bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns and Outcomes of Intensive Care on Acute Ischemic Stroke Patients in the US
Authors: Santos Daniel , Maillie Luke , Dhamoon Mandip S. 
Published: February 2023

Background:
Up to 20% of acute ischemic stroke (AIS) patients may benefit from intensive care unit (ICU)-level care; however, there are few studies evaluating ICU availability for AIS. We aim to summarize the proportion of elderly AIS patients in the United States who are admitted to an ICU and assess the national availability of ICU-level care in AIS.

Methods:

We performed a retrospective cohort study using de-identified Medicare inpatient datasets from January 1, 2016 through December 31, 2019 for US individuals aged ≥65 years. We used validated
International Classification of Diseases, Tenth Revision
, Clinical Modification codes to identify AIS admission and interventions. ICU-level care was identified by revenue center code. AIS patient characteristics and interventions were stratified by receipt of ICU-level care, comparing differences through calculated standardized mean difference score due to large sample sizes.

Results:

From 2016 through 2019, a total of 952 400 admissions by 850 055 individuals met criteria for hospital admission for AIS with 19.9% involving ICU-level care. Individuals were predominantly >75 years of age (58.5%) and identified as white (80.0%). Hospitals on average admitted 11.4% (SD 14.6) of AIS patients to the ICU, with the median hospital admitting 7.7% of AIS patients to the ICU. The ICU admissions were younger and more likely to receive reperfusion therapy but had more comorbid conditions and neurologic complications. Of the 5084 hospitals included, 1971 (38.8%) reported no ICU-level AIS care. Teaching hospitals (36.9% versus 1.6%,
P
<0.0001) with larger AIS volume (
P
<0.0001) or in larger metropolitan areas (
P
<0.0001) were more likely to have an ICU available.

Conclusions:
We found evidence of national variation in the availability of ICU-level care for AIS admissions. Since ICUs may provide comprehensive care for the most severe AIS patients, continued effort is needed to examine ICU accessibility and utility among AIS.
Methods to Enhance Causal Inference for Assessing Impact of Clinical Informatics Platform Implementation
Authors: Gaies Michael , Olive Mary K. , Owens Gabe E. , Charpie John R. , Zhang Wenying , Pasquali Sara K. , Klugman Darren , Costello John M. , Schwartz Steven M. , Banerjee Mousumi 
Published: February 2023

Background:
Hospitals are increasingly likely to implement clinical informatics tools to improve quality of care, necessitating rigorous approaches to evaluate effectiveness. We leveraged a multi-institutional data repository and applied causal inference methods to assess implementation of a commercial data visualization software in our pediatric cardiac intensive care unit.

Methods:
Natural experiment in the University of Michigan (UM) Cardiac Intensive Care Unit pre and postimplementation of data visualization software analyzed within the Pediatric Cardiac Critical Care Consortium clinical registry; we identified N=21 control hospitals that contributed contemporaneous registry data during the study period. We used the platform during multiple daily rounds to visualize clinical data trends. We evaluated outcomes—case-mix adjusted postoperative mortality, cardiac arrest and unplanned readmission rates, and postoperative length of stay—most likely impacted by this change. There were no quality improvement initiatives focused specifically on these outcomes nor any organizational changes at UM in either era. We performed a difference-in-differences analysis to compare changes in UM outcomes to those at control hospitals across the pre versus postimplementation eras.

Results:

We compared 1436 pre versus 779 postimplementation admissions at UM to 19 854 (pre) versus 14 160 (post) at controls. Admission characteristics were similar between eras. Postimplementation at UM we observed relative reductions in cardiac arrests among medical admissions, unplanned readmissions, and postoperative length of stay by −14%, −41%, and −18%, respectively. The difference-in-differences estimate for each outcome was statistically significant (
P
<0.05), suggesting the difference in outcomes at UM pre versus postimplementation is statistically significantly different from control hospitals during the same time.

Conclusions:
Clinical registries provide opportunities to thoroughly evaluate implementation of new informatics tools at single institutions. Borrowing strength from multi-institutional data and drawing ideas from causal inference, our analysis solidified greater belief in the effectiveness of this software across our institution.
Efficacy and Safety of Balloon Pulmonary Angioplasty for Patients With Chronic Thromboembolic Pulmonary Hypertension and Comorbid Chronic Obstructive Pulmonary Disease
Authors: Fujii Hiroyuki , Taniguchi Yu , Yoneda Sachiyo , Miwa Keisuke , Matsuoka Yoichiro , Yanaka Kenichi , Tsuboi Yasunori , Emoto Noriaki , Hirata Kenichi 
Published: February 2023

Background
Balloon pulmonary angioplasty (BPA) is a promising treatment modality for nonoperable chronic thromboembolic pulmonary hypertension (CTEPH). However, BPA for atypical CTEPH with concurrent chronic obstructive pulmonary disease (COPD) remains controversial owing to the risk of exacerbation of ventilation‐perfusion mismatch. We aimed to evaluate the efficacy and safety of BPA for CTEPH with moderate or severe COPD.

Methods and Results

Data from 149 patients with CTEPH, who underwent BPA from March 2011 to June 2021, were retrospectively analyzed. Patients were divided based on COPD comorbidity: the COPD group (n=32, defined as forced expiratory volume in 1 second/forced vital capacity <70% and forced expiratory volume in 1 second <80% predicted) and the non‐COPD group (n=101); patients with mild COPD (n=16) were excluded. Hemodynamic and respiratory parameters were compared between the groups. Hemodynamics improved similarly in both groups (reduction in pulmonary vascular resistance): −55.6±29.0% (COPD group) and −58.9±21.4% (non‐COPD group);
P
=nonsignificant. Respiratory function and oxygenation improved in the COPD group (forced expiratory volume in 1 second/forced vital capacity [61.8±7.0% to 66.5±10.2%,
P
=0.02] and arterial oxygen partial pressure [60.9±10.6 mm Hg to 69.3±13.6 mm Hg,
P
<0.01]). Higher vital capacity (
P
=0.024) and higher diffusing capacity for lung carbon monoxide (
P
=0.028) at baseline were associated with greater improvement in oxygenation in the multivariable linear analysis. Lung injury per BPA session was 1.6% in the COPD group.

Conclusions
The efficacy and safety of BPA for nonoperable CTEPH in patients with comorbid COPD were similar to those in patients without COPD. Oxygenation and forced expiratory volume in 1 second/forced vital capacity improved in patients with COPD. BPA should be considered in patients with CTEPH with concurrent COPD.
High‐Mobility Group Box 1–Signaling Inhibition With Glycyrrhizin Prevents Cerebral T‐Cell Infiltration After Cardiac Arrest
Authors: Boissady Emilie , Abi Zeid Daou Yara , Faucher Estelle , Kohlhauer Matthias , Lidouren Fanny , El Hedjaj Cynthia , Chateau‐Joubert Sophie , Hocini Hakim , Hue Sophie , Ghaleh Bijan , Tissier Renaud 
Published: February 2023

Background
High‐mobility group box 1 (HMGB1) is a major promotor of ischemic injuries and aseptic inflammatory responses. We tested its inhibition on neurological outcome and systemic immune response after cardiac arrest (CA) in rabbits.

Methods and Results

After 10 minutes of ventricular fibrillation, rabbits were resuscitated and received saline (control) or the HMGB1 inhibitor glycyrrhizin. A sham group underwent a similar procedure without CA. After resuscitation, glycyrrhizin blunted the successive rises in HMGB1, interleukin‐6, and interleukin‐10 blood levels as compared with control. Blood counts of the different immune cell populations were not different in glycyrrhizin versus control. After animal awakening, neurological outcome was improved by glycyrrhizin versus control, regarding both clinical recovery and histopathological damages. This was associated with reduced cerebral CD4
+
and CD8
+
T‐cell infiltration beginning 2 hours after CA. Conversely, granulocytes' attraction or loss of microglial cells or cerebral monocytes were not modified by glycyrrhizin after CA. These modifications were not related to the blood–brain barrier preservation with glycyrrhizin versus control. Interestingly, the specific blockade of the HMGB1 receptor for advanced glycation end products by FPS‐ZM1 recapitulated the neuroprotective effects of glycyrrhizin.

Conclusions
Our findings support that the early inhibition of HMGB1‐signaling pathway prevents cerebral chemoattraction of T cells and neurological sequelae after CA. Glycyrrhizin could become a clinically relevant therapeutic target in this situation.
Recategorising research: Mapping from FoR 2008 to FoR 2020 in Dimensions
Authors: Porter Simon J. , Hawizy Lezan , Hook Daniel W. 
Published: February 2023

Abstract
In 2020 the Australia New Zealand Standard Research Classification Fields of Research Codes (ANZSRC FoR codes) were updated by their owners. This has led the sector to need to update their systems of reference and has caused suppliers working in the research information sphere to need to update both systems and data. This paper focuses on the approach developed by Digital Science’s Dimensions team to the creation of an improved machine-learning training set, and the mapping of that set from FoR 2008 codes to FoR 2020 codes so that the Dimensions classification approach for the ANZSRC codes could be improved and updated.
A Climatology of Easterly Wind Lake-Effect and Lake-Enhanced Precipitation Events over the Western Lake Superior Region
Authors: Sandstrom Joshua D. , Cordeira Jason M. , Hoffman Eric G. , Metz Nicholas D. 
Published: February 2023

Abstract
Lake-effect precipitation is convective precipitation produced by relatively cold air passing over large and relatively warm bodies of water. This phenomenon most often occurs in North America over the southern and eastern shores of the Great Lakes, where high annual snowfalls and high-impact snowstorms frequently occur under prevailing west and northwest flow. Locally higher snow or rainfall amounts also occur as a result of lake-enhanced synoptic precipitation when conditionally unstable or neutrally stratified air is present in the lower troposphere. Although likely less common, lake-effect and lake-enhanced precipitation can also occur with easterly winds, impacting the western shores of the Great Lakes. This study describes a 15-yr climatology of easterly lake-effect (ELEfP) and lake-enhanced (ELEnP) precipitation [conjointly, easterly lake collective precipitation (ELCP)] events that developed in east-to-east-northeasterly flow over western Lake Superior from 2003 to 2018. ELCP occurs infrequently but often enough to have a notable climatological impact over western Lake Superior, with an average of 14.6 events per year. The morphology favors both single shore-parallel ELEfP bands due to the convex western shoreline of Lake Superior and mixed-type banding due to ELEnP events occurring in association with “overrunning” synoptic-scale precipitation. ELEfP often occurs in association with a surface anticyclone to the north of Lake Superior. ELEnP typically features a similar northerly displaced anticyclone and a surface cyclone located over the upper Midwest that favor easterly boundary layer winds over western Lake Superior.
The Edge Intensification of Eastern Pacific ITCZ Convection
Authors: Masunaga Hirohiko 
Published: February 2023

Abstract
Tropical precipitation is climatologically most intense at the heart of the intertropical convergence zone (ITCZ), but this is not always true in instantaneous snapshots. Precipitation is amplified along the ITCZ edge rather than at its center from time to time. In this study, satellite observations of column water vapor, precipitation, and radiation as well as the thermodynamic field from reanalysis data are analyzed to investigate the behavior of ITCZ convection in light of the local atmospheric energy imbalance. The analysis is focused on the eastern Pacific ITCZ, defined as the areas where column water vapor exceeds 50 mm over a specified width (typically 400–600 km) in the domain of 20°S–20°N, 180°–90°W. The events with a precipitation maximum at the southern and northern edges of the ITCZ are each averaged into composite statistics and are contrasted against the reference case with peak precipitation at the ITCZ center. The key findings are as follows. When precipitation peaks at the ITCZ center, suppressed radiative cooling forms a prominent positive peak in the diabatic forcing to the atmosphere, counteracted by an export of moist static energy (MSE) owing to a deep vertical advection and a large horizontal export of MSE. When convection develops at the ITCZ edges, to the contrary, a positive peak of the diabatic forcing is only barely present. An import of MSE owing to a shallow ascent on the ITCZ edges presumably allows an edge intensification to occur despite the weak diabatic forcing.
Southern Hemisphere Response to the Quasi-Biennial Oscillation in the CMIP5/6 Models
Authors: Rao Jian , Garfinkel Chaim I. , Ren Rongcai , Wu Tongwen , Lu Yixiong 
Published: February 2023

Abstract
Using 25 quasi-biennial oscillation (QBO)-resolving models from phases 5 and 6 of the Coupled Model Intercomparison Project (CMIP5/6), this study systematically explores the Southern Hemisphere (SH) extratropical response to the QBO. The observed maximum stratospheric polar vortex–weakening response to the 20-hPa easterly QBO appears in the austral spring, which is reproduced qualitatively by seven models. The Eliassen–Palm (EP) flux convergence associated with enhanced upward propagation of waves from the SH midlatitude troposphere is also reasonably simulated following easterly QBO in these seven models. The Brewer–Dobson (BD) circulation response, especially its deep branch, has a large bias among models. The anomalous upwelling of the deep branch of the BD circulation and the cold anomalies are confined to midlatitudes above 20 hPa in reanalyses, while this deep branch is simulated to expand to the Antarctic stratosphere with unrealistically cold anomalies for some models. Models with a decent stratospheric pathway tend to simulate the observed negative Southern Annular Mode (SAM)-like response in the troposphere. Further, the largest enhanced convection center is observed over the tropical Indo-Pacific Ocean and simulated by 12 models, most of which also simulate a more reasonable height anomaly pattern in the troposphere. The near-surface response to the QBO also resembles the SAM pattern with warm anomalies over eastern Antarctic, which are simulated by only five models. Seven models simulate the observed wet signals in the midlatitude southern Indo-Pacific Ocean, where an anomalous low develops. Overall, models with a better reproduction of the SH stratospheric polar vortex response exhibit a more reasonable near-surface response, though for all models the response is too weak.

Significance Statement
The equatorial stratospheric quasi-biennial oscillation (QBO) has been widely reported to influence the Northern Hemisphere. This paper focuses on the possible impact of the QBO on the Southern Hemisphere (SH) using 25 models. The maximum QBO signal in the Antarctic stratosphere forms in austral spring when the climatological vortex intensity has weakened relative to austral winter. The timing and magnitude of the QBO signal is simulated with different degrees of success by the 25 models, and those with a reasonable polar vortex response tend to better simulate the near-surface response. The QBO has another pathway for the extratropical circulation change via modifying tropical convection, and models also simulate a large spread in the tropical convection change associated with the QBO.
M2 Internal Tide Energetics and Behaviors in the Subpolar North Pacific
Authors: You Jia , Xu Zhenhua , Li Qun , Zhang Peiwen , Yin Baoshu , Hou Yijun 
Published: February 2023

Abstract
Energetic internal tides in the Pacific Ocean generated from multiple sources are the subject of many studies, although the subpolar North Pacific (SNP) is known as a high-latitude hotspot that remains less explored. The present study is the first detailed investigation on M2 internal tide energetics and dynamics in the SNP by high-resolution numerical simulations. The M2 internal tides in the SNP mainly originate from the Aleutian Ridge (area-integrated 5.51 GW and averaged ∼10−3 W m−2 of barotropic-to-baroclinic conversion rate), wherein the Amukta Pass is the most significant source. The Amukta Pass radiates northward 0.55 GW (averaged 2.3 kW m−1) to the Bering Sea and southward 1.40 GW (averaged 3.7 kW m−1) to the North Pacific. The subsequent south–north asymmetric radiation pattern is consistent with satellite altimeter detection. In the Bering basin, multiwave superposition in the near field between the Amukta Pass and adjacent sources generates two standing wave patterns. After approaching the Bering Sea slope, remote internal tides from Aleutian Ridge enhance local generation and dissipation. The dissipation field is relatively similar to the generation map, which is explained by the higher local dissipation efficiency q (>1/2) and the faster energy attenuation than in the midlatitudes. The simulated dissipation rates compare favorably with the estimate from fine-scale parameterization, indicating the dominance of internal tidal mixing. The averaged dissipation rate in SNP is O(10−10) W kg−1, and the depth-integrated dissipation rates reach O(10−1) W m−2 near the Amukta Pass. It is important to understand the unique physics and dissipative process of high-latitude internal tides to fully characterize the redistribution of global tidal energy and associated mixing.
Swimming in Pools: Collusion in the Salmon Market
Authors: Asmat Danial , Levenstein Margaret C. , Suslow Valerie Y. , Wang Zhihan (Helen) 
Published: February 2023

We study the events alleged in recent Norwegian salmon industry antitrust cases to explore the relationship between vertical integration, public price indexes, and collusion. The salmon market provides an intriguing opportunity to study these issues, as there was a vertical merger followed by a reformulation of the methodology by which prices were reported for a new price index. We explore whether the confluence of the merger and the creation of the Nasdaq price index is associated with evidence consistent with collusion. JEL codes: L13, L41, L42, Q22
What determines public affairs researchers’ motivations for policy impact? Results from an exploratory study
Authors: Nelson John P. , Lindsay Spencer 
Published: February 2023

Although public policy and public administration are intuitively practical fields of scholarship, much public affairs research never affects practice. Previous studies have shown that one major predictor of whether a given research study or researcher achieves impact is the researcher's motivation to do so. Using data from a survey of 409 authors of articles in major public affairs journals, we present and test models of the determinants of researchers’ use motivations with regard to specific research studies and over the course of their careers. Results indicate that previous experience as a practitioner is positively associated with perceived career-long use motivation and rewards for use associated with tenure and promotion, although not with annual evaluations. In addition, project-specific use motivation is positively associated with perceived career-long use motivation, academic age, a study suggestion made by a practitioner, and methodological contribution. Motivations based on a desire to appear productive or on suggestions from researcher colleagues are negatively associated with study-specific use. Points for practitioners Academic motivation to affect policymaking is positively associated with rewards associated with tenure and promotion, although not with year-end evaluations. Longer-serving researchers, and those with practitioner experience, report greater motivation to affect practice through their research.
Stressful Life Events and Risk of Homelessness After Active Duty: An Assessment of Risk and Resilience Among Servicemembers
Authors: Montgomery Ann Elizabeth , Koh Katherine A. , King Andrew J. , O’Brien Robert , Sampson Nancy A. , Petriceks Aldis , Stein Murray B. , Ursano Robert J. , Kessler Ronald C. 
Published: February 2023

Objectives: The transition from military to civilian life may present increased exposure to various stressful life events (SLEs) that can increase the risk of homelessness (eg, loss of employment, dissolution of romantic relationships). We assessed the extent to which exposure to SLEs occurring proximal to US Army soldier transitions out of active duty was associated with risk of homelessness. Methods: A total of 16 589 respondents who were no longer on active duty but participated while on active duty during 2011-2014 baseline surveys completed follow-up surveys during 2016-2018 and 2018-2019. The follow-up surveys assessed SLEs and homelessness occurring in the past 12 months. We used modified Poisson regression models to evaluate how much differential SLE exposure and effects explained the aggregate association of a risk index with homelessness among a sample of 6837 respondents, weighted to represent the full sample. Results: More than half (n = 3510, 52.8%) of respondents reported experiencing any SLEs in the past 12 months. Most (60.5%) of the difference in prevalence of homelessness among respondents defined as being at high risk of homelessness (vs lower risk) was explained by differential exposure to, and/or effects of, these SLEs. Personal betrayal by a loved one and economic problems played the largest roles in adjusted risk differences (0.045 and 0.074, respectively). Conclusions: Homelessness might be reduced by gearing interventions toward soldiers at high risk of homelessness who are transitioning out of active duty to reduce exposure to and effects of modifiable SLEs on experiencing homelessness.
A novel carbazole based bismaleimide monomer: Synthesis, characterization, thermal and optical properties
Authors: Karaca Nurcan 
Published: February 2023

In this study, a novel bismaleimide monomer: Carbazole-Bismaleimide (Cz-BisMI) was introduced to the literature as a first. Cz-BisMI was synthesized by a catalytic cyclodehydration reaction of 3,6-bismalemic acid carbazole which is an intermediate product obtained by an imidization reaction of 3,6-diamino carbazole. Then, the chemical structure of Cz-BisMI was elucidated by FT-IR, 1H NMR, 13C NMR and LC-MS spectroscopies. The thermal properties of Cz-BisMI were investigated by DSC in comparison with a commercial bismaleimide monomer, 4,4-bismaleimidophenylmethane (DPM-BisMI). Cz-BisMI has a melting point of 192°C and also, the onset temperature of the exothermic curve was measured as 293°C. Furthermore, it was determined that Cz-BisMI has a 35.6 percent larger processing window than DPM-BisMI. The spin-coated films of Cz-BisMI showed a high refractive index in the range of 1.61 to 1.50 between 400 and 650 nm with good transparency of over 85%. On the other hand, a new poly(bismaleimide): P(Cz-BisMI)s containing carbazole units was prepared by the self-polymerization process of Cz-BisMI. P(Cz-BisMI)s showed a high thermal transition temperature of 356°C. In conclusion, Cz-BisMI is a viable choice as a bismaleimide monomer for the development of opto-electronic materials due to its enhanced optical properties and thermal behavior.