bluuebunny/crossref_metadata_2025_split huggingface dataset:
Under-Representation of Racial Groups in Genomics Studies of Gastroenteropancreatic Neuroendocrine Neoplasms
Authors: Herring Brendon R. , Bonner Andrew , Guenter Rachael E. , Vickers Selwyn , Yates Clayton , Lee Goo , Dhall Deepti , Chen Herbert , Rose J. Bart 
Published: September 2022

Not all populations are poised to benefit from advancing genomics in gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN), as genomics have focused on White patients. This study aimed to evaluate racial populations represented in genomic studies of GEP-NENs and to provide evidence of differential genomic findings between racial groups in GEP-NENs. Manuscripts analyzing DNA, RNA, or DNA methylation in GEP-NENs were queried using PUBMED and EMBASE. NIH race/ethnicity term frequency was then determined by Natural Language Processing, followed by manual evaluation of tumor types and subjects by racial group. IHC of institutional tissue micro-arrays and analysis of AACR GENIE data analyzed was performed to determine mutational differences between Black and White pancreatic NEN (pNEN) patients. 313 manuscripts conducted the requisite genomic analyses, 16 of which included subject race data. Race data were included in 13/184 DNA, 4/107 RNA, and 1/54 DNA Methylation analyses. These studies included 89% White subjects (n = 2032), 5.8% Asian subjects (n = 132), 4.0% “Other” subjects (n = 93), and 1.2% Black subjects (n = 27). No Native American/Alaska Native, Native Hawaiian/Pacific Islander, or ethnically Hispanic/Latinx subjects were represented. There were significant differences in MEN1 mutations among Black and White patients in immunohistochemical (13:40) and GENIE data (24:268 patients per group, respectively), with 9 additional genes differentially mutated in the GENIE dataset. Genomic sequencing data for GEP-NENs is almost racially homogenous. Differences in pNEN genomics may exist between racial groups, highlighting a need for diversity in future genomic analyses of GEP-NENs to understand the putative influence of interracial genomic variation on GEP-NEN prevention, diagnosis, and therapy.Significance:There is little diversity in genomic studies of GEP-NENs, which may exhibit clinically impactful variation in their tumor biology among racial groups. Improved diversity in such studies is imperative for understanding this variation and its potential impacts on disease prevention, diagnosis, therapeutic targeting, and clinical outcomes.
Protestant Parishioners, Their Pastors, and Euthanasia
Authors: Graafland Wim , Groenewoud A. Stef , Pleizier T. Theo J. , Boer Theo A. 
Published: September 2022

Abstract
In the past, research was done in the Netherlands among pastors to study their attitudes and experiences regarding euthanasia. Also, the attitudes of protestant believers have been studied, however very superficially. This paper presents the results of a survey among 736 parishioners of the Protestant Church in the Netherlands about their experiences, views, and understanding of euthanasia and about what they expect from their pastor. Two-thirds of the respondents are positive about euthanasia being permissible in the Netherlands, and half of them consider euthanasia a possibility for themselves. A parishioner’s theological subdenomination (orthodox, evangelical, middle-orthodox, liberal) is related significantly to their views about euthanasia and pastoral care. Most parishioners value a central role for their pastor at the end of their lives, including those who would possibly consider euthanasia. The relevance of this survey is that a better insight in the parishioners’ wishes about euthanasia can improve the practice of pastoral care at the end of life.
Assurance for Implementing the State’s Responsibility to Protect: Lessons from Burundian Practice
Authors: Mbirigi Ferdinand 
Published: September 2022

Abstract
The state’s responsibility to protect is one of the well-established principles of international law recalled by the Resolution a/res/60/1 of 16 September 2005. Given the controversies surrounding the scope of the principle, this paper analyses the practice of its implementation with a particular focus on Burundi which withdrew from the 1998 Rome Statute of the International Criminal Court on 27 October 2017. The reflection consisted in collecting and analysing previous academic works and official documents inter alia national laws, international instruments, official statements, reports, and records of meeting on the responsibility to protect and related topics. The paper demonstrates that Burundi has made progress to build the state’s resilience to atrocity crimes by establishing a deterrent legal framework and institutional mechanisms. Nonetheless, these significant efforts failed to achieve the expected outcomes in terms of legal effect.
Relating Sound and Sight in Simulated Environments
Authors: Tsang Kevin Y. , Mannion Damien J. 
Published: September 2022

Abstract
The auditory signals at the ear can be affected by components arriving both directly from a sound source and indirectly via environmental reverberation. Previous studies have suggested that the perceptual separation of these contributions can be aided by expectations of likely reverberant qualities. Here, we investigated whether vision can provide information about the auditory properties of physical locations that could also be used to develop such expectations. We presented participants with audiovisual stimuli derived from 10 simulated real-world locations via a head-mounted display (HMD; ) or a web-based () delivery method. On each trial, participants viewed a first-person perspective rendering of a location before hearing a spoken utterance that was convolved with an impulse response that was from a location that was either the same as (congruent) or different to (incongruent) the visually-depicted location. We find that audiovisual congruence was associated with an increase in the probability of participants reporting an audiovisual match of about 0.22 (95% credible interval: ), and that participants were more likely to confuse audiovisual pairs as matching if their locations had similar reverberation times. Overall, this study suggests that human perceivers have a capacity to form expectations of reverberation from visual information. Such expectations may be useful for the perceptual challenge of separating sound sources and reverberation from within the signal available at the ear.
Linkages between Amplified Quasi-Stationary Waves and Humid Heat Extremes in Northern Hemisphere Midlatitudes
Authors: Lin Qiyan , Yuan Jiacan 
Published: September 2022

Abstract
Humid heat extremes, taking account of both temperature and humidity, have adverse impacts on society, particularly on human health. It has been suggested that quasi-stationary waves (QSWs) with anomalously high amplitudes contribute to the occurrence of near-surface precipitation extremes and temperature extremes in the midlatitudes of the Northern Hemisphere. However, little attention has been paid to the linkages between amplified QSWs and humid heat extremes. Using the ERA5 dataset, we identify amplified QSWs of zonal wavenumbers 5–7 (Wave 5–7) in summer months from 1979 to 2020. These amplified QSWs show clear circumglobal wave patterns horizontally and nearly barotropic structure vertically. Linking amplified Wave 5–7 to wet-bulb temperature (WBT) extremes, we find that amplified QSWs preferentially induce prominently prolonged WBT extremes in specific regions: north-central North America for amplified Wave 5; western United States, south-central Asia, and eastern Asia for amplified Wave 6; and western Europe and the Caspian Sea region for amplified Wave 7. Analyses of physical processes indicate that, accompanied by the amplification of Wave 5–7, the changes in horizontal temperature advection, adiabatic heating associated with descending motion, downward solar radiation, moisture transport and moisture flux convergence, and surface latent heat fluxes largely account for the increase in persistence of WBT extremes.

Significance Statement
In the context of climate change, humid heat extremes exhibit different changes and impacts from high-temperature extremes, but the physical processes that may cause them remain unclear. This study aims to explore the atmospheric dynamic processes leading to the concurrence of humid heat extremes, which may exacerbate the risk from heat stress in today’s interconnected world. In specific regions over the Northern Hemisphere midlatitudes, durations of humid heat extremes are found to be elevated simultaneously by amplified quasi-stationary waves. We further identify the physical connections between amplified quasi-stationary waves and humid heat extremes over targeted regions. This would help in better understanding the role of changing atmospheric circulations in the humid heat extremes.
Internal Ocean Dynamics Contribution to North Atlantic Interdecadal Variability Strengthened by Ocean–Atmosphere Thermal Coupling
Authors: Arzel Olivier , Huck Thierry , Hochet Antoine , Mussa Alexandre 
Published: September 2022

Abstract
Identifying the primary drivers of North Atlantic interdecadal climate variability is crucial for improving climatic prediction over the coming decades. Here the effect of thermal coupling on the leading energy sources of the interdecadal variability of the ocean–atmosphere system is examined by means of a stochastically forced idealized coupled model. The effect of coupling is quantified from a comparison of the buoyancy variance budget of coupled and uncoupled model configurations. The simplicity of the model allows us to contrast the effect of coupling between a supercritical regime where the deterministic ocean dynamics drive the variability and a damped regime where noise forcing is central to its existence. The results show that changes in surface buoyancy fluxes act as a sink of temperature variance in the supercritical regime, and only become a source in the strongly damped regime. By contrast, internal ocean dynamics associated with the interaction of transient buoyancy fluxes with mean buoyancy gradients always act as a source of interdecadal variability. In addition to the reduced thermal damping effect in coupled integrations, thermal coupling with the atmosphere is shown to significantly increase the role of internal ocean dynamics in the variability, particularly in the regime where interdecadal modes are damped. Only for oceanic background states in the strongly damped regime do changes in surface buoyancy fluxes play a leading role in the upper-ocean variability. A stochastically forced coupled box model is proposed that captures the basic effect of thermal coupling on atmospheric and oceanic energy sources of variability.

Significance Statement
The purpose of this study is to better understand the impact of ocean–atmosphere thermal coupling on the leading energy sources of Atlantic interdecadal variability. Increasing our understanding of the physical mechanisms driving climate variability at interdecadal time scales is important to improve climate prediction. We show that the effect of ocean–atmosphere thermal coupling, as measured by the atmospheric feedback on sea surface temperature anomalies, is to substantially increase the role of internal ocean dynamics in the low-frequency variability of the upper-ocean heat content and sea surface temperature. Atmospheric stochastic forcing only becomes the primary driver of the oceanic temperature variability in the large dissipative limit, when internal ocean modes are strongly damped.
Conservative Surface Wave Effects on a Wind-Driven Coastal Upwelling System
Authors: Wang Peng , McWilliams James C. , Wang Dongxiao , Yi Daling Li 
Published: September 2022

Abstract
Upwelling brings deep, cold, and nutrient-rich water to the euphotic zone, enhancing biological primary productivity. Coastal upwelling is affected by various factors, such as winds, topography, and tides. However, it remains unclear how the upwelling is affected by surface waves, particularly the Stokes drift and its related forces, that is, conservative wave effects. Here using a coupled wave–circulation model, we examined how conservative wave effects impact the wind-driven coastal upwelling system over an idealized continental shelf. We showed that conservative wave effects reduce upwelling but enhance downwelling; consequently, the amount of deep cold water brought up to the surface by upwelling is reduced with waves, leading to a weaker upwelling front than that without waves. Conservative wave effects also change the potential vorticity (PV) fluxes across the sea surface/bottom and alter the thickness of surface/bottom negative-PV layers. In addition, conservative wave effects modify the turbulent thermal wind (TTW) associated with the upwelling front, forming a Stokes–TTW balance. Further, we studied sensitivities of the upwelling and downwelling magnitudes to four parameters: wave height, wind stress, shelf slope, and wave incident angle. We combined these parameters into a single nondimensional number that can indicate when conservative wave effects need to be included in the upwelling and downwelling.

Significance Statement
Upwelling is important to the marine ecosystem because it enhances biological primary productivity by bringing nutrient-rich water to the euphotic zone from depths. However, it remains unclear how the upwelling is affected by ubiquitous surface waves. Here using numerical simulations, we showed that Stokes drift and its related forces due to surface waves reduce upwelling but enhance downwelling. It implies that there could be a substantial bias in the estimation of upwelling and downwelling if surface waves are not considered. Further, we proposed a nondimensional number to indicate when surface waves need to be considered in the upwelling and downwelling.
Post-Trauma Discharge Instructions: Are We Dropping the Ball?
Authors: Flippin J. Alford , DeMario Belinda S. , Adomshick Victoria J. , Stanley Samuel P. , Truong Evelyn I , Hendrickson Sarah , Kalina Mark A. , Lasinski Alaina M. , Ho Vanessa P. 
Published: September 2022

Introduction Complex follow-up plans for polytrauma patients are compiled at the end of hospitalization into discharge instructions. We sought to identify how often patient discharge instructions incorrectly communicated specialist recommendations. We hypothesized that patients with more complex hospitalizations would have more discharge instruction errors (DI-errors). Methods We reviewed adult trauma inpatients (March 2017-March 2018), excluding those who left against medical advice or were expected to follow up outside our system. Complex hospitalizations were represented using injury severity (ISS), hospital length of stay (LOS), intensive care unit length of stay (iLOS), and number of consultants (NC). We recorded the type of consultant (surgical or nonsurgical), and consultant recommendations for follow-up. DI-errors were defined as either follow-up necessary but omitted or follow-up not necessary yet present on the instructions. Patients with DI-errors were compared to patients without DI-errors. Groups were compared using Wilcoxon rank sum or chi-square (alpha <.05). Results We included 392 patients (median age 45 [IQR 26-58], ISS 14 [10-21], LOS 6 [3-11]). 55 patients (14%) had DI-errors. Factors associated with DI-errors included the total number of consultants and use of nonsurgical consultants. ISS, LOS, iLOS, were not associated with DI-errors. Conclusion Common measures of admission complexity were not associated with DI-errors, although the number and type of consultants were associated with DI-errors. Non-surgical specialty consultant recommendations were more likely to be omitted. It is crucial for patients to receive accurate discharge instructions, and systematic processes are needed to improve communication with the patients at discharge.
A co-produced online cultural experience compared to a typical museum website for mental health in people aged 16–24: A proof-of-principle randomised controlled trial
Authors: Syed Sheriff Rebecca J , Vuorre Matti , Riga Evgenia , Przybylski Andrew K , Adams Helen , Harmer Catherine J , Geddes John R 
Published: September 2022

The mental health of young people (YP) is a major public health concern that has worsened during the COVID-19 pandemic. Whilst engaging with culture and the arts may have mental health benefits there is a dearth of experimental research regarding the impact of online arts and culture on depression and anxiety in YP. In particular online interventions, which may improve accessibility. Objective: We aimed to compare a co-produced online intervention encompassing the diverse human stories behind art and artefacts, named Ways of Being (WoB), with a typical museum website, the Ashmolean (Ash) on negative affect (NA), positive affect (PA) and psychological distress (K10). Methods: In this parallel group RCT, 463 YP aged 16-24 were randomly assigned, 231 to WoB and 232 to Ash. Results: Over the intervention phase (an aggregate score including all post-allocation timepoints to day-five) a group difference was apparent in favour of WoB for NA (WoB-Ash n=448, NA -0.158, p=0.010) but no differences were detected for PA or K10 and differences were not detected at week six. Group differences in NA in favour of WoB were detected in specific subgroups, e.g. ethnic minorities and males. Across participants (from both groups) mean K10 and NA improved between baseline and six weeks despite increased COVID-19 restrictions. Trial recruitment was rapid, retention high and feedback positive with broad geographical, occupational and ethnic diversity. Conclusions: Online engagement with arts and culture has the potential to impact on mental health in a measurable way in YP with high unmet mental health needs.
Measuring subjective aspects of participation in adults with disabilities: A systematic review of the coverage, content validity and internal structure of standardised instruments
Authors: Antunes Ana Amélia Moraes , de Sousa Junior Ricardo Rodrigues , Vaz Daniela Virgínia 
Published: September 2022

Objective To systematically review evidence on the coverage, content validity and internal structure of self-report measures capturing subjective aspects of participation for adults with disabilities. Data sources EMBASE, MEDLINE and reference lists were searched until July 10th, 2022 for articles on measurement properties of instruments measuring participation as defined in the International Classification of Functioning, Disability and Health, from a subjective perspective. Method Each instrument was assessed for its coverage of subjective aspects of participation. The Consensus-based Standards for the Selection of Health Measurement Instruments were used to assess the quality of each study. Content validity and internal structure (structural validity, internal consistency and cross-cultural validity) were rated against published standards and qualified by the adapted Grading of Recommendations Assessment, Development and Evaluation. Results Thirty-eight studies regarding 10 instruments were analysed. Most instruments mix activity and participation items. Only the Measure of Experiential Aspects of Participation (with high-quality evidence of sufficient structural validity and generally sufficient internal consistency), the Participation Enfranchisement and the Community Integration Measure showed adequate coverage. For all instruments, evidence of content validity is of low- to very low quality. There is high-quality evidence that the Participation Scale is not unidimensional. Conclusion In general, the coverage and the evidence for content validity and internal structure of measures capturing experiential aspects of participation are limited. The Measure of Experiential Aspects of Participation has the best level of evidence in support of its use. The score of the Participation Scale cannot be considered an adequate reflection of participation.
A feasibility study of a decision aid to support family carers of people with severe dementia or those towards the end-of-life
Authors: Davies Nathan , Aker Narin , Vickerstaff Victoria , Sampson Elizabeth L , Rait Greta 
Published: September 2022

Background: Advance care planning in dementia does not always happen. As dementia progresses, decisions are often left for family carers to make with professionals. Aim: To test the feasibility and acceptability of the delivery and use of a decision aid for family carers of people with severe dementia or towards the end-of-life. Design: Feasibility study using a before-after design of a paper-based decision aid with family carers of people with severe dementia or towards the end-of-life. Criteria for whether to progress to full evaluation included achieving: 70% recruitment rate of target of 30 people, and retention of 70% at 6 months. Outcome measures at baseline, 3 and 6 months, included: the Decisional Conflict Scale (DCS), Kessler Psychological Distress Scale (K10), EQ5D-5L and Satisfaction with Care at the End of Life (SWC-EOLD). Participants: Twenty-eight family carers were recruited (93% of target), 26 completed baseline assessment and 20 (71%) of those were followed-up at 6 months. Results: Almost all outcomes changed indicating improvement over 6 months. The DCS and K10 scores decreased indicating less decisional conflict and less psychological distress. The decision aid was acceptable, 25% found it very helpful and 55% a little helpful at 6 months. Conclusion: We met the success criteria demonstrating this study was feasible and acceptable to carers. Future research should test the effectiveness of the decision aid in a full scale evaluation.
Prognostic nomograms for lung neuroendocrine carcinomas based on lymph node ratio: a SEER database analysis
Authors: Xiong Lan , Jiang Youfan , Hu Tianyang 
Published: September 2022

Objective The current study aimed to explore the prognostic value of the lymph node ratio (LNR) in patients with lung neuroendocrine carcinomas (LNECs). Methods Data for 1564 elderly patients with LNECs between 1998 and 2016 were obtained from the Surveillance, Epidemiology, and End Results database. The cases were assigned randomly to training (n = 1086) and internal validation (n = 478) sets. The association between LNR and survival was investigated by Cox regression. Results Multivariate analyses identified age, tumor grade, summary stage, M stage, surgery, and LNR as independent prognostic factors for both overall survival (OS) and lung cancer-specific survival (LCSS). Tumor size was also a prognostic determinant for LCSS. Prognostic nomograms combining LNR with other informative variables showed good discrimination and calibration abilities in both the training and validation sets. In addition, the C-index of the nomograms was statistically superior to the American Joint Committee on Cancer (AJCC) staging system in both the training and validation cohorts. Conclusions These nomograms, based on LNR, showed superior prognostic predictive accuracy compared with the AJCC staging system for predicting OS and LCSS in patients with LNECs.