bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age‐Associated Changes in Endothelial Transcriptome and Epigenetic Landscapes Correlate With Elevated Risk of Cerebral Microbleeds
Authors: Mohan Kshitij , Gasparoni Gilles , Salhab Abdulrahman , Orlich Michael M. , Geffers Robert , Hoffmann Steve , Adams Ralf H. , Walter Jörn , Nordheim Alfred 
Published: August 2023

Background
Stroke is a leading global cause of human death and disability, with advanced aging associated with elevated incidences of stroke. Despite high mortality and morbidity of stroke, the mechanisms leading to blood‐brain barrier dysfunction and development of stroke with age are poorly understood. In the vasculature of brain, endothelial cells (ECs) constitute the core component of the blood‐brain barrier and provide a physical barrier composed of tight junctions, adherens junctions, and basement membrane.

Methods and Results
We show, in mice, the incidents of intracerebral bleeding increases with age. After isolating an enriched population of cerebral ECs from murine brains at 2, 6, 12, 18, and 24 months, we studied age‐associated changes in gene expression. The study reveals age‐dependent dysregulation of 1388 genes, including many involved in the maintenance of the blood‐brain barrier and vascular integrity. We also investigated age‐dependent changes on the levels of CpG methylation and accessible chromatin in cerebral ECs. Our study reveals correlations between age‐dependent changes in chromatin structure and gene expression, whereas the dynamics of DNA methylation changes are different.

Conclusions

We find significant age‐dependent downregulation of the
Aplnr
gene along with age‐dependent reduction in chromatin accessibility of promoter region of the
Aplnr
gene in cerebral ECs.
Aplnr
is associated with positive regulation of vasodilation and is implicated in vascular health. Altogether, our data suggest a potential role of the apelinergic axis involving the ligand apelin and its receptor to be critical in maintenance of the blood‐brain barrier and vascular integrity.
The Evolution of Conformity, Malleability, and Influence in Simulated Online Agents
Authors: Downing Keith L. 
Published: August 2023

Abstract
The prevalence of artificial intelligence (AI) tools that filter the information given to internet users, such as recommender systems and diverse personalizers, may be creating troubling long-term side effects to the obvious short-term conveniences. Many worry that these automated influencers can subtly and unwittingly nudge individuals toward conformity, thereby (somewhat paradoxically) restricting the choices of each agent and/or the population as a whole. In its various guises, this problem has labels such as filter bubble, echo chamber, and personalization polarization. One key danger of diversity reduction is that it plays into the hands of a cadre of self-interested online actors who can leverage conformity to more easily predict and then control users’ sentiments and behaviors, often in the direction of increased conformity and even greater ease of control. This emerging positive feedback loop and the compliance that fuels it are the focal points of this article, which presents several simple, abstract, agent-based models of both peer-to-peer and AI-to-user influence. One of these AI systems functions as a collaborative filter, whereas the other represents an actor the influential power of which derives directly from its ability to predict user behavior. Many versions of the model, with assorted parameter settings, display emergent polarization or universal convergence, but collaborative filtering exerts a weaker homogenizing force than expected. In addition, the combination of basic agents and a self-interested AI predictor yields an emergent positive feedback that can drive the agent population to complete conformity.
Holy G/ghost?
Authors: Crace Benjamin D. 
Published: August 2023

Abstract
This article contests the current narrative of the development of the Pentecostal theology of tongues. It argues that 19th and 20th century Spiritualism is a critical and overlooked contextual factor in the historiography of the transition from xenolalia to glossolalia, and, consequently, Pentecostal theology more broadly. Its rival claims to hosting spiritual communication formed part of the backdrop against which a Pentecostal theology of tongues emerged. In light of Spiritualism’s impact, the author concludes that the missionary disappointment narrative needs serious revision. Further, he concludes that the historical psychical research into Spiritualism has potential purchase for contemporary pneumatology.
Who Has the Spirit?
Authors: Bowes William B. 
Published: August 2023

Abstract
While Jude and 1 John emerged from different situations, each letter makes a case against the beliefs and behaviors of groups causing disruption in their respective communities. Both arguments against their opponents involve appeals to authority, necessary because the opponents legitimize themselves and their authority by claiming God’s Spirit. In this article, the author argues that the message of both letters is better understood when read alongside first-century views of S/spirit possession and represent contemporaneous attempts to distinguish who legitimately possesses God’s Spirit. For Jude, this entails conformity to divinely established authoritative structures, defining and unifying the community and delimiting behaviors. For 1 John, this entails conformity to the community’s authoritative tradition, defining and unifying the community and distinguishing truth from error. Reading these letters in this way aids our understanding of how early communities handled division and how their pneumatologies relate to the need to adhere to a certain order.
Parliamentarians and Normative Power Diffusion
Authors: Keva Silja 
Published: August 2023

Abstract
Are parliamentarians involved in normative power diffusion? This case study of Japanese parliamentarians’ international activities shows how they engage in international norm diffusion at interparliamentary meetings in a way that multiplies the normative power efforts of Japan’s government. While parliamentarians are neither official foreign policy actors nor diplomats, they actively promote topics that support Japan’s normative power interests and employ mechanisms identified for normative power diffusion. Thus, parliamentarians become multipliers of Japan’s normative power efforts and have the ability to reach legislators in Japan’s key partner countries. This paper argues that, when abroad, Japanese legislators adopt the identity of an international representative of Japan, who supports promoting Japan’s interests in various areas, such as climate change, overseas agricultural investments, or regional financial stability.
Observing Mineral Dust in Northern Africa, the Middle East, and Europe: Current Capabilities and Challenges ahead for the Development of Dust Services
Authors: Mona Lucia , Amiridis Vassilis , Cuevas Emilio , Gkikas Antonis , Trippetta Serena , Vandenbussche Sophie , Benedetti Angela , Dagsson-Waldhauserova Pavla , Formenti Paola , Haefele Alexander , Kazadzis Stelios , Knippertz Peter , Laurent Benoit , Madonna Fabio , Nickovic Slobodan , Papagiannopoulos Nikolaos , Pappalardo Gelsomina , Pérez García-Pando Carlos , Popp Thomas , Rodríguez Sergio , Sealy Andrea , Sugimoto Nobuo , Terradellas Enric , Vukovic Vimic Ana , Weinzierl Bernadette , Basart Sara 
Published: August 2023

Abstract
Mineral dust produced by wind erosion of arid and semiarid surfaces is a major component of atmospheric aerosol that affects climate, weather, ecosystems, and socioeconomic sectors such as human health, transportation, solar energy, and air quality. Understanding these effects and ultimately improving the resilience of affected countries requires a reliable, dense, and diverse set of dust observations, fundamental for the development and the provision of skillful dust-forecast-tailored products. The last decade has seen a notable improvement of dust observational capabilities in terms of considered parameters, geographical coverage, and delivery times, as well as of tailored products of interest to both the scientific community and the various end-users. Given this progress, here we review the current state of observational capabilities, including in situ, ground-based, and satellite remote sensing observations in northern Africa, the Middle East, and Europe for the provision of dust information considering the needs of various users. We also critically discuss observational gaps and related unresolved questions while providing suggestions for overcoming the current limitations. Our review aims to be a milestone for discussing dust observational gaps at a global level to address the needs of users, from research communities to nonscientific stakeholders.
Clarifying the Distinction between Steric and Baroclinic Sea Surface Height
Authors: Zaron Edward D. , Ray Richard D. 
Published: August 2023

Abstract
One of the most fundamental uses of ocean models is for the prediction of sea level. Vertical integration of the hydrostatic equation leads to the partitioning of sea level in terms of atmospheric pressure, steric height, and bottom pressure. In an effort to validate the baroclinic wave dynamics of numerical ocean models, some researchers have compared the steric height from models with the sea level anomaly derived from satellite altimetry. The use of steric height in these comparisons captures the qualitative aspects of the baroclinic waves, but it neglects a nonnegligible contribution from bottom pressure. A more accurate evaluation of baroclinic wave dynamics using sea level would involve projecting the pressure field onto orthogonal barotropic and baroclinic components to isolate the baroclinic sea level anomaly. This note illustrates the quantitative difference between steric height and baroclinic sea level, which amounts to approximately a 20% bias of steric height over baroclinic sea level, depending on location.

Significance Statement
The bottom pressure variability associated with superinertial internal waves is not negligible, but it has been neglected in a recent series of ocean model validation studies. Baroclinic surface pressure, and its associated sea level anomaly, should be used instead of steric height for model–data comparisons of baroclinic sea level variability.
Euro-Atlantic Weather Regimes and Their Modulation by Tropospheric and Stratospheric Teleconnection Pathways in ECMWF Reforecasts
Authors: Roberts Christopher D. , Balmaseda Magdalena A. , Ferranti Laura , Vitart Frederic 
Published: August 2023

Abstract
This study combines operational reforecasts (2001–21) with results from a lower-resolution 41-yr reforecast (1980–2020) to provide a robust assessment of wintertime Euro-Atlantic regimes and their modulation by tropospheric and stratospheric teleconnection pathways in the European Centre for Medium-Range Weather Forecasts (ECMWF) Subseasonal to Seasonal Prediction project (S2S). In both operational and lower-resolution reforecasts, the climatological properties of wintertime Euro-Atlantic regimes, including regime structures, frequencies, and transition probabilities, are accurately simulated at S2S lead times. However, the 41-yr reforecasts allow us to diagnose substantial errors in regime statistics when conditioned on modes of intraseasonal-to-interannual variability. In particular, ECMWF reforecasts underestimate the response of the North Atlantic Oscillation (NAO) to the Madden–Julian oscillation (MJO) and fail to reproduce the modulation of MJO–NAO teleconnections by El Niño–Southern Oscillation (ENSO). Teleconnection and atmospheric wave diagnostics highlight two specific issues that are likely to contribute to these conditional errors in ECMWF reforecasts: (i) insufficient propagation of Rossby wave activity from the Pacific to the Atlantic following MJO phase 3 during El Niño conditions, when the direct tropospheric teleconnection pathway is most active; and (ii) an underestimated response of the stratospheric polar vortex following MJO phase 8 during La Niña conditions, when the indirect stratospheric teleconnection pathway is most active. Improving the representation of tropospheric and stratospheric teleconnection pathways is thus a priority for improving ECMWF forecasts of extratropical weather regimes and their associated surface impacts.

Significance Statement
Subseasonal to Seasonal Prediction project (S2S) forecasts are used operationally at ECMWF to provide early warning of cold conditions in Europe associated with persistent large-scale circulation patterns known as weather regimes. On average, ECMWF reforecasts accurately simulate wintertime Euro-Atlantic regime structures and frequencies at S2S lead times. However, regime forecasts show substantial errors when we restrict our analysis to certain phases of intraseasonal and interannual variability, such as El Niño–Southern Oscillation (ENSO). These errors are related to deficiencies in the simulated response of weather regimes to well-predicted variability in the tropics. Improving the representation of such tropical–extratropical teleconnections will improve predictions of extratropical weather regimes and their associated surface impacts.
Ten-Year Review of Tracheostomy Techniques and Related Complications
Authors: Umstot Richard , Samanta Damayanti , Umstot Emma , Area Scott A. , Richmond Bryan K. , Jarrouj Aous 
Published: August 2023

Background Tracheostomy is a frequently performed procedure that allows for definitive airway access in critically ill patients. Complications associated with tracheostomy have been well documented in the literature. This study aims to examine if different tracheostomy techniques were associated with specific complications. Secondary objectives were to determine the rate and commonality of post-tracheostomy complications. Methods This was a descriptive retrospective study of patients who underwent tracheostomy between June 2009 and June 2019. Patients included in the study were ≥18 years and were admitted to a rural tertiary care hospital system. Results Overall procedure complication rate was 34.3% with pneumonia (18.6%), obstruction (6.2%), bleeding (4.0%), and accidental tube decannulation (3.8%) being the most common. Rate of complications was not associated with the timing of the tracheostomy, the incision type, tube location, tracheostomy technique, and securing technique. However, tube size significantly differed between patients with or without complications ( P = .016). Tube size 8 Shiley was most commonly used in both groups and was significantly associated with reduced complication rate (72.0% vs 78.8%, P = .002). Conclusion Tracheostomy technique should be guided by proceduralist experience and patient clinical picture to determine the best approach. However, the association of post-tracheostomy complication with tube size perhaps will guide clinicians with tube size selection.
Primacy Effects in Extended Cognitive Strategy Choice: Initial Speed Benefits Outweigh Later Speed Benefits
Authors: Weis Patrick P. , Kunde Wilfried 
Published: August 2023

Background Human performers often recruit environment-based assistance to acquire or process information, such as relying on a smartphone app, a search engine, or a conversational agent. To make informed choices between several of such extended cognitive strategies, performers need to monitor the performance of these options. Objective In the present study, we investigated whether participants monitor an extended cognitive strategy’s performance—here, speed—more closely during initial as compared to later encounters. Methods In three experiments, 737 participants were asked to first observe speed differences between two competing cognitive strategies—here, two competing algorithms that can obtain answers to trivia questions—and eventually choose between both strategies based on the observations. Results Participants were sensitive to subtle speed differences and selected strategies accordingly. Most remarkably, even when participants performed identically with both strategies across all encounters, the strategy with superior speed in the initial encounters was preferred. Worded differently, participants exhibited a technology-use primacy effect. Contrarily, evidence for a recency effect was weak at best. Conclusion These results suggest that great care is required when performers are first acquainted with novel ways to acquire or process information. Superior initial performance has the potential to desensitize the performer for inferior later performance and thus prohibit optimal choice. Application Awareness of primacy enables users and designers of extended cognitive strategies to actively remediate suboptimal behavior originating in early monitoring episodes.
Efficacy of the Hepcon system in reducing hemorrhagic and thrombotic complications in antiphospholipid syndrome patients undergoing cardiac surgery
Authors: Michael Sheu , Sofia Molina Garcia , Wei Wei , Patrick Grady , John Apostolakis , Dana Angelini 
Published: August 2023

Introduction Patients with Antiphospholipid Syndrome (APS) undergoing cardiopulmonary bypass (CPB) surgery are at increased risk for thrombotic and hemorrhagic complications. Anticoagulation during CPB is typically monitored with activated clotting time (ACT) which may be falsely prolonged in patients with APS. The Hepcon Hemostasis Management System quantitatively determines the whole blood heparin concentration through heparin/protamine titration. Methods This was a retrospective study of APS patients who underwent cardiac surgery requiring CPB at the Cleveland Clinic between April 2013, and July 2020. The primary endpoint was the composite rate of hemorrhagic or thromboembolic complications per surgical case in patients monitored by Hepcon versus patients monitored by ACT. Secondary endpoints were median volume of chest tube output and packed red blood cell (PRBC) transfusion within the first three post-operative days. Results 43 patients were included. 20 (47%) patients were monitored using Hepcon while 23 (53%) were monitored using ACT. For the primary endpoint of rate of thromboembolic or hemorrhagic complications per surgical case, there was no statistically significant difference between the Hepcon and ACT groups (HMS, 6/20 [30%]; ACT, 7/23 [30%]; p = >0.99). For the secondary endpoints, there was no statistically significant difference in median post-operative chest tube output (780 mL vs. 850 mL; p = 0.88) and median post-operative PRBC transfusion (1 unit vs. 0 unit; p = 0.28) between the Hepcon and ACT groups, respectively. Conclusion There was no difference in the composite outcome of thrombotic or hemorrhagic complications in patients monitored by Hepcon versus those monitored by ACT.
Effectiveness and tolerability of methotrexate monotherapy in Crohn’s disease patients: a multicenter observational study
Authors: Park Jihye , Chun Jaeyoung , Park Soo Jung , Park Jae Jun , Kim Tae Il , Yoon Hyuk , Cheon Jae Hee 
Published: August 2023

Background: Methotrexate monotherapy is recommended as a maintenance therapy for Crohn’s disease (CD). However, long-term follow-up data are scarce. Objectives: We aimed to examine the effectiveness and tolerability of methotrexate monotherapy in 94 CD patients from three inflammatory bowel disease Clinics in Korea. Design: This was a multicenter retrospective observational study. Methods: Patients with active CD treated with methotrexate monotherapy were included. Clinical characteristics, laboratory indicators, endoscopy indices were evaluated at baseline, 6, 12, and 24 months. Independent factors associated with long-term clinical and endoscopic outcomes were determined. Results: Methotrexate was administered orally (70.2%) or parenterally (29.8%). The mean methotrexate induction dose was 15.3 ± 0.4 mg/week, and the mean duration of therapy was 26.2 months. Of 76 patients who were treated for >6 months, the clinical remission rates were 76.3%, 74.6%, and 80.0% at 6, 12, and 24 months, respectively, by per-protocol analysis. The mean CRP levels were 7.5 ± 1.3, 5.3 ± 1.2, 3.8 ± 0.7, and 2.6 ± 0.5 mg/L at 0, 6, 12, and 24 months, respectively. Of 31 patients who underwent follow-up endoscopy after 27.5 months, the endoscopic remission rate was 38.7%. Baseline hemoglobin level <10 g/dL was a significant independent factor negatively associated with clinical remission at 6 [odds ratio (OR): 0.023, 95% confidence interval (CI): 0.003–0.206, p = 0.001] and 12 (OR: 0.079, 95% CI: 0.009–0.699, p = 0.023) months. Parenteral administration was a significant independent factor positively associated with clinical remission (OR: 11.231, 95% CI: 1.027–122.811, p = 0.047) and endoscopic remission (hazard ratio: 4.711, 95% CI: 1.398–15.874, p = 0.012) at 12 months. Conclusions: Methotrexate monotherapy was effective and tolerable as a maintenance therapy in CD patients.
Evaluating and Comparing the Correlation and Performance of PROMIS and FAAM ADL in a Foot and Ankle Patient Population
Authors: Bernstein David N. , Friswold Alec , Waryasz Gregory , DiGiovanni Christopher W. , Tobert Daniel G. 
Published: August 2023

Background There is a paucity of literature assessing 2 of the commonly used static Patient-Reported Outcomes Measurement Information System (PROMIS) forms (PROMIS Global-10 and PROMIS Physical Function Short Form 10a [PF SF 10a]) and the Foot and Ankle Ability Measure Activities of Daily Living (FAAM ADL). Methods The PROMIS Global-10, PROMIS PF SF 10a, and FAAM ADL were compared among new foot and ankle patients. Spearman rho (ρ) correlations were calculated, and ceiling and floor effects were determined. Results The FAAM ADL demonstrated strong correlations with PROMIS PF SF 10a, P = .88, 95% confidence interval (CI): 0.86-0.90, P < .001, and PROMIS Global-10 Physical Health (P = .75, 95% CI: 0.71-0.78, p < .001). The FAAM ADL and PROMIS Global-10 Mental Health demonstrated a moderate correlation (P = .41, 95% CI: 0.34-0.47, P < .001). No PROM demonstrated an appreciable floor effect. The PROMIS Global-10 Physical Health demonstrated the lowest ceiling effect (n=11 [1.6%]). Conclusion Because the PROMIS Global-10 captures physical health adequately, provides mental health insight, and performs as well (if not better), we recommend the PROMIS Global-10 among the PROMs studied. Level of Evidence: Level III
Training Priority for Managerial Competence of Nurse Managers in Small and Medium-Sized Hospitals: Focusing on the Management Level
Authors: Jun MunHee , Noh Wonjung 
Published: August 2023

Introduction The managerial competence of nurse managers varies according to their management level. Objectives This study aims to explore the training priority of managerial competence for nurse managers in small- and medium-sized hospitals based on their management level. Methods Nurse managers (122 front-line and 65 middle-level nurse managers and chief nurse executives (CNEs)) from 21 small- and medium-sized hospitals with less than 300 beds participated in a survey. T-test and Borich Priority were analyzed. Results Nurse managers identified control competence as the most significant management function in both groups. The training priority for front-line nurse managers was motivation in directing, while it was human resource development in human resource management for middle-level nurse managers and, CNEs. Conclusion Five management strategies were reported, which will be the basis for future systematic nursing management in nursing organizations.