bluuebunny/crossref_metadata_2025_split huggingface dataset:
The world’s tiniest land snails from Laos and Vietnam (Gastropoda, Pulmonata, Hypselostomatidae)
Authors: Páll-Gergely Barna , Jochum Adrienne , Vermeulen Jaap J. , Anker Katja , Hunyadi András , Örstan Aydin , Szabó Ábel , Dányi László , Schilthuizen Menno 
Published: January 2022

Abstract
Two new, extremely small land snail species, Angustopila coprologos Páll-Gergely, Jochum & Hunyadi n. sp. and Angustopila psammion Páll-Gergely, Vermeulen & Anker n. sp. are described from northern Vietnam and northern Laos, respectively. The former is characterized by a rough surface sculpture and bears tiny mud granules arranged in a pattern of radial lines on its shell surface. The latter species is the new global record-holder of the tiniest land snail title, with a shell width of 0.6–0.68 mm and a shell height of 0.46–0.57 mm. These measurements surpass the former records of Angustopila pallgergelyi and Acmella nana.
Comprehensive Assessment and Variation Characteristics of the Drought Intensity in North China Based on EID
Authors: Zhao Haiyan , Chen XianYan , Yang JiaXi , Yao Chuang , Zhang Qiang , Mei Ping 
Published: January 2022

Abstract
Under the new background of climate change, it is very important to identify the characteristics of drought in North China. Based on the daily meteorological drought comprehensive index from 494 national meteorological stations in North China during 1961–2019, the drought processes and their intensity are identified by applying the “extreme” intensity–duration (EID) theory. Then, the stage variation characteristics of the drought trend, the average drought intensity, and the drought frequency are analyzed. The results show that among the five drought intensity indices the process maximum intensity demonstrates the greatest correlation coefficient with the disaster rate of drought in North China. Therefore, the process maximum intensity of drought is selected as the annual drought intensity to analyze the drought characteristics in North China. According to the climate warming trends, the study period is divided into three stages, that is, 1951–84 (stage I), 1985–97 (stage II), and 1998–2019 (stage III). The comprehensive results show that the drought intensity in North China has significant stage characteristics. In stage I, the drought shows an increasing trend in most parts of North China, but its average intensity is relatively weaker, with a lower severe drought frequency. The drought also shows an increasing trend in most parts in stage II, with a more significant increase rate than that in stage I, and the average drought intensity is the strongest and the severe drought frequency is the highest. In stage III, the drought shows a decreasing trend in some areas, and the average intensity is the weakest, with a lower severe drought frequency.

Significance Statement
In this paper, we develop a drought intensity formula, the maximum intensity of drought, based on the “extreme” intensity–duration theory. The maximum intensity of drought was then calculated and selected as an annual drought intensity to analyze the drought characteristics in North China. We found that the annual drought intensity better captured the extremity and the patterns of drought process than that obtained with single indices and comprehensive indices. The results show a decreasing trend of drought in North China after 1998.
Subsurface Warm Biases in the Tropical Atlantic and Their Attributions to the Role of Wind Forcing and Ocean Vertical Mixing
Authors: Zhang Qiushi , Zhu Yuchao , Zhang Rong-Hua 
Published: January 2022

Abstract
Realistic ocean subsurface simulations of thermal structure and variation are critically important to success in climate prediction and projection; currently, substantial systematic subsurface biases still exist in the state-of-the-art ocean and climate models. In this paper, subsurface biases in the tropical Atlantic Ocean (TA) are investigated by analyzing simulations from the Ocean Model Intercomparison Project (OMIP) and conducting ocean-only experiments that are based on the Parallel Ocean Program, version 2 (POP2). The subsurface biases are prominent in almost all OMIP simulations, characterized by two warm-bias patches off the equator. By conducting two groups of POP2-based ocean-only experiments, two potential origins of the biases are explored, including uncertainties in wind forcing and vertical mixing parameterization, respectively. It is illustrated that the warm bias near 10°N can be slightly reduced by modulating the prescribed wind field, and the warm biases over the entire basin are significantly reduced by reducing background diffusivity in the ocean interior in ways to match observations. By conducting a heat-budget analysis, it is found that the improved subsurface simulations are attributed to the enhanced cooling effect by constraining the vertical mixing diffusivity in terms of the observational estimate, implying that overestimation of vertical mixing is primarily responsible for the subsurface warm biases in the TA. Since the climate simulation is very sensitive to the vertical mixing parameterization, more accurate representations of ocean vertical mixing are clearly needed in ocean and climate models.

Significance Statement
The purpose of our study is to analyze the characteristics of subsurface temperature biases in the tropical Atlantic Ocean and to investigate the causes for the biases. This is important because subsurface biases greatly reduce the reliability of models in climate prediction and projection. It is found that significant subsurface warm biases arise in 100–150 m over the entire tropical Atlantic basin and the biases are mainly attributed to overestimated ocean vertical mixing. Our work highlights that subsurface ocean simulations are highly sensitive to vertical mixing parameterization, and further research is necessary for more accurate representations of ocean vertical mixing in ocean and climate modeling.
Risk Factors for Delirium and Association of Antipsychotic Use with Delirium Progression in Critically Ill Trauma Patients
Authors: Shoulders Bethany R. , Elsabagh Sarah , Tam Douglas J. , Frantz Amanda M. , Alexander Kaitlin M. , Voils Stacy A. 
Published: January 2022

Background Delirium occurs frequently in critically ill and injured patients and is associated with significant morbidity and mortality. Limited data exists on the risk factors for developing delirium in critically ill trauma patients and the effect of antipsychotic (AP) medications on delirium progression. Objective The objective of this study is to determine the incidence of delirium in critically ill trauma versus non-trauma surgical patients and determine if the presence of trauma was associated with intensive care unit (ICU) delirium. Secondary outcomes included identifying risk factors for delirium and determining the impact of AP medication use on delirium progression in critically ill trauma patients. Methods This retrospective review studies adult trauma/surgical ICU patients admitted between May 2017-July 2018 to a level I trauma and tertiary referral center. Regression modeling was used to determine the impact of AP use on delirium-free days. Results Delirium was more common in critically ill trauma patients versus non-trauma surgical ICU patients [54/157 (34.4%) vs 42/270 (15.6%), P < .001]. Of the 54 trauma patients with delirium, 28 (52%) received an AP medication for delirium treatment and in the multiple linear regression analysis, AP use was significantly associated with fewer delirium-free days ( P = .02). Discussion Higher admission sequential organ failure assessment scores and increased length of stay were significantly associated with delirium onset in critically ill trauma patients. Use of AP medications for delirium treatment in this population had a negative impact on delirium-free days.
A New Predictor of Mortality in ST-Elevation Myocardial Infarction: The Uric Acid Albumin Ratio
Authors: Kalkan Sedat , Cagan Efe Süleyman , Karagöz Ali , Zeren Gönül , Yılmaz Mehmet Fatih , Şimşek Barış , Batgerel Ulaankhuu , Özkalaycı Flora , Tanboğa İbrahim Halil , Oduncu Vecih , Karabay Can Yücel , Kırma Cevat 
Published: January 2022

Several studies have shown that high uric acid (UA) and low serum albumin (SA) values increase the risk of cardiovascular disease and mortality in ST-elevation myocardial infarction (STEMI). We determined whether the uric acid/albumin ratio (UAR) is a predictor of mortality in STEMI patients. All patients who presented at our center with a diagnosis of STEMI and underwent percutaneous intervention from 2015 to 2020 were screened consecutively; 4599 patients were included. A Cox proportional hazards model was used to evaluate UAR, and adjusted predictors obtained from laboratory findings and clinical characteristics contributed to mortality. Also, a regression model was presented with a directed acyclic graph (DAG). The median age of the patients was 58 years (IQR [interquartile range]: 50–67); 3581 patients (77.9%) were male. The incidence of mortality in the entire patient group was 11.9%. Median follow-up duration of all groups was 42 months. Multivariate Cox proportional regression (model-1) analysis showed age (increase 50 to 67 years; HR [hazard ratio]: 1.34, 95% CI 1.18–1.52) and UAR (increase 1.15–1.73; HR: 1.33, 95% CI 1.16–1.52) were associated with mortality. UAR may be a prognostic factor for mortality in STEMI patients and an easily accessible parameter to identify high-risk patients.
Risk Factors for Post-Thrombotic Syndrome in Patients With a First Proximal Deep Venous Thrombosis Treated With Direct Oral Anticoagulants
Authors: Spiezia Luca , Campello Elena , Simion Chiara , Poretto Anna , Dalla Valle Fabio , Simioni Paolo 
Published: January 2022

The incidence of post-thrombotic syndrome (PTS) in patients with deep vein thrombosis (DVT) treated with direct oral anticoagulants (DOACs) remains a matter of debate. Hence, our endeavor to investigate a large cohort of patients with a first episode of proximal DVT treated with DOACs to ascertain the incidence and predisposing risk factors for PTS. All consecutive patients referred to the Thrombotic and Haemorrhagic Diseases Unit of Padova University Hospital (Italy) between January 2014 and January 2018 for a first episode of proximal DVT were considered for enrollment. Participants received DOACs for a minimum period of 3 months. PTS was assessed using the Villalta score up to 36 months after DVT diagnosis. Among 769 enrolled patients (M/F 353/416, age range 26–87 years), 152 (19.8%) developed PTS and 30 (3.9%) developed severe PTS. The adjusted hazard ratio was significant for obesity (1.64, 95% CI 1.28–2.39) and DVT site (femoral and/or iliac veins vs popliteal vein) (1.23, 95% CI 1.15–3.00). The incidence of PTS is not negligible in patients with proximal DVT despite the use of DOACs. We identified obesity and iliofemoral DVT as possible risk factors for PTS. Larger prospective studies are needed to confirm our findings and optimize therapeutic strategies.
Resilience in advanced cancer caregiving. A systematic review and meta-synthesis
Authors: Opsomer Sophie , Lauwerier Emelien , De Lepeleire Jan , Pype Peter 
Published: January 2022

Background: Close relatives provide much of the care to people with cancer. As resilience can shield family caregivers from mental health problems, there has been a burgeoning interest in resilience-promoting interventions. However, the evidence necessary for the development of these interventions is scant and unsynthesized. Aim: To create an overall picture of evidence on resilience in cancer caregiving by a theory-driven meta-synthesis. Design: In this systematically constructed review a thematic synthesis approach has been applied. The original findings were coded and structured deductively according to the theoretical framework. Consequently, the codes were organized inductively into themes and subthemes. Data sources: Through September 2019, five electronic databases were searched for qualitative studies on resilience in cancer caregiving. The search was extended by a supplementary hand search. Seventeen studies met the eligibility criteria. Results: The elements of resilience, as described in the pre-defined theoretical framework of Bonanno, are reflected in the lived experiences of family caregivers. The resilience process starts with the diagnosis of advanced cancer and may result in mental wellbeing, benefit finding, and personal growth. The process is influenced by context elements such as individual history, sociocultural background, caregiver characteristics, and the behavior of the supportive network. A repertoire of coping strategies that caregivers use throughout the caregiving process moderates the resilience process. Conclusion: This review and theoretical synthesis reveal key elements of resilience in the process of cancer caregiving, including influencing factors and outcomes. Implications and avenues for further research are discussed.
Can routine MRI spine T1 sequences be used for prediction of decreased bone density?
Authors: Kale Hrishikesh , Yadav Saksham 
Published: January 2022

Background Bone marrow signal is ideally evaluated with magnetic resonance imaging (MRI) due to its high tissue contrast. While advanced MRI quantitative methods can be used for estimating bone density, there are no readily available parameters on routine clinical MRI sequences of the lumbar spine. Purpose To evaluate whether T1 signal intensity (SI) ratio of lumbar vertebral body (VB)/cerebrospinal fluid (CSF) may predict decreased bone density. Material and Methods A retrospective study was conducted. After use of inclusion/exclusion criteria, 36 patients who had an MRI scan of the lumbar spine and a DEXA scan performed as a part of annual health visit were selected. T1 SI of the lumbar vertebral bodies and adjacent CSF were recorded. Ratio of T1 SI of L1–L4 (VB)/CSF was calculated. The corresponding bone-density values on DEXA scan measured as g/cm2 were obtained. Pearson's r correlation statistic was used to determine the correlation between these variables. Results T1 VB/T1 CSF SI ratio was between 1.308 and 2.927 (mean = 2.028). Mean T1 SI value of vertebral bodies (L1–L4) was 264.9 and mean CSF SI value was 131.9. Bone density in g/cm2 was between 0.851 and 1.398 (mean = 1.081). Pearson correlation coefficient was r = −0.619 ( P=0.0001), which shows a negative moderate correlation between the T1 VB/T1 CSF SI ratio and bone density. Conclusion A high T1 VB/T1 CSF SI ratio on routine MRI sequences may indicate decreased bone density. This ratio may be of substantial benefit in unsuspected osteoporosis/osteopenia on routine MRI lumbar spine imaging.
Clinical prediction rule for bacteremia with pyelonephritis and hospitalization judgment: chi-square automatic interaction detector (CHAID) decision tree analysis model
Authors: Fukui Sayato , Inui Akihiro , Saita Mizue , Kobayashi Daiki , Naito Toshio 
Published: January 2022

Objective This study was performed to identify predictive factors for bacteremia among patients with pyelonephritis using a chi-square automatic interaction detector (CHAID) decision tree analysis model. Methods This retrospective cross-sectional survey was performed at Juntendo University Nerima Hospital, Tokyo, Japan and included all patients with pyelonephritis from whom blood cultures were taken. At the time of blood culture sample collection, clinical information was extracted from the patients’ medical charts, including vital signs, symptoms, laboratory data, and culture results. Factors potentially predictive of bacteremia among patients with pyelonephritis were analyzed using Student’s t-test or the chi-square test and the CHAID decision tree analysis model. Results In total, 198 patients (60 (30.3%) men, 138 (69.7%) women; mean age, 74.69 ± 15.27 years) were included in this study, of whom 92 (46.4%) had positive blood culture results. The CHAID decision tree analysis revealed that patients with a white blood cell count of >21,000/μL had a very high risk (89.5%) of developing bacteremia. Patients with a white blood cell count of ≤21,000/μL plus chills plus an aspartate aminotransferase concentration of >19 IU/L constituted the high-risk group (69.0%). Conclusion The present results are extremely useful for predicting the results of bacteremia among patients with pyelonephritis.
Anthracycline, taxane, and trastuzumab-based neoadjuvant chemotherapy in HER2-positive early breast cancer: phase II trial
Authors: Conte Benedetta , Montemurro Filippo , Levaggi Alessia , Blondeaux Eva , Molinelli Chiara , Cardinali Barbara , Poggio Francesca , Buzzatti Giulia , Bighin Claudia , Lambertini Matteo , Del Mastro Lucia 
Published: January 2022

Objective: Neoadjuvant chemotherapy has become the preferred treatment in HER2-positive early breast cancer. Several trials investigated the neoadjuvant efficacy of dual HER2 blockade with anthracycline-free chemotherapy, whereas few data are available on single-agent trastuzumab and anthracycline-based regimens, which represent the standard of care in the adjuvant setting. This phase II, single-arm trial assessed anthracycline-based chemotherapy and trastuzumab as neoadjuvant treatment for high-risk HER2-positive breast cancer. Methods: Forty-three patients with stage II–III HER2-positive breast cancer were treated with 4 courses of neoadjuvant 5-fluorouracil 600 mg/m2, epirubicin 90 mg/m2, cyclophosphamide 600 mg/m2 (FEC ×4) every 21 days, followed by 12 courses of weekly paclitaxel 80 mg/m2 and trastuzumab 2 mg/Kg IV (loading dose 4 mg/kg). Results: Pathologic complete response (pCR) was observed in 22 (51%) of 43 patients. After a median follow-up of 6 years, the 5-year disease-free survival and overall survival were 85.8% (95% confidence interval 75.9%–97%) and 89.6% (80.4%–99.8%), respectively. A temporary decrease in left ventricular ejection fraction was observed in two patients. No cardiac death or congestive heart failure occurred. One patient died due to febrile neutropenia. Conclusions: FEC ×4 followed by paclitaxel and trastuzumab was associated with high pCR rates and favorable long-term outcomes. However, this regimen was associated with relevant hematologic toxicity.
Evaluation and comparison of S.T.O.N.E. and Guy’s scoring systems for predicting percutaneous nephrolithotomy outcomes in supine position
Authors: Arıman Ahmet , Merder Erkan , Toprak Erdem 
Published: January 2022

Background: Percutaneous nephrolithotomy (PCNL) was applied in the prone position until recently. But also, in recent years supine positions was applied in patients with kidney stones. Predicting how much renal stones can be cleared after surgery and possibility of complications is an important question for both surgeons and patients. Therefore different scoring systems are used to evaluate outcomes of PCNL before surgery. Patients and methods: Between 2018 and 2020, 80 patients with renal stone who underwent PCNL in the supine position were evaluated preoperatively by S.T.O.N.E. and Guy’s scoring systems (GSS). The predictions of both scoring systems for stone-free and complication rates in patients who underwent PCNL in the supine position were evaluated. Also, these scoring systems were compared among themselves for reliability. Result: In both scoring systems, there was a statistically significant difference between postoperative stone-free (SF) and residual stone (RS) of patients and in predicting the likelihood of complications in patients. No statistically significant difference was found between the two scoring systems in predicting the stone-free rate. Conclusion: Our findings revealed that S.T.O.N.E. nephrolithometry and Guy’s score systems can be used effectively to predict stone-free rate, complications, and operation duration in supine position PCNL for renal stones.
Lupus band test for diagnostic evaluation in systemic lupus erythematosus
Authors: Wongtada Chanidapa , Kerr Stephen J , Rerknimitr Pawinee 
Published: January 2022

Background The lupus band test (LBT) using a sample of clinically normal skin was proposed as a useful diagnostic test for systemic lupus erythematosus (SLE). It is mostly performed to help diagnosing SLE in patients with insufficient clinical and serological profiles. However, most published studies on its utility are outdated and the results remain controversial. Objectives To determine the diagnostic performance of LBT on non-lesion sun-protected (NLSP) and sun-exposed (NLSE) skin for SLE. Methods Consecutively presenting patients with clinical and serological suspicion of SLE who had LBT performed on non-lesion skin during January 2012 to August 2021 were retrospectively studied. LBT performed on either NLSE or NLSP skin biopsies were all included. Laboratory characteristics, number, types and patterns of deposited immunoreactants and disease activity were also assessed. Results LBT was performed in 57 patients with suspected SLE. LBT was positive in 18/57, 9/28 and 6/21 patients in overall non-lesion, NLSE and NLSP, respectively. Of all patients, 23 patients were diagnosed with SLE and 34 patients with other diseases. Overall, the sensitivity and specificity of LBT on non-lesion skin was 56.5% and 88.2%, respectively. The ability of the test to discriminate between those with and without SLE, assessed by the area under the Receiver-Operating Characteristic curve, was 0.72 (0.61–0.84). The sensitivity and specificity of LBT on NLSE skin was 58.3% and 87.5% while those of NLSP skin, were 57.1% and 85.7%, respectively. We found no significant correlation between the positivity of LBT and overall disease activity. Types, number and pattern of deposited immunoreactants also showed no correlation with disease activity (all p > 0.05). Conclusions Used as a diagnostic adjunct, non-lesion LBT is still of value for diagnosing SLE in inconclusive cases.
Balanced Crystalloid Versus Normal Saline as Resuscitative Fluid in Diabetic Ketoacidosis
Authors: Carrillo Adriana R. , Elwood Kirsten , Werth Chris , Mitchell Jessica , Sarangarm Preeyaporn 
Published: January 2022

Background: Large volume resuscitation with normal saline (NS) may be associated with iatrogenic hyperchloremia and renal injury. Objective: The purpose of this study was to assess clinical outcomes associated with the use of Lactated Ringer’s (LR) compared to NS as resuscitative fluid in diabetic ketoacidosis (DKA). Methods: Single-center, retrospective analysis of patients admitted for DKA. The primary objective of this study was to evaluate the incidence of iatrogenic hyperchloremia associated with fluid resuscitation using balanced crystalloid compared to NS. Results Iatrogenic hyperchloremia occurred more frequently in the NS group compared to the LR group (74.4% vs 64.2%; P = 0.05). Mean maximum serum chloride was higher in the NS group (115.7 mmol/L vs 113.7 mmol/L; P = 0.004). Incidence of hypernatremia was higher in the NS group (18.3% vs 9.3%; P = 0.02). There was no significant difference in the incidence of AKI; however, mean change in serum creatinine at 48 hours showed a significantly greater decrease in the LR group (-0.15 mg/dL vs -0.04 mg/dL; P = 0.002). No significant differences were found in intensive care unit (ICU) length of stay or total hospital length of stay. Conclusion and Relevance This study found a statistically significant reduction in the incidence of iatrogenic hyperchloremia with the use of LR compared to NS as fluid resuscitation in DKA. Serum creatinine was more improved in the LR group versus NS group at 48 hours. Preferential use of balanced crystalloid for fluid resuscitation in DKA may reduce incidence of hyperchloremia and support renal recovery in this population.