bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamics of eddying abyssal mixing layers over sloping rough topography
Authors: Drake Henri F. , Ruan Xiaozhou , Callies Jörn , Ogden Kelly , Thurnherr Andreas M. , Ferrari Raffaele 
Published: July 2022

Abstract
ABSTRACT: The abyssal overturning circulation is thought to be primarily driven by small-scale turbulent mixing. Diagnosed watermass transformations are dominated by rough topography “hotspots”, where the bottom-enhancement of mixing causes the diffusive buoyancy flux to diverge, driving widespread downwelling in the interior—only to be overwhelmed by an even stronger up-welling in a thin Bottom Boundary Layer (BBL). These watermass transformations are significantly underestimated by one-dimensional (1D) sloping boundary layer solutions, suggesting the importance of three-dimensional physics. Here, we use a hierarchy of models to generalize this 1D boundary layer approach to three-dimensional eddying flows over realistically rough topography. When applied to the Mid-Atlantic Ridge in the Brazil Basin, the idealized simulation results are roughly consistent with available observations. Integral buoyancy budgets isolate the physical processes that contribute to realistically strong BBL upwelling. The downwards diffusion of buoyancy is primarily balanced by upwelling along the sloping canyon sidewalls and the surrounding abyssal hills. These flows are strengthened by the restratifying effects of submesoscale baroclinic eddies and by the blocking of along-ridge thermal wind within the canyon. Major topographic sills block along-thalweg flows from restratifying the canyon trough, resulting in the continual erosion of the trough’s stratification. We propose simple modifications to the 1D boundary layer model which approximate each of these three-dimensional effects. These results provide local dynamical insights into mixing-driven abyssal overturning, but a complete theory will also require the non-local coupling to the basin-scale circulation.
Second Victim Syndrome in Trauma Practitioners and Other Ancillary Staff
Authors: Bakshi Arjun S. , Hardy Sierra L. , Moore Erica , Nicely Kelly Wiltse , Koganti Deepika , Hanos Dustin , Thompson Alexis N. , Grant April , Nguyen Jonathan , Sola Richard , Williams Keneeshia N. , Sciarretta Jason D. , Dente Christopher J. , Castater Christine A. , Smith Randi N. 
Published: July 2022

In health care, second victims are traumatized clinicians involved in unanticipated or untoward patient events. Programs that address second victim syndrome are sparse and its diagnosis often goes unrecognized. Consistently, literature has identified gaps in support resources, leading to compromised patient care and provider health. This project evaluates the need for second victim resources in trauma care providers at a tertiary public level 1 trauma hospital by electronically implementing a validated second victim survey over 5 weeks. Our results illustrate that second victim syndrome is prevalent among 57.1% of trauma care providers, of which 22.9% agree that second victim syndrome results in some form of undesirable work intentions.
Survival Outcomes Related to Treatment Modalities in Patients With Oropharyngeal Squamous Cell Carcinoma
Authors: Cheng Danni , Rao Yufang , Qiu Jianqing , Song Yao , Pang Wendu , Qiu Ke , Dong Yijun , Liu Qiurui , Zhao Yu , Liu Jun , Xu Wei , Ren Jianjun 
Published: July 2022

Background More patients with oropharyngeal squamous cell carcinoma (OPSCC) in Eastern countries receive surgically inclusive treatment (SIT), while most patients in Western countries receive nonsurgical treatment (NST). The optimal treatment modality for OPSCC patients remains controversial. Methods A total of 153 consecutive OPSCC cases diagnosed between 2009 and 2019 in West China Hospital (WCH) and 15,400 OPSCC cases from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2017) were obtained. Clinical characteristics, treatments, and survival outcomes were retrospectively collected. We constructed Kaplan–Meier curves and performed univariate (UVA) and multivariate (MVA) analyses to compare the prognosis of OPSCC patients among the WCH, SEER Asian, and SEER all ethnic populations by different treatment modality, human papilloma virus (HPV) infection status, age, and tumor stage. Results Overall, the proportions of patients with younger age, advanced tumors and HPV-negative status, and receiving SIT in WCH population were higher than those in the SEER all ethnic population, while the proportions in the SEER Asian population were between those of the other two populations. We observed consistent beneficial effects of SIT on the overall survival (OS) in OPSCC patients in all three populations (SEER Asian: MVA, hazard ratio (HR): 0.2, p < .001; SEER all ethnic: MVA, HR: 0.46, p < .001; WCH: UVA, HR: 0.62, p = .071), and HPV-negative Asian patients showed greater benefits from the SIT than HPV-positive Asian patients (HPV Negative: HR: 0.16, p = .005; HPV positive: HR = 0.28, p = .059). Male was a risk factor for reduced OS in OPSCC patients in the WCH population (HR: 3.17, p = .043), but was a protective factor in the SEER population (HR: 0.8, p = .002), which might be related to the differences of HPV infection status. Conclusions Even though differences in patient characteristics existed between the Chinese, American, and Asian American populations, our ten-year real-world data and SEER data suggested that patients with OPSCC who received SIT had a better prognosis than those who received NST.
Dose-dependent influence of red blood cell transfusion volume on adverse outcomes in cardiac surgery
Authors: Zhang Qiaoni , Gao Sizhe , Diao Xiaolin , Yan Weidong , Yan Shujie , Gao Guodong , Qi Jiachen , Zhang Yanming , Ji Bingyang 
Published: July 2022

Introduction Red blood cell (RBC) transfusion is associated with adverse outcomes, but there are few studies on the RBC volume. This study aimed to evaluate the relationship between intraoperative RBC volume and postoperative adverse outcomes for on-pump cardiac surgery. Methods Adult patients undergoing on-pump cardiac surgery from 1 January 2017 to 31 December 2018 were included. Those transfused with more than 6 units of RBC were excluded. The clinical characteristics of four groups with various RBC volume were compared. We analyzed the relationship between RBC volume and adverse outcomes through multivariable logistic regression. Results 12,143 patients were analyzed, of which 3353 (27.6%) were transfused with 1–6U RBC intraoperatively. The incidence of death, overall morbidity, acute kidney injury and prolonged mechanical ventilation were increased stepwise along with incremental RBC volume. After adjusting for possible confounders, patients transfused with 1–2U were associated with a 1.42-fold risk of death (99% CI, 1.21–2.34, p = 0.01) compared with patients without RBC, patients with 3–4U were associated with a 1.57-fold risk (99% CI, 1.32–2.80, p = 0.005) and patients with 5–6U had a 2.26-fold risk of death (99% CI, 1.65–3.88, p < 0.001). Similarly, the incidence of overall morbidity, acute kidney injury and prolonged mechanical ventilation increased several folds as the RBC numbers increased. Conclusions There was a significant dose-dependent influence of incremental intraoperative RBC volume on increased risk of adverse outcomes for on-pump cardiac surgery patients. Patient blood management practice should aim to reduce not only transfusion rate but also the volume of blood use.
Markov Cohort State-Transition Model: A Multinomial Distribution Representation
Authors: Iskandar Rowan , Berns Cassandra 
Published: July 2022

Markov cohort state-transition models have been the standard approach for simulating the prognosis of patients or, more generally, the life trajectories of individuals over a time period. Current approaches for estimating the variance of a Markov model using a Monte Carlo sampling or a master equation representation are computationally expensive and analytically difficult to express and solve. We introduce an alternative representation of a Markov model in the form of a multinomial distribution. We derive this representation from principles and then verify its veracity in a simulation exercise. This representation provides an exact and fast approach to computing the variance and a way of estimating transition probabilities in a Bayesian setting. Highlights A Markov model simulates the average experience of a cohort of patients. Monte Carlo simulation, the standard approach for estimating the variance, is computationally expensive. A multinomial distribution provides an exact representation of a Markov model. Using the known formulas of a multinomial distribution, the mean and variance of a Markov model can be readily calculated.
Comparison of oncological, surgical, and functional outcomes between radical retropubic and radical perineal prostatectomy: A multi-institutional study
Authors: Moussa Mohamad , Abou Chakra Mohamad , Peyromaure Michael , Barry Delongchamps Nicolas , Bailly Hugo , Duquesne Igor 
Published: July 2022

Introduction: To investigate the safety, oncologic, surgical, and functional outcomes of RPP and RRP for localized prostate cancer (Pca), especially focusing on RPP. Materials and methods: From March 2005 to January 2021, we retrospectively reviewed the records of 685 patients undergoing RPP ( n = 320) or RRP ( n = 365) for localized Pca. Surgical and functional outcomes, and complications were compared. Oncological outcomes were also compared using Kaplan-Meier survival analysis. Results: A higher biochemical recurrence rate were noted in RRP than in RPP group (28.8% vs 21.6%, respectively; p = 0.03). A local recurrence was detected in a few numbers of patients (4.4%) with no statistically significant differences by surgical groups ( p = 0.71). No significant differences were observed in the cancer-specific survival and the overall survival according to the surgical approach. Positive surgical margins were similar in the two techniques. In comparison to RRP, patients undergoing RPP have less postoperative pain, decreased transfusion rate, and less catheterization time. Complete continence was achieved in 96.9% of the RPP group at 18 and 24 months versus 91.8% and 92.3% in the RRP group at 18 and 24 months, respectively ( p = 0.005 and p = 0.01, respectively). At 18 months of follow-up, the nerve-sparing technique was performed equally between the two groups, the mean of erectile function domain improved more in RPP than RRP (12.71 vs 10.42 respectively, p < 0.001). Medical and surgical complication rates were higher for RRP than RPP. Conclusions: RPP showed acceptable oncologic outcomes and excellent functional outcomes when compared to RRP.
Study of lead-induced neurotoxicity in cholinergic cells differentiated from bone marrow-derived mesenchymal stem cells
Authors: Jafarzadeh Emad , Soodi Maliheh , Tiraihi Taki , Zarei Mohammadhadi , Qasemian‐Lemraski Mehdi 
Published: July 2022

The developing brain is susceptible to the neurotoxic effects of lead. Exposure to lead has main effects on the cholinergic system and causes reduction of cholinergic neuron function during brain development. Disruption of the cholinergic system by chemicals, which play important roles during brain development, causes of neurodevelopmental toxicity. Differentiation of stem cells to neural cells is recently considered a promising tool for neurodevelopmental toxicity studies. This study evaluated the toxicity of lead acetate exposure during the differentiation of bone marrow–derived mesenchyme stem cells (bone marrow stem cells, BMSCs) to CCholinergic neurons. Following institutional animal care review board approval, BMSCs were obtained from adult rats. The differentiating protocol included two stages that were pre-induction with β-mercaptoethanol (BME) for 24 h and differentiation to cholinergic neurons with nerve growth factor (NGF) over 5 days. The cells were exposed to different lead acetate concentrations (0.1–100 μm) during three stages, including undifferentiated, pre-induction, and neuronal differentiation stages; cell viability was measured by MTT assay. Lead exposure (0.01–100 μg/ml) had no cytotoxic effect on BMSCs but could significantly reduce cell viability at 50 and 100 μm concentrations during pre-induction and neuronal differentiation stages. MAP2 and choline acetyltransferase (ChAT) protein expression were investigated by immunocytochemistry. Although cells treated with 100 μm lead concentration expressed MAP2 protein in the differentiation stages, they had no neuronal cell morphology. The ChAT expression was negative in cells treated with lead. The present study showed that differentiated neuronal BMSCs are sensitive to lead toxicity during differentiation, and it is suggested that these cells be used to study neurodevelopmental toxicity.
Differences in Beliefs and Behaviors Related to COVID-19 Prevention Among Adult Current and Former Smokers and With and Without A Cancer Diagnosis
Authors: Pebley Kinsey , Krukowski Rebecca A. 
Published: July 2022

Purpose Study aims included assessing differences in beliefs/behaviors about COVID-19 prevention among current and former smokers with and without cancer. Design A cross-sectional survey about COVID-19 beliefs/behaviors was administered from June 2020 to January 2021. Setting Survey conducted online via Qualtrics from June 2020 to January 2021. Subjects Participants were current (n = 101) and former (n = 102) smokers with and without cancer. Measures Questions were related to beliefs about efficacy of and engagement in behaviors for COVID-19 prevention. Results Results from logistic regressions displayed that individuals with cancer were more likely to indicate using hand sanitizer with at least 60% alcohol was ineffective ( OR = .12, 95% CI: [.02, .65]) and avoided public transportation ( OR = 1.84, 95% CI: [1.04, 3.28]) compared to those without cancer. Former smokers were more likely to indicate taking vitamin C was effective ( OR = .45, 95% CI: [.22, .93]) and rinsing your mouth with salt water ( OR = 1.89, 95% CI: [1.02, 3.50]) was ineffective compared to current smokers. Current smokers were more likely to indicate not smoking was effective compared to former smokers ( OR = 2.19, 95% CI: [1.13, 4.24]). Conclusions Counters to COVID-19 misinformation may need to be tailored to different at-risk groups based on differential beliefs and behaviors.
Effect of side dilution jets on the velocity field and mixing in swirl and bluff-body stabilised annular confined flows
Authors: Gillani Syed Ehtisham , Al-Abdeli Yasir M , Tian Zhao F 
Published: July 2022

Stationary and mobile power generation systems, as well as those for aero propulsion, continue to rely heavily on gas turbines. Operational envelopes which critically depends on (flame) jet stabilisation mechanisms, such as swirl, are also affected by considerations for emissions control. In this context, the evolving swirling flow domains feature injection of side (peripheral) dilution air. Despite this, the role of side dilution jets on modifying the flow, turbulence, and mixing fields of turbulent bluff-body (BB) stabilised (swirling) annular flows has not been investigated. This study uses three-dimensional simulations, supported with experimental data to establish boundary conditions, to investigate the interaction of side dilution jets (Red = 18,000) with both non-swirling (S = 0) and swirling (S = 0.3) turbulent BB stabilised annular flows (Res = 35,500). Constant Temperature Anemometry (CTA) measurements are conducted to resolve inlet boundary conditions. The Reynolds Stress Model (RSM) and species transport model (isothermal) are used with validations against benchmark datasets. Results show that the introduction of side dilution jets into a confined domain, whether swirling or not, induces (asymmetrical) Peripheral Recirculation Zones (PRZ). However, the strength, length, and location of PRZ varies with swirl and the downstream positioning of side dilution jets (H = 2.6D, 6.6D). Additionally, side dilution jets increase centreline velocity decay for both, non-swirling and swirling BB flows. In terms of turbulence characteristics, addition of side dilution jets leads to significant gains in shear layer turbulence with an increase of 72% and 35% in turbulent kinetic energy for non-swirling and swirling BB flows, respectively. Analysis of the mixing characteristics shows negligible impact of side dilution jets in the upstream region, however, from x/D > 3 considerable improvement in central jet (fuel) mixing is observed.
Exploration of machine learning methods to predict systemic lupus erythematosus hospitalizations
Authors: Jorge April M , Smith Dylan , Wu Zhiyao , Chowdhury Tashrif , Costenbader Karen , Zhang Yuqing , Choi Hyon K , Feldman Candace H , Zhao Yijun 
Published: July 2022

Objectives Systemic lupus erythematosus (SLE) is a heterogeneous disease characterized by disease flares which can require hospitalization. Our objective was to apply machine learning methods to predict hospitalizations for SLE from electronic health record (EHR) data. Methods We identified patients with SLE in a longitudinal EHR-based cohort with ≥2 outpatient rheumatology visits between 2012 and 2019. We applied multiple machine learning methods to predict hospitalizations with a primary diagnosis code for SLE, including decision tree, random forest, naive Bayes, logistic regression, and an ensemble method. Candidate predictors were derived from structured EHR features, including demographics, laboratory tests, medications, ICD-9/10 codes for SLE manifestations, and healthcare utilization. We used two approaches to assess these variables over longitudinal follow-up, including the incorporation of lagged features to capture changes over time of clinical data. The performance of each model was evaluated by overall accuracy, the F statistic, and the area under the receiver operator curve (AUC). Results We identified 1996 patients with SLE. 4.6% were hospitalized for SLE in their most recent year of follow-up. Random forest models had highest performance in predicting SLE hospitalizations, with AUC 0.751 and AUC 0.772 for two approaches (averaging and progressive), respectively. The leading predictors of SLE hospitalizations included dsDNA positivity, C3 level, blood cell counts, and inflammatory markers as well as age and albumin. Conclusion We have demonstrated that machine learning methods can predict SLE hospitalizations. We identified key predictors of these events including known markers of SLE disease activity; further validation in external cohorts is warranted.
“Septoplasty” Performed at Primary Cleft Rhinoplasty: A Systematic Review of Techniques and Call for Accurate Terminology
Authors: Park Jenn J. , Rodriguez Colon Ricardo , Arias Fernando D. , Laspro Matteo , Chaya Bachar F. , Rochlin Danielle H. , Staffenberg David A. , Flores Roberto L. 
Published: July 2022

Objective Primary cleft nasal repair can include septal reconstruction. We hypothesize that primary cleft septoplasty and adult septoplasty have fundamental differences that render these procedures as distinct surgical entities. Design Systematic review of the PubMed, Cochrane, and Embase databases performed on pediatric cleft and general adult septoplasty techniques through December 2021. (PROSPERO ID CRD42022295763) Main Outcome Measures Collected data included information on septal dissection, septal detachment, and management of the bony and cartilaginous septum. Results Twenty-eight pediatric cleft septoplasty and 229 adult septoplasty studies were included. Dissection in primary cleft septoplasty was limited to the anterocaudal septum, while secondary cleft septoplasty and adult septoplasty techniques entailed wide exposures of the cartilaginous septum with or without exposure of the perpendicular plate of the ethmoid. In primary cleft septoplasty, detachment of the septum was mostly limited to the nasal spine and anterior base of the cartilaginous septum, while secondary cleft septoplasty and adult septoplasty included detachment from the vomer, and ethmoid. In the few reports of cartilage excision during primary cleft septoplasty, removal was limited to the anterior inferior border of the septum, while secondary cleft septoplasty and adult septoplasty included excision of the cartilaginous and bony septum. Conclusion Primary cleft septoplasty is distinct from septoplasty performed on facially mature patients. More specifically, septal dissection and detachment are limited to the anterior caudal area during primary lip repair, with rare removal of cartilage or bone. Given these differences, the authors suggest the term “septal reset” to describe septoplasty performed during primary cleft nasal repair.
Prediction Models for Prognosis of Hypoglycemia in Patients with Diabetes: A Systematic Review and Meta-Analysis
Authors: Wu Yi , Li Ruxue , Zhang Yating , Long Tianxue , Zhang Qi , Li Mingzi 
Published: July 2022

Objective To systematically summarize the reported prediction models for hypoglycemia in patients with diabetes, compare their performance, and evaluate their applicability in clinical practice. Methods We selected studies according to the PRISMA, appraised studies according to the Prediction model Risk of Bias Assessment Tool (PROBAST), and extracted and synthesized the data according to the CHARMS. The databases of PubMed, Web of Science, Embase, and Cochrane Library were searched from inception to 31 October 2021 using a systematic review approach to capture all eligible studies developing and/or validating a prognostic prediction model for hypoglycemia in patients with diabetes. The risk bias and clinical applicability were assessed using the PROBAST. The meta-analysis of the performance of the prediction models were also conducted. The protocol of this study was recorded in PROSPERO (CRD42022309852). Results Sixteen studies with 22 models met the eligible criteria. The predictors with the high frequency of occurrence among all models were age, HbA1c, history of hypoglycemia, and insulin use. A meta-analysis of C-statistic was performed for 21 prediction models, and the summary C-statistic and its 95% confidence interval and prediction interval were 0.7699 (0.7299–0.8098), 0.7699 (0.5862–0.9536), respectively. Heterogeneity exists between different hypoglycemia prediction models (τ2 was 0.00734≠0). Conclusions The existing predictive models are not recommended for widespread clinical use. A high-quality hypoglycemia screening tool should be developed in future studies.