bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neural keyword confidence estimation for open‐vocabulary keyword spotting
Authors: Liu Zuozhen , Li Ta , Zhang Pengyuan 
Published: November 2021

AbstractDespite the recent prevalence of keyword spotting (KWS) in smart home, open‐vocabulary KWS remains a keen but unmet need among the users. Conventional open‐vocabulary KWS systems are difficult to obtain a high wake‐up rate and low false alarms simultaneously due to the lack of specific data for model optimisation. In this letter, a light‐weight neural keyword confidence estimation module (KCEM) for the second detection part in the open‐vocabulary KWS system is proposed, which utilises the transformer structure to calculate the confidence by fusing the keyword embedding and the acoustic feature obtained from the KWS model. KCEM method is evaluated on a self‐collected open‐vocabulary KWS test set, yielding equally efficient performance compared with typical confidence estimation methods, a reduction in false reject rate by 34% and 29% relative under clean and noisy conditions, respectively, at 0.04 false alarms per hour.
GBAZ segregation thickness and solute concentration effect on the mechanical properties in polycrystalline Ag‐doped Cu alloy
Authors: Zhu Dasheng , Zhang Feng , Li Guo , Ma Yinzhong 
Published: November 2021

AbstractUtilising molecular dynamics simulation, the effect of segregation thickness and solute concentration on the mechanical properties of poly‐crystalline Ag‐doped Cu alloy are explored. The alloying atoms are dispersed randomly nearby grain boundaries with equidistant offset method. The dispersed domains are restricted in grain boundary affect zone. The uniaxial tensile simulation results indicate that dispersed alloying atoms exert a negative effect on the tensile behaviours of Ag‐doped Cu alloy and its peak stress decreases as the increasing of segregation thickness and solute concentration. Moreover, the corresponding tensile deformation mechanisms are analysed according to the observed dislocation activities and structure evolutions.
Single electricity market forecasting and energy arbitrage maximization framework
Authors: Mohamed Ahmed A.Raouf , Best Robert J. , Liu Xueqin , Morrow D. John 
Published: November 2021

AbstractThe rapid deployment of renewable‐based generation to meet the net‐zero carbon targets has affected the wholesale energy paradigm. In the island of Ireland, the Single Electricity Market (SEM) aims to deliver high levels of supply security, reliability, and transparency through multiple markets with different trading time frames and clearing procedures. This paper proposes a powerful methodology to maximize the revenues from the participation in the SEM. A forecasting model of four successive stages based on neural networks is proposed to predict the demand and system marginal prices of the SEM ex‐ante markets. An energy arbitrage optimization framework is proposed for battery energy storage systems (BESS) to maximize the arbitrage profits. The methodology efficacy is validated by achieving 91.1% selling accuracy, 97.9% buying accuracy, and 85.1% energy arbitrage net accuracy of the ideal case where the SEM data is perfectly‐known for three consecutive months. Furthermore, the BESS degradation is evaluated and a cost‐benefit analysis is introduced to evaluate the economic feasibility of BESS participating in the SEM ex‐ante markets. The results reveal that the participation of BESS in the SEM solely is not profitable, however, under stacked revenues arrangement, the proposed methodology can be applied to boost the BESS revenues.
A two‐phase non‐inverting buck‐boost converter for an RL load
Authors: Liao Hsuan , Chen Jiann‐Fuh 
Published: November 2021

AbstractThere is an increase in renewable energy sources, which are regarded as current sources, where DC‐DC converters are widely used which require more suitable loads for driving current type loads. This paper uses a duality approach to show that the converter circuit can apply to the current type loads without too much voltage variation. It illustrates the derived steps for a conventional buck converter by using graph formation. To validate the duality approach, five original switching converters are detailed. A current source with an R‐L load (CSRL) converter is used for current‐based applications, such as electrical motors, electromagnetic relays, or light‐emitting diodes (LEDs). This study proposes a two‐phase non‐inverting buck‐boost converter with an R‐L load which is suitable for driving current‐based applications. The design procedure and steady‐state analysis are presented. SIMPLISTM software is used to simulate the topologies. This method for operation mode and formula derivation is like in voltage type circuit structures, and this study has sufficient mathematical analysis capabilities. For demonstration, a 650 W VSRL converter is implemented to verify the feasibility of the method. The corresponding circuit topology of the conventional circuit can be illustrated by using the duality approach rapidly.
Characterization of Different Forms of Kava (Piper methysticum) Products by UPLC-MS/MS
Authors: Mamallapalli Jessica , Kanumuri Siva Rama Raju , Corral Pedro , Johnston Edward , Zhuang Chunlin , McCurdy Christopher R. , Mathews Carol A. , Sharma Abhisheak , Xing Chengguo 
Published: November 2021

AbstractThere are several forms of kava (Piper methysticum) products available for human consumption, and many factors are known to influence their chemical compositions and therefore their pharmacological properties. Because of the increased popularity of kava intake, a rigorous characterization of their content diversity is prerequisite, particularly due to its known potential to cause hepatotoxicity. To understand the composition diversity of kavalactones and flavokavains in commercial kava products, we developed a UPLC-MS/MS-based analytical method for the quantification of six kavalactones (kavain, dihydrokavain, methysticin, dihydromethysticin, yangonin and desmethoxyyangonin) and two flavokavains (flavokavains A and B) and analyzed their contents in 28 different kava products in the form of capsules, tinctures, traditional aqueous suspensions and dried powders. Our results demonstrated a great variation in terms of the total and relative abundance of the analyzed kavalactones and flavokavains among the analyzed kava preparations. More importantly, the kavalactone abundance in the product label could differ up to 90% from our experimental measurements. Therefore, more rigorous and comprehensive quality control of kava products is required with respect to the content of individual kavalactones and flavokavains. Accurate content information is essential to understand the pharmacological properties and safety of different kava products.
In Vitro Cytotoxic and Leishmanicidal Activity of Isolated and
Semisynthetic ent-Pimaranes from Aldama arenaria
Authors: de Oliveira Adriana da Silva Santos , Conrado Gabrielly Galdino , Grazzia Nathalia , Miguel Danilo Ciccone , Franchi Júnior Gilberto Carlos , Garcia Vera Lúcia 
Published: November 2021

AbstractTwo pimaranes ent-pimara-8(14),15-dien-19-oic acid (1) and
ent-8(14),15-pimaradien-3β-ol (2), isolated from
Aldama arenaria, and six semi-synthetic derivatives methyl ester of
the ent-pimara-8(14),15-dien-19-oic acid (3),
ent-pimara-8(14),15-dien-19-ol (4), acetate of
ent-pimara-8(14),15-dien-19-ol (5),
ent-pimara-8(14),15-dien-19-ol succinic acid (6), acetate of
ent-8(14),15-pimaradien-3β-ol (7),
ent-8(14),15-pimaradien-3β-ol succinic acid (8) were
evaluated in vitro for their cytotoxic activities to childhood leukemia
cell lines and leishmanicidal activity against the parasite Leishmania
amazonensis. Among these compounds, 1 to 6 presented
moderate cytotoxic activity, with compound 4 being the most active
(GI50 of 2.6 µM for the HL60 line) and the derivatives 7
and 8 being inactive. Against the parasite Leishmania amazonensis,
the most promising derivative was the acetate of
ent-pimara-8(14),15-dien-19-ol (5), with EC50 of
20.1 µM, selectivity index of 14.5, and significant reduction in the parasite
load. Pimarane analogues 1, ent-pimara-8(14),15-dien-19-oic acid,
and 2, ent-8(14),15-pimaradien-3β-ol, presented different
activities, corroborating the application of such molecules as prototypes for
the design of other derivatives that have greater cytotoxic or leishmanicidal
potential.
Episiotomy: Evolution of a Common Obstetric Practice at a Public Hospital
Authors: Dillon Shena J. , Nelson David B. , Spong Catherine Y. , McIntire Donald D. , Leveno Kenneth J. 
Published: December 2021

Objective This study aimed to evaluate the rate and impact of episiotomy on maternal and newborn outcomes before and after restricted use of episiotomy.
Study Design This population-based observational study used an obstetric database of all deliveries since 1990 that has been maintained with quality checks. Inclusion criteria were vaginal deliveries at ≥37 weeks. Exclusion criteria included fetal malformations, multifetal gestations, or fetal deaths known on arrival to Labor and Delivery. The primary outcomes of interest were episiotomy, perineal lacerations, and newborn outcomes. To evaluate the impact of restrictive episiotomy, data from 1990 to 1997 (35% overall episiotomy rate) were compared with data from 2010 to 2017 (2.5% overall episiotomy rate). Univariable analysis of maternal and infant outcomes were performed comparing the two-time epochs with the Pearson's Chi-squared test.
Results Overall, 268,415 women met inclusion criteria and 49,089 (18.2%) had an episiotomy. The rate of episiotomy decreased from 37% of deliveries in 1990 to 2% in 2017. A total of 82,082 deliveries occurred in the 1990 to 1997 epoch and 57,183 in 2010 to 2017. Indicated use of episiotomy was associated with a significant decrease in third and fourth degree lacerations. Immediate newborn condition (5-minute Apgar's score ≤3 and umbilical artery pH <7.1) and neonatal outcomes (intraventricular hemorrhage [IVH] grade 3/4, positive culture sepsis, neonatal seizures, and neonatal demise) were not significantly different.
Conclusion Selective, indicated use of episiotomy compared with routine was associated with lower rates of third/fourth-degree lacerations with no change in neonatal outcomes. The common obstetric practice of routinely performing episiotomy, presumably to prevent perineal trauma, proved untrue when analyzed over almost three decades.
Key Points
Adverse Perinatal Outcomes Associated with Stage 1 Hypertension in Pregnancy: A Retrospective Cohort Study
Authors: Norton Elizabeth , Shofer Frances , Schwartz Hannah , Dugoff Lorraine 
Published: November 2021

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women.
Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP]: 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups.
Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06).
Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk.
Key Points
Gestational Weight Gain and Adverse Maternal and Neonatal Outcomes for Pregnancies Complicated by Pregestational and Gestational Diabetes
Authors: Kiefer Miranda K. , Adebayo Adesomo , Cleary Erin , Klebanoff Mark , Costantine Maged M. , Landon Mark B. , Gabbe Steven , Frey Heather , Venkatesh Kartik K. 
Published: November 2021

Objective This study aimed to investigate the association between excess and less than recommended gestational weight gain (GWG) and adverse maternal and neonatal outcomes in women with pregestational and gestational diabetes.
Study Design We conducted a secondary analysis of the National Institute of Child Health and Human Development (NICHD) Consortium on Safe Labor (CSL) study. We included deliveries >23 weeks of nonanomalous singletons with either pregestational or gestational diabetes. The exposure was GWG greater than or less than compared with the U.S. Institute of Medicine recommendations for total pregnancy weight gain per prepregnancy body mass index. Consistent with the 2020 Delphi outcome for diabetes in pregnancy, maternal outcomes included cesarean delivery and preeclampsia and neonatal outcomes included small for gestational age (SGA), large for gestational age (LGA), macrosomia >4,000 g, preterm birth <37 weeks, stillbirth, and neonatal death. We modeled both absolute GWG and GWG z-scores, standardized for gestational duration. Multivariable logistic regression with generalized estimating equations was used, adjusting for age, race/ethnicity, parity, prior cesarean delivery, chronic hypertension, tobacco use, U.S. region, and delivery year.
Results Of 8,322 deliveries (n = 8,087 women) complicated by pregestational or gestational diabetes, 47% were in excess, 27% were within, and 26% were less than GWG recommendations. Deliveries with excess absolute GWG were at higher adjusted odds of cesarean delivery, preeclampsia, LGA, and macrosomia, compared with those within recommendations. Similar results were observed when using standardized GWG z-scores, in addition to higher likelihood of preterm birth and neonatal death. Less than recommended GWG was associated with a lower likelihood of these adverse outcomes but higher SGA. Additionally, less GWG by z-score was associated with a lower likelihood of stillbirth.
Conclusion Excess GWG increases the risk of adverse maternal and neonatal outcomes for women with pregestational and gestational diabetes. Less GWG than recommended may decrease this risk.
Key Points
Fetal Echocardiogram and Detailed First Trimester Obstetric Ultrasound: ICD-10 Indications
Authors: Bsat Fadi , Fisher Barbra M. , Malisch Trisha , Jain Vanita 
Published: November 2021

The American Institute of Ultrasound in Medicine and multiple national organizations have published the indications for fetal echocardiogram and for the detailed first trimester obstetric ultrasound. We present the corresponding International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for those indications.
Key Points
Risk Factors for Adverse Maternal Outcomes following Expectantly Managed Preterm Prelabor Rupture of Membranes
Authors: Darling Alice J. , Harris Hailey M. , Zemtsov Gregory E. , Small Maria , Grace Matthew R. , Wheeler Sarahn , Dotters-Katz Sarah K. 
Published: November 2021

Objective We sought to characterize the incidence and risk factors associated with developing maternal morbidity following preterm prelabor rupture of membranes.
Study Design Retrospective case–control study of patients with preterm prelabor rupture of membranes at a single institution from 2013 to 2019 admitted at ≥23 weeks gestational age. The primary outcome was a composite of maternal morbidity which included: death, sepsis, intensive care unit (ICU) admission, acute kidney injury, postpartum dilation and curettage, postpartum hysterectomy, venous thromboembolism, postpartum hemorrhage, postpartum wound complication, postpartum endometritis, pelvic abscess, postpartum pneumonia, readmission, and/or need for blood transfusion were compared with patients without above morbidities. Severe morbidity was defined as: death, ICU admission, venous thromboembolism, acute kidney injury, postpartum hysterectomy, sepsis, and/or transfusion >2 units. Demographics, antenatal, and delivery characteristics were compared between patients with and without maternal morbidity. Bivariate statistics and regression models were used to compare outcomes and calculate adjusted odd ratios.
Results Of 361 included patients, 64 patients (17.7%) experienced maternal morbidity and nine (2.5%) had severe morbidity. Patients who experienced maternal morbidity were significantly (p < 0.05) more likely to be older, have private insurance, have BMI ≥40, have chorioamnionitis at delivery, and undergo cesarean or operative vaginal delivery when compared with patients who did not experience morbidity. After controlling for confounders, cesarean delivery (aOR 2.38, 95% CI[1.30,4.39]), body mass index ≥40 at admission (aOR 2.54, 95% CI[1.12,5.79]), private insurance (aOR 3.08, 95% CI[1.54,6.16]), and tobacco use (aOR 3.43, 95% CI[1.58,7.48]) were associated with increased odds of maternal morbidity.
Conclusion In this cohort, maternal morbidity occurred in 17.7% of patients with preterm prelabor rupture of membranes. Private insurance, body mass index ≥40, tobacco use, and cesarean delivery were associated with higher odds of morbidity. These data can be used in counseling and to advocate for smoking cessation.
Key Points
Imaging-Based Risk Stratification for Recurrence Risk in Women with a History of Peripartum Cardiomyopathy
Authors: Ma'ayeh Marwan , Slivnick Jeremy A. , McKiever Monique E. , Garrett Zachary D. , Lim Woobeen , Cackovic Michael , Rood Kara M. , Bradley Elisa A. 
Published: December 2021

Objective Peripartum cardiomyopathy (PPCM) affects 1:1,000 U.S. pregnancies, and while many recover from the disease, the risk of recurrence in subsequent pregnancy (SSP) is high. This study aims to evaluate the utility of left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) to predict the risk of recurrence of PPCM in SSP.
Study Design We retrospectively evaluated outcomes in women with a history of PPCM and SSP at a large-volume cardioobstetrics program (2008–2019).
Results There were 18 women who had incident PPCM and pursued SSP. Of 24 pregnancies in these women, 8 (33%) were complicated by the development of recurrent PPCM. LVEF ≥ 52% or GLS ≤ −16 was associated with a low risk of recurrent PPCM.
Conclusion Approximately one-third of women with PPCM developed recurrent PPCM in SSP. LVEF and GLS on prepregnancy echocardiography may predict the risk of recurrence. Additional studies evaluating risk for recurrence are required to better understand which women are the safest to consider SSP.
Key Points
Comparing Two Testing Strategies: Universal versus Symptomatic SARS-CoV-2 Testing in Obstetric Patients
Authors: Aderibigbe Oluyemi A. , Lappen Justin R. , Albertini Megan , Gibson Kelly S. 
Published: November 2021

Objective To compare universal severe acute respiratory syndrome coronvirus-2 (SARS-CoV-2) testing to symptomatic testing at two large academic centers.
Study Design We performed a retrospective cohort study comparing the approach to testing at two academic centers in Northeast Ohio. The study period started with the inception of symptomatic testing for SARS-CoV-2 at both institutions in March 2020. Women younger than 18 years were excluded. The primary outcome was the SARS-CoV-2 positivity rate in symptomatic pregnant patients at both institutions. Our coprimary outcome was the additional positivity rate obtained from universal testing at the University Hospitals. The secondary outcome of interest was the percentage of SARS-CoV-2 screen positive mothers with screen positive neonates. Data were analyzed using Mann–Whitney U test for continuous variables with chi-square and Fisher's exact tests for proportions.
Results During the study period, 144 pregnant women with symptoms of coronavirus disease 2019 (COVID-19) were tested at MetroHealth of which 27 resulted as positive for SARS-CoV-2 (18.7% positivity rate). University Hospitals tested 392 pregnant women with symptoms of COVID-19 of which 67 resulted as positive for SARS-CoV-2 (positivity rate 17.0%). In the universal testing program at University Hospitals, an additional 2,870 tests were performed on asymptomatic pregnant women of which 30 were positive for SARS-CoV-2 (1.0% positivity rate).There were no SARS-CoV-2 positive infants in our cohort, and all cases of maternal critical illness occurred in symptomatic patients.
Conclusion Universal and symptomatic testing approaches demonstrated similar clinical performance within a single geographic region in obstetric patients.
Key Points
Middle Cerebral Artery Dopplers and Abnormal Neonatal Outcomes among Pregnant Women with Zika Virus Infection
Authors: Mok Thalia , Pereira Jose Paulo , Sobhani Nasim C. , Cardozo Renan Fonseca , Valle Helena Abreu , Dutra Beatriz Ribeiro Torres , Gama Helder Dotta , Moreira Maria Elisabeth , Vasconcelos Zilton , Pone Marcos , Gaw Stephanie L. 
Published: November 2021

Objective The aim of this study was to investigate the role of middle cerebral artery (MCA) Doppler measurements for the prediction of abnormal neonatal outcomes in pregnancies affected by Zika virus (ZIKV).
Methods Secondary analysis of a prospective cohort of pregnant women diagnosed with ZIKV infection from September 2015 to December 2016 at a single regional referral center. Ultrasonography with measurements of MCA peak systolic velocity (PSV), PSV multiples of the median (MoM) for gestational age, and pulsatility index (PI) were collected. The primary outcome was a composite abnormal neonatal outcome. MCA Doppler values of normal and abnormal neonatal outcomes were compared with Wilcoxon rank sum test. The predictive value of MCA Dopplers for development of abnormal neonatal outcome was calculated by logistic regression.
Results One-hundred twenty-seven ZIKV-positive pregnancies with MCA Doppler measurements and known neonatal outcomes were included. Of the 132 neonates, 66 (50%) had an abnormal neonatal outcome. Lower MCA PSV (p = 0.027) and PSV MoM (p = 0.008) were associated with abnormal neonatal outcomes. There was no significant difference in MCA PI. Abnormal neonatal outcomes had lower MCA PSV by 5.36 cm/s (95% confidence interval [CI]: 0.95–9.77, p = 0.018) and lower MCA PSV MoM by 0.13 (95% CI: 0.05–0.22, p = 0.002). MCA PSV of 30 cm/s had a 65% predicted probability of an abnormal neonatal outcome (95% CI: 51–79%).
Conclusion In ZIKV-infected pregnancies, lower MCA PSV and PSV MoM measurements were seen with abnormal neonatal outcomes. This may represent a physiologic response to fetal ZIKV infection. Evaluation of MCA Dopplers may be of clinical utility in the surveillance of ZIKV-affected pregnancies.
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