Caradonna Mirielle 
Published: May 2023

ABSTRACT
We perform high-resolution hydrodynamical simulations using the framework of MACER to investigate supermassive black hole (SMBH) feeding and feedback in a massive compact galaxy, which has a small effective radius but a large stellar mass, with a simulation duration of 10 Gyr. We compare the results with a reference galaxy with a similar stellar mass but a less concentrated stellar density distribution, as typically found in local elliptical galaxies. We find that about 10 per cent of the time, the compact galaxy develops multiphase gas within a few kpc, but the accretion flow through the inner boundary below the Bondi radius is always a single phase. The inflow rate in the compact galaxy is several times larger than in the reference galaxy, mainly due to the higher gas density caused by the more compact stellar distribution. Such a higher inflow rate results in stronger SMBH feeding and feedback and a larger fountain-like inflow-outflow structure. Compared to the reference galaxy, the star formation rate in the compact galaxy is roughly two orders of magnitude higher but is still low enough to be considered quiescent. Over the whole evolution period, the black hole mass grows by ∼50 per cent in the compact galaxy, much larger than the value of ∼ 3 per cent in the reference galaxy.
Star cluster formation from turbulent clumps – III. Across the mass spectrum
Authors: Farias Juan P , Tan Jonathan C 
Published: May 2023

ABSTRACT
We study the formation and early evolution of star clusters that have a wide range of masses and background cloud mass surface densities, Σcloud, which help set the initial sizes, densities, and velocity dispersions of the natal gas clumps. Initial clump masses of 300, 3000, and 30 000 M⊙ are considered, from which star clusters are born with an assumed 50 per cent overall star formation efficiency and with 50 per cent primordial binarity. This formation is gradual, i.e. with a range of star formation efficiencies per free-fall time from 1 to 100 per cent, so that the formation time can range from 0.7 Myr for low-mass, high-Σcloud clumps to ∼30 Myr for high-mass, low-Σcloud clumps. Within this framework of the turbulent clump model, for a given Σcloud, clumps of higher mass are of lower initial volume density, but their dynamical evolution leads to higher bound fractions and causes them to form much higher density cluster cores and maintain these densities for longer periods. This results in systematic differences in the evolution of binary properties, degrees of mass segregation, and rates of creation of dynamically ejected runaways. We discuss the implications of these results for observed star clusters and stellar populations.
A small survey for massive stars in the LMC/SMC: binaries and pulsations
Authors: Çakırlı Ömür , Hoyman Barış , Özdarcan Orkun 
Published: May 2023

ABSTRACT
Binarity and pulsations are two notable properties that frequently appear together in massive stars. To place constraints on how binarity affects stellar evolution, the exact parameters of massive stars in binary systems must be known. Their exact and accurate masses and radii, which were calculated from binary dynamics, present model-independent restrictions and challenge existing theories of stellar evolution. In this investigation, our goal is to determine the atmospheric characteristics of nine double-lined spectroscopic binaries that are located in the Large Magellanic Cloud and Small Magellanic Cloud. Nine newly discovered double-lined eclipsing binaries with B-type massive components have been studied; these binaries were found using the OGLE variable star catalogues. The absolute physical parameters of each component have been measured with an accuracy of less than or equal to 3 per cent. By analysing through Transiting Exoplanet Survey Satellite data of the systems, we were able to identify five candidates for slowly pulsating B stars in massive binary systems with masses ranging from 2 to 25 M⊙. According to the results of the preliminary research, the orbital periods of these binary systems span anywhere from 1.8 to 6.3 d, whereas the pulsating periods range anywhere from 0.3 to 1.5 d. The achievement in identifying a significant number of pulsating eclipsing systems opens the door to the initial sensible approach of constraining the internal physics of a group of massive stars via asteroseismology of eclipsing binaries including such stars.
Chaco War
Authors: Shesko Elizabeth 
Published: May 2023

For twenty-seven months between 1932 and 1935, Bolivia and Paraguay fought an active war over the Chaco Boreal. Sparsely populated by Indigenous groups, the disputed area lay north of the Pilcomayo River, where the two countries share borders with one another, Argentina, and Brazil. It was a punishing landscape for war, with few water sources except during the rainy season, when scrubland turned to mud and made the region virtually impassable. The conflict’s origins lay in boundaries that had been poorly defined during the formation of these nation-states in the nineteenth century, but the proximate cause was nationalist efforts to develop the region and improve export routes. Fought in the interwar period with the tools of modern warfare, the Chaco War holds important lessons for military historians. Airpower played a role, but it was primarily an infantry war because the terrain made cavalry and tanks of little use. The Chaco War was the deadliest interstate conflict in 20th-century Latin America. The belligerents depleted their coffers, mobilized between 10 and 15 percent of their populations, and suffered at least 25 percent casualty rates. Bolivia’s forces had three commanders during the war, including German General Hans Kundt (b. 1869–d. 1939), while Paraguay was capably led by Mariscal José Félix Estigarribia (b. 1888–d. 1940). Paraguay was the clear victor, gaining more territory than it claimed prior to the war but less than it held at the end of the conflict. In both countries, the war had profound effects and led to the end of the liberal period. In Paraguay, Colonel Rafael Franco (b. 1896–d. 1973) overthrew President Eusebio Ayala (b. 1875–d. 1942) in February 1936, in what is known as the Febrerista Revolution, and established a populist administration emphasizing veterans’ needs. Bolivia’s postwar period was characterized by instability until the 1952 Revolution by the Revolutionary Nationalist Movement (MNR), which emphasized wartime sacrifice. The literature on the Chaco War is extensive, but most publications are Spanish-language firsthand accounts and partisan histories. This bibliographic guide contains most of the English-language scholarship available along with some of the more important and widely available titles in Spanish. Much work remains to understand this conflict and the impact of veterans on these societies, but scholars have begun to mine military archives to offer less nationalistic accounts and have made significant headway in revealing the impact on the region’s Indigenous inhabitants.
Specialty Differences in Medical Aid in Dying Experiences: Results of a Survey of Physicians in Colorado
Authors: Kessler Elizabeth R , Ressalam Julie , DeCamp Matthew , Lum Hillary D , Kini Vinay , Campbell Eric G 
Published: May 2023

Abstract
In Colorado, medical aid in dying (MAiD) is legal, allowing a terminally ill person to request a prescription and self-administer a medication to end their life. Such requests are granted under certain circumstances, including a malignant neoplasm diagnosis, with a goal of peaceful death. This study examined differences in attitudes and actual participation in MAiD between oncologists and non-oncologists, using data from a recent survey of physicians regarding MAiD.
Collating Piers Plowman in Archbishop Parker’s Household
Authors: Warner Lawrence 
Published: May 2023

Abstract
This essay brings to light the most substantial episodes of textual scholarship on Piers Plowman to have occurred over the space of 300-odd years, of which one certainly, the other likely, took place in the household of Archbishop Matthew Parker. The former consists of a series of red numbers inscribed next to lines in two passus of the C-version copy Cambridge, Corpus Christi MS 293, which are shown to refer to the pages on which the equivalent lines appear in a sixteenth-century printed edition of Piers B, reflecting careful comparison of their respective texts. The latter is manifested in the ‘correction’ of a portion of the C-text manuscript London, British Library, MS Royal 18 B xvii so as to bring it into line with its equivalent in a printed edition of B. The placement of the lines is suggestive of access by the corrector to unbound printed matter. This episode, so it is argued, is most intelligible in the context of such episodes of correction as that in which John Joscelyn, Parker’s secretary, engaged. A sub-theme of the essay is that Stephan Batman’s putative centrality to the topic of the Parkerian Piers is not supported by any evidence.
SURVEY OF COMPUTED TOMOGRAPHY PRACTICE IN UKRAINE AND ESTABLISHMENT OF NATIONAL DIAGNOSTIC REFERENCE LEVELS FOR MOST COMMON CT EXAMINATIONS OF ADULTS
Authors: Stadnyk Larysa , Nosyk Olga , Tonkopi Elena , Boguslavska Alexandra , Vassileva Jenia 
Published: May 2023

Abstract
This study reports results of the first nationwide survey of computed tomography (CT) practice in Ukraine and proposed national diagnostic reference levels (DRLs) for common CT examinations. The collected data included characteristics of CT scanners, frequency of CT exams per anatomical region, dose indices CTDIvol and dose-length product (DLP). National DRLs were proposed at the 75th percentile of median dose indices distributions for four common CT protocols: head without contrast (brain examinations for stroke and trauma), routine chest without contrast, single-phase contrast-enhanced CT of abdomen and pelvis and oncology protocol (chest–abdomen–pelvis). The results showed 4- to 9-fold variations of median dose indices between CT scanners for the same type of examination. The following values of the CTDIvol and DLP were proposed as national DRLs: 59 mGy and 1130 mGy•cm for head, 14 mGy and 492 mGy•cm for chest, 22 mGy and 845 mGy•cm for abdomen/pelvis and 2120 mGy•cm for oncological protocol.
Impact of Selective Immunosuppressive Therapy on Subsequent Immune-Related Adverse Events After Immune Checkpoint Inhibitor-Induced Colitis Treatment
Authors: Pizuorno Machado Antonio , Shatila Malek , Glitza Oliva Isabella C. , Altan Mehmet , Siddiqui Bilal , Zhou Yan , Varatharajalu Krishnavathana , Zhang Hao Chi , Thomas Anusha , Wang Yinghong 
Published: May 2023

Objectives:
Immune checkpoint inhibitors (ICI) can cause immune-related adverse events (irAEs) such as colitis. irAEs can be managed by selective immunosuppressive therapy (SIT) agents such as infliximab and vedolizumab. We aimed to elucidate the incidence of subsequent new irAEs after exposure to SIT by describing patients’ clinical course.

Methods:
We conducted a retrospective chart review of adult patients at a tertiary cancer center diagnosed with ICI-mediated colitis (IMC) treated with SIT from February 2013 through October 2021. Patients’ clinical courses, treatments, and outcomes of new irAEs after SIT were collected and analyzed.

Results:
The study included 156 patients. Most were male (67.3%), 44.8% had melanoma, and 43.5% received anti-PD1/L1 ICIs. For IMC treatment, 51.9% received infliximab and 37.8% received vedolizumab. Twenty-six patients (16.6%) resumed ICI treatment after their colitis event. Twenty-five patients (16%) developed a new irAE after receiving SIT. The most common new irAE involved skin (44%), and most (60%) were treated with steroids. Higher diarrhea grade and ≥2 doses of SIT were associated with lower incidence of post-SIT irAEs (P=0.038, P=0.050). However, the type of SIT or individual dosage of infliximab did not affect the occurrence of subsequent irAEs.

Conclusions:
New irAEs usually occur more than 6 months after SIT completion for initial colitis event. Severe diarrhea grade and higher number of SIT infusions appeared to have protective effect to lower the occurrence of new irAEs. Otherwise, the type of SIT or individual dosage of infliximab did not affect the occurrence of subsequent irAEs.
Postoperative recovery after breast cancer surgery
Authors: Zhang Qingfen , Wu Yaqing , An Haiyan , Feng Yi 
Published: May 2023

BACKGROUND
Perioperative use of opioids has revealed significant adverse effects associated with poor postoperative outcomes.

OBJECTIVE
To determine whether opioid-free anaesthesia based on thoracic paravertebral block (TPVB) could improve postoperative recovery after breast cancer surgery.

DESIGN
A randomised controlled trial.

SETTING
A tertiary teaching hospital.

PATIENTS
Eighty adult women undergoing breast cancer surgery were enrolled. Key exclusion criteria included remote metastasis (but not to axillary lymph nodes of the surgical side), contraindication to interventions or drugs and a history of chronic pain or chronic opioid use.

INTERVENTIONS
Eligible patients were randomised at a 1 : 1 ratio to receive either TPVB-based opioid-free anaesthesia (OFA group) or opioid-based anaesthesia (control group).

MAIN OUTCOME MEASURES
The primary outcome was the global score of the 15-item Quality of Recovery (QoR-15) questionnaire at 24 h after surgery. Secondary outcomes included postoperative pain and health-related quality of life.

RESULTS
The QoR-15 global score was 140.3 ± 5.2 in the OFA group and 132.0 ± 12.0 in the control group (P < 0.001). The percentage of patients with good recovery (QoR-15 global score ≥118) was 100% (40/40) in the OFA group and 82.5% (33/40) in the control group (P = 0.012). Improved QoR in the OFA group was also evident in sensitivity analysis that rated QoR as excellent for a score of 136 to 150, as good at 122 to 135, as moderate at 90 to 121 and as poor at 0 to 89. The OFA group had higher scores in the domains of physical comfort (45.7 ± 3.0 versus 41.8 ± 5.7, P < 0.001) and physical independence (18.3 ± 2.2 versus 16.3 ± 4.5, P = 0.014). The two groups did not differ in pain outcomes or health-related quality of life.

CONCLUSION
TPVB-based opioid-free anaesthesia improved early postoperative quality of recovery without compromising pain control in patients undergoing breast cancer surgery.

TRIAL REGISTRATION
Clinicaltrials.gov; Identifier: NCT04390698.
Impact of HEART Score Decision Aid on Coronary Computed Tomography Angiography Utilization and Diagnostic Yield in the Emergency Department
Authors: McMahon Brian J. , Shrestha Pragati , Thode Henry C. , Morley Eric J. , Rao Ballakur , Tawfik George-Abraam , Adhiyaman Akshitha , Devitt Catherine , Godbole Nisha , Pizzuti Joseph , Shah Kunal , Willems Bernardus , McKenna Peter , Singer Adam J. 
Published: May 2023

Objective:
Emergency physicians are challenged to efficiently and reliably risk stratify patients presenting with chest pain (CP) to optimize diagnostic testing and avoid unnecessary hospital admissions. The objective of our study was to evaluate the impact of a HEART score-based decision aid (HSDA) integrated in the electronic health record on coronary computed tomography angiography (CCTA) utilization and diagnostic yield in adult emergency department (ED) CP patients with suspected acute coronary syndrome.

Methods:
We conducted a before and after study to determine whether implementation of a mandatory computerized HSDA would reduce CCTA utilization in ED CP patients and improve the diagnostic yield of obstructive coronary artery disease (CAD) (≥50%). We included all adult ED CP patients with suspected acute coronary syndrome during the first 6 months of 2018 (before) and 2020 (after) at a large academic center. CCTA utilization and obstructive CAD yield were compared in patients before and after implementing the HSDA using χ2 tests. Secondarily, we assessed the association of HEART scores and CCTA results.

Results:
Of the 3095 CP patients during the before study period, 733 underwent CCTA. Of the 2692 CP patients during the after study period, 339 underwent CCTA. CCTA utilization before and after HSDA was 23.4% [95% confidence interval (95% CI), 22.2-25.2] and 12.6% (95% CI, 11.4-13.0), respectively; mean difference was 11.1% (95% CI, 0.9-13.0). Among 1072 patients undergoing CCTA, mean (SD) age and percent females before versus after HSDA were 54 (11) versus 56 (11) years and 50% versus 49%, respectively. We included 1014 patients (686 before and 328 after) for the yield analysis. Obstructive CAD was present in 15% (95% CI, 12.7-17.9) and 20.1% (95% CI, 16.1-24.7) before and after HSDA, respectively; mean difference was 4.9% (95% CI, 0.1-10.1).

Conclusions:
Implementation of a mandatory electronic health record HSDA aid reduced ED CCTA utilization by half and improved the diagnostic yield.
The Presence of Pneumonia Is Strongly Associated With Higher Prevalence of Non-ST-Elevation Myocardial Infarction Using a Large NIS Database
Authors: Gill Manrit , Movahed Mohammad Reza , Hashemzadeh Mehrtash , Hashemzadeh Mehrnoosh 
Published: May 2023

Objective:
Inflammation is a risk factor for myocardial infarction. Pneumonia leads to severe inflammatory response. Some studies suggest higher risk of myocardial infarction in patients with pneumonia. We used a large inpatient database (National Inpatient Sample) to evaluate this association.

Methods:
This study includes patients from a Nationwide Inpatient Sample hospital in 2005 to 2014 with International Classification of Diseases, Ninth Revision, and Clinical Modification codes consistent with pneumonia and non-ST elevation myocardial infarction (NSTEMI). Subjects were stratified into all hospitalized patients aged 30 and above. Univariate and multivariate analysis was performed adjusting for age, race, gender, tobacco use, diabetes mellitus, hypertension, and hyperlipidemia.

Results:
NSTEMI was present in 3.2% of pneumonia patients versus 1.8% in the non-pneumonia population over 10-year period. For example, the 2005 database: [odds ratio (OR), 1.77; 95% confidence interval (CI), 1.73-1.80; P < 0.001]. For 2014, NSTEMI was present in 4.1% of pneumonia patients (PNA) versus 2.4% in the non-pneumonia population (OR, 1.72; 95% CI, 1.70-1.75; P < 0.001). NSTEMI remained independently associated with pneumonia following a multivariate analysis in 2005 (OR, 1.477; 95% CI, 1.447-1.508; P < 0.001) with a similar value in 2014 (OR, 1.445; 95% CI, 1.421-1.469; P < 0.001).

Conclusions:
Using a large inpatient database, we found that NSTEMI was strongly associated with PNA versus non-pneumonia population over a 10-year period. Suggesting acute inflammatory cytokines or hypoxia which occurs during lung infection may play a role in NSTEMI development, reinforcing the importance of acute cardiac monitoring in patients with PNA.
Impact of a targeted temperature management quality improvement project on survival and neurologic outcomes in cardiac arrest patients
Authors: Hsu Thung-Hsien , Huang Wei-Chun , Lin Kun-Chang , Huang Chieh-Ling , Tai Hsiao-Yun , Tsai Yi-Ching , Wu Meng-Chen , Chang Yun-Te 
Published: May 2023

Background:
Targeted temperature management (TTM) is recommended for postresuscitation care of patients with sudden cardiac arrest (SCA) and its implementation remains challenging. This study aimed to evaluate the newly designed Quality Improvement Project (QIP) to improve the quality of TTM and outcomes of patients with SCA.

Methods:
Patients who experienced out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) with return of spontaneous circulation (ROSC) and were treated in our hospital between January 2017 and December 2019 were enrolled retrospectively. All included patients received QIP intervention initiated as follows: (1) Protocols and standard operating procedures were created for TTM; (2) shared decision-making was documented; (3) job training instruction was created; and 4) lean medical management was implemented.

Results:
Among 248 included patients, the postintervention group (n = 104) had shorter duration of ROSC to TTM than the preintervention group (n = 144) (356 vs 540 minutes, p = 0.042); better survival rate (39.4% vs 27.1%, p = 0.04), and neurologic performance (25.0% vs 17.4%, p < 0.001). After propensity score matching (PSM), patients who received TTM (n = 48) had better neurologic performance than those without TTM (n = 48) (25.1% vs 18.8%, p < 0.001). OHCA (odds ratio [OR] = 2.705, 95% CI: 1.657-4.416), age >60 (OR = 2.154, 95% CI: 1.428-3.244), female (OR = 1.404, 95% CI: 1.005-1.962), and diabetes mellitus (OR = 1.429, 95% CI: 1.019-2.005) were negative predictors of survival; while TTM (OR = 0.431, 95% CI: 0.266-0.699) and bystander cardiopulmonary resuscitation (CPR) (OR=0.589, 95% CI: 0.35-0.99) were positive predictors. Age >60 (OR= 2.292, 95% CI: 1.58-3.323) and OHCA (OR= 2.928, 95% CI: 1.858-4.616) were negative predictors of favorable neurologic outcomes; while bystander CPR (OR=0.572, 95% CI: 0.355-0.922) and TTM (OR=0.457, 95% CI: 0.296-0.705) were positive predictors.

Conclusion:
A new QIP with defined protocols, documented shared decision-making, and medical management guidelines improves TTM execution, duration from ROSC to TTM, survival, and neurologic outcomes of cardiac arrest patients.
Federal Data for Conducting Patient-centered Outcomes Research on Economic Outcomes
Authors: Brown Derek S. , Srinivasan Mithuna , Arbulu Lucas , Dullabh Prashila , Curtis Kamisha , Zott Courney , Smith Scott R. 
Published: May 2023

Background:Patients are increasingly interested in data on the economic burdens and impacts of health care choices; caregivers, employers, and payers are also interested in these costs. Although there have been various federal investments into patient-centered outcomes research (PCOR), an assessment of the coverage and gaps in federally funded data for PCOR economic evaluations has not been produced to date.Objectives:To classify relevant categories of PCOR economic costs, to assess current federally funded data for coverage of these categories, and to identify gaps for future research and collection.Research Design:A targeted internet search was conducted to identify a list of relevant outcomes and data sources. The study team assessed data sources for coverage of economic outcomes. A technical panel and key informant interviews were used for evaluation and feedback.Results:Four types of formal health care sector costs, 3 types of informal health care sector costs, and 10 types of non–health care sector costs were identified as relevant for PCOR economic evaluations. Twenty-nine federally funded data sources were identified. Most contained elements on formal costs. Data on informal costs (eg, transportation) were less common, and non–health care sector costs (eg, productivity) were the least common. Most data sources were annual, cross-sectional, nationally representative individual-level surveys.Conclusions:The existing federal data infrastructure captures many areas of the economic burden of health and health care, but gaps remain. Research from multiple data sources and potential future integrations may offset gaps in individual data sources. Linkages are promising strategies for future research on patient-centered economic outcomes.