bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ensemble Precipitation Forecast Postprocessing with Ensemble Coalescence and Quantile Mapping
Authors: Henderson John M. , Hamill Thomas M. , Nehrkorn Thomas 
Published: January 2025

Abstract
Ensemble forecast systems are an integral part of the National Weather Service’s (NWS) program for producing skillful, reliable deterministic and probabilistic forecasts, but statistical postprocessing is often required to address known deficiencies. Here, we test improvements to the ensemble postprocessing procedure currently implemented at the NWS Meteorological Development Laboratory (MDL) that generates a deterministic quantitative precipitation forecast from multimodel ensemble means. The existing approach uses recent forecast and analysis data to estimate cumulative distributions of precipitation and then applies a quantile mapping between the mean forecast and analysis. In the current work, we use a revised version of this approach that, in addition, utilizes ensemble mean inputs improved by a coalescence procedure based on the feature alignment technique (FAT). This is a variational technique for determining the displacements needed to adjust precipitation features of individual ensemble members toward their positions in the raw ensemble mean. The performance of the combined coalescence–quantile mapping algorithm was evaluated over a 2-yr period of forecasts from version 12 of the NCEP Global Ensemble Forecast System (GEFSv12) after extensive testing of configurable parameters to ensure the physical reasonableness of the precipitation fields. The coalescence procedure by itself was shown to correct some of the raw ensemble mean deficiencies related to position errors in the individual ensemble forecasts, especially as lead times increase. The combined approach resulted in improved forecasts as measured by fractional bias and equitable threat scores. Implementation of the techniques described here for operational guidance is being considered by the National Oceanic and Atmospheric Administration (NOAA) and is applicable to other forecast models.

Significance Statement
Ensemble weather prediction systems provide information about the uncertainty in weather forecasts. However, the raw output from these models is voluminous and suffers from biases. Here, we combine two statistical approaches to correct for the biases and create a single deterministic forecast that is more manageable to use by stakeholders. The two techniques—coalescence and then quantile mapping—are applied in sequence and the resulting model forecast is compared against observations. Our approaches improve the statistical performance with precipitation fields that have more realistic extrema and a smaller extent of small precipitation amounts. The techniques are being evaluated for operational implementation by the National Weather Service.
Disparities in Medication Prescriptions and Post-Tracheostomy Outcomes in Pediatric Patients
Authors: Reddy Pooja D. , Raman Akshaya , Eljamri Soukaina , Shaffer Amber , Padia Reema 
Published: January 2025

Background: Granulation tissue formation and tracheitis are common pediatric tracheostomy complications. Ciprofloxacin/dexamethasone is frequently prescribed, but the influence of social determinants on this topic is unexplored. Methods: This study extends a prior cohort study of pediatric tracheostomy patients at a single academic institution from 2016 to 2020. Social determinants of health, including race, insurance status, and residence characteristics, including Area Deprivation Index (ADI), were evaluated. Logistic regression, Wilcoxon rank-sum, and log-rank tests (α = .05) analyzed relationships between these determinants and prescriptions and post-tracheostomy outcomes. Results: This cohort included 182 patients; 98/182 (53.9%) were male, and 140/182 (76.9%) were White, non-Hispanic. Non-White race was associated with increased odds of receiving nebulized ciprofloxacin/dexamethasone (OR = 2.80, 95% CI = 1.25-6.29). In those with tracheal culture results available (n = 63), Staphylococcus aureus was more common with public insurance (29/47, 7 with MRSA, 61.7%) compared with private (5/16, 3 with MRSA, 31.3%; OR = 3.54, 95% CI = 1.05-11.9). ADI was greater in the 7 patients with Streptococcus pneumoniae (median = 95, IQR = 88-99) compared to without (median = 77, IQR = 65-81, P = .003). Patients with tracheitis lived further from our center (median = 44.7 miles, IQR = 27.7-91.4 miles) compared with those who did not develop tracheitis (median = 33.4 miles, IQR = 12.0-85.2 miles, P = .02). Antibiotic resistance was more prevalent in children discharged home (14/35, 40.0%) than to transitional care (3/28, 10.7%; OR = 5.56, 95% CI = 1.40-22.0) and was associated with longer hospital stays (median = 70 days, range = 34-152 vs median = 35 days, range = 15-75 days, P = .02). Non-White patients experience increased odds of decannulation over time compared with White patients (HR = 2.85, 95% CI = 1.21-6.70). Discharge locations and ADI were associated with dressing choice post-tracheostomy. Discussion: This study revealed racial disparities in ciprofloxacin/dexamethasone usage, residence-related differences in tracheal culture results, and ADI-related dressing choices, which highlight the need for tailored, equitable care to optimize outcomes. Level of Evidence: 4
Presence of Heavy Metals in Vegetables Irrigated with Wastewater-Impacted Rivers and Its Health Risks in Ethiopia: Systematic Review
Authors: Negassa Belay , Dadi Dessalegn , Soboksa Negasa Eshete , Fekadu Samuel 
Published: January 2025

Background: Vegetables play critical role in human nutrition and overall health. However, consumption of vegetables cultivated through wastewater-impacted river can be source of potentially toxic heavy metals, which can cause detrimental health effects when their concentration exceeds the recommended maximum levels. Despite growing body of evidence highlighting the dangers associated with heavy metal accumulation in vegetables, there remains critical gap in systematic assessments within Ethiopian context. Therefore, objective of this review is to reveal heavy metals concentrations in vegetables grown with wastewater-impacted river and assess associated public health risks. Methodology: Research articles published in English were identified through systematic searching using electronic databases including PubMed, Google Scholar, WHO/FAO library, and searching from Google manually. The outcomes of interest were mean concentration of heavy metals in vegetables and associated health risks. Cross-sectional studies that met inclusion criteria were considered. Data were extracted by independent reviewers. Methodological quality of included studies was assessed using critical appraisal tools. Moreover, health risks of consumers were assessed through evaluating estimated daily intakes (EDI), Health Risk Index (HRI), and Hazard Index (HI). Results: Nineteen articles were included in this systematic review. The findings revealed that the mean concentration of Pb, Cr, Cd, As, Hg, Cu, Ni, Zn, Mn, and Fe in tested vegetables ranged from: 0.28-7.68, 0.75-33.01, 0.14-3.93, 0.05-3.13, ND-4.25, 0.92-15.33, 2.13-13.1, 18.27-62.83, 8.83-331.8, and 177.8-1034.3 mg/kg (dry weight), respectively. The EDI of Pb, Cr, Cd, As, Hg, Cu, Ni, Zn, Mn, and Fe in vegetables was range from: 0.00104-0.0286, 0.00279-0.123, 0.00052-0.0146, 0.0000372-0.0116, 0.0124-0.0158, 0.00342-0.0439, 0.0079-0.0487, 0.068-0.23, 0.03-1.23, and 0.53-3.84 mg/kg/day, respectively. The HRI of toxic heavy metals for all vegetable types ranged as; Pb (0.26-7.15), Cr (0.00186-0.0820), Cd (0.52-14.6), As (0.12-38.7), and Hg (1.24-1.58). The HRI due to consumption of all vegetables was 35, 0.168, 46.6, 70, and 2.82 for Pb, Cr, Cd, As, and Hg, respectively indicating severe health impact except for Cr. Conclusion: This review underscores health implications linked to consumption of vegetables cultivated using wastewater in Ethiopia. It revealed that the concentration of toxic heavy metals in vegetables grown with wastewater-affected water was higher than the maximum allowable safe limit set for edible vegetables by WHO that would be a public health risk.
Healthcare Professionals’ Ratings and Views of Person-Centred Care in the Context of Allogeneic Hematopoietic Stem Cell Transplantation
Authors: O’Sullivan Anna , Winterling Jeanette , Malmborg Kisch Annika , Bergkvist Karin , Edvardsson David , Wengström Yvonne , Lundh Hagelin Carina 
Published: January 2025

Introduction: Allogeneic stem cell transplantation (allo-HCT) involves a long trajectory with high risk of complications. In person-centred care (PCC), patients’ needs, resources and the care relationship are central to the care process. Healthcare professionals’ (HCPs) ratings of PCC have not previously been investigated in this context. Objectives: The aim of this study was to investigate healthcare professionals’ ratings and views of person-centred care in allo-HCT care, and associations with individual characteristics and targeted PCC education. Design: Cross-sectional study, employing quantitative and qualitative methods. Methods: 85 HCPs at two Swedish allo-HCT centres participated (80% women; mean age: 44 years, range: 23-72 years). A survey was conducted using the PCC Assessment Tool (P-CAT), containing 13 items, a total scale (min 13-max 65) and two subscales (I: min 8-max 40; II: min 5-max 25). Additionally, HCPs’ written responses to four study-specific questions about PCC were collected. Results: The mean for P-CAT total scale was 45.31, (subscale I: 28.41; subscale II: 16.90). Higher ratings of PCC were reported for assessment of patients’ needs, discussion about how to provide PCC and patients’ care, while time to provide PCC, the care environment and how the organization prevents providing PCC were rated lower. Higher age and targeted PCC education were associated with higher PCC ratings. HCPs described PCC as the patient being seen as a capable individual with their own resources, with PCC increasing patient and family involvement—giving higher satisfaction and tailored care for patients. However, HCPs reported time as a barrier for PCC. Conclusion: HCPs’ ratings of PCC in this context are high regarding discussing and assessing patients’ needs, but there is room for improvement regarding organizational and environmental aspects. Targeted PCC education increases the level of PCC. HCPs’ views of PCC partly reflect the foundations of PCC—patient’s narrative, capability and involvement.
Does language experience and bilingualism shape empathy and emotional intelligence?
Authors: Ward Rebecca , Ragosko Malgozata 
Published: January 2025

Aims and objectives: Previous research has reported that varied language experiences and language use can play a role in the development of empathy and emotional intelligence (EI). The present study aimed to investigate the association between language experience, bilingualism and personality. Methodology: One hundred and forty-two participants completed a language background questionnaire along with a series of measures to assess empathy and both trait and ability EI. Data and analysis: Measures included the Trait Emotional Intelligence Questionnaire short form (TEIQue), the Toronto Empathy Questionnaire (TEQ), and the Situational Test of Emotional Understanding Brief (STEU-B). Hierarchical regression models, analyses of variance (ANOVAs), and Structural Equation Modelling were used to examine the relationships between language experience, bilingualism, and measures of empathy and EI. Findings: Findings reveal that bilingualism and language experiences did not contribute to empathy and EI. These results question the role that linguistic experience has in shaping empathy and EI. However, a significant difference in empathy and EI scores emerged when comparing participants who processed information in their first (or native) language to those who did not, suggesting that empathy and EI are stronger when processed in the first language. Originality: This study provides a new understanding of the influence of language background on empathy and EI as well as the impact of processing information in a first language. Significance: This study highlights the importance of considering the role that language has in future cross-cultural and cross-linguistic studies. Implications for the use of culturally appropriate measures and future research are discussed.
Yes, It Matters: Assessing Service-Related Cultural Competency of New York State Department of Health-Funded Providers From Multiple Angles
Authors: Levandowski Brooke A. , naimool kk , Rietberg-Miller Susan B. , Aldrich Petra L. 
Published: January 2025

Background: While cultural competency has been recognized as an important feature in health care delivery, evaluating intervention effectiveness is often overlooked. Methods: This project used an explanatory sequential mixed methods study design within a community-based participatory research structure. A 29-item Organization cultural competency Checklist was created and distributed to a purposive sample of staff at 55 New York State (NYS) Department of Health AIDS Institute-funded health and human service providers. Organizations recruited clients to complete a 27-item Client Checklist. Basic univariate analyses were conducted on quantitative items (Stata v.18). For questions asked to both groups, we conducted chi-square tests to determine statistically significant differences (p-value < 0.10). Qualitative stories about the impact of culturally competent care provision were analyzed using the Most Significant Change process by a Community Advisory Board (CAB) of LGBTQ+ NYS residents. Results: The Organization Checklist had 92 responses from 37 organizations. The Client Checklist yielded 32 responses from five organizations. While high agreement between client and staff was reached on the majority of items, opportunities for improvement included updated intake forms and strengthening relationships with other local LGBTQ+ organizations. Using 62 raw stories, the CAB identified two main themes of affirming and un-affirming care, further organized into personal, perception, provider, and systemic categories. Discussion: Clients reported higher engagement in health-seeking behavior with culturally competent providers and care-avoidance with culturally incompetent care. Clients decided the safety of expending emotional labor to educate providers. Improving organizational cultural competency is an ongoing process requiring consistent and prompt attention.
Exclusion of people from oncology clinical trials based on functional status
Authors: Agaronnik Nicole D , Peters Mary Linton B , Iezzoni Lisa I 
Published: January 2025

Background/Aims: People with disability have higher rates of cancer, excluding skin cancer, compared with people without disability. Food and Drug Administration draft guidelines from 2024 address use of performance status criteria to determine eligibility for clinical trials, advocating for less restrictive thresholds. We examined the exclusion of people with disability from clinical trials based on performance status and other criteria. Methods: We reviewed eligibility criteria in approved interventional Phase III and Phase IV oncology clinical trials listed on ClinicalTrails.gov between 1 January 2019 and 31 December 2023. Functional status thresholds were assessed using the Eastern Cooperative Oncology Group Performance Status Scale and Karnofsky Performance Scale in clinical trial eligibility criteria. Qualitative analysis was used to review eligibility criteria relating to functional impairments or disability. Results: Among 96 oncology clinical trials, approximately 40% had restrictive Eastern Cooperative Oncology Group and Karnofsky Performance Scale thresholds, explicitly including only patients with Eastern Cooperative Oncology Group 0 or 1, or equivalent Karnofsky Performance Scale 70 or greater. Only 20% of studies included patients with Eastern Cooperative Oncology Group 2 and Karnofsky Performance Scale 60. Multiple studies contained miscellaneous eligibility criteria that could potentially exclude people with disability. No studies described making accommodations for people with disability to participate in the clinical trial. Conclusion: Draft Food and Drug Administration guidelines recommend including patients with Eastern Cooperative Oncology Group scores of 2 and Karnofsky Performance Scale scores of 60 in oncology clinical trials. We found that oncology clinical trials often exclude people with more restrictive performance status scores than the draft Food and Drug Administration guidelines, as well as other criteria that relate to disability. These estimates provide baseline information for assessing how the 2024 Food and Drug Administration guidance, if finalized, might affect the inclusion of people with disability in future trials.
A framework for sequential monitoring of individual N-of-1 trials and combining results across a series of sequentially monitored N-of-1 trials
Authors: Selukar Subodh , Prince David K , May Susanne 
Published: January 2025

Background: N-of-1 trials compare two or more treatment options for a single participant. These trials have been used to study options for chronic conditions such as arthritis and attention deficit hyperactivity disorder. In addition, they have been suggested as a means to study interventions in rare populations that may not be tractable to include in standard clinical trials, such as treatment options for HIV-positive patients in need of organ transplant. Sequential monitoring of accruing data has been well-studied in traditional clinical trials, but these methods have not yet been implemented in N-of-1 trials. However, the option to validly stop an N-of-1 trial early could deliver faster decisions that could directly improve the patient’s health. Methods: In this work, we propose and evaluate a framework to (1) facilitate sequential monitoring in individual N-of-1 trials with a continuous outcome and (2) combine results across a series of already-completed sequentially monitored N-of-1 trials. By employing the block structure common to N-of-1 trials, we suggest that existing approaches to sequential monitoring may be employed when data from one N-of-1 trial are analyzed with a linear mixed-effects model. To combine results across a series of already-completed sequentially monitored N-of-1 trials, we propose combining the naive estimates from constituent trials in a random-effects model with inverse-variance weighting. We evaluate these proposals via simulation. Results: We find that type 1 error can be substantially inflated for N-of-1 trials with a small number of planned blocks but can reach the nominal rate for trials with more planned blocks or those with larger numbers of periods per block or by using a [Formula: see text]-value correction. For those settings with acceptable type 1 error, sequential monitoring results in similar power and on average earlier stopping compared with trials with no sequential monitoring. And, as expected, we find that including a larger number of constituent trials in a series reduces the mean-squared error of the combined point estimator. Conclusion: Under suitable design considerations, our proposed framework for sequential monitoring can support clinicians in providing important decisions earlier, on average, for patients engaged in N-of-1 trials.
Unlocking breast cancer in Brazilian public health system: Using tissue microarray for accurate immunohistochemical evaluation with limitations in subtyping
Authors: Ruppenthal Rubia Denise , Pilar Emily Ferreira Salles , Santos Jordan Boeira dos , Coelho Rafael Correa , Henriques Carina Machado Costamilan , Uchôa Diego de Mendonça , Graudenz Marcia Silveira 
Published: January 2025

Background: Breast cancer (BC) is a significant burden on healthcare systems, especially in low- and middle-income countries where access to diagnosis and treatment is challenging. Objectives: The purpose of this study was to assess the diagnostic accuracy and cost using tissue microarray (TMA) instead of traditional immunohistochemical (IHC) evaluation for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), and the proliferation marker Ki-67 and BC subtyping within the Brazilian public health system. Design: This is a retrospective cohort study comparing TMA slides with traditional whole-slide evaluation for IHC markers in 242 BC cases. Methods: We used formalin-fixed tissue blocks for TMA assembly. Clinical data and IHC scores for ER, PR, HER2, and Ki-67 were obtained from pathology reports. Cohen’s kappa ( k) was used to assess TMA performance. Results: BC samples were distributed in 10 TMAs and 968 cores were scored (242 BC cases × 4 markers). In 97% of these, TMA reached high quality to adequate IHC scoring with minimal technical issues. Inter-examiner agreement was almost perfect for all markers (ranging from 0.85 for HER2 to 0.91 for ER, p < 0.001). The intratumoral heterogeneity ranged from almost perfect agreement for ER and HER2 to moderate to substantial for PR and Ki-67. TMA offers substantial time and cost savings, with an approximately 11-fold reduction compared to traditional methods. The concordance between TMA and original reports was almost perfect, with 93% overall agreement ( k = 0.81, p < 0.001). However, TMA performance varied between markers, with intratumoral heterogeneity significantly impacting discordant results, particularly for Ki-67 and HER2. This ultimately affected the accuracy of BC subtyping. TMA performed well in identifying luminal A and triple-negative cases, but misclassification was common for luminal B and HER2-positive cases. Conclusion: TMA offers accurate and lower-cost results in the individualized IHC assessment of BC markers. However, we do not recommend the use of TMA in the subtyping of BC, where analysis of the whole section remains necessary for more accurate results. We advocate more studies using the TMA approach in the Brazilian public health system to advance women’s health care.