bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Counseling+” Roles of the Speech-Language Pathologist Serving Older Adults With Mild Cognitive Impairment and Dementia From Alzheimer's Disease
Authors: Lanzi Alyssa M. , Ellison James M. , Cohen Matthew L. 
Published: June 2021

PurposePersons with dementia and mild cognitive impairment (MCI) are major consumers of services provided by speech-language pathologists (SLPs). These services include not only direct assessment and treatment of communication and swallowing but also counseling, collaboration, prevention, and wellness. These “counseling+” activities can be especially challenging for SLPs to deliver because of the lack of evidence, as well as the complex nature of Alzheimer's disease (AD) and other conditions that cause MCI and dementia.MethodThis tutorial is written by a speech-language pathologist, a neuropsychologist, and a geriatric psychiatrist to provide education, resources, and recommendations for SLPs delivering counseling+ activities to patients with MCI and dementia from AD and related disorders.Results and ConclusionsWe describe counseling+ activities across the continuum of care ranging from educating and conducting cognitive screenings with adults experiencing age-related cognitive decline to supporting end-of-life wishes. Because of their expertise in communication, SLPs can provide an array of important leading and supporting services to patients, their family, and other health care professionals on the care team, such as providing patients with appropriate feedback following a cognitive screening and helping caregivers identify the communicative intent of a responsive behavior. The demand for SLP services for patients with MCI and dementia will grow significantly over the next few decades, necessitating more systematic research and clinical evidence in this area.
Real‐time automatic helmet detection of motorcyclists in urban traffic using improved YOLOv5 detector
Authors: Jia Wei , Xu Shiquan , Liang Zhen , Zhao Yang , Min Hai , Li Shujie , Yu Ye 
Published: June 2021

AbstractIn traffic accidents, motorcycle accidents are the main cause of casualties, especially in developing countries. The main cause of fatal injuries in motorcycle accidents is that motorcycle riders or passengers do not wear helmets. In this paper, an automatic helmet detection of motorcyclists method based on deep learning is presented. The method consists of two steps. The first step uses the improved YOLOv5 detector to detect motorcycles (including motorcyclists) from video surveillance. The second step takes the motorcycles detected in the previous step as input and continues to use the improved YOLOv5 detector to detect whether the motorcyclists wear helmets. The improvement of the YOLOv5 detector includes the fusion of triplet attention and the use of soft‐NMS instead of NMS. A new motorcycle helmet dataset (HFUT‐MH) is being proposed, which is larger and more comprehensive than the existing dataset derived from multiple traffic monitoring in Chinese cities. Finally, the proposed method is verified by experiments and compared with other state‐of‐the‐art methods. Our method achieves mAP of 97.7%, F1‐score of 92.7% and frames per second (FPS) of 63, which outperforms other state‐of‐the‐art detection methods.
A two‐stage neural network prediction of chronic kidney disease
Authors: Peng Hongquan , Zhu Haibin , Ieong Chi Wa Ao , Tao Tao , Tsai Tsung Yang , Liu Zhi 
Published: June 2021

AbstractAccurate detection of chronic kidney disease (CKD) plays a pivotal role in early diagnosis and treatment. Measured glomerular filtration rate (mGFR) is considered the benchmark indicator in measuring the kidney function. However, due to the high resource cost of measuring mGFR, it is usually approximated by the estimated glomerular filtration rate, underscoring an urgent need for more precise and stable approaches. With the introduction of novel machine learning methodologies, prediction performance is shown to be significantly improved across all available data, but the performance is still limited because of the lack of models in dealing with ultra‐high dimensional datasets. This study aims to provide a two‐stage neural network approach for prediction of GFR and to suggest some other useful biomarkers obtained from the blood metabolites in measuring GFR. It is a composite of feature shrinkage and neural network when the number of features is much larger than the number of training samples. The results show that the proposed method outperforms the existing ones, such as convolutionneural network and direct deep neural network.
Non-local thermodynamic equilibrium effects determine the upper atmospheric temperature structure of the ultra-hot Jupiter KELT-9b
Authors: Fossati L. , Young M. E. , Shulyak D. , Koskinen T. , Huang C. , Cubillos P. E. , France K. , Sreejith A. G. 
Published: June 2021

Context. Several observational and theoretical results indicate that the atmospheric temperature of the ultra-hot Jupiter KELT-9b in the main line formation region is a few thousand degrees higher than predicted by self-consistent models.
Aims. Our aim was to test whether non-local thermodynamic equilibrium (NLTE) effects are responsible for the presumably higher temperature.
Methods. We employed the Cloudy NLTE radiative transfer code to self-consistently compute the upper atmospheric temperature-pressure (TP) profile of KELT-9b, assuming solar metallicity and accounting for Roche potential. In the lower atmosphere, we used an updated version of the HELIOS radiative-convective equilibrium code to constrain the Cloudy model.
Results. The Cloudy NLTE TP profile is ≈2000 K hotter than that obtained with previous models assuming LTE. In particular, in the 1–10−7 bar range the temperature increases from ≈4000 to ≈8500 K, remaining roughly constant at lower pressures. We find that the high temperature in the upper atmosphere of KELT-9b is driven principally by NLTE effects modifying the Fe and Mg level populations, which strongly influence the atmospheric thermal balance. We employed Cloudy to compute LTE and NLTE synthetic transmission spectra on the basis of the TP profiles computed in LTE and NLTE, respectively, finding that the NLTE model generally produces stronger absorption lines, particularly in the ultraviolet, than the LTE model (up to 30%). We compared the NLTE synthetic transmission spectrum with the observed Hα and Hβ line profiles obtaining an excellent match, thus supporting our results.
Conclusions. The NLTE synthetic transmission spectrum can be used to guide future observations aiming at detecting features in the KELT-9b transmission spectrum. Metals, such as Mg and Fe, and NLTE effects shape the upper atmospheric temperature structure of KELT-9b, and thus affect the mass-loss rates derived from it. Finally, our results call for checking whether this is the case also for cooler planets.
Performance of solar far-side active region neural detection
Authors: Broock E. G. , Felipe T. , Asensio Ramos A. 
Published: June 2021

Context. Far-side helioseismology is a technique used to infer the presence of active regions in the far hemisphere of the Sun based on the interpretation of oscillations measured in the near hemisphere. A neural network has recently been developed to improve the sensitivity of the seismic maps to the presence of far-side active regions.
Aims. Our aim is to evaluate the performance of the new neural network approach and to thoroughly compare it with the standard method commonly applied to predict far-side active regions from seismic measurements.
Methods. We have computed the predictions of active regions using the neural network and the standard approach from five years of far-side seismic maps as a function of the selected threshold in the signatures of the detections. The results have been compared with direct extreme ultraviolet observations of the far hemisphere acquired with the Solar Terrestrial Relations Observatory.
Results. We have confirmed the improved sensitivity of the neural network to the presence of far-side active regions. Approximately 96% of the active regions identified by the standard method with a strength above the threshold commonly employed by previous analyses are related to locations with enhanced extreme ultraviolet emission. For this threshold, the false positive ratio is 3.75%. For an equivalent false positive ratio, the neural network produces 47% more true detections. Weaker active regions can be detected by relaxing the threshold in their seismic signature. For almost the entire range of thresholds, the performance of the neural network is superior to that of the standard approach, delivering a higher number of confirmed detections and a lower rate of false positives.
Conclusions. The neural network is a promising approach for improving the interpretation of the seismic maps provided by local helioseismic techniques. Additionally, refined predictions of magnetic activity in the non-visible solar hemisphere can play a significant role in space weather forecasting.
Determining the source and eruption dynamics of a stealth CME using NLFFF modelling and MHD simulations
Authors: Yardley S. L. , Pagano P. , Mackay D. H. , Upton L. A. 
Published: June 2021

Context. Coronal mass ejections (CMEs) that exhibit weak or no eruption signatures in the low corona, known as stealth CMEs, are problematic as upon arrival at Earth they can lead to geomagnetic disturbances that were not predicted by space weather forecasters.
Aims. We investigate the origin and eruption of a stealth event that occurred on 2015 January 3 that was responsible for a strong geomagnetic storm upon its arrival at Earth.
Methods. To simulate the coronal magnetic field and plasma parameters of the eruption we use a coupled approach. This approach combines an evolutionary nonlinear force-free field model of the global corona with a MHD simulation.
Results. The combined simulation approach accurately reproduces the stealth event and suggests that sympathetic eruptions occur. In the combined simulation we found that three flux ropes form and then erupt. The first two flux ropes, which are connected to a large AR complex behind the east limb, erupt first producing two near-simultaneous CMEs. These CMEs are closely followed by a third, weaker flux rope eruption in the simulation that originated between the periphery of AR 12252 and the southern polar coronal hole. The third eruption coincides with a faint coronal dimming, which appears in the SDO/AIA 211 Å observations, that is attributed as the source responsible for the stealth event and later the geomagnetic disturbance at 1 AU. The incorrect interpretation of the stealth event being linked to the occurrence of a single partial halo CME observed by LASCO/C2 is mainly due to the lack of STEREO observations being available at the time of the CMEs. The simulation also shows that the LASCO CME is not a single event but rather two near-simultaneous CMEs.
Conclusions. These results show the significance of the coupled data-driven simulation approach in interpreting the eruption and that an operational L5 mission is crucial for space weather forecasting.
Nonfactor Therapies: New Approaches to Prophylactic Treatment of Haemophilia
Authors: Chowdary Pratima 
Published: June 2021

AbstractFor several decades, the treatment of haemophilia has relied on factor replacement therapy, which restores haemostasis by replacing the missing coagulation factor. In recent years, novel alternative therapies for the treatment of haemophilia in patients with and without inhibitors have been developed. These emergent therapies promote haemostasis by mimicking coagulation factors or inhibiting natural anticoagulants. They provide a less invasive route of administration (i.e. subcutaneous) and some offer reduced frequency of dosing (i.e. every 2 weeks, monthly) compared with the majority of factor replacement therapies, and thus have the potential to simplify treatment, increase adherence and subsequently improve outcomes for patients. Their introduction has transformed the care of haemophilia patients with inhibitors to factor VIII, with similar expectation for haemophilia B patients with inhibitors. However, these therapies also come with several new challenges including their limitation to prophylactic treatment, the observed increased incidence of thrombosis, or their impact on the natural history of the disease and potential disruption of existing treatment guidelines like the use of immune tolerance induction. Moreover, questions remain regarding the long-term impact of non-replacement therapies on joint health as well as the optimal strategy to manage breakthrough bleeds in patients with inhibitors.
Berufliche Teilhabe nach einer medizinischen Rehabilitation aufgrund
pneumologischer Erkrankungen
Authors: Zollmann Pia , Streibelt Marco 
Published: June 2021

Zusammenfassung
Ziel der Studie Für das deutsche Rehabilitationssystem existieren
nur wenige repräsentative Erkenntnisse zur beruflichen
Wiedereingliederung nach einer medizinischen Rehabilitation. Für
Personen, die aufgrund einer Atemwegserkrankung eine Rehabilitation in
Trägerschaft der Deutschen Rentenversicherung (DRV) absolvierten, soll
deshalb ermittelt werden, (a) welche sozialmedizinischen Risiken im Vorfeld der
Rehabilitation bestehen, (b) wie gut die berufliche Teilhabe im Anschluss
gelingt und (c) welche Informationen mit der beruflichen Teilhabe assoziiert
sind.
Methodik Die Fragen wurden anhand der Reha-Statistik-Datenbasis der DRV
beantwortet. Eingeschlossen wurden Rehabilitanden, die in 2016 eine medizinische
Rehabilitation mit einer 1. Entlassdiagnose aus dem Kapitel J der ICD-10
abgeschlossen hatten. Die Analysen wurden für die Gesamtgruppe sowie
differenziert nach den beiden Haupterkrankungen Asthma bronchiale und COPD
durchgeführt. Berufliche Teilhabe wurde sowohl über eine
monatliche Zustandsvariable bis 24 Monate nach der Rehabilitation als auch als
Quote aller Personen, die nach 12 respektive 24 Monaten im Erhebungsmonat und
den 3 vorhergehenden Monaten sozialversicherungspflichtig beschäftigt
waren, operationalisiert. Für die Analyse der Einflussfaktoren auf
stabile berufliche Teilhabe wurden multiple logistische Regressionsmodelle mit
schrittweisem Einschluss, getrennt für die Quoten nach 12 und 24
Monaten, kalkuliert.
Ergebnisse Insgesamt flossen 19 287 Datensätze in die
Analyse ein (Asthma bronchiale: n=9108, 47%; COPD:
n=6215, 32%). Pneumologische Patienten waren durchschnittlich 53
Jahre alt, beide Geschlechter waren gleich verteilt. 14% wiesen keine
Fehlzeiten, 11% 6 Monate und mehr im Jahr vor der Reha auf. Bei 39 bzw.
38% wurde eine psychische bzw. kardiologische Komorbidität
dokumentiert. Insgesamt wiesen Patienten mit einer COPD größere
sozialmedizinische Risiken vor der Reha auf als Asthma-Patienten.
Dementsprechend verblieben COPD-Patienten nur etwa zur Hälfte in aktiver
Beschäftigung, während dies etwa 80% der
Asthma-Patienten gelang. Die stärksten Einflussfaktoren auf stabile
berufliche Teilhabe waren die Fehlzeiten sowie das Entgelt vor
Rehabilitation.
Schlussfolgerung Etwa 2 Drittel aller Personen mit Atemwegserkrankungen
sind nach einer medizinischen Rehabilitation in Deutschland wieder stabil in
Arbeit, wobei große Unterschiede zwischen Asthma bronchiale und COPD
bestehen. Insbesondere die Fehlzeiten sowie das Entgelt vor Reha determinieren
dies. Die Analyse stellt erstmals repräsentative Daten zur beruflichen
Wiedereingliederung nach medizinischer Rehabilitation aufgrund einer
Atemwegserkrankung vor.
Pelvic Reconstruction following Abdominoperineal Resection and Pelvic Exenteration: Management Practices among Plastic and Colorectal Surgeons
Authors: Stein Michael J. , Karir Aneesh , Hanson Melissa N. , Cavale Naveen , Almoudaris Alex M. , Voineskos Sophocles 
Published: June 2021

Abstract
Background Pelvic reconstruction with a muscle flap significantly improves postoperative outcomes following abdominoperineal resection (APR). Despite it being the gold standard, significant surgeon-selection bias remains with respect to the necessity of pelvic obliteration, flap choice, and ostomy placement. The objective of the study was to characterize management practices among colorectal surgeons (CSs) and plastic surgeons (PSs).
Methods Specialty-specific surveys were distributed electronically to CSs and PSs via surgical societies. Surveys were designed to illustrate geographic and specialty-specific differences in management.
Results Of 106 (54 CSs and 52 PSs) respondents (58% Canada, 21% Europe, 14% the United States, and 6% Asia/Africa), significant interdisciplinary differences in practices were observed. Most respondents indicated that multidisciplinary meetings were not performed (74% of CSs and 78% of PSs). For a nonradiated pelvic dead space with small perineal defect, 91% of CSs and 56% of PSs indicated that flap reconstruction was not required. For a radiated pelvic dead space with small perineal defect, only 54% of CSs and 6% of PSs indicated that there was no need for flap reconstruction. With respect to ostomy placement, 87% of CSs and 21% of PSs indicated that stoma placement through the rectus was superior. When two ostomies were required, most CSs preferred exteriorizing ostomies through bilateral recti and requesting thigh-based reconstruction. PSs favored the vertical rectus abdominis muscle (VRAM; 52%) over the gracilis (23%) and inferior gluteal artery perforator (IGAP; 23%) flaps. Among PSs, North Americans favor abdominally based flaps (VRAM 60%), while Europeans favor gluteal-based flaps (IGAP 78%).
Conclusion A lack of standardization continues to exist with respect to the reconstruction of pelvic defects following APR and pelvic exenteration. Geographic and interdisciplinary biases with respect to ostomy placement, flap choice, and role for pelvic obliteration continues to influence reconstructive practices. These cases should continue to be approached on a case by case basis, driven by pathology, presence of radiation, comorbidities, and the size of the pelvic and perineal defect.
Do Intra-articular Corticosteroid Injections Prior to Total Knee Arthroplasty Increase Postoperative Complication Rates: A Retrospective Review
Authors: Rhode David T. , Siegel Matthew A. , Volchenko Elan , Patetta Michael J. , Schwarzman Garrett R. , Chmell Samuel J. , Gonzalez Mark H. 
Published: June 2021

AbstractThere is conflicting literature suggesting that intra-articular corticosteroid injections before total knee arthroplasty (TKA) may lead to an increase in the rate of postoperative complications, specifically periprosthetic joint infection (PJI). Thus, this retrospective review of all TKAs performed at a large, urban hospital will add valuable evidence to help guide future patient care. After exclusion criteria, we retrospectively reviewed 417 patients who received a TKA from a group of fellowship-trained orthopaedic surgeons between 2009 and 2016 at a single academic medical center. Minimum follow-up time was 1 year. Patients were separated into two groups: those who received a preoperative intra-articular corticosteroid injection and those who did not receive an injection. Subgroups were created based on the timing of their most recent preoperative injection: 0 to 3 months, 3 to 6 months, 6 to 12 months, 12+ months, and an unknown time period. Postoperative outcomes for PJI, revision TKA, and manipulation under anesthesia (MUA) were analyzed via a Chi-square test. No statistically significant postoperative differences were observed between groups: PJI (p = 0.904), revision TKA (p = 0.206), and MUA (p = 0.163). The temporal subgroups also failed to demonstrate a statistically significant result: PJI (p = 0.348), revision TKA (p = 0.701), and MUA (p = 0.512). This study revealed no absolute or temporal association between preoperative, intra-articular corticosteroid injections, and complications after TKA. Because these injections are a commonly used treatment modality prior to TKA, further studies should be conducted on a nationwide basis to draw more concrete conclusions.
Results of Robotic-Assisted Versus Manual Total Knee Arthroplasty at 2-Year Follow-up
Authors: Marchand Kevin B. , Moody Rachel , Scholl Laura Y. , Bhowmik-Stoker Manoshi , Taylor Kelly B. , Mont Michael A. , Marchand Robert C. 
Published: June 2021

AbstractRobotic-assisted technology has been developed to optimize the consistency and accuracy of bony cuts, implant placements, and knee alignments for total knee arthroplasty (TKA). With recently developed designs, there is a need for the reporting longer than initial patient outcomes. Therefore, the purpose of this study was to compare manual and robotic-assisted TKA at 2-year minimum for: (1) aseptic survivorship; (2) reduced Western Ontario and McMaster Universities Osteoarthritis Index (r-WOMAC) pain, physical function, and total scores; (3) surgical and medical complications; and (4) radiographic assessments for progressive radiolucencies. We compared 80 consecutive cementless robotic-assisted to 80 consecutive cementless manual TKAs. Patient preoperative r-WOMAC and demographics (e.g., age, sex, and body mass index) were not found to be statistically different. Surgical data and medical records were reviewed for aseptic survivorship, medical, and surgical complications. Patients were administered an r-WOMAC survey preoperatively and at 2-year postoperatively. Mean r-WOMAC pain, physical function, and total scores were tabulated and compared using Student's t-tests. Radiographs were reviewed serially throughout patient's postoperative follow-up. A p < 0.05 was considered significant. The aseptic failure rates were 1.25 and 5.0% for the robotic-assisted and manual cohorts, respectively. Patients in the robotic-assisted cohort had significantly improved 2-year postoperative r-WOMAC mean pain (1 ± 2 vs. 2 ± 3 points, p = 0.02), mean physical function (2 ± 3 vs. 4 ± 5 points, p = 0.009), and mean total scores (4 ± 5 vs, 6 ± 7 points, p = 0.009) compared with the manual TKA. Surgical and medical complications were similar in the two cohorts. Only one patient in the manual cohort had progressive radiolucencies on radiographic assessment. Robotic-assisted TKA patients demonstrated improved 2-year postoperative outcomes when compared with manual patients. Further studies could include multiple surgeons and centers to increase the generalizability of these results. The results of this study indicate that patients who undergo robotic-assisted TKA may have improved 2-year postoperative outcomes.