bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Not Attempt Resuscitation Order Rates in Hospitalized Patients With Heart Failure, Acute Myocardial Infarction, Chronic Obstructive Pulmonary Disease, and Pneumonia
Authors: Shore Supriya , O'Leary Michael , Kamdar Neil , Harrod Molly , Silveira Maria J. , Hummel Scott L. , Nallamothu Brahmajee K. 
Published: November 2022

Background
Descriptions of do not attempt resuscitation (DNAR) orders in heart failure (HF) are limited. We describe use of DNAR orders in HF hospitalizations relative to other common conditions, focusing on race.

Methods and Results
This was a retrospective study of all adult hospitalizations for HF, acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), and pneumonia from 2010 to 2016 using the California State Inpatient Dataset. Using a hierarchical multivariable logistic regression model with random effects for the hospital, we identified factors associated with DNAR orders for each condition. For racial variation, hospitals were divided into quintiles based on proportion of Black patients cared for. Our cohort comprised 399 816 HF, 190 802 AMI, 192 640 COPD, and 269 262 pneumonia hospitalizations. DNAR orders were most prevalent in HF (11.9%), followed by pneumonia (11.1%), COPD (7.9%), and AMI (7.1%). Prevalence of DNAR orders did not change from 2010 to 2016 for each condition. For all conditions, DNAR orders were more common in elderly people, women, and White people with significant site‐level variation across 472 hospitals. For HF and COPD, hospitalizations at sites that cared for a higher proportion of Black patients were less likely associated with DNAR orders. For AMI and pneumonia, conditions such as dementia and malignancy were strongly associated with DNAR orders.

Conclusions
DNAR orders were present in 12% of HF hospitalizations, similar to pneumonia but higher than AMI and COPD. For HF, we noted significant variability across sites when stratified by proportion of Black patients cared for, suggesting geographic and racial differences in end‐of‐life care.
Trustworthy Government: The Obligations of Government & the Responsibilities of the Governed
Authors: Levi Margaret 
Published: November 2022

Abstract
Establishing trustworthy government is a major problem for contemporary democracies. Without public confidence, government faces considerable noncompliance with its policies, as has been the case with the reaction of some subpopulations to COVID safety requirements. The pressures on government today are numerous. The challenges are complex and the polity diverse. Creating confidence and thus willing compliance requires a demonstrated government competence. It also requires political leadership committed to the collective good and to forging a common identity among multiple subgroups while recognizing their distinctive differences and needs. Citizens are also crucial actors. It is incumbent upon a democratic citizenry that it recognizes its responsibilities to and interdependence with others in the polity as members of an expanded community of fate.
On General Terms for Texts in Early China
Authors: Fahr Paul 
Published: November 2022

Abstract
This article explores the lexical field of “text” in early China. It argues that words pertaining to it should not be understood as referring to textual genres, but as conveying an abstract notion of “(written) text.” In particular, it treats the word shi 事 in Liu Xiang’s 劉向 (79–8 BCE) editorial reports as well as yu 語 in many different early sources. Especially the second term has been understood as denoting a certain textual genre. This is incorrect as can be shown by analyzing occurrences of this word in relevant contexts. Rather, yu first referred to short proverbs and later, by way of semantic derivation, came to acquire the meaning “text” in general. This meaning also applies to the word’s usage in designations of early compilations such as Lunyu. Accordingly, the latter title should simply be understood as “compiled texts.”
Knowledge is Power: Politics and Formal Education in the Sixteenth-Century Kongo Kingdom
Authors: Brinkman Inge 
Published: November 2022

Abstract
This paper takes us to the beginning of the sixteenth century in the West Central African kingdom of Kongo, some years after Portuguese navigators first established contact with the Kongo royal elite. A formal school system was introduced with the support of the Kongo king Afonso I – who ruled from 1509 to 1542 – as he used the Christian school system to integrate the districts of the kingdom more fully into political unity. Apart from this centralising tendency, there was at the same time a process to establish contacts abroad. Quite a few young Kongo men of noble birth were sent to schools at convents in Portugal to be trained as church staff, interpreters or ambassadors of the Kongo kingdom.
These two tendencies – internally oriented centralisation and externally oriented internationalisation – will be discussed in the light of the developments of the school system in the Kongo kingdom in the sixteenth century and beyond. This will lead to an interpretation of the Kongo school system in terms of global integration and local appropriation.
Women, Military, and State: Indonesian Women’s Military Representation During the Early Independence Period
Authors: Salebaran Salebaran , Amini Mutiah 
Published: November 2022

Abstract
This article looks at the role of women in the Indonesian military in the second half of the twentieth century, specifically from Indonesia’s independence on 17 August 1945 until the 1960s. Following state efforts to create uniformity among citizens by including women in all sectors of national life, including the military – long perceived to be a masculine institution – Indonesian women only became active in the military after men. Women’s early military participation was critical in advancing their role in the public sphere and in eroding men’s military dominance. The purpose of this analysis is to investigate the role of the state in providing space for women in the armed forces. It uncovers how early policies in Indonesia excluded women from military forces and activities; the first women’s corps was established only fifteen years after Indonesia declared independence. Even then, they were confined to the female-only corps to allow the Indonesian military to maintain its masculine image.
Accurate Attribution and Seasonal Prediction of Climatic Anomalies Using Causal Inference Theory
Authors: He Shan , Yang Song , Chen Dake 
Published: November 2022

Abstract
Using features based on correlation or noncausal dependence metrics can lead to false conclusions. However, recent research has shown that applying causal inference theory in conjunction with Bayesian networks to large-sample-size data can accurately attribute synoptic anomalies. Focusing on the East Asian summer monsoon (EASM), this study adopts a causal inference approach with model averaging to investigate causation of interannual climate variability. We attribute the EASM variability to five winter climate phenomena; our result shows that the eastern Pacific El Niño–Southern Oscillation has the largest causal effect. We also show that the causal precursors of the EASM variability are interpretable in terms of physics. Using linear regression, these precursors can predict the EASM one season ahead, outperforming correlation-based empirical models and three climate models. This study shows that even without large-sample-size data and substantial human intervention, even laymen can implement the causal inference approach to investigate the causes of climatic anomalies and construct reliable empirical models for prediction.

Significance Statement
We use causal inference theory to redesign the attribution procedure fundamentally and adjust a causal inference approach to commonly used climate research data. Our study shows that the causal inference approach can exhaustively reveal the causes of climatic anomalies with little human intervention, which is impossible for correlation-based studies. According to this attribution, one can construct models with a better predictive performance than the climate and correlation-based empirical models. Therefore, our causal inference approach will tremendously help both meteorologists and laymen (e.g., stakeholders and policymakers) accurately predict climate phenomena and reveal their interpretable causes. We recommend that it become a standard practice in attribution studies and operational prediction.
Framing the Problem of Flood Risk and Flood Management in Metropolitan Los Angeles
Authors: Ulibarri Nicola , Valencia-Uribe Claudia , Sanders Brett F. , Schubert Jochen , Matthew Richard , Forman Fonna , Allaire Maura , Brady David 
Published: November 2022

Abstract
This paper develops the concept of flood problem framing to understand decision-makers’ priorities in flood risk management in the Los Angeles Metropolitan Region in California (LA Metro). Problem frames shape an individual’s preferences for particular management strategies and their future behaviors. While flooding is a complex, multifaceted problem, with multiple causes and multiple impacts, a decision-maker is most likely to manage only those dimensions of flooding about which they are aware or concerned. To evaluate flood decision-makers’ primary concerns related to flood exposure, vulnerability, and management in the LA Metro, we draw on focus groups with flood control districts, city planners, nonprofit organizations, and other flood-related decision-makers. We identify numerous concerns, including concerns about specific types of floods (e.g., fluvial vs pluvial) and impacts to diverse infrastructure and communities. Our analyses demonstrate that flood concerns aggregate into three problem frames: one concerned with large fluvial floods exacerbated by climate change and their housing, economic, and infrastructure impacts; one concerned with pluvial nuisance flooding, pollution, and historic underinvestment in communities; and one concerned with coastal and fluvial flooding’s ecosystem impacts. While each individual typically articulated concerns that overlapped with only one problem frame, each problem frame was discussed by numerous organization types, suggesting low barriers to cross-organizational coordination in flood planning and response. This paper also advances our understanding of flood risk perception in a region that does not face frequent large floods.

Significance Statement
This paper investigates the primary concerns that planners, flood managers, and other decision-makers have about flooding in Southern California. This is important because the way that decision-makers understand flooding shapes the way that they will plan for and respond to flood events. We find that some decision-makers are primarily concerned with large floods affecting large swaths of infrastructure and housing; others are concerned with frequent, small floods that mobilize pollution in low-income areas; and others are concerned with protecting coastal ecosystems during sea level rise. Our results also highlight key priorities for research and practice, including the need for flexible and accessible flood data and education about how to evacuate.
An emergency department nurse led intervention to facilitate serious illness conversations among seriously ill older adults: A feasibility study
Authors: Ouchi Kei , Lee Rachel S. , Block Susan D. , Aaronson Emily L. , Hasdianda Mohammad A. , Wang Wei , Rossmassler Sarah , Palan Lopez Ruth , Berry Donna , Sudore Rebecca , Schonberg Mara A. , Tulsky James A. 
Published: November 2022

Background: Serious illness conversations may lead to care consistent with patients’ goals near the end of life. The emergency department could serve as an important time and location for these conversations. Aim: To determine the feasibility of an emergency department-based, brief motivational interview to stimulate serious illness conversations among seriously ill older adults by trained nurses. Design: A pre-/post-intervention study Settings/participants: In an urban, tertiary care, academic medical center and a community hospital from January 2021 to January 2022, we prospectively enrolled adults ⩾50 years of age with serious illness and an expected prognosis <1 year. We measured feasibility outcomes using the standardized framework for feasibility studies. In addition, we also collected the validated 4-item Advance Care Planning Engagement Survey (a 5-point Likert scale) at baseline and 4-week follow-up and reviewing the electronic medical record for documentation related to newly completed serious illness conversations. Results: Among 116 eligible patients who were willing and able to participate, 76 enrolled (65% recruitment rate), and 68 completed the follow-up (91% retention rate). Mean patient age was 64.4 years (SD 8.4), 49% were female, and 58% had metastatic cancer. In all, 16 nurses conducted the intervention, and all participants completed the intervention with a median duration of 27 min. Self-reported Advance Care Planning Engagement increased from 2.78 pre to 3.31 post intervention (readiness to “talk to doctors about end-of-life wishes,” p < 0.008). Documentation of health care proxy forms increased (62–70%) as did Medical Order for Life Sustaining Treatment (1–11%) during the 6 months after the emergency department visit. Conclusion: A novel, emergency department-based, nurse-led brief motivational interview to stimulate serious illness conversations is feasible and may improve advance care planning engagement and documentation in seriously ill older adults.
Evaluation of dynamic derailment in a railway switch considering the longitudinal impacts caused by vehicle retarder
Authors: Lai Jun , Xu Jingmang , Chen Yu , Zheng Zhaoguang , Wang Jian , Wang Ping 
Published: November 2022

The operating conditions at the railway marshalling station are quite complicated, featuring low-speed turnouts, sharp curves, and vehicle retarders. Train derailments frequently occur in the switch panel. However, the passive safety and derailment behaviour considering the longitudinal impacts are still not clearly understood. With this aim in mind, a three-dimensional freight wagon-track (turnout) dynamic interaction model considering the impacts between wagons in longitudinal direction is established. The braking of the vehicle retarder on wheels is also simulated. The comparative analysis between the simulation results and field observation for the derailment is presented. The derailment limits along the switch are assessed based on 3D quasi-static analysis and numerical simulation. The results show that the longitudinal impact from the rear wagon can significantly increase the derailment risk when an empty wagon located in the middle passes through the vehicle retarder and switch. As the side wear depth of the switch rail increases to 5 mm, the vertical wheel rise at the front of the switch increases from 0 to 4.73 mm even though the other parameters keep an ideal level. Proper measures such as rail grinding and lubricating are suggested to be adopted for optimizing wheel-rail contact relationships and improving running safety.
Acute liver injury induced by drug interaction between dacomitinib and metoprolol due to the inhibition of CYP2D6 by dacomitinib
Authors: Qiu Xuejia , Ren Bingnan , Lian Yufei , Fang Lingzhi , Dong Zhanjun 
Published: November 2022

Introduction In recent years, oral antineoplastic agents are commonly used in antitumor therapy. The interaction between drugs may affect the efficacy of drugs or lead to adverse reactions. We describe the case of a patient who presented acute liver injury, possibly induced by the concomitant use of metoprolol and dacomitinib. Case report A 62-year-old male patient with non-small cell lung cancer was admitted for anti-cancer treatment. He regularly took metoprolol tartrate 12.5 mg, 2/day for hypertension. He was treated with dacomitinib according to EGFR Exon21 L858R positive. After 3 days of dacomitinib, the patient's alanine aminotransferase (ALT) and glutathione aminotransferase (AST) increased, and the heart rate and systolic blood pressure of the patient decreased significantly. The patient was diagnosed with acute liver injury. Management and outcomes Dacomitinib was discontinued and glutathione, magnesium isoglycyrrhizinate were given to treat acute liver injury. Two days after discontinued dacomitinib, the patient's heart rate increased, but the ALT and AST of the patient elevated again. Metoprolol tartrate was subsequently discontinued and the ALT and AST gradually decreased and the patient discharged from the hospital eight days later with his liver function improved. Discussion To our knowledge, this is the first case in the literature of acute liver injury possibly induced by the interaction between metoprolol and dacomitinib. The interaction most likely arose because dacomitinib is a CYP2D6 strong inhibitor and could therefore impair the metabolism of metoprolol (a CYP2D6 substrate) and increase its serum concentration. Therefore, hepatic function should be carefully monitored in patients treated with dacomitinib and metoprolol and other inhibitors or inducers of CYP2D6.
Occupant’s thermal comfort in a radiant ceiling cooling room with hot wall surface
Authors: Wu Xiaozhou , Liu Genglin , Tian Zhen , Gao Jie 
Published: November 2022

A radiant ceiling cooling (CC) system integrated with a mechanical ventilation system was extensively applied in a modern office in a glass curtain wall building. Thermal comfort in a radiant ceiling cooling room with mixing ventilation (MV) or underfloor air distribution (UFAD) was investigated by objective measurements and subjective questionnaires. The external wall surface temperature and mean radiant temperature were 33.9–34.6°C and 27.2–27.4°C, respectively, with a heat transfer of 41.5 W/m2 from the external wall and 37.8–38.6°C and 27.4–28.2°C with a heat transfer of 69.5 W/m2 from the external wall. The indoor air velocity in the occupied zone was 0.17–0.23 m/s in the room with CC+MV and 0.09–0.16 m/s in the room with CC + UFAD. There was a considerable difference between occupants’ thermal perceptions with different distances away from the external wall. Both the ventilation system type and hot wall surface temperature did not influence occupants’ overall thermal perceptions, but their local thermal sensation and skin temperature. The results suggest that the impacts of ventilation system type and hot wall surface temperature on occupants’ local thermal response should be considered during the design of a radiant ceiling cooling system combined with a mechanical ventilation system.
Comparison of quadriceps muscle size and quality in adults with cystic fibrosis with different severities of cystic fibrosis transmembrane conductance regulator protein dysfunction
Authors: Wu Kenneth , Michalski Anna , Sykes Jenna , Batt Jane , Stephenson Anne L , Mathur Sunita 
Published: November 2022

Background Cystic fibrosis (CF) is characterized by CF transmembrane conductance regulator (CFTR) dysfunction. CFTR protein is expressed in human skeletal muscle; however, its impact on skeletal muscle is unknown. The objectives of this study were to compare quadriceps muscle size and quality between adults with various severities of CFTR protein dysfunction. Methods We conducted a prospective, cross-sectional study comparing 34 adults with severe versus 18 with mild CFTR protein dysfunction, recruited from a specialized CF centre. Ultrasound images of rectus femoris cross-sectional area (RF-CSA) and quadriceps layer thickness for muscle size, and rectus femoris echogenicity (RF-ECHO) (muscle quality) were obtained. Multivariable linear regression models were developed using purposeful selection technique. Results People with severe CFTR protein dysfunction had larger RF-CSA by 3.22 cm2, 95% CI (1.03, 5.41) cm2, p=.0049], after adjusting for oral corticosteroid use and Pseudomonas aeruginosa colonization. However, a sensitivity analysis indicated that the result was influenced by the specific confounders being adjusted for in the model. We did not find any significant differences in quadriceps layer thickness or RF-ECHO between the two groups. Conclusion We found no differential impact of the extent of diminished CFTR protein activity on quadriceps muscle size or quality in our study cohort. Based on these findings, CFTR mutation status cannot be used differentiate leg muscle size or quality in people with CF.
Influencing factors of shielding effectiveness test of electromagnetic shielding clothing
Authors: Wang Xiuchen , Zhang Jian , Hang Gege , Wei Ying , Liu Zhe 
Published: November 2022

There is no perfect method to test and evaluate electromagnetic shielding (EMS) clothing up to now. The main reason is that the influence laws of the emission source parameters and the test position on the shielding effectiveness (SE) of the EMS clothing has not been clarified. In this paper, the SE of the EMS clothing is tested using a semi anechoic chamber in the frequency range of 1–18 GHz. The variation of the SE of the clothing is explored when the emission source parameters and the test positions are different. It is found that the SE of the EMS clothing decreases obviously with the increase of the testing distance, and the decline degrees are different with different frequencies. The decline trend slows down and approaches stability as the distance increases to a certain extent. The influence of the emission source angle on the SE is closely related to the frequency and positive or negative effects are produced at different frequency points. The SE are low when the test points are in the leakage areas with seams and openings, and the SE are high in the normal area. Under certain conditions, the measured SE of the clothing is close to zero or even less than zero. That is, a dangerous frequency point is formed. The mechanism of the above-mentioned laws is analyzed, and a new multi-index composite evaluation method is proposed to scientifically evaluate the EMS clothing based on the comprehensive consideration of the influencing factors. This research has great significance to promote the scientific test, evaluation and relevant standard formulation of the EMS clothing, and provides a reference role for the design and production of the EMS clothing.