bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical students as health workers during the COVID-19 pandemic
Authors: Boggon Adam , Poole Ashley , Smith Sarah , Burns Aine , Dilworth Paul 
Published: August 2022

BackgroundWe describe efforts at one tertiary university teaching hospital to rapidly recruit, train and deploy medical students into paid clinical support worker roles during the COVID-19 pandemic.MethodsRecruitment was conducted by means of a single email outlining the emergent clinical situation and specifying role descriptions, terms and conditions, and temporary staff enrolment paperwork. Applicants could begin work provided they were in good standing and received departmental orientation. Student representatives liaised with teaching faculty and participating departments. Roles were modified in response to student and departmental feedback.ResultsBetween 25 December 2020 and 9 March 2021, 189 students contributed 1335 shifts, providing 10 651 hours of clinical care in total. The median number of shifts worked per student was 6 (mean: 7; range: 1–35). Departmental leaders attested that the student workers eased the burden on hospital nursing teams.ConclusionMedical students contributed usefully and safely to the provision of healthcare within well-defined and supervised clinical support worker roles. We propose a model of working which could be adapted in the event of future pandemics or major incidents. The pedagogical value to medical students of working in clinical support roles warrants closer evaluation.
Sports Medical Image Modeling of Injury Prevention in Wushu Training
Authors: Feng Yuanyuan 
Published: August 2022

In order to solve the problem of injury prevention in Wushu training, this paper proposes a research on modeling using sports medical images. The main content of this technology research is to drive the muscle strength modeling method based on the sports medical image data. According to the acquisition of MRI/CT images, through the research and application of DFIS, it is concluded that the research on sports medical image modeling has a high accuracy for injury prevention in Wushu training. The experimental results show that translation

accuracy
≤
0.03

~0.27,

rotation

accuracy
≤
0.24

~0.63,

flexion

and

extension

accuracy
≤
0.1

,

translation

retest

error
≤
0.2

~1.2,

rotation

retest

error
≤
0.5

~3.4,

rotation

retest

accuracy
≤
0.4

~1.04, and sports medical images have a high accuracy for injury prevention in Wushu training. It is proved that the research on sports medical image modeling is effective and accurate for the problem of injury prevention in Wushu training.
Correlation between 24-Hour Ambulatory Blood Pressure Variability and White Matter Lesions in Patients with Cerebral Small Vascular Disease: A Cross-Sectional Study
Authors: Liu Ping , Yin Changhao , Liu Meilingzi , Chang Lu , Wu Tianjiao , Li Zihao , Luo Ruidi , Du Xiao , Zhao Weina 
Published: August 2022

Objective. The goals of this study are to assess the correlation between 24-hour ambulatory blood pressure (BP) variability and white matter lesions (WML) in patients with cerebral small vascular disease (CSVD) and to provide guidance for the prevention of WML. Methods. A total of 136 patients diagnosed with CSVD and essential hypertension were recruited and divided into two groups. The Fazekas scale was used to quantify the severity of WML. The basic information, BP levels, BP variability, and circadian rhythm changes across these groups were recorded and compared. Results. The control group consisted of 40 subjects without WML (

Fazekas

score
=
0

), and the WML group was composed of 96 patients with WML (

Fazekas

score
≥
1

). Patients in the WML group were then divided into three subgroups: mild WML (

n
=
43

,

Fazekas

score
=
1

), moderate WML (

n
=
24

,

Fazekas

score
=
2

), and severe WML (

n
=
29

,

Fazekas

score
=
3
–
4

). Age, history of diabetes, and serum uric acid levels were significantly increased between the WML and control groups (

P
<
0.05

). The levels of 24-hour mean diastolic BP (

F
=
3.158

,

P
=
0.026

) and daytime mean systolic BP (

F
=
3.526

,

P
=
0.017

) were significantly increased between the control and WML groups. There was no significant difference in the rhythmic classification of BP among all groups (

P
>
0.05

). An ordered multinomial logistic regression analysis revealed that age, triglyceride levels, and nondipper BP were independent risk factors in WML. Conclusion. Age, history of diabetes, serum uric acid levels, 24-hour mean systolic level, and daily mean systolic BP level were significantly increased between the WML and control groups. Age, triglyceride levels, and nondipper BP were independent risk factors in WML in patients with CSVD, while the 24-hour dynamic blood pressure standard deviation and 24-hour dynamic blood pressure coefficient of variation were not associated with the occurrence of WML.
ZL-1211 Exhibits Robust Antitumor Activity by Enhancing ADCC and Activating NK Cell–mediated Inflammation in CLDN18.2-High and -Low Expressing Gastric Cancer Models
Authors: Konno Hiroyasu , Lin Tracey , Wu Renyi , Dai Xinchuan , Li Shou , Wang Grace , Chen Min , Li Wenying , Wang Lina , Sun Bee-Chun , Luo Zhen , Huang Tom , Chen Yuping , Zhang John , Ye Qiuping , Bellovin David , Wan Bing , Kang Lishan , Szeto Christopher , Hsu Karl , Kabbarah Omar 
Published: August 2022

CLDN18.2 (Claudin18.2)-targeting therapeutic antibodies have shown promising clinical efficacy in approximately 30% of gastric cancers expressing high levels of CLDN18.2 and less pronounced activity in low expressing malignancies. Here, we report that ZL-1211 is a mAb targeting CLDN18.2 engineered to promote enhanced antibody-dependent cellular cytotoxicity (ADCC) with the goal of achieving more potent activity in a wider spectrum of high- and low-CLDN18.2 expressing tumors. ZL-1211 demonstrated more robust in vitro ADCC activity than clinical benchmark not only in CLDN18.2-high but also CLDN18.2-low expressing gastric tumor cell lines. Greater antitumor efficacy was also observed in mouse xenograft models. Natural killer (NK) cell played critical roles in ZL-1211 efficacy and NK-cell depletion abrogated ZL-1211–mediated ADCC activity in vitro. ZL-1211 efficacy in vivo was also dependent on the presence of an NK compartment. Strikingly, NK cells strongly induced an inflammatory response in response to ZL-1211 treatment, including increased IFNγ, TNFα, and IL6 production, and were recruited into tumor microenvironment in patient-derived gastric tumors expressing CLDN18.2 upon ZL-1211 treatment to lyse the tumor cells. Taken together, our data suggest that ZL-1211 more effectively targets CLDN18.2-high gastric cancers as well as -low expressing malignancies that may not be eligible for treatment with the leading clinical benchmark by inducing enhanced ADCC response and activating NK cells with robust inflammation to enhance antitumor efficacy. Clinical activity of ZL-1211 is currently under evaluation in a phase I clinical trial (NCT05065710).Significance:ZL-1211, anti-CLDN18.2 therapeutic antibody can target CLDN18.2-high as well as -low gastric cancers that may not be eligible for treatment with clinical benchmark. ZL-1211 treatment induces NK-cell activation with robust inflammation to further activate antitumor immunity in tumor microenvironment.
Delivery Timing and Associated Outcomes in Pregnancies With Maternal Congenital Heart Disease at Term
Authors: Mok Thalia , Woods Allison , Small Adam , Canobbio Mary M. , Tandel Megha D. , Kwan Lorna , Lluri Gentian , Reardon Leigh , Aboulhosn Jamil , Lin Jeannette , Afshar Yalda 
Published: August 2022

Background
Current recommendations for delivery timing of pregnant persons with congenital heart disease (CHD) are based on expert opinion. Justification for early‐term birth is based on the theoretical concern of increased cardiovascular stress. The objective was to evaluate whether early‐term birth with maternal CHD is associated with lower adverse maternal or neonatal outcomes.

Methods and Results

This is a retrospective cohort study of pregnant persons with CHD who delivered a singleton after 37 0/7 weeks gestation at a quaternary care center with a multidisciplinary cardio‐obstetrics care team between 2013 and 2021. Patients were categorized as early‐term (37 0/7 to 38 6/7 weeks) or full‐term (≥39 0/7) births and compared. Multivariable logistic regression was conducted to calculate the adjusted odds ratio for the primary outcomes. The primary outcomes were composite adverse cardiovascular, maternal obstetric, and adverse neonatal outcome. Of 110 pregnancies delivering at term, 55 delivered early‐term and 55 delivered full‐term. Development of adverse cardiovascular and maternal obstetric outcome was not significantly different by delivery timing. The rate of composite adverse neonatal outcomes was significantly higher in early‐term births (36% versus 5%,
P
<0.01). After adjusting for confounding variables, early‐term birth remained associated with a significantly increased risk of adverse neonatal outcomes (adjusted odds ratio 11.55 [95% CI, 2.59–51.58]).

Conclusions
Early‐term birth for pregnancies with maternal CHD was associated with an increased risk of adverse neonatal outcomes, without an accompanying decreased rate in adverse cardiovascular or obstetric outcomes. In the absence of maternal or fetal indications for early birth, induction of labor before 39 weeks for pregnancies with maternal CHD should be reserved for routine obstetrical indications.
Clinical Diagnosis and Magnetic Resonance Imaging in Patients With Transient and Minor Neurological Symptoms: A Prospective Cohort Study
Authors: Whiteley William N. , MacRaild Allan , Wang Ying , Dennis Martin , Al-Shahi Salman Rustam , Gray Alasdair , Reed Matthew J. , Graham Catriona , Wardlaw Joanna M. 
Published: August 2022

Background:
The utility of magnetic resonance imaging (MRI) brain in patients with transient or minor neurological symptoms is uncertain. We sought to determine the proportion of participants with transient or minor neurological symptoms who had MRI evidence of acute ischemia at different clinical probabilities of transient ischemic attack (TIA) or minor stroke.

Methods:
Cohort of participants with transient or minor neurological symptoms from emergency and outpatient settings. Clinicians at different levels of training gave each participant a diagnostic probability (probable when TIA/stroke was the most likely differential diagnosis; possible when TIA/stroke was not the most likely differential diagnosis; or uncertain when diagnostic probability could not be given) before 1.5 or 3T brain MRI ≤5 days from onset. Post hoc, each clinical syndrome was defined blind to MRI findings as National Institute of Neurological Disorders and Stroke criteria TIA/stroke; International Headache Society criteria migraine aura; non-TIA focal symptoms; or nonfocal symptoms. MRI evidence of acute ischemia was defined by 2 reads of MRI. Stroke was ascertained for at least 90 days and up to 18 months after recruitment.

Results:

Two hundred seventy-two participated (47% female, mean age 60, SD 14), 58% with MRI ≤2 days of onset. Most (92%) reported focal symptoms. MR evidence of acute ischemia was found, for stroke/TIA clinical probabilities of probable 23 out of 75 (31% [95% CI, 21%–42%]); possible 26 out of 151 (17% [12%–24%]); and uncertain 9 out of 43, (20% [10%–36%]). MRI evidence of acute ischemia was found in National Institute of Neurological Disorders and Stroke criteria TIA/stroke 40 out of 95 (42% [32%–53%]); migraine aura 4 out of 38 (11% [3%–25%]); non-TIA focal symptoms 16 out of 99 (16% [10%–25%]); and no focal features 1 out of 29 (3% [0%–18%]). After MRI, a further 14 (5% [95% CI, 3–8]) would be treated with an antiplatelet drug compared with treatment plan before MRI. By 18 months, a new ischemic stroke occurred in 9 out of 61 (18%) patients with MRI evidence of acute ischemia and 2 out of 211 (1%) without (age-adjusted hazard ratio, 13 [95% CI, 3–62];
P
<0.0001).

Conclusions:
MRI evidence of acute brain ischemia was found in about 1 in 6 transient or minor neurological symptoms patients with a nonstroke/TIA initial diagnosis or uncertain diagnosis. Methods to determine the clinical and cost-effectiveness of MRI are needed in this population.
Bishops and Pentecost
Authors: Jillions John A. 
Published: August 2022

Abstract
The heart of Orthodox identity has to do with a sense of continuity with the past through the apostolic church, the Scriptures, ecumenical councils, the Fathers (and Mothers), the saints, the sacraments, and the tradition of liturgical life, all manifested in the role assigned to the bishops. Its identity is equally about the experience of Pentecost in the present: through the love, joy, peace, and freedom in the Holy Spirit, revealed in the unrepeatable uniqueness of each saint. Despite the Orthodox Church’s complicated history, painful internal debates, cultural differences, geographic separation, state oppression and persecution, there remains a powerful unity around these two dimensions of Orthodox identity. This article examines these dimensions, with particular focus on the order of service for consecrating a new bishop.
‘Taking the Spirit as our Guide’
Authors: Cross Terry L. 
Published: August 2022

Abstract
This article is a constructive work in ecclesiology from a Pentecostal perspective. It is proposed that the unique nature of Pentecostal spirituality and theology combine to form several bases for the doctrine of the church. Written for a Pentecostal-Orthodox dialogue, it will be clear that there are several crossovers in this proposal for a pneumatic ecclesiology that resonates well with the Eastern Churches. Three areas receive attention in this proposal: first, an encounter with the Spirit as a basis for a Pentecostal ecclesiology; second, the ministry of the Spirit and gifts as a basis for the church’s mission; and third, leadership through the Spirit as a basis for discipleship.
Exploring Snowfall Variability through the High-Latitude Measurement of Snowfall (HiLaMS) Field Campaign
Authors: Cooper Steven J. , L’Ecuyer Tristan S. , Wolff Mareile Astrid , Kuhn Thomas , Pettersen Claire , Wood Norman B. , Eliasson Salomon , Schirle Claire E. , Shates Julia , Hellmuth Franziska , Engdahl Bjørg Jenny Kokkvoll , Vásquez-Martín Sandra , Ilmo Trond , Nygård Knut 
Published: August 2022

Abstract
The High-Latitude Measurement of Snowfall (HiLaMS) campaign explored variability in snowfall properties and processes at meteorologically distinct field sites located in Haukeliseter, Norway, and Kiruna, Sweden, during the winters of 2016/17 and 2017/18, respectively. Campaign activities were founded upon the sensitivities of a low-cost, core instrumentation suite consisting of Micro Rain Radar, Precipitation Imaging Package, and Multi-Angle Snow Camera. These instruments are highly portable to remote field sites and, considered together, provide a unique and complementary set of snowfall observations including snowflake habit, particle size distributions, fall speeds, surface snowfall accumulations, and vertical profiles of radar moments and snow water content. These snow-specific parameters, used in combination with existing observations from the field sites such as snow gauge accumulations and ambient weather conditions, allow for advanced studies of snowfall processes. HiLaMS observations were used to 1) successfully develop a combined radar and in situ microphysical property retrieval scheme to estimate both surface snowfall accumulation and the vertical profile of snow water content, 2) identify the predominant snowfall regimes at Haukeliseter and Kiruna and characterize associated macrophysical and microphysical properties, snowfall production, and meteorological conditions, and 3) identify biases in the HARMONIE-AROME numerical weather prediction model for forecasts of snowfall accumulations and vertical profiles of snow water content for the distinct snowfall regimes observed at the mountainous Haukeliseter site. HiLaMS activities and results suggest value in the deployment of this enhanced snow observing instrumentation suite to new and diverse high-latitude locations that may be underrepresented in climate and weather process studies.
Southeast China Extreme Drought Event in August 2019: Context of Coupling of Midlatitude and Tropical Systems
Authors: Jiang Jilan , Su Tonghua , Liu Yimin , Wu Guoxiong , Yu Wei , Li Jinxiao 
Published: August 2022

Abstract
An extreme drought occurred over Southeast China (SEC) in August 2019. We demonstrate synergistic effects of midlatitude and tropical circulation on this extreme event and highlight the impacts of the coupling and locking of two cyclones at different latitudes, which are otherwise ignored. We propose the relaying roles of the Tibetan Plateau (TP) and western North Pacific in connection with the tropical convection and SEC precipitation. The equivalent-barotropic anticyclone over the TP and lower-tropospheric cyclone over the western North Pacific both resulted from the positive Indian Ocean dipole and El Niño Modoki. The equivalent-barotropic cyclone over Northeast China originated from the dispersion of Rossby waves upstream along the subtropical waveguide associated with the North Atlantic tripole sea surface temperature anomaly pattern and the Rossby wave response to the TP precipitation deficiency. Further, they jointly contributed to this drought by inducing strong northerly wind anomalies in the entire troposphere over East China. These anomalous northerly winds led to decreased warm moisture from the south and substantial sinking motions, which inhibited the occurrence of the SEC local convection and precipitation. The SEC precipitation is closely related to convection over the Maritime Continent from a climate perspective. This relationship is verified by observations, linear baroclinic model experiments, and general circulation model sensitivity experiments with and without the TP, in which precipitation anomalies over the southern TP and Philippine Sea play important bridge roles. The results will advance the prediction of the SEC extreme drought events.
Together–A couples’ program integrating relationship and financial education: A randomized controlled trial
Authors: Falconier Mariana K , Kim Jinhee , Lachowicz Mark J 
Published: August 2022

The present study evaluated the effectiveness of the TOGETHER program through a randomized controlled trial. A sample of community couples, predominantly African-American and low-income, was randomly assigned to either a no-intervention control group ( N = 147) or the intervention group ( N = 145) that participated in the program consisting of a 20-hour integrated relationship and financial education workshop and referrals to community services for family needs. Both groups completed self-report instruments upon enrollment (T1), 8 weeks later (workshop end = T2), and 6 months later (T3) regarding general and financial individual coping and well-being, general and financial relationship functioning, and financial self-efficacy and management. Dyadic multilevel models controlling for demographic variables and baseline measurement of outcome variables were used to test T1 – T2, T2 – T3, and T1 – T3 mean differences. Improvements in the intervention group were statistically significantly different from the control group at 6-month follow-up in the following areas: Stress levels, use of positive individual and dyadic strategies to manage financial and non-financial stress, conflict management, relationship satisfaction and commitment, and budgeting. Considering the reciprocal influence of individual/relational emotional and financial aspects, TOGETHER may be a particularly useful relationship education program for financially distressed couples. However, given the absence of significant differences between the intervention and control groups in financial stress, financial shared goals and values, cash and credit management, and savings/investment, future studies should continue evaluating whether the financial literacy component of the program may have a positive impact in such outcomes. Limitations and implications are discussed.
Variation in outcomes with extracorporeal membrane oxygenation in the era of coronavirus: A multicenter cohort evaluation
Authors: Stammers Alfred H , Tesdahl Eric A , Sestokas Anthony K , Mongero Linda B , Patel Kirti , Barletti Shannon , Firstenberg Michael S , St. Louis James D , Jain Ankit , Bailey Caryl , Jacobs Jeffrey P , Weinstein Samuel 
Published: August 2022

Extracorporeal membrane oxygenation (ECMO) is used in critically ill patients with coronavirus disease 2019 (COVID-19) with acute respiratory distress syndrome unresponsive to other interventions. However, a COVID-19 infection may result in a differential tolerance to both medical treatment and ECMO management. The aim of this study was to compare outcomes (mortality, organ failure, circuit complications) in patients on ECMO with and without COVID-19 infection, either by venovenous (VV) or venoarterial (VA) cannulation. This is a multicenter, retrospective analysis of a national database of patients placed on ECMO between May 2020 and January 2022 within the United States. Nine-hundred thirty patients were classified as either Pulmonary (PULM, n = 206), Cardiac (CARD, n = 279) or COVID-19 (COVID, n = 445). Patients were younger in COVID groups: PULM = 48.4 ± 15.8 years versus COVID = 44.9 ± 12.3 years, p = 0.006, and CARD = 57.9 ± 15.4 versus COVID = 46.5 ± 11.8 years, p < 0.001. Total hours on ECMO were greatest for COVID patients with a median support time two-times higher for VV support (365 [101, 657] hours vs 183 [63, 361], p < 0.001), and three times longer for VA support (212 [99, 566] hours vs 70 [17, 159], p < 0.001). Mortality was highest for COVID patients for both cannulation types (VA-70% vs 51% in CARD, p = 0.041, and VV-59% vs PULM-42%, p < 0.001). For VA supported patients hepatic failure was more often seen with COVID patients, while for VV support renal failure was higher. Circuit complications were more frequent in the COVID group as compared to both CARD and PULM with significantly higher circuit change-outs, circuit thromboses and oxygenator failures. Anticoagulation with direct thrombin inhibitors was used more often in COVID compared to both CARD (31% vs 10%, p = 0.002) and PULM (43% vs 15%, p < 0.001) groups. This multicenter observational study has shown that COVID patients on ECMO had higher support times, greater hospital mortality and higher circuit complications, when compared to patients managed for either cardiac or pulmonary lesions.