bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two‐Piece Craniotomy Is Associated With Improved Postoperative Outcomes of Combined Revascularization in Patients With Moyamoya Disease
Authors: Kanamori Fumiaki , Takasu Syuntaro , Hatano Norikazu , Araki Yoshio , Seki Yukio , Saito Ryuta 
Published: May 2023

Background
Revascularization for both anterior cerebral artery (ACA) and middle cerebral artery (MCA) territories in patients with moyamoya disease is often performed in a single operation. The influence of craniotomy type on postoperative outcomes has not been investigated. This study aimed to clarify the effects of craniotomy type on acute postoperative outcomes after combined revascularization by comparing 2‐piece, and large 1‐piece craniotomy approaches.

Methods
This retrospective study included 337 consecutive combined revascularizations of the ACA and MCA territories in patients with moyamoya disease. Surgeries were classified into 2‐piece and large 1‐piece craniotomy groups. For indirect bypass, the following methods were used: (1) large 1‐piece craniotomy and encephalo‐myo‐galeo‐periosteal‐synangiosis for the MCA and ACA territories; (2) 2‐piece craniotomy and encephalo‐myo‐synangiosis for the MCA territory and encephalo‐periosteal‐synangiosis for the ACA territory. Acute postoperative outcomes were compared between the groups.

Results

Two‐piece and large 1‐piece craniotomies were performed in 230 and 107 patients, respectively. The incidence of radiological and symptomatic infarction tended to be lower in the 2‐piece craniotomy group than that in the large 1‐piece craniotomy group (3.9% versus 11.2%;
P
=0.014, and 2.6% versus 6.5%;
P
=0.12, respectively). Logistic regression adjusted for potential confounders further explained the relationship between craniotomy type and radiological infarction (large 1‐piece/2‐piece craniotomy: odds ratio, 3.1; 95% CI, 1.2–7.6;
P
=0.015).

Conclusion
In combined revascularization of the ACA and MCA territories in moyamoya disease, 2‐piece craniotomy may reduce the risk of postoperative cerebral infarction.
Neglected Rural Women: Comparative Study on the Regional Differences of Agricultural Feminization in Mainland China
Authors: Cai Hong , Guo Mingwen , Huang Yuanlin 
Published: May 2023

Abstract
The main objective of the thesis was to analyze the structure, distribution, and impact of women farmers who have been neglected for a long time in the agricultural development of mainland China based on the national population census data from 1982 to 2020. Findings showed that the proportion of female agricultural labor force in 24 regions increased to varying degrees from 1990 to 2010. Areas where the distribution of female agricultural labor is relatively densely distributed largely overlap with cotton planting and growing areas and commodity grain bases, and nearly 1/4 of the areas have more female farmers than males. The feminization of agricultural labor force in China compared with developing regions of Latin America, Africa, and South Asia, has special because of balancing the relationship between rural women, rural families, and agricultural production and maximizing the economic efficiency of farmers during the transition period. The article recommends, in the promotion of rural revitalization strategy, China needs to actively integrate gender awareness, cultivate more female elites in agricultural technology, marketing, and management, giving play to the “super half effect” of rural women in cultural inheritance.
Why are University Teachers in Northeastern China Lost? An Analysis based on the Survey of Teachers’ Intention to Leave
Authors: Yang Yannan , Ma Zhengyu , Xue Xia 
Published: May 2023

Abstract
In recent years, universities in northeastern China have been losing teachers. This paper uses the survey results of university teachers in Northeastern China to analyze the factors that cause the loss of teachers in universities in Northeastern China. Based on the findings of this study, the factors that affect the flow tendency of teachers at worklife include promotion and development, university management, working conditions, salary and interpersonal relationship, of which promotion and development has the greatest impact. The factors that affect the flow tendency of teachers in the external environment include family responsibility, organizational prestige, conditions for talent acquisition and urban living environment, of which organizational prestige has the greatest impact. To alleviate the loss of teachers in universities from northeastern China, universities can improve the promotion and development channels of teachers, perfect their working conditions and management level, raise the basic salary standard of teachers and establish a remuneration system for distribution according to performance. For good measure, they can also stabilize the current teachers while attracting more outstanding talents by exploiting the advantages of location, making more efforts to build high-level disciplines, and offering more favorable conditions for talent introduction.
Is the Hobbesian State of Nature Racialized?
Authors: Sreedhar Susanne 
Published: May 2023

Abstract
Thomas Hobbes, like other early modern social contract theorists, has been accused of promoting racist views in his philosophy – ideas used to justify European imperialism and the devastation of Indigenous peoples. I argue that his philosophy does not assume or promote a naturalized racial hierarchy. I demonstrate that the logic of Hobbes’s project requires rejecting a racially essentialist conception of human nature. His is a thoroughgoing and unrepentant anti-essentialism; he claims that there are no objective, immutable, necessary differences between ‘civilized’ people and ‘savages.’ Instead, I locate Hobbes’s bias in his reliance on culturally-specific notions of government. Finally, I suggest that the Hobbes’s natural law requirement of ‘acknowledging’ equality can be applied to questions about race. Though this was not its purpose, this requirement might provide a useful – and distinctively Hobbesian – tool to combat the impulse behind the problematic and persistent desire to find ‘real’ differences among racial groups.
Writing about the Mawlid al-Sharīf in Eighth/Fourteenth-Century Maghrib: A Sufi-Legal Discourse
Authors: Atanasova Kameliya 
Published: May 2023

Abstract
Recent scholarship on the relationship between premodern Sufism and Islamic jurisprudence (fiqh) has highlighted the overlap between Sufis and jurists at the level of social and intellectual life. Despite this growing body of studies on Sufi-jurist dynamics, the role of Sufi metaphysics in this intellectual intersection remains unexplored. To address this gap, I provide a close reading of an entry in the Miʿyār al-muʿrib, a fatwa collection written in the ninth/fifteenth-century by Aḥmad al-Wansharīsī (d. 914/1508) that deals with the birthday of the Prophet Muhammad, the mawlid al-sharīf. The entry in Wansharīsī’s collection consists of three interconnected texts: a fourteenth-century fatwa by Ibn ʿ⁠Abbād al-Rundī (d. 792/1390), a metalinguistic commentary by Wansharīsī, and an excerpt from the Janāʾ al-jannatayn, a treatise by Shams al-Dīn b. Marzūq al-Tilimsānī (d. 781/1379) on the preeminence of the Night of Birth (laylat al-mawlid) over the Night of Power (laylat al-qadr). I analyze this triad of texts in order to create a road map for understanding the intersection of Sufi metaphysical and legal discourses. I begin by situating my argument within existing scholarship on Sufi-jurist dynamics in the premodern period (pre-thirteenth/nineteenth century). Next, I introduce readers to the main historical figures in the article – Ibn ʿ⁠Abbād, Ibn Marzūq, and Wansharīsī. In the third and fourth parts of the article, I explore these interconnected texts and argue that Wansharīsī uses Ibn Marzūq’s excerpt on the mawlid as a kind of precedent text to help his readers decipher Ibn ʿ⁠Abbād’s fatwa. In this way, the fatwa compiler links the two texts and their corresponding Sufi metaphysical and juridical elements.
Impact of La Niña on the Following-Summer East Asian Precipitation through Intermediate SST Anomalies
Authors: Wen Na , Li Laurent 
Published: May 2023

Abstract
This study investigates the impact of boreal winter–peaked La Niña on the following-summer precipitation in East Asia through intermediate sea surface temperature (SST) anomalies playing the role of relay in observation and numerical models. There are widespread dry conditions in both North and South China and wet conditions in coastal areas of central and eastern China. Such a pattern is mainly attributed to an anomalous low pressure over the western tropical Pacific and an anomalous anticyclone over northeast Asia. It is found that the delayed impact of La Niña on the East Asian climate is operated through intermediate SST anomalies—the Z-shape cold SST anomalies in the tropical North Pacific. There might be three ways for the SST anomalies to operate. First, they produce tropical atmospheric perturbations that can penetrate into the subtropical jet through the westerly trough over the northeast subtropical Pacific, the wave train being then excited along the jet. Second, perturbations created through the monsoon trough over the western Pacific can directly stimulate northward-propagating Rossby waves along the East Asian coast, mainly at low level. And third, perturbations over the tropical Atlantic–northwest Africa can also trigger downstream propagating waves along the subtropical jet. The observation effects of the intermediate SST anomalies and their possible impact mechanisms on atmospheric circulation are largely reproduced within numerical simulations performed with the Community Earth System Model.
Ocean Temperature Observations in Hurricane Dorian (2019)
Authors: Densmore Casey R. , Sanabia Elizabeth R. , Jayne Steven R. 
Published: May 2023

Abstract
Upper-ocean temperatures from 72 airborne expendable bathythermographs (AXBTs) collected during U.S. Air Force Hurricane Hunter flights into Hurricane Dorian (2019) over a 72-h period are examined. Three transects collected behind the storm reveal increased cross-track sea surface temperature gradient magnitudes as Dorian intensified to a category-5 hurricane and slowed while approaching the Bahamas. The cold wake, evident in vertical and horizontal cross sections from in situ and satellite sensors, appears as an expected response to tropical cyclone passage. Atypical, however, is the 2°C surface cooling observed over 36 h in a pair of transects ahead of hurricane force winds in Dorian, likely due to changes in the tropical cyclone’s translation speed and direction and/or proximity to the Gulf Stream and continental shelf. Collocated AXBT pairs document a dynamical regime shift from mixing to upwelling as Dorian slows and turns. Relationships between time-integrated wind stress and sea surface temperature indicate track-relative differences varying with storm translation speed and heading changes, paralleling the shift in cooling dynamics.

Significance Statement
We studied in situ and satellite ocean temperature observations beneath Hurricane Dorian (2019) as the storm moved slowly, turned north, and weakened near Grand Bahama Island. We found a distinct change in the spatial distribution of cool upper-ocean temperatures beneath the storm, which indicated a shift in the primary cooling mechanism from ocean mixing to upwelling. This mechanism shift is important because hurricanes depend on warm ocean temperatures for energy, and upwelling roughly doubles the area of cooling beneath the storm. Our results highlight the effects of large heading changes on the upper-ocean response beneath tropical cyclones, especially in tandem with slow translation speeds.
A Multimodal Approach to Control of Massive Hemorrhage Secondary to Rectal Cancer
Authors: Kelly Lauren S. , Byun John K. , Panetti Ryan A. , Mousavi Mohammad-Ali , Lenza Christopher , Vossough-Teehan Sima , Kunac Anastasia 
Published: May 2023

The management of patients with symptomatic rectal masses can be challenging and is further complicated in cases of advanced age, comorbidities, prior surgeries, and acute hemorrhage. In this report, we describe a patient who presented with massive hemorrhage from a 7 cm low rectal tumor with subsequent cardiac arrest. After return of spontaneous circulation, emergent pelvic angiography identified extensive tumor enhancement and blush off the anterior division of the right internal iliac artery from multiple parasitized vessels. The right internal iliac artery was embolized with multiple microcoils to decrease the tumor blood supply and slow the rate of bleeding. The patient was then taken directly from the angiography suite to radiation oncology for planning CT, and within several hours, underwent his first session of radiation. In conjunction with angioembolization, short-course radiation therapy can be an effective treatment modality for advanced bleeding rectal tumors not amenable to surgical resection.
Clinical Indicators to Determine the Timing of Surgery for Adhesive Small Bowel Obstruction
Authors: Nakao Eiichi , Honda Michitaka , Takano Yoshinao , Suzuki Nobuyasu , Todate Yukitoshi , Kawamura Hidetaka , Miyakawa Teppei , Toshiyama Satoshi , Yamamoto Ryuya , Konno Shinichi 
Published: May 2023

Background Decompression of the intestine with a long tube or nasogastric tube is the first-choice treatment for adhesive small bowel obstruction (ASBO). Scheduling surgery while weighing the risks of surgery against conservative care is a crucial factor in clinical decision-making. Whenever feasible, unnecessary surgeries should be avoided, and it is essential to provide clinical markers for this. This study aimed to obtain evidence regarding the optimal timing of ASBO and when conservative treatment options are not successful. Methods The data of patients diagnosed with ASBO and receiving long tube insertion for more than 7 days were reviewed. We investigated transit ileal drainage volume and recurrence. The primary outcomes were the change in the drainage volume from the long tube over time and the percentage of patients who required surgery. We evaluated some cutoff values to determine the indication for surgery based on the insertion duration and volume of long tube drainage. Results Ninety-nine patients were enrolled in this study. Fifty-one patients showed improvement with conservative treatment, whereas 48 ultimately required surgery. When a daily drainage volume of ≥500 mL was considered an indication for surgery, 13-37 cases (25%-72%) would be judged unnecessary within 6 days of long tube insertion, while 5 cases (9.8%) would be judged unnecessary on day 7. Discussion Unnecessary surgical interventions for ASBO might be avoided by assessing the drainage volume on day 7 after inserting a long tube.
The American Association for the Surgery of Trauma Organ Injury Scale for Spleen Does Not Equally Predict Interventions in Penetrating and Blunt Trauma
Authors: Abdel-Aziz Hossam , Murray Clark , Roberts Drew , Capron Gwenviere , Starr Frederic , Bokhari Faran , Brigode William 
Published: May 2023

Background The American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) for the spleen (and other organs) was created in 1989. It has been validated to predict mortality, need for operation, length of stay (LOS), and intensive care unit (ICU) LOS. Purpose We aimed to determine if the Spleen OIS is applied equally to blunt and penetrating trauma. Research Design/Study Sample We analyzed the Trauma Quality Improvement Program (TQIP) database from 2017-2019, including patients with spleen injuries. Data Collection Outcomes included the rates of mortality, operation, spleen-specific operation, splenectomy, and splenic embolization. Results 60900 patients had a spleen injury with an OIS grade. Mortality rates increased in Grades IV and V for both blunt and penetrating trauma. In blunt trauma, the odds for any operation, spleen-specific operation, and splenectomy increased, for each increase in grade. Penetrating trauma showed similar trends in grades up to grade IV, but were statistically similar between grade IV and V. Splenectomy was higher in penetrating trauma for all grades. Splenic embolization peaked at 25% of grade IV trauma before decreasing in grade V. Rates in penetrating trauma were significantly lower in all grades, peaking at 2.5% of Grade III injuries. Conclusions The mechanism of trauma is a significant factor for all outcomes, independent of AAST-OIS. Hemostasis is predominantly surgical in penetrating trauma, achieved with angioembolization more frequently in blunt trauma. Penetrating trauma management is influenced by the potential for injury to peri-splenic organs.
How, when and where to intervene in self-harm in youth in low- and middle-income countries: Thinking beyond healthcare systems
Authors: Aggarwal Shilpa , Armstrong Greg 
Published: May 2023

Background: Low- and middle-income countries (LMICs) account for 78% of global suicides. Self-harm is the clearest antecedent of suicide. The health and social systems have struggled to provide adequate evidence based help to young people with self-harm. In addition, the negative attitudes towards those who self-harm in these settings interfere with help-seeking behaviour. Aims and method: In our submission of a comment, we discuss the reasons for thinking beyond healthcare systems in LMICs to address self-harm in youth and the possible ways to achieve it. Results and conclusion: We truly believe that harnessing the potential of social systems such as schools is important for addressing self-harm in LMICs. We present our arguments in favour of feasible measures that can be implemented to achieve this.
More on the Use of Goggles and Snorkel in Learning-to-Swim: New Results for Children Without Fear of Water
Authors: Misimi Fatmir , Kajtna Tajna , Štirn Igor , Zoretić Dajana , Misimi Samir , Kapus Jernej 
Published: May 2023

In recent research, we found that the use of goggles and snorkel benefited non-swimmers with fear of water in a learn-to-swim program. Our purpose in this study was to examine the effects of using goggles and snorkel during a learn-to-swim program on the aquatic skills of young non-swimmers without fear of water. We modelled this research on our prior study. Following informed parental consent, 40 children (aged 10–11 years) were randomly divided into two groups: one that used goggles and snorkel (GS) and one that did not (NGS). After 4 weeks (five sessions per week) of learn-to-swim intervention, both groups improved aquatic skills such that the only group differences were for the blowing bubbles test, for which the learn-to-swim program resulted in smaller gains for the GS than the NGS group. Thus, the use (vs. non-use) of goggles and snorkels during the learn-to-swim program had no significant effect on most aquatic skills of young non-swimmers without fear of water. The only exception was a significant finding of reduced improvement in blowing bubbles in the goggles and snorkels group when compared to the no goggles and snorkel group. Together with past findings these results highlight important learn-to-swim differences between young non-swimmers with and without fear of water.
Can peritumoral edema evaluated by Magnetic Resonance Imaging before neoadjuvant chemotherapy predict complete pathological response in breast cancer?
Authors: Cakir Pekoz Burcak , Dilek Okan , Koseci Tolga , Tas Zeynel Abidin , Irkorucu Oktay , Gulek Bozkurt 
Published: May 2023

Background and Aims The complete pathological response (pCR) following neoadjuvant chemotherapy (NAC) in breast cancer is essential for the accurate prediction of prognosis. We aimed to evaluate the efficacy of the presence and type of peritumoral edema detected by magnetic resonance imaging (MRI) in predicting pCR to NAC in breast cancer patients. Methods and Results One hundred five patients with the diagnosis of invasive carcinoma were evaluated by MRI before NAC. Edema was evaluated in fat-suppressed T2-weighted images. The patients were categorized into three groups: patients with no peritumoral edema, patients with peritumoral edema, and patients demonstrating subcutaneous edema. The cases were categorized as being pCR and non-pCR. Molecular subtypes, lymphovascular invasion (LVI), tumor size, and apparent diffusion coefficient (ADC) were evaluated. A positive relationship was found between the presence of edema and tumor size. Subcutaneous edema was found to be statistically higher in non-pCR patients. While the number of pCR patients with subcutaneous edema was 17 (30.4%), the number of non-pCR patients with subcutaneous edema was 26 (53.1%) ( p  =  0.018). LVI was found to be statistically higher in patients with edema. The number of edema-negative and LVI (+) patients was 4 (15.4%), while the number of edema-positive and LVI (+) patients was 28 (35.4%) ( p = 0.042). Intratumoral and peritumoral ADC values were significantly higher in tumors with edema. Conclusion The presence of subcutaneous edema and LVI may be utilized for the prediction of pCR outcomes in breast cancer patients scheduled for NAC treatment.
Impact of a one-stop rapid access venous ulcer clinic on inpatient admissions
Authors: CR Keohane , M Alagha , MP O’Shaughnessy , DP Joyce , W Tawfick , MA Tubassam , SR Walsh 
Published: May 2023

Objectives Venous leg ulcers (VLU) are prevalent and require a large investment of resources to manage. We investigated whether the introduction of a rapid access see-and-treat clinic for VLU patients affected rates of unplanned inpatient admissions with VLU. Methods The Hospital Inpatient Enquiry database was consulted for data on admission rates, length of stay, bed-days used, and costs, across a 4-year period; 2 years since the introduction of the clinic, and the 2 years prior as a control. Results Two hundred and eighteen patients admitted with VLU accounted for 2,529 inpatient bed-days, 4.5 (2–6) admissions per month, and a median hospital stay of 7 (4–13) days across the study period. Median admissions decreased from 6 (2.5–8.5) per month before, to 3.5 (2–5) after introduction of the clinic ( p = 0.04). Bed-day usage fell from 62.5 (27–92.5), to 36.5 (21–44) days per month ( p = 0.035). Conclusions Admissions and bed-day usage for inpatient management of VLU fell after commencing a one-stop, rapid access clinic.
Meaningful Improvements in Rett Syndrome: A Qualitative Study of Caregivers
Authors: McGraw Sarah A. , Smith-Hicks Constance , Nutter James , Henne Jeffrey C. , Abler Victor 
Published: May 2023

Background Rett syndrome is a rare neurodevelopmental disorder primarily affecting females. This syndrome is associated with many comorbidities and impairments related to motor function, breathing, sleep, expressive language, and repetitive hand movements. The Rett Syndrome Behaviour Questionnaire (RSBQ) is one measure used to assess changes in Rett syndrome–related manifestations or core symptoms. Little is known about how caregivers think about meaningful changes in the items that make up the RSBQ scale. Methods This qualitative study explored how caregivers of individuals with Rett syndrome viewed changes in the symptoms covered in the RSBQ. We conducted semistructured interviews with 40 caregivers and employed thematic analysis, identifying themes using an iterative process. Results Two factors characterized caregivers’ thoughts about meaningful changes in Rett syndrome manifestations. First, general features of these symptoms rendered them bothersome: the extent of bother compared to other symptoms, if or how they prevented desirable behaviors and their temporal qualities. Second, caregivers evaluated the meaning of improvements by considering the decrease in bother and the potential benefits of change. Improvements had social and psychological consequences for individuals with Rett syndrome and caregivers. In addition, implications for health, fine and gross motor skills, and communication were also substantial.