bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a classification to identify emergency department visits suitable for subacute and virtual care models: a randomised single-blinded agreement study protocol
Authors: Strum Ryan P , Mondoux Shawn , Mowbray Fabrice , Worster Andrew , Griffith Lauren E , Tavares Walter , Miller Paul , Hanel Erich , Aryal Komal , Sivakumaran Ravi , Costa Andrew P 
Published: December 2022

IntroductionRedirecting suitable patients from the emergency department (ED) to alternative subacute settings may assist in reducing ED overcrowding while delivering equivalent care. The Emergency Department Avoidance Classification (EDAC) was constructed to retrospectively classify ED visits that may have been suitable for safe management in a subacute or virtual clinical setting. The EDAC has established face and content validity but has not been tested against a reference standard as a criterion.ObjectivesOur primary objective is to examine the agreement between the EDAC and ED physician judgements in retrospectively identifying ED visits suitable for subacute care management. Our secondary objective is to assess the validity of ED physicians’ judgement as a criterion standard. Our tertiary objective is to examine how the ED physician’s perception of a virtual ED care alternative correlates with the EDAC.Methods and analysisA randomised single-centre, single-blinded agreement study. We will randomly select ED charts between 1 January and 31 December 2019 from an academic hospital in Hamilton, Canada. ED charts will be randomly assigned to participating ED physicians who will evaluate if this ED visit could have been managed appropriately and safely in a subacute and/or virtual model of care. Each chart will be reviewed by two physicians independently. We compute our needed sample size to be 79 charts. We will use kappa statistics to measure inter-rater agreement. A repeated measures regression model of physician ratings will provide variance estimates that we will use to assess the intraclass correlation of ED physician ratings and the EDAC.Ethics and disseminationThis study has been approved by the Hamilton Integrated Research Ethics Board (2022-14625). If validated, the EDAC may provide an ED-based classification to identify potentially avoidable ED visits, monitor ED visit trends, and proactively delineate those best suited for subacute or virtual care models.
Access, relationships, quality and safety (ARQS): a qualitative study to develop an Indigenous-centred understanding of virtual care quality
Authors: Roach Pamela , Ody Meagan , Campbell Paige , Bablitz Cara , Toth Ellen , Murry Adam , Henderson Rita , Kennedy Andrea , Montesanti Stephanie , Barnabe Cheryl , Crowshoe Lynden 
Published: December 2022

BackgroundAmong Indigenous peoples in Canada, access to high-quality healthcare remains an important determinant of health. The shift to virtual and remote-based approaches, expedited during the COVID-19 pandemic, influenced the ways in which individuals accessed care and the quality of care received. This study sought to determine which elements are required for effective and sustainable virtual care approaches for delivery of primary care to Indigenous patients and develop quality indicators grounded in Indigenous community and experience. We share a conceptual framework to understand how Indigenous patients access and define high-quality virtual care, grounded in Indigenous patient experiences and worldviews.MethodsUsing principles of patient-oriented research, we grounded this work in social justice and participatory action research. We sought to gain an in-depth understanding of the Indigenous experiences of virtual care and specifically of primary care. This was developed through semistructured interviews with Indigenous patients and Indigenous virtual primary care providers.ResultsThirteen participants were interviewed between 5 August 2021 and 25 October 2021. Using Framework Analysis, we constructed four domains including access, relationships, quality and safety as being primary facets of defining high-quality Indigenous virtual primary care.DiscussionThe results presented here indicate that the shift to virtual care, largely seen in response to the COVID-19 pandemic, does not compromise quality of care, nor does it lead to negative patient experiences. Optimal care is possible in virtual settings for some care needs and types of appointments and has the potential to decrease barriers to access and improve patient experiences of safety and quality while facilitating patient/provider relationships.ConclusionIn summary, high-quality Indigenous virtual care benefits from attention to patients’ experiences of access, relationships, safety and quality with their service providers and healthcare teams.
Functional connectivity of the default mode network subsystems in patients with major depressive episodes with mixed features
Authors: Liu Rui , Qi Han , Guan Lin , Wu Hang , Liu Jing , Li Xiaoya , Huang Juan , Zhang Ling , Zhou Yuan , Zhou Jingjing 
Published: December 2022

BackgroundThe neuroimaging mechanism of major depressive episodes with mixed features (MMF) is not clear.AimsThis study aimed to investigate the functional connectivity of the default mode network (DMN) subsystems among patients with MMF and patients with major depressive disorder without mixed features (MDDnoMF).MethodsThis study recruited 47 patients with MDDnoMFand 27 patients with MMF from Beijing Anding Hospital, Capital Medical University, between April 2021 and June 2022. Forty-five healthy controls (HCs) were recruited. All subjects underwent resting-state functional magnetic resonance imaging scanning and clinical assessments. Intranetwork and internetwork functional connectivity were computed in the DMN core subsystem, dorsal medial prefrontal cortex (dMPFC) subsystem and medial temporal lobe (MTL) subsystem. Analysis of covariance method was performed to compare the intranetwork and internetwork functional connectivity in the DMN subsystems among the MDDnoMF, MMF and HC groups.ResultsThe functional connectivity within the DMN core (F=6.32, pFDR=0.008) and MTL subsystems (F=4.45, pFDR=0.021) showed significant differences among the MDDnoMF, MMF and HC groups. Compared with the HC group, the patients with MDDnoMFand MMF had increased functional connectivity within the DMN MTL subsystem, and the patients with MMF also showed increased functional connectivity within the DMN core subsystem. Meanwhile, compared with the MDDnoMF, the patients with MMF had increased functional connectivity within the DMN core subsystem (mean difference (MDDnoMF−MMF)=−0.08, SE=0.04, p=0.048). However, no significant differences were found within the DMN dMPFC subsystem and all the internetwork functional connectivity.ConclusionsOur results indicated abnormal functional connectivity patterns of DMN subsystems in patients with MMF, findings potentially beneficial to deepen our understanding of MMF’s neural basis.
Evolution for Khovanov polynomials for figure-eight-like family of knots
Authors: Dunin-Barkowski Petr , Popolitov Aleksandr , Popolitova Svetlana 
Published: December 2022

We look at how evolution method deforms, when one considers Khovanov polynomials instead of Jones polynomials. We do this for the figure-eight-like knots (also known as ’double braid’ knots, see arXiv:1306.3197) — a two-parametric family of knots which “grows” from the figure-eight knot and contains both two-strand torus knots and twist knots. We prove that parameter space splits into four chambers, each with its own evolution, and two isolated points. Remarkably, the evolution in the Khovanov case features an extra eigenvalue, which drops out in the Jones [Formula: see text] limit.
Investigation of the Optimal PID-Like Fuzzy Logic Controller for Ball and Beam System with Improved Quantum Particle Swarm Optimization
Authors: Altinoz O. Tolga , Yilmaz A. Egemen 
Published: December 2022

Fuzzy Logic Controllers (FLCs) are intelligent control methods, where membership functions and corresponding rules are defined to get a proper control signal. The parameters were defined for these controllers, and they are named as PID-like FLC since the input and output parameters are connected to the Fuzzy controller with integral and derivative action of the error signal to change the behavior/performance of FLC. In this research, three different rule sets for Fuzzy controllers; 3 × 3, 5 × 5, and 7 × 7 are used and parameters are optimized with; differential evolution, genetic algorithm, particle swarm optimization and quantum-behaved particle swarm optimization. In addition to these controllers, a novel algorithm named as improved quantum particle swarm optimization is proposed as a part of this research. The simulation and real-life implementation on the experimental set results of these controllers are discussed in this paper.
Razão e razões masculinas: geração de desigualdades pelas práticas de meritocracia em uma empresa tecnocrática brasileira
Authors: Alvarenga Gustavo Leite , Pimentel Ricardo 
Published: December 2022

O artigo revela como a meritocracia – transvestida como um sistema neutro de promoções – produz e reproduz as desigualdades entre atributos de gênero, em uma empresa brasileira do setor elétrico. O enfoque teórico estabelece paralelo entre a prática meritocrática, como luta de categorias e seus valores, e a praxiologia de Bourdieu. A abordagem é qualitativa, baseada em entrevistas semiestruturadas e observação participante. Da análise de conteúdo emergiram três pares de categorias analíticas: técnico/não técnico, meritoso/não meritoso e masculino/feminino. A associação entre atributos masculinos e méritos mais valorizados é uma relação desigual de gênero não explícita no discurso, mas envolta em atributos de mérito que se agrupam em rótulos neutros e dissimuladores associados à masculinidade. O estudo contribui com a ampliação da compreensão sobre a construção de significados que subjazem aos processos de ascensão na estrutura hierárquica organizacional, ao revelar as relações entre os atributos de méritos e de valor; além de os atributos de masculinidade e racionalidade.
Trabalhando como militar-músico: subjetividade, afetos e antinomias no Exército Brasileiro
Authors: Zimmerman Alessandra Caroline Ortiz , Roso Adriane Rubio , Souza Ana Flavia de 
Published: December 2022

O presente estudo teve como objetivo refletir acerca da experiência de trabalho no Exército Brasileiro e seus efeitos na subjetivação de militares- músicos, identificando suas estratégias de acomodação, resistência e singularização (invenção de vida) para lidarem com o modelo disciplinar e vigilante da instituição. Participaram deste estudo, de caráter qualitativo, descritivo e exploratório, sete sargentos músicos, pertencentes a uma banda de música do exército de uma cidade do Rio Grande do Sul, no Brasil. Para se aproximar das experiências dos participantes, utilizou-se a técnica de grupo focal. As análises foram construídas considerando a noção de poder, especialmente a partir do referencial foucaultiano, e autores do campo das representações sociais. Foi percebida uma distinção entre ser músico ou militar músico, além de um forte sentimento de desvalorização dos militares-músicos. Concluiu-se que a música é um dispositivo importante para a saúde mental dos trabalhadores no exército, propiciando processos de resistência e a permanência em contexto militar.
“Patrão é patrão, empregado é empregado”: identidade profissional de domésticas
Authors: Mourão Luciana , Reis Lucimar dos Santos , Carvalho Luara , Sandall Hugo Leonardo Póvoa 
Published: December 2022

O trabalho doméstico vem passando por mudanças, principalmente nos países em desenvolvimento. No Brasil, as mudanças no trabalho doméstico têm sido impulsionadas pela Emenda Constitucional nº 72, de 2013. Esta pesquisa objetivou discutir a identidade profissional e as relações de trabalho de empregadas domésticas brasileiras a partir dos discursos das próprias trabalhadoras. Assim, foram realizadas dez entrevistas em profundidade, sendo cinco com empregadas mensalistas e cinco com diaristas da Região Metropolitana do Rio de Janeiro. As entrevistas foram gravadas em áudio e transcritas. Seguindo o método de análise dos núcleos de sentido, foram identificados dois núcleos centrais: ingresso na profissão e identidade profissional; e ambiguidade na relação empregada-empregadora ou empregador. Os discursos das trabalhadoras domésticas sinalizaram uma inserção precoce no mundo do trabalho e uma identidade profissional tênue, com relações dúbias entre patroas e empregadas e dúvidas quanto ao reconhecimento e valorização por parte dos empregadores. Os resultados são discutidos à luz da literatura da área e do contexto atual.
West Germany and NATO's Nuclear Force Posture in the Early 1960s (Part 1)
Authors: Lutsch Andreas 
Published: December 2022

Abstract
In the late 1950s and early 1960s, the member-states of the North Atlantic Treaty Organization (NATO) debated whether a counterforce capability of hundreds of mobile medium-range ballistic missiles (MRBMs) under joint command in Europe was needed to reinforce U.S. extended nuclear deterrence. The conventional wisdom about this issue, echoing the official U.S. government position, has long been that deterrence was robust even without a joint missile force. According to this argument, U.S. policymakers tried to reassure NATO allies, particularly the West Germans, that sharing control of strategic nuclear weapons was unnecessary and unwise. The analysis presented here shows that the problem was not so straightforward. Many officials in NATO countries, particularly in the Federal Republic of Germany (FRG), viewed the MRBM debate not so much as a problem of nuclear weapons control but as a question of extended deterrence credibility and strategic stability, posing an all-or-nothing challenge to NATO.
The United States and Strategic Arms Limitation during the Nixon-Kissinger Period: Building a Stable International System?
Authors: Trachtenberg Marc 
Published: December 2022

Abstract
The Strategic Arms Limitation Talks (SALT) played a key role in U.S.-Soviet relations in the early 1970s. This article reassesses some aspects of the SALT process in the light of important evidence that has become available in recent years. The key question is whether U.S. policy in the SALT negotiations was rooted in strategic stability theory—that is, in the idea that both major powers should work out an arrangement that would guarantee the survivability and effectiveness of both sides’ strategic nuclear forces, thereby reducing whatever incentive either of them might have to strike first in a crisis. The notion that U.S. policy on SALT was rooted in that theory is essentially a myth—although a myth that had important political consequences. The SALT process of the 1970s, as shaped by decisions made during the administration of Richard M. Nixon, helped pave the way for the hardening of U.S. policy toward the Soviet Union in the early 1980s—scarcely the result supporters of nuclear arms control had been hoping for a decade earlier.
Observations of River Plume Mixing in the Surf Zone
Authors: Kastner S. E. , Horner-Devine A. R. , Thomson J. M. , Giddings S. N. 
Published: December 2022

Abstract
We use salinity observations from drifters and moorings at the Quinault River mouth to investigate mixing and stratification in a surf-zone-trapped river plume. We quantify mixing based on the rate of change of salinity DS/Dt in the drifters’ quasi-Lagrangian reference frame. We estimate a constant value of the vertical eddy diffusivity of salt of Kz = (2.2 ± 0.6) × 10−3 m2 s−1, based on the relationship between vertically integrated DS/Dt and stratification, with values as high as 1 × 10−2 m2 s−1 when stratification is low. Mixing, quantified as DS/Dt, is directly correlated to surf-zone stratification, and is therefore modulated by changes in stratification caused by tidal variability in freshwater volume flux. High DS/Dt is observed when the near-surface stratification is high and salinity gradients are collocated with wave-breaking turbulence. We observe a transition from low stratification and low DS/Dt at low tidal stage to high stratification and high DS/Dt at high tidal stage. Observed wave-breaking turbulence does not change significantly with stratification, tidal stage, or offshore wave height; as a result, we observe no relationship between plume mixing and offshore wave height for the range of conditions sampled. Thus, plume mixing in the surf zone is altered by changes in stratification; these are due to tidal variability in freshwater flux from the river and not wave conditions, presumably because depth-limited wave breaking causes sufficient turbulence for mixing to occur during all observed conditions.

Significance Statement
River outflows are important sources of pollutants, sediment, and nutrients to the coastal ocean. Small rivers often meet large breaking waves in the surf zone close to shore, trapping river water and river-borne material near the beach. Such trapped material can influence coastal public health, beach morphology, and nearshore ecology. This study investigates how trapped fresh river water mixes with salty ocean water in the presence of large breaking waves by using high-resolution measurements of waves, salinity, and turbulence. We find that the surf zone is often fresh and stratified, which could have significant implications for the fate of riverine material. Wave breaking provides a constant source of turbulence, and the amount of mixing is limited by the degree of vertical salt stratification; more mixing occurs when stratification is higher.
Longitudinal Trajectories of Post-Stroke Depression Symptom Subgroups
Authors: Ashaie Sameer A. , Funkhouser Carter J. , Jabbarinejad Roxana , Cherney Leora R. , Shankman Stewart A. 
Published: December 2022

Background Post-stroke depressive symptoms are prevalent and impairing, and elucidating their course and risk factors is critical for reducing their public health burden. Previous studies have examined the course of post-stroke depression, but distinct depressive symptom dimensions (eg, somatic symptoms, negative affect [eg, sadness], anhedonia [eg, loss of interest]) may vary differently over time. Objective The present study examined within-person and between-person associations between depressive symptom dimensions across 3 timepoints in the year following discharge from in-patient rehabilitation hospitals, as well as the impact of multiple clinical variables (eg, aphasia). Methods Stroke survivors completed the Center for Epidemiologic Depression Scale (CES-D) at discharge from post-stroke rehabilitation (“T1”) and at 3-month (“T2”) and 12-month (“T3”) follow-ups. Scores on previously identified CES-D subscales (somatic symptoms, anhedonia, and negative affect) were calculated at each timepoint. Random intercept cross-lagged panel model analysis examined associations between symptom dimensions while disaggregating within-person and between-person effects. Results There were reciprocal, within-person associations between somatic symptoms and anhedonia from T1 to T2 and from T2 to T3. Neither dimension was predictive of, or predicted by negative affect. Conclusions The reciprocal associations between somatic symptoms and anhedonia may reflect a “vicious cycle,” and suggest these 2 symptom dimensions may be useful indicators of risk and/or intervention targets. Regularly assessing depression symptoms starting during inpatient rehabilitation may help identify stroke survivors at risk for depression symptoms and facilitate early intervention.
Functional Neuroplasticity and Motor Skill Change Following Gross Motor Interventions for Children With Diplegic Cerebral Palsy
Authors: Hilderley Alicia J. , Wright F. Virginia , Taylor Margot J. , Chen Joyce L. , Fehlings Darcy 
Published: December 2022

Background Gross motor intervention designs for children with diplegic cerebral palsy (DCP) require an improved understanding of the children’s potential for neuroplasticity. Objective To identify relations between functional neuroplasticity and motor skill changes following gross motor interventions for children with DCP. Methods There were 17 participants with DCP (ages 8-16 years; 6 females; Gross Motor Function Classification System Level I [n = 9] and II [n = 8]). Each completed a 6-week gross motor intervention program that was directed toward achievement of individualized motor/physical activity goals. Outcomes were assessed pre/post and 4 to 6 months post-intervention (follow-up). An active ankle dorsiflexion task was completed during functional magnetic resonance imaging. The ratio of motor cortical activation volume in each hemisphere was calculated using a laterality index. The Challenge was the primary gross motor skill measure. Change over time and relations among outcomes were evaluated. Results Challenge scores improved post-intervention (4.57% points [SD 4.45], P = .004) and were maintained at follow-up (0.75% [SD 6.57], P = 1.000). The laterality index for dominant ankle dorsiflexion increased ( P = .033), while non-dominant change was variable ( P = .534). Contralateral activation (laterality index ≥+0.75) was most common for both ankles. Challenge improvements correlated with increased ipsilateral activity (negative laterality index) during non-dominant dorsiflexion ( r = −.56, P = .045). Smaller activation volume during non-dominant dorsiflexion predicted continued gross motor gains at follow-up ( R2 = .30, P = .040). Conclusions Motor cortical activation during non-dominant ankle dorsiflexion is a modest indicator of the potential for gross motor skill change. Further investigation of patterns of neuroplastic change will improve our understanding of effects. ClinicalTrials.gov Registry: NCT02584491 and NCT02754128
Application of mixed linear models for the estimation of functional effects on bovine stature based on SNP summary statistics from a whole-genome association study
Authors: Kotlarz Krzysztof , Kosinska-Selbi Barbara , Cai Zexi , Sahana Goutam , Szyda Joanna 
Published: December 2022

AbstractGenome-wide association studies (GWAS) help identify polymorphic sites or genes linked to phenotypic variance, but a few identified genes and/or single nucleotide polymorphisms (SNPs) are unlikely to explain a large part of the phenotypic variability of complex traits. In this study, the focus was moved from single loci to functional units, expressed by the metabolic pathways as defined in the Kyoto Encyclopaedia of Genes and Genomes (KEGG) database. Consequently, the aim of this study was to estimate KEGG effects on stature in three Nordic dairy cattle breeds using SNP effects from GWAS as the dependent variable. The SNPs were annotated to genes, then the genes to KEGG pathways. The effects of KEGG pathways were estimated separately for each breed using a mixed linear model incorporating the similarity between pathways expressed by common genes. The KEGG pathway D-amino acid metabolism (map00473) was estimated to be significant for stature in two of the analysed breeds and revealed a borderline significance in the third breed. Thus, we demonstrate that the approach to statistical modelling of higher order functional effects on complex traits is useful, and provides evidence of the importance of D-amino acids for growth in cattle.