bluuebunny/crossref_metadata_2025_split huggingface dataset:
Negotiating the Gemeinschaft/Gesellschaft Dichotomy: Appalachian Medical Student Perceptions of Practice☆
Authors: Hedrick Jason S. , McHenry‐Sorber Erin 
Published: May 2023

AbstractThis study investigated motivations for Appalachian medical students to stay or leave the region weighing postgraduation options. Semi‐structured interviews were employed with final year medical students. Transcripts were open‐coded and analyzed using the theoretical concept of Gemeinschaft/Gesellschaft. Participants were in continuous negotiation between notions of Gemeinschaft and Gesellschaft in their decisions to stay or leave rural Appalachian communities. Students navigated multiple tensions in their decisions to stay or leave, including: (1) geographic isolation versus place identity and (2) community responsibility versus individual opportunity. Utilization of Gemeinschaft/Gesellschaft provides a novel contribution to the literature on decisions to stay or leave as the majority of participants hedged in their decision‐making regarding future practice location. These students tended to employ a Gesellschaft rationale to stay and a Gemeinschaft rationale to leave, expressing complicated ideas about community and individual opportunity.
Removing hepatitis C antibody testing for Australian blood donations: A cost‐effectiveness analysis
Authors: Cheng Qinglu , Hoad Veronica C. , Roy Choudhury Avijoy , Seed Clive R. , Bentley Peter , Shih Sophy T. F. , Kwon Jisoo A. , Gray Richard T. , Wiseman Virginia 
Published: May 2023

AbstractBackground and ObjectivesThe risk of transfusion‐transmitted hepatitis C virus (HCV) infections is extremely low in Australia. This study aims to conduct a cost‐effectiveness analysis of different testing strategies for HCV infection in blood donations.Materials and MethodsThe four testing strategies evaluated in this study were universal testing with both HCV antibody (anti‐HCV) and nucleic acid testing (NAT); anti‐HCV and NAT for first‐time donations and NAT only for repeat donations; anti‐HCV and NAT for transfusible component donations and NAT only for plasma for further manufacture; and universal testing with NAT only. A decision‐analytical model was developed to assess the cost‐effectiveness of alternative HCV testing strategies. Sensitivity analysis and threshold analysis were conducted to account for data uncertainty.ResultsThe number of potential transfusion‐transmitted cases of acute hepatitis C and chronic hepatitis C was approximately zero in all four strategies. Universal testing with NAT only was the most cost‐effective strategy due to the lowest testing cost. The threshold analysis showed that for the current practice to be cost‐effective, the residual risks of other testing strategies would have to be at least 1 HCV infection in 2424 donations, which is over 60,000 times the baseline residual risk (1 in 151 million donations).ConclusionThe screening strategy for HCV in blood donations currently implemented in Australia is not cost‐effective compared with targeted testing or universal testing with NAT only. Partial or total removal of anti‐HCV testing would bring significant cost savings without compromising blood recipient safety.
Prevalence of weak D phenotypes in the general population of Québec, Canada: A focus on weak D type 42
Authors: Drouin Mathieu , Rochette Samuel , St‐Louis Maryse , Lewin Antoine , Laganière Josée 
Published: May 2023

AbstractBackground and ObjectivesWeak D type 42 accounts for an unusually high proportion of weak D phenotypes in Québec (Canada), which contrasts with other predominantly White populations. However, its prevalence in the general population is unknown. We estimated the prevalence of weak D type 42 and other common weak D phenotypes in Québec.Materials and MethodsWe screened forRHD*01W.42alleles among 1000 individuals of CARTaGENE—a cohort representative of Québec's population. The prevalence of weak D type 42 was calculated based on the allele frequency ofRHD*01W.42andd(i.e., all recessive alleles that confer a D− phenotype), assuming a Hardy–Weinberg equilibrium. This prevalence was then leveraged to calculate that of other common weak D phenotypes, using published prevalence estimates among weak D phenotypes.ResultsTwo individuals harboured theRHD*01W.42/RHD*01heterozygous genotype. Assuming an allele frequency of 38.19% ford, the overall prevalence of weak D type 42 was 0.08%. The following prevalence estimates were also obtained: 0.44% for all weak D phenotypes and 0.07%, 0.01% and 0.04% for weak D types 1, 2 and 3, respectively.ConclusionQuébec has the highest documented prevalence of weak D type 42, which was estimated at 0.08%.
Performance and Emission Characteristics for Karanja Biodiesel Blends Assisted With Green Hydrogen Fuel and Nanoparticles
Authors: Praveenkumar T. R. , Rath Badrinarayan , Devanesan Sandhanasamy , Alsahi Mohamad S. , Jhanani G. K. , Gemede Habtamu Fekadu , Solowski Gawel , Daniel Freedon 
Published: May 2023

Abstract
Extensive efforts are being made to produce and use a variety of alternative energies in order to meet the rising global energy demand. The main purpose of this research was to evaluate the mass fuel burnt, emissions, and performance properties of biodiesel made from non-edible karanja oil along with hydrogen and nanoparticles in a standard diesel engine. Upon experimental evaluation, it was determined that the transesterified karanja oil retained all of its vital physicochemical properties within the specified tolerances. The emission and performance characteristics of karanja biodiesel blended with nanoparticles and hydrogen fuel were assessed at different engine loads ranging from 0% to 100%. The uniform amount of nanoparticles and hydrogen was incorporated into test fuels. Al2O3 nanoparticles of 50 ppm were used in this study and hydrogen of 5 L/min was supplied to the engine. K20NH test fuel had the maximum brake thermal efficiency and less brake-specific fuel consumption compared to the other fuel blend. The emissions were considerably reduced on karanja oil, nanoparticles, and hydrogen-blended biodiesel except for nitrogen emission compared with conventional diesel fuel. In this study, the utilization of karanja, nanoparticles, and hydrogen-blended biodiesel showed a promising alternative to fossil fuels due to reduced emission and enhanced performance characteristics.
Hypothesis on the Reasons for Strong Variability in the Concentrations of Impurities in Natural Waters
Authors: Danilov-Danilyan V. I. , Rozenthal O. M. 
Published: May 2023

Abstract
A hypothesis has been put forward about the formation of increased dispersion of the concentration of substances contaminating flowing river water under the influence of internal synergistic factors. The effect is manifested in the dispersion of monitored quality factors, exceeding their average values, which in practice makes it difficult to manage water use. It is assumed that such dispersion is a consequence of the nonlinearity of systems that are far from thermodynamic equilibrium. It is possible that the driving force in this case is the turbophoresis of impurity particles in a turbulent, as a rule, water flow.
Neotectonic Dislocations on the Barents Sea Shelf and Their Origin on the Basis of Morphometry of the Seafloor Relief, Seismic Survey, and the Deep Structure of the Mantle
Authors: Sokolov S. Yu. , Abramova A. S. , Shkarubo S. I. 
Published: May 2023

Abstract
A comprehensive analysis of the morphometric attribute “general curvature” for the Barents Sea bathymetry and reports on the seismic and seismoacoustic data on tectonic dislocations in a wave field, the fault network of the sedimentary cover, and seismotomographic data on the heterogeneous deep pattern of the distribution of seismic wave velocities in the upper mantle are provided. The analysis showed that mobile blocks of the upper mantle, exhibiting heterogeneous rheological properties, are associated with the consolidated part of the Earth’s crust fault network of deep-seated origin. The fault network emerges on the seafloor and, becoming a relief-forming factor, forms specific domains with different textures displayed in the morphometric attribute “general curvature.”
Navigating two ‘truths’: a qualitative study of physician-led end-of-life decision-making for children with life-limiting conditions
Authors: Vemuri Sidharth , Hynson Jenny , Williams Katrina , Gillam Lynn 
Published: May 2023

ObjectiveTo describe how paediatricians undertake the process of end-of-life decision-making for a child with a life-limiting condition who is unable to participate in decision-making for themselves.DesignA qualitative phenomenological study using semistructured interviews based around a clinical vignette matched to the clinical practice of individual paediatricians. Verbatim transcripts underwent thematic analysis.SettingPaediatricians practising in Victoria (Australia) between mid-2019 and mid-2020.ParticipantsTwenty-five purposively sampled paediatricians caring for children with specific life-limiting conditions: children with severe neurodisability, oncological or haematological malignancies or complex cardiac disease in an inpatient intensive care or outpatient clinic setting.ResultsA process of physician-led end-of-life decision-making was described. Paediatricians first contemplate that the child’s death is approaching, then prepare themselves by ensuring there are no reversible factors at play. They then inform parents of this view and, if needed, hold discordant views between parents and themselves about the child’s death in a ‘fruitful tension’. Ultimately, they seek to bring parents’ views of their child in line with theirs to facilitate goal alignment.ConclusionsPaediatricians feel responsible for facilitating the alignment of parental understanding of the child’s health status with their own. This is achieved either through direction or by holding differences between parental and medical truths about the child’s health in tension to provide time, space, and clarity. This alignment was seen as key to enabling end-of-life treatment decisions, without which conflict in end-of-life decision-making can arise or persist.
Alternating 17β-Estradiol and Aromatase Inhibitor Therapies Is Efficacious in Postmenopausal Women with Advanced Endocrine-Resistant ER+ Breast Cancer
Authors: Schwartz Gary N. , Kaufman Peter A. , Giridhar Karthik V. , Marotti Jonathan D. , Chamberlin Mary D. , Arrick Bradley A. , Makari-Judson Grace , Goetz Matthew P. , Soucy Shannon M. , Kolling Fred , Demidenko Eugene , Miller Todd W. 
Published: May 2023

Abstract

Purpose:
Strategies to implement estrogen therapy for advanced estrogen receptor–positive (ER+) breast cancer are underdeveloped. Preclinical data suggest that cycling treatment with 17β-estradiol followed by estrogen deprivation can control tumor growth long-term.

Patients and Methods:
Postmenopausal women with advanced ER+/HER2− breast cancer with recurrence or progression on ≥ 1 antiestrogen or aromatase inhibitor (AI)-based therapy were eligible. Patients received 17β-estradiol (2 mg orally, three times a day) for 8 weeks followed by AI (physician's choice) for 16 weeks, alternating treatments on an 8-week/16-week schedule until disease progression. Patients then optionally received continuous single-agent treatment until a second instance of disease progression. Endpoints included 24-week clinical benefit and objective response per RECIST, and tumor genetic alterations.

Results:
Of 19 evaluable patients, clinical benefit rate was 42.1% [95% confidence interval (CI), 23.1%–63.9%] and objective response rate (ORR) was 15.8% (95% CI, 5.7%–37.9%). One patient experienced a grade 3 adverse event related to 17β-estradiol. Among patients who received continuous single-agent treatment until a second instance of disease progression, clinical benefit was observed in 5 of 12 (41.7%) cases. Tumor ER (ESR1) mutations were found by whole-exome profiling in 4 of 7 (57.1%) versus 2 of 9 (22.2%) patients who did versus did not experience clinical benefit from alternating 17β-estradiol/AI therapy. The only two patients to experience objective responses to initial 17β-estradiol had tumor ESR1 mutations.

Conclusions:
Alternating 17β-estradiol/AI therapy may be a promising treatment for endocrine-refractory ER+ breast cancer, including following progression on CDK4/6 inhibitors or everolimus. Further study is warranted to determine whether the antitumor activity of 17β-estradiol differs according to ESR1 mutation status.
Association Between Postresuscitation 12‐Lead ECG Features and Early Mortality After Out‐of‐Hospital Cardiac Arrest: A Post Hoc Subanalysis of the PEACE Study
Authors: Gentile Francesca Romana , Baldi Enrico , Klersy Catherine , Schnaubelt Sebastian , Caputo Maria Luce , Clodi Christian , Bruno Jolie , Compagnoni Sara , Fasolino Alessandro , Benvenuti Claudio , Domanovits Hans , Burkart Roman , Primi Roberto , Ruzicka Gerhard , Holzer Michael , Auricchio Angelo , Savastano Simone 
Published: May 2023

Background
Once the return of spontaneous circulation after out‐of‐hospital cardiac arrest is achieved, a 12‐lead ECG is strongly recommended to identify candidates for urgent coronary angiography. ECG has no apparent role in mortality risk stratification. We aimed to assess whether ECG features could be associated with 30‐day survival in patients with out‐of‐hospital cardiac arrest.

Methods and Results

All the post‐return of spontaneous circulation ECGs from January 2015 to December 2018 in 3 European centers (Pavia, Lugano, and Vienna) were collected. Prehospital data were collected according to the Utstein style. A total of 370 ECGs were collected: 287 men (77.6%) with a median age of 62 years (interquartile range, 53–70 years). After correction for the return of spontaneous circulation‐to‐ECG time, age >62 years (hazard ratio [HR], 1.78 [95% CI, 1.21–2.61];
P
=0.003), female sex (HR, 1.5 [95% CI, 1.05–2.13];
P
=0.025), QRS wider than 120 ms (HR, 1.64 [95% CI, 1.43–1.87];
P
<0.001), the presence of a Brugada pattern (HR, 1.49 [95% CI, 1.39–1.59];
P
<0.001), and the presence of ST‐segment elevation in >1 segment (HR, 1.75 [95% CI, 1.59–1.93];
P
<0.001) were independently associated with 30‐day mortality. A score ranging from 0 to 26 was created, and by dividing the population into 3 tertiles, 3 classes of risk were found with significantly different survival rate at 30 days (score 0–4, 73%; score 5–7, 66%; score 8–26, 45%).

Conclusions
The post‐return of spontaneous circulation ECG can identify patients who are at high risk of mortality after out‐of‐hospital cardiac arrest earlier than other forms of prognostication. This provides important risk stratification possibilities in postcardiac arrest care that could help to direct treatments and improve outcomes in patients with out‐of‐hospital cardiac arrest.
Association Between Spotty Calcification in Nonstenosing Extracranial Carotid Artery Plaque and Ipsilateral Ischemic Stroke
Authors: Homssi Moayad , Vora Amar , Zhang Cenai , Baradaran Hediyeh , Kamel Hooman , Gupta Ajay 
Published: May 2023

Background
Small spotty calcifications in the coronary arteries are associated with an increased risk of myocardial infarction. We examined the association between spotty calcifications near the carotid bifurcations and ipsilateral ischemic stroke in patients with <50% luminal stenosis of the extracranial carotid arteries.

Methods and Results

We used data from the CAESAR (Cornell Acute Stroke Academic Registry), a prospective registry of all patients with acute ischemic stroke admitted to our institution. We included patients who met criteria for cryptogenic stroke and underwent computed tomography angiography and brain magnetic resonance imaging. Patients with extracranial carotid artery stenosis ≥50% and patients with posterior or bilateral anterior circulation infarcts were excluded. We examined the carotid bifurcations for spotty calcifications, defined as ≥1 contiguous regions of luminal calcification ≤3 mm along the long axis of the vessel. We also measured low‐density plaque and maximum plaque thickness. The eligible cohort consisted of 117 patients with a mean age of 66.7±1.65 years with a median National Institute of Health Stroke Scale stroke at the time of arrival of 6 (range, 3–13). The number of spotty calcifications present within a low‐density plaque was significantly associated with ipsilateral infarction (0.3±0.8 versus 0.1±0.4,
P
=0.02). Maximum plaque thickness was also significantly associated with ipsilateral infarction (1.4 mm ±1.5 versus 1.0 mm ±1.1,
P
=0.004).

Conclusions
Spotty calcifications associated with low‐density plaque and maximum plaque thickness were associated with ipsilateral ischemic stroke in patients with nonstenotic carotid atherosclerosis, suggesting a role as imaging markers of high‐risk plaque.
Cost Implications of Left Atrial Appendage Occlusion During Cardiac Surgery: A Cost Analysis of the LAAOS III Trial
Authors: Eqbal Adam , Tong Wesley , Lamy Andre , Belley‐Cote Emilie , Paparella Domenico , Bogachev‐Prokophiev Alexander , Royse Alistair G. , Reents Wilko , Devereaux P. J. , Brady Katheryn , Vincent Jessica , Connolly Stuart J. , Whitlock Richard P. ,   the LAAOS III Investigators
Published: May 2023

Background

The LAAOS III (Left Atrial Appendage Occlusion Study) clinical trial demonstrated that concomitant left atrial appendage (LAA) occlusion leads to a lower risk of ischemic stroke or systemic embolism compared with no occlusion in participants with atrial fibrillation and a CHA
2
DS
2
‐VASc score of ≥2 undergoing cardiac surgery for another indication. We report the cost implications of concomitant LAA occlusion during cardiac surgery.

Methods and Results
Using LAAOS III data, we compared the costs (in US dollars) associated with LAA occlusion to no occlusion from the perspective of the Centers for Medicare and Medicaid Services. We calculated the average cost per participant during the trial by applying Medicare reimbursement costs to cardiovascular events for all trial participants. We conducted sensitivity analyses, varying the cost of stroke ±25% and occlusion technique use. Cost neutrality was defined as a mean cost difference within ±5% of the cost per participant in the no‐occlusion group. Total study cost per participant was $3878 in the LAA occlusion group and $4490 in the no‐occlusion group, a mean difference of −$612 (95% CI, −$1276 to $45). The main drivers of cost savings were fewer stroke events during the trial (mean difference of −$1021). In sensitivity analyses, LAA occlusion was cost saving for suture and stapler techniques but more expensive with closure device.

Conclusions

Concomitant LAA occlusion was cost saving for participants in LAAOS III. Our findings support concomitant LAA occlusion as an economically dominant strategy for patients with atrial fibrillation and a CHA
2
DS
2
‐VASc score of ≥2 undergoing cardiac surgery.
The Importance of Being Constrained: Dealing with Infeasible Solutions in Differential Evolution and Beyond
Authors: Kononova Anna V. , Vermetten Diederick , Caraffini Fabio , Mitran Madalina-A. , Zaharie Daniela 
Published: May 2023

Abstract
We argue that results produced by a heuristic optimisation algorithm cannot be considered reproducible unless the algorithm fully specifies what should be done with solutions generated outside the domain, even in the case of simple bound constraints. Currently, in the field of heuristic optimisation, such specification is rarely mentioned or investigated due to the assumed triviality or insignificance of this question. Here, we demonstrate that, at least in algorithms based on Differential Evolution, this choice induces notably different behaviours in terms of performance, disruptiveness, and population diversity. This is shown theoretically (where possible) for standard Differential Evolution in the absence of selection pressure and experimentally for the standard and state-of-the-art Differential Evolution variants, on a special test function and the BBOB benchmarking suite, respectively. Moreover, we demonstrate that the importance of this choice quickly grows with problem dimensionality. Differential Evolution is not at all special in this regard—there is no reason to presume that other heuristic optimisers are not equally affected by the aforementioned algorithmic choice. Thus, we urge the heuristic optimisation community to formalise and adopt the idea of a new algorithmic component in heuristic optimisers, which we refer to as the strategy of dealing with infeasible solutions. This component needs to be consistently: (a) specified in algorithmic descriptions to guarantee reproducibility of results, (b) studied to better understand its impact on an algorithm's performance in a wider sense (i.e., convergence time, robustness, etc.), and (c) included in the (automatic) design of algorithms. All of these should be done even for problems with bound constraints.
Conductance-Based Phenomenological Nonspiking Model: A Dimensionless and Simple Model That Reliably Predicts the Effects of Conductance Variations on Nonspiking Neuronal Dynamics
Authors: Naudin Loïs , Raison-Aubry Laetitia , Buhry Laure 
Published: May 2023

Abstract
The modeling of single neurons has proven to be an indispensable tool in deciphering the mechanisms underlying neural dynamics and signal processing. In that sense, two types of single-neuron models are extensively used: the conductance-based models (CBMs) and the so-called phenomenological models, which are often opposed in their objectives and their use. Indeed, the first type aims to describe the biophysical properties of the neuron cell membrane that underlie the evolution of its potential, while the second one describes the macroscopic behavior of the neuron without taking into account all of its underlying physiological processes. Therefore, CBMs are often used to study “low-level” functions of neural systems, while phenomenological models are limited to the description of “high-level” functions. In this letter, we develop a numerical procedure to endow a dimensionless and simple phenomenological nonspiking model with the capability to describe the effect of conductance variations on nonspiking neuronal dynamics with high accuracy. The procedure allows determining a relationship between the dimensionless parameters of the phenomenological model and the maximal conductances of CBMs. In this way, the simple model combines the biological plausibility of CBMs with the high computational efficiency of phenomenological models, and thus may serve as a building block for studying both high-level and low-level functions of nonspiking neural networks. We also demonstrate this capability in an abstract neural network inspired by the retina and C. elegans networks, two important nonspiking nervous tissues.
Dynamic Modeling of Spike Count Data With Conway-Maxwell Poisson Variability
Authors: Wei Ganchao , Stevenson Ian H. 
Published: May 2023

Abstract
In many areas of the brain, neural spiking activity covaries with features of the external world, such as sensory stimuli or an animal's movement. Experimental findings suggest that the variability of neural activity changes over time and may provide information about the external world beyond the information provided by the average neural activity. To flexibly track time-varying neural response properties, we developed a dynamic model with Conway-Maxwell Poisson (CMP) observations. The CMP distribution can flexibly describe firing patterns that are both under- and overdispersed relative to the Poisson distribution. Here we track parameters of the CMP distribution as they vary over time. Using simulations, we show that a normal approximation can accurately track dynamics in state vectors for both the centering and shape parameters (λ and ν). We then fit our model to neural data from neurons in primary visual cortex, “place cells” in the hippocampus, and a speed-tuned neuron in the anterior pretectal nucleus. We find that this method outperforms previous dynamic models based on the Poisson distribution. The dynamic CMP model provides a flexible framework for tracking time-varying non-Poisson count data and may also have applications beyond neuroscience.