bluuebunny/crossref_metadata_2025_split huggingface dataset:
Buoyancy Forcing Dominates the Cross-Equatorial Ocean Heat Transport Response to Northern Hemisphere Extratropical Cooling
Authors: Luongo Matthew T. , Xie Shang-Ping , Eisenman Ian 
Published: June 2022

Abstract
Cross-equatorial ocean heat transport (OHT) changes have been found to damp meridional shifts of the intertropical convergence zone (ITCZ) induced by hemispheric asymmetries in radiative forcing. Zonal-mean energy transport theories and idealized model simulations have suggested that these OHT changes occur primarily due to wind-driven changes in the Indo-Pacific’s shallow subtropical cells (STCs) and buoyancy-driven changes in the deep Atlantic meridional overturning circulation (AMOC). In this study we explore the partitioning between buoyancy and momentum forcing in the ocean’s response. We adjust the top-of-atmosphere solar forcing to cool the Northern Hemisphere (NH) extratropics in a novel set of comprehensive climate model simulations designed to isolate buoyancy-forced and momentum-forced changes. In this case of NH high-latitude forcing, we confirm that buoyancy-driven changes in the AMOC dominate in the Atlantic. However, in contrast with prior expectations, buoyancy-driven changes in the STCs are the primary driver of the heat transport changes in the Indo-Pacific. We find that buoyancy-forced Indo-Pacific STC changes transport nearly 4 times the amount of heat across the equator as the shallower wind-driven STC changes. This buoyancy-forced STC response arises from extratropical density perturbations that are amplified by the low cloud feedback and communicated to the tropics by the ventilated thermocline. While the ocean’s specific response is dependent on the forcing scheme, our results suggest that partitioning the ocean’s total response to energy perturbations into buoyancy and momentum forcing provides basin-specific insight into key aspects of how the ocean damps ITCZ migrations that previous zonal-mean frameworks omit.
Promoting a research culture in family medicine: Five years of scholarly works and activities group
Authors: Fields Scott A , Tanner Andy R , Bors Kathleen P , Bottera Angeline R 
Published: June 2022

Background The professional advancement of Family Medicine faculty requires contributions in the form of clinical service, teaching, and scholarly activity. While teaching and clinical work are part of the everyday routine of faculty members, a research culture can be challenging to build. Methods Our department started a Scholarly Works and Activities Group (SWAG). The group’s aim is to promote a collegial, collaborative research culture in the department. Meetings occur monthly, and faculty have the opportunity to discuss scholarly projects with peers, as well as promotion/tenure goals. Minutes from each meeting are sent to all faculty members in the department. The aim of this retrospective study was to determine if SWAG meetings impacted faculty scholarly activity. Data were collected on presentations, publications, and collaborations from Curriculum Vitae (CVs), and were compared between 5 years prior to the intervention and the 5 years since. Results Results indicated increased scholarly activity in the time period during the SWAG group meetings. Faculty presentations increased by 34% while faculty publications more than doubled (221% increase), with publications constituting a small Cohen’s d effect size. Interestingly, faculty collaboration did not increase. Two faculty members were promoted during the 5 years study period, and the total number of faculty who published went from three to eight. Conclusions Implementation of a monthly SWAG meeting led to an increase in faculty peer reviewed publications. Furthermore, two faculty members were promoted during the time of the intervention. A monthly faculty meeting, even when brief, can help promote and build a research culture.
Adverse Childhood Experiences, Aggression, Empathy, and Psychopathology in Adult Males Accused of Rape
Authors: Satapathy Sujata , Choudhary Vandana , Behera Chittaranjan , Swain Rajanikanta , Sharma Renu , Sagar Rajesh 
Published: June 2022

Background: Investigating the underlying psychosocial factors is a cornerstone of planning need-based intervention for adult males accused of rape. Unresolved debates on its etiology, mediation, or interaction among causal psychosocial variables fuel curiosity to scrutinize it further. Hence, we studied potential influence of and relation between adverse childhood experiences, aggression, empathy, and psychopathology in adult males accused of rape in India and investigated the risk factors for the same. Methods: With a correlational research design, 40 literate and consenting adult males medically confirmed for rape were recruited using convenient sampling. The assessment was done on Adverse Childhood Experiences, Aggression Questionnaire, Symptom Checklist-90, and Interpersonal Reactivity Index. Descriptive statistics, Pearson’s product–moment correlation, and stepwise linear regression analysis were calculated. Results: Approximately 75% of the participants experienced at least one category of Adverse Childhood Experiences. Scores above cut-off points were obtained on anger, hostility, fantasy, and personal distress. Significant correlations were obtained between adverse childhood experiences and psychopathology; between hostility and psychopathology, perspective taking, and personal distress; and in case of indirect aggression, with perspective taking and empathetic concerns. Regression analysis revealed that an increase in Symptom Checklist-90 global scores increases hostility and that lower personal distress predicts higher scores on hostility on Aggression Questionnaire. Conclusions: Adverse childhood experiences, aggression, and psychopathology play a critical role and, therefore, should be included as core components of the prevention of rape or relapse prevention programs at the community level.
Impact of Comorbidity Burden on Cardiac Implantable Electronic Devices Outcomes
Authors: Ajibawo Temitope , Okunowo Oluwatimilehin , Okunade Adeniyi 
Published: June 2022

Background: There is limited data on the impact of comorbidity burden on clinical outcomes of patients undergoing cardiac implantable electronic devices (CIED) implantation. Objectives: Our aim was to assess trends in CIED implantations and explore the relationship between comorbidity burden and outcomes in patients undergoing de novo implantations. Methods: Using the National Inpatient Sample database from 2000 to 2014, we identified adults ⩾18 years undergoing de novo CIED procedures. Comorbidity burden was assessed by Charlson comorbidity Index (CCI), and patients were classified into 4 categories based on their CCI scores (CCI = 0, CCI = 1, CCI = 2, CCI ⩾3). Annual implantation trends were evaluated. Logistic regression was conducted to measure the association between categorized comorbidity burden and outcomes. Results: A total of 3 103 796 de-novo CIED discharge records were identified from the NIS database. About 22.4% had a CCI score of 0, 28.2% had a CCI score of 1, 22% had a CCI score of 2, and 27.4 % had a CCI score ⩾3. Annual de-novo CIED implantations peaked in 2006 and declined steadily from 2010 to 2014. Compared to CCI 0, CCI ⩾3 was independently associated with increased odds of in-hospital mortality, bleeding, pericardial, and cardiac complications (all P < .05). Length of stay and hospital charges increased with increasing comorbidity burden. Conclusions: CCI is a significant predictor of adverse outcomes after CIED implantation. Therefore, comorbidity burden needs to be considered in the decision-making process for CIED implant candidates.
Characterization and size distribution of initial droplet concentration discharged from human breathing and speaking
Authors: Pan Shihai , Xu Chunwen , Yu Chuck Wah Francis , Liu Li 
Published: June 2022

A study of the aerodynamic characteristics of aerosol expiration is important for understanding the size distribution of droplet concentration in COVID-19 disease transmission. This study measured the initial concentration and size distribution of droplets released during four breathing processes: nose breathing, mouth breathing, reading alphabets and counting numbers. Influencing factors on droplet generation were studied by statistical analyses. Significant differences in droplet concentration among the four breathing activities in pairs were found ( p < 0.001), except for reading alphabets and numbers ( p = 1). The droplet concentration during nose breathing ( p < 0.05), but not mouth breathing ( p = 0.136), of male subjects, was found significantly higher than that of female subjects. The droplet concentration generated by speaking during letters reading with special phonemes, for example, /i:/, was significantly ( p < 0.05) higher than reading letters without phonemes. The discharged droplet sizes from four breathing activities were dominated by small droplets ( dp < 1.037 μm of over 50% and dp < 2.642 μm of over 80%). Basically, no particles larger than 8 μm were detected by the aerodynamic particle sizer. The inference indicates a possible aerosol transmission of disease during non-symptomatic aerosol-producing activities such as breathing or speaking and may elucidate the disease transmission pathway of COVID-19.
Retreatment of previously flow diverted intracranial aneurysms with the pipeline embolization device
Authors: Lauzier David C , Cler Samuel J , Chatterjee Arindam R , Osbun Joshua W , Moran Christopher J , Kansagra Akash P 
Published: June 2022

Background and Purpose Flow diversion of intracranial aneurysms with the Pipeline Embolization Device (PED) is frequently performed, but the outcomes of retreatment for aneurysms that failed to occlude after prior treatment with PED have not been well studied. Here, we report the safety and efficacy of PED retreatment after initial failure to occlude. Materials and Methods Clinical and angiographic data from eligible patients were retrospectively assessed for demographics, aneurysm occlusion status, and clinical outcomes. Patients were included in this study if they underwent PED retreatment to treat an aneurysm that had previously been treated with PED. Results Retreatment of previously flow-diverted aneurysms with PED was performed in 42 cases. At final angiographic follow-up, angiographic improvement was observed after 45% (19/42) of retreatments and complete aneurysm occlusion was observed following 26% (11/42). Significant clinical complications occurred in 10% (4/42) of PED retreatments. Conclusions Retreatment of intracranial aneurysms with PED following initial failure to achieve aneurysm occlusion has a low rate of subsequent complete aneurysm occlusion.
Systemic Analysis of the Anticancer Effects of Sijunzi Decoction on Gastric Cancer Based on Network Pharmacology
Authors: Li Yuejun , Wang Hong , Liao Linli , Tang Ping , He Haihui , Liu Lingzhi , Yan Junfeng , Peng Qinghua 
Published: June 2022

Objective: Sijunzi decoction (SJZD) has been used for alleviating peptic ulcer or gastric discomfort, and treating spleen disorders since the Song Dynasty, but its pharmacological effect on human gastric cancer (GC) is still unclear. In this research, a network pharmacology-based strategy was applied to explore active ingredients, potential targets, and molecular mechanisms of SJZD against GC. Methods: The active compounds and potential targets of SJZD, as well as GC-associated gene targets, were retrieved from publicly available databases. Bioinformatics approaches were used to assess the network interaction, functional regulation, and signaling pathways between SJZD ingredients and GC targets. The anticancer effects of SJZD against GC were verified in vivo by a mouse subcutaneous model. Results: The results of network analysis showed that quercetin was the most active ingredient in SJZD. Several prominent target genes of SJZD were identified, such as AKT1 and STAT3. Gene ontology analysis revealed that the core anti-GC targets of SJZD included transcription factor activity and kinase activity. Pathway enrichment analysis indicated that GC patients could be benefited from SJZD treatment via modulation of signaling pathways related to endocrine system, cancer, and infectious disease. Furthermore, in vivo experiments showed that high-dose SJZD could inhibit GC xenograft tumor growth, reduce GC cell proliferation, induce GC cell apoptosis, and decrease the expression of p-AKT1 and p-STAT3. Conclusions: Taken together, our results suggest that SJZD can serve as an effective adjuvant therapeutic agent for GC patients.
Comparative study of Iselin’s technique for the treatment of Bennett’s fracture with large and small fragments
Authors: Bouaicha Walid , Jlidi Mohamed , Bellila Senda , Daas Selim , Ben Ammar Ahmed , Sbai Mohamed Ali , Khorbi Adel 
Published: June 2022

Objective: The thumb is very exposed to trauma due to its position and function. Fractures of the base of the first metacarpal bone are very frequent in hand traumatology. Most Bennett’s fractures are treated surgically. However, the optimal surgical approach is controversial. The aim of this study is to compare the results of closed reduction and percutaneous pinning in the treatment of Bennett’s fracture of the base of firsthand metacarpal in fractures with both small and large fragments. Methods: We studied retrospectively the data of 40 patients treated for a Bennett’s fracture in the department of orthopaedic and traumatologic surgery between January 2016 and December 2018. The purpose of this study was to compare the functional (pain, grip strength, first web space opening and thumb opposition) and radiological (quality of reduction and arthritic changes) results of the Iselin’s technique for the treatment of Bennett’s fractures in two groups of patients with large and small bone fragments according to the size of articular surface detached with the antero-medial fragment (superior or inferior to 25%). Results: The average age of the patients was 34 (range = 19–66) years. Males were by far the most affected (90%). We noted 24 cases of large fragment fractures (60%) and 16 cases of small fragment fracture (40%). An excellent overall functional result was found in 68.8% of cases of small fragment fractures versus 50% of cases of large fragment fractures. Radiological results were roughly similar. Conclusion: All surgical techniques aim to restore the articular congruence to the best, maintain the opening of the first web space and obtain a stable and painless trapezo-metacarpal joint. The Iselin’s technique is simple, inexpensive and easy to perform even by inexperienced surgeons. It yields satisfactory results in most cases of Bennett’s fracture regardless of the size of the fragment.
Congenital Cytomegalovirus Knowledge, Practices, and Beliefs Among Primary Care Physicians and Newborn Hospitalists
Authors: Pesch Megan H. , Muldoon Kathleen M. 
Published: June 2022

Background: Congenital cytomegalovirus (cCMV) affects 1 in every 200 United States infants, at present there are 9 states which mandate newborn cCMV screening. With more infants being diagnosed, more children will need continuing care from providers who are knowledgeable about cCMV. Objectives: To examine pediatric provider knowledge, practices, and beliefs around cCMV. Methods: Primary care and newborn hospitalist pediatricians (N = 103) from Michigan, who “regularly care for infants” were invited to participate in a survey about their cCMV-related knowledge, clinical practices, and beliefs. Results: Respondents had low knowledge of typical cCMV presentation and sequelae, with mixed knowledge of screening and testing standards. Most (68%) reported rarely/never screening for cCMV, though 71% strongly agreed/agreed that primary care providers should test for cCMV. Most (90%) strongly agreed/agreed that infants who fail/refer on their newborn hearing screen should be tested for cCMV, yet 81% expressed not being comfortable diagnosing and managing cCMV. Most (72%) felt that cCMV was not sufficiently covered in their medical training; almost all respondents endorsed interest in learning more. Conclusions: Primary care and newborn hospitalists in this study expressed mixed knowledge about, infrequent practice of and low comfort with screening and caring for children with cCMV. This may present a prime opportunity for education and clinician support by professional organizations.
Progression of Symptomatic Partial-Thickness Rotator Cuff Tears: Association With Initial Tear Involvement and Work Level
Authors: Ko Sang-Hun , Jeon Young-Dae , Kim Myung-Seo 
Published: June 2022

Background: Partial-thickness rotator cuff tears (PTRCTs) often progress to full-thickness rotator cuff tears (FTRCTs). Thus, it is important to analyze the risk factors for tear progression to determine the proper timing of repair. Purpose: To identify the risk factors associated with progression of PTRCT. Study Design: Case-control study; Level of evidence, 3. Methods: Included were 89 patients diagnosed with PTRCT on magnetic resonance imaging (MRI) scans who underwent nonoperative treatment at the authors’ institution between August 2012 and August 2019. Patient characteristics, shoulder stiffness (compared with the contralateral shoulder); work level (classified as high [heavy manual labor], medium [manual labor with less activity], and low [sedentary activity]); and radiological factors including initial tear size, acromion type (flat, curved, hooked, or heel-shaped), and initial tear involvement (as a percentage of the rotator cuff tendon footprint length) were analyzed to assess their association with tear progression, defined as >20% increase in tear involvement. Results: The mean MRI follow-up period was 22.3 ± 17.2 months (median, 16.1 months; range, 6.4-89.5 months), and tear progression was observed in 12 patients (13.5%). In these 12 patients, tear involvement increased by 60% of the rotator cuff footprint, while mediolateral (ML) and anteroposterior (AP) tear sizes progressed by 1.1 and 1.8 mm, respectively. Univariate regression analysis showed that shoulder stiffness ( P = .031), work level ( P = .001), initial tear involvement ( P < .001), ML and AP tear sizes ( P < .001 and P = .005, respectively), and acromion type ( P = .003) were significantly associated with tear progression. Multivariate regression analysis showed that initial tear involvement (odds ratio [OR], 1.053; 95% CI, 1.006-1.102; P = .026) and high work level (OR, 15.831; 95% CI, 1.150-217.856; P = .039) were independent risk factors for tear progression. The cutoff value for initial tear involvement was 47.5% (sensitivity, 81.8%; specificity, 85.7%). Conclusion: Tear progression was observed in 14% of patients with PTRCT in this study. To predict tear progression, evaluating the tear involvement during initial MRI is essential. The risk of tear progression increased with initial tear involvement >47.5% and a heavy work level.
Assessment of Outcomes After Decompressive Craniectomy—An Institutional-Based Study from India
Authors: Karri Madhavi , Ramasamy Balakrishnan , Varghese Angel P. 
Published: June 2022

Background: Decompressive craniectomy (DC) is a life-saving treatment modality for acute malignant strokes. We aimed to identify the risk factors and assess the long-term functional outcome in patients with malignant stroke undergoing DC. Methods: We conducted an ambispective study on patients (>18 years) undergoing DC between January 2016 and January 2019. Demographic data, stroke risk factors, clinical characteristics, and serial imaging findings were collected. We measured the functional outcomes using the National Health Stroke Scale (NIHSS), Glasgow Coma Scale (GCS), modified Ranking Scale (mRS), and Barthel index (BI) at 3, 6, and 12 months postoperatively. We did univariate and multivariate regression analyses for the independent variables and outcomes. Results: On admission, the 93 patients (70 males) had a mean GCS of 11.77 (standard deviation [SD]: 2.90) and a mean NIHSS score of 13.65 (SD: 4.41). Diabetes (odds ratio [OR]: 1.76; 0.67-4.46, 95% confidence interval [CI]) and ischemic heart disease (OR: 4.50; 1.44-14.07, 95% CI) showed a positive correlation with the outcome. Forty patients underwent surgery within 48 h of stroke onset, while 53 patients were operated on after 48 h. Twenty-two (23.66%) patients died during the study period, and 55 patients (59.14%) had an mRS score <2 one year after the stroke. Conclusions: DC can produce favorable outcomes in patients with malignant strokes, and early aggressive intervention helps improve the prognosis and quality of life. Only a few studies were reported on the results of DC in stroke, much less from developing countries like India.
Stress hyperglycemia is predictive of clinical outcomes in patients with spontaneous intracerebral hemorrhage
Authors: Li Sijia , Wang Yu , Wang Wenjuan , Zhang Qian , Wang Anxin , Zhao Xingquan 
Published: June 2022

Abstract
Background
Stress hyperglycemia is a common condition in patients suffering from critical illness such as spontaneous intracerebral hemorrhage (ICH). Our study aimed to use glucose-to-glycated hemoglobin (HbA1c) ratio to investigate the impact of stress hyperglycemia on clinical outcomes in patients with ICH.

Methods
A sample of eligible 586 patients with spontaneous intracerebral hemorrhage from a multicenter, hospital-based cohort between 2014 and 2016 were recruited in our study. Stress hyperglycemia was evaluated by the index of the glucose-to-HbA1c ratio that was calculated by fasting blood glucose (mmol/L) divided by HbA1c (%). Patients were divided into two groups based on the median of the glucose-to-HbA1c ratio. The main outcomes were poor functional outcomes (modified Rankin Scale score of 3–6) at discharge and 90 days. Multivariable logistic regression and stratified analyses were performed to explore the association of stress hyperglycemia with poor prognosis of ICH.

Results
On multivariable analysis, higher glucose-to-HbA1c ratio (≥1.02) was independently correlated with poor functional outcomes at discharge (adjusted OR = 3.52, 95%CI: 1.98–6.23) and 90 days (adjusted OR = 2.27, 95%CI: 1.38–3.73) after adjusting for potential confounding factors. The correlation between glucose-to-HbA1c ratio and worse functional outcomes still retained in patients with or without diabetes mellitus.

Conclusions
Stress hyperglycemia, calculated by glucose-to-HbA1c ratio, was independently correlated with worse functional outcomes at discharge and 90 days in patients with ICH. Moreover, glucose-to-HbA1c ratio, might not only be used as a simple and readily available index to predict clinical outcomes of ICH but also provide meaningful insight into future analysis to investigate the optimal range of glucose levels among ICH patients and develop tailored glucose-lowering strategies.