bluuebunny/crossref_metadata_2025_split huggingface dataset:
Closing the gap: addressing telehealth disparities across specialties in the sustained pandemic era
Authors: Amagai Saki , Vonesh Edward , Adams James , Luo Yuan 
Published: August 2024

AbstractMissed appointments, or no-shows, disrupt healthcare delivery, exacerbating chronic disease management and leading to worse health outcomes. Telehealth has surged as a viable solution to reduce no-shows and improve healthcare accessibility, especially during the COVID-19 pandemic. However, telehealth disparities and its long-term efficacy across various medical specialties remain understudied. To address this, we performed a retrospective analysis of electronic health records from a heterogenous network of hospitals in Illinois, examining telehealth use and no-shows across among 444,752 adult patients with 1,973,098 outpatient encounters across nine specialties during the sustained pandemic phase (i.e., January 1, 2021 to July 1, 2022). Among them, 84,290 (4.27%) were no-shows, and telehealth constituted 202,933 (10.3%) of the total encounters. Telehealth use during the sustained phase varied significantly by specialty type. Overall, telehealth encounters were associated with reduced no-show odds compared to in-person encounters (OR, 0.28; 95% CI, 0.26–0.29). Black and Hispanic patients, as well as those with Medicaid, had higher no-show odds relative to their counterparts, even when using telehealth. Mental health specialty had the highest telehealth usage rate and the highest no-show odds (OR, 2.99; 95% CI, 2.84–3.14) relative to other specialties included in the study. Moreover, specialty type had differential effects on no-shows for telehealth. These results underscore the variability in telehealth use by specialty type and pervasive disparities telehealth use and no-shows. As we move beyond the pandemic, our findings can inform policymakers to tailor policies and incentives to reach different patient groups as well as specialties, with varying needs, to promote equitable telehealth utilization.
Adapting the Early Communication Indicator as a Social Communication Outcome Measure for Young Autistic Children: A Pilot Study
Authors: Nowell Sallie , Steinbrenner Jessica R. , Wallisch Anna , Salley Brenda , McGovern Jamie , McGauley Sarah , Watson Linda R. , Irvin Dwight , Buzhardt Jay , Boyd Brian 
Published: August 2024

Purpose:
We sought to conduct a pilot investigation of the reliability and administration fidelity of a new play-based measure of social communication for infants and toddlers with an autism diagnosis.

Method:

Our team adapted an existing measure, the Early Communication Indicator (ECI), for use with young autistic children in clinical and research contexts. In this brief report, we detail our adaptation process including administration and scoring of the final adapted measure based on data from a two-phase pilot study with young autistic children (
N
= 17).

Results:
This adapted measure, the Early Communication Indicator–Autism (ECI-A), captured a range of scores for the ECI, Initiation of Joint Attention, and Directed Communication in pilot testing. Interrater reliability was moderate to strong across the scored behaviors. Finally, parents were able to administer the ECI-A with high fidelity with support from the research staff.

Conclusions:
This two-phase pilot study demonstrated promise for the ECI-A as a brief measure of social communication that can be administered by parents and reliably scored by trained staff with limited background in autism assessments. Validation of the ECI-A is presently underway.

Supplemental Material:

https://doi.org/10.23641/asha.26042077
Velopharyngeal Gap Size During Sustained Vowel Production Correlates With Perceptual Ratings of Hypernasality in Connected Speech
Authors: Williams Jessica L. , Perry Jamie L. , Bunton Kate , Cordero Kelly Nett , Snodgrass Taylor D. , Singh Davinder J. , Temkit Hamy , Sitzman Thomas J. 
Published: August 2024

Purpose:
The purpose of this study was to investigate the relationship between perceptual ratings of hypernasality made during connected speech and velopharyngeal (VP) gap size measured in millimeters in the sagittal plane during sustained vowel production using magnetic resonance imaging (MRI).

Method:

A retrospective cross-sectional analysis was completed. A subgroup of 110 participants from another study with an
M
age
of 10.1 years presenting for management of VP insufficiency was included. Perceptual ratings of hypernasality during connected speech and measurement of gap size during sustained /i/ production on MRI were performed by raters blinded to the participants' medical and surgical history.

Results:

There was a moderate-to-strong, positive correlation (
r
= .61;
p
< .001) between hypernasality ratings and VP gap size measured on MRI using sustained /i/. The odds of a higher hypernasality rating increased as the gap size increased (odds ratio = 1.34; 95% CI [1.20, 1.49];
p
< .001). The predicted probability for hypernasality ratings of none/minimal/mild steadily decreased as the gap size increased indicating that lower ratings of hypernasality were associated with smaller gap sizes. For the rating of “moderate” hypernasality, the predicted probability of the rating steadily increased up to 8 mm and then decreased as the gap size continued to increase. The predicted probability for a hypernasality rating of “severe” consistently increased as the gap size increased.

Conclusions:
Hypernasality ratings made at the connected speech level were significantly associated with VP gap size as measured during sustained vowel production. These findings suggest sustained vowel production elicited on MRI may adequately characterize VP gap size in the evaluation of VP insufficiency.
Multi‐agent reinforcement learning in a new transactive energy mechanism
Authors: Mohsenzadeh‐Yazdi Hossein , Kebriaei Hamed , Aminifar Farrokh 
Published: August 2024

AbstractThanks to reinforcement learning (RL), decision‐making is more convenient and more economical in different situations with high uncertainty. In line with the same fact, it is proposed that prosumers can apply RL to earn more profit in the transactive energy market (TEM). In this article, an environment that represents a novel framework of TEM is designed, where all participants send their bids to this framework and receive their profit from it. Also, new state‐action spaces are designed for sellers and buyers so that they can apply the Soft Actor‐Critic (SAC) algorithm to converge to the best policy. A brief of this algorithm, which is for continuous state‐action space, is described. First, this algorithm is implemented for a single agent (a seller and a buyer). Then we consider all players including sellers and buyers who can apply this algorithm as Multi‐Agent. In this situation, there is a comprehensive game between participants that is investigated, and it is analyzed whether the players converge to the Nash equilibrium (NE) in this game. Finally, numerical results for the IEEE 33‐bus distribution power system illustrate the effectiveness of the new framework for TEM, increasing sellers' and buyers' profits by applying SAC with the new state‐action spaces. SAC is implemented as a Multi‐Agent, demonstrating that players converge to a singular or one of the multiple NEs in this game. The results demonstrate that buyers converge to their optimal policies within 80 days, while sellers achieve optimality after 150 days in the games created between all participants.
Security constrained optimal power shutoff for wildfire risk mitigation
Authors: Rhodes Noah , Coffrin Carleton , Roald Line 
Published: August 2024

AbstractElectric grid faults are increasingly the source of ignition for major wildfires. To reduce the likelihood of such ignitions in high risk situations, utilities use preemptive de‐energization of power lines, commonly referred to as Public Safety Power Shutoffs (PSPS). Besides raising challenging trade‐offs between power outages and wildfire safety, PSPS removes redundancy from the network at a time when component faults are likely to happen. This may leave the network particularly vulnerable to unexpected line faults that may occur while the PSPS is in place. Previous works have not explicitly considered the impacts of these outages. To address this gap, the Security Constrained Optimal Power Shutoff problem is proposed which uses post‐contingency security constraints to model the impact of unexpected line faults when planning a PSPS. This model enables, for the first time, the exploration of a wide range of trade‐offs between both wildfire risk and pre‐ and post‐contingency load shedding when designing PSPS plans, providing useful insights for utilities and policy makers considering different approaches to PSPS. The efficacy of the model is demonstrated using the EPRI 39‐bus system as a case study. The results highlight the potential risks of not considering security constraints when planning PSPS and show that incorporating security constraints into the PSPS design process improves the resilience of current PSPS plans.
Durchführung von Online-Klausuren in der dermatologischen Lehre
Authors: Wiegand Cornelia , Tittelbach Jörg 
Published: August 2024

ZusammenfassungPrüfungen in elektronischer Form (kurz E-Prüfung) wurden während der COVID-19-Pandemie nahezu flächendeckend eingeführt, um die Lehre an Hochschulen fortführen zu können. Dies hat Lehrende und Studierende gleichermaßen vor Probleme gestellt. Mit dem Wechsel von Präsenz- zu Online-Klausuren ergaben sich aber auch Chancen, neue Lehr- und Prüfungsformate auszuprobieren. War die Einführung der Open-Book-Klausur zunächst eher die Einsicht, dass man bei Online-Prüfungen mit technischen Hilfsmitteln nur beschränkt Betrugsversuchen proaktiv entgegenwirken kann, so bietet dieses Format die Chance, die Anwendung von Wissen durch die Studierenden zu testen und damit im besten Fall kritisches Denken vor dem reinen Auswendiglernen von Fakten zu fördern. Die technischen Anforderungen bei Online-Klausuren stellen eine weitere Hürde dar, die von Prüfern und Studierenden gleichermaßen bewältigt werden muss. Des Weiteren befürchten beide Parteien, dass es bei Online-Prüfungen häufiger zu Täuschungsversuchen kommen könnte. Die Schaffung gleicher Prüfungsbedingungen für alle Prüfungsteilnehmerinnen und -teilnehmern ist ein wichtiger Aspekt, um den Charakter einer Klausur als Aufsichtsarbeit unter chancengleichen Bedingungen zu gewährleisten. Daher sollten nach Empfehlungen die Universitäten eine Videoaufsicht in Echtzeit (ohne Aufzeichnung) durchführen, die am ehesten mit der Klausuraufsicht in Präsenz zu vergleichen ist. Auf Basis der gewonnenen Erfahrungen und Erkenntnisse ist davon auszugehen, dass Hochschulen zukünftig verstärkt Gebrauch von innovativen Prüfungsverfahren machen werden. Die technischen Möglichkeiten sind geschaffen und werden weiter genutzt werden, denn die Vorteile, wie Unabhängigkeit von Raumverfügbarkeiten, Reduktion des Aufsichtspersonals und erleichterte Auswertung, liegen klar auf der Hand.
Ein dynamischer Trachealkollaps bei einem Wagyukalb mit multiplen
Rippenfrakturen nach einer Schwergeburt
Authors: Endriß Kai Josef , Golbeck Lennart , Hellige Maren , Twele Lara , Störk Theresa , Hansmann Florian , Rehage Jürgen , Heppelmann Maike 
Published: August 2024

ZusammenfassungEin dynamischer Trachealkollaps infolge multipler Rippenfrakturen wurde bei einem
Wagyukalb mit Hilfe von röntgenologischen, endoskopischen und
computertomografischen Untersuchungen diagnostiziert. Es erfolgte ein
konservativer Behandlungsversuch, der in einer Reduktion von Stressfaktoren und
einer medikamentösen, antiinflammatorischen Therapie bestand. Die
respiratorischen Symptome verbesserten sich deutlich, so dass das Kalb in den
Heimatbestand entlassen werden konnte. Nach einigen Wochen ohne Behandlung kam
es zu einer Verschlechterung des Zustands, die wahrscheinlich durch eine
exzessive Kallusbildung im Bereich der Rippenfrakturen mit einer weiteren
Verringerung des Tracheallumens hervorgerufen wurde.
Lahmheit und Schwellung des Metatarsus bei einem Saluki – Könnte es
eine arteriovenöse Fistel sein?
Authors: Schippers Paula Andrea , Meyer-Wilmes Jana , Langenmayer Martin Christoph , Partale Klas 
Published: August 2024

ZusammenfassungEin 12 Jahre alter Saluki wurde mit einer akuten Lahmheit und plantaren
Schwellung des rechten Metatarsus nach dem Freilauf vorgestellt. Im Röntgen war
lediglich eine Weichteilschwellung zu erkennen, die beteiligten Knochen- und
Gelenkstrukturen zeigten sich unbeteiligt. Einige Monate später kam es zum
Rezidiv der Schwellung. Bei der diesbezüglich durchgeführten
Ultraschalluntersuchung war eine gut vaskularisierte kavernöse Struktur zu
erkennen. Die folgende operative Entfernung und histopathologische Untersuchung
der Struktur ergab den ersten Verdacht auf eine arteriovenöse Fistel, welche
sich auch bei einer zweiten operativen Entfernung nach einem weiteren Rezidiv
histologisch bestätigte. Der vorliegende Fallbericht soll die mögliche
Komplexität einer zunächst einfach zu behandelnden Lahmheit darstellen.
Gleichzeitig liegt das Augenmerk auf der Möglichkeit, dass arteriovenöse Fisteln
zu Rezidiven tendieren können.
Duodenal ileus caused by a cage magnet in a Fleckvieh
cow
Authors: Huber Lisa , Feist Melanie , Knubben-Schweizer Gabriela , Trefz Florian M. 
Published: August 2024

AbstractThe present report aims to describe the case of a duodenal obstruction ileus in a
dairy cow that was caused by a cage magnet. The 4.7-year-old German Fleckvieh
cow was hospitalized because of symptoms of intestinal obstruction such as
anorexia, noticeable drop in milk yield, reduced defecation, dehydration and
positive percussion and swinging auscultation in a circumscribed area cranial of
the right flank over the last 2 ribs. Six months as well as 3 days prior to
hospitalization the cow had already been treated for signs of hardware disease,
which included administration of a cage magnet.After the initial clinical diagnostic procedure on hospital admission, a
diagnostic laparotomy in the right paralumbar fossa was performed to identify
the cause of the ileus. The cranial part of the duodenum was markedly dilated,
and a solid foreign body was found obstructing the intestine immediately aboral
to the duodenal sigmoid flexure. This was identified as a cage magnet, which was
massaged in retrograde direction into the pyloric antrum and removed via
abomasotomy. The cow recovered from surgical intervention and was discharged
from the hospital 6 days later.The present report describes an unusual complication of cage magnet
administration, which is a standard veterinary procedure and generally
considered a safe treatment option in cows with clinical signs of acute
traumatic reticuloperitonitis.
Interaction of Purine and its Derivatives with A1,
A2-Adenosine Receptors and Vascular Endothelial Growth Factor
Receptor-1 (Vegf-R1) as a Therapeutic Alternative to Treat
Cancer
Authors: Figueroa Lauro , Rosas Marcela , Alvarez Magdalena , Aguilar Emilio , Mateu Virginia , Bonilla Enrique 
Published: August 2024

Abstract
Background There are several studies that indicate that cancer development
may be conditioned by the activation of some biological systems that involve the
interaction of different biomolecules, such as adenosine and vascular
endothelial growth factor. These biomolecules have been targeted of some drugs
for treat of cancer; however, there is little information on the interaction of
purine derivatives with adenosine and vascular endothelial growth factor
receptor (VEGF-R1).
Objective The aim of this research was to determine the possible
interaction of purine (1) and their derivatives (2–31) with
A1, A2-adenosine receptors, and VEGF-R1.
Methods Theoretical interaction of purine and their derivatives with
A1, A2-adenosine receptors and VEGF-R1 was carried out
using the 5uen, 5mzj and 3hng proteins as theoretical tools. Besides, adenosine,
cgs-15943, rolofylline, cvt-124, wrc-0571, luf-5834, cvt-6883, AZD-4635,
cabozantinib, pazopanib, regorafenib, and sorafenib drugs were used as
controls.
Results The results showed differences in the number of aminoacid residues
involved in the interaction of purine and their derivatives with 5uen, 5mzj and
3hng proteins compared with the controls. Besides, the inhibition constants (Ki)
values for purine and their derivatives 5, 9, 10,
14, 15, 16, and 20 were lower compared with the
controls
Conclusions Theoretical data suggest that purine and their derivatives
5, 9, 10, 14, 15, 16, and
20 could produce changes in cancer cell growth through inhibition of
A1, A2-adenosine receptors and VEGFR-1 inhibition.
These data indicate that these purine derivatives could be a therapeutic
alternative to treat some types of cancer.
Boundaries in Kinematic Alignment: Why, When, and How
Authors: Indelli Pier Francesco , Petralia Giuseppe , Ghirardelli Stefano , Valpiana Pieralberto , Aloisi Giuseppe , Salvi Andrea Giordano , Risitano Salvatore 
Published: August 2024

AbstractThe use of alternative alignments in total knee arthroplasty (TKA) has recently been increasing in popularity: many of these alignments have been included in the broad spectrum of “kinematic alignment.” This alternative approach was recommended to increase patients' satisfaction since many studies based on patient-reported outcome measures (PROMs) showed that every fifth patient is not satisfied with the surgical outcome. In fact, the original kinematic alignment technique was designed as a “pure resurfacing” technique, maintaining the preoperative axes (flexion–extension and axial rotation) of the knee. In adjunct, many new classifications of the preoperative limb deformity have been proposed to include a large range of knee anatomies, few of them very atypical. Following those classifications, many surgeons aimed for a reproduction of unusual anatomies putting in jeopardy the survivorship of the implant according to the classical “dogma” of a poor knee kinematics and TKA biomechanics if the final hip–knee–ankle (HKA) axis was not kept within 5 degrees from neutral. This article reviews the literature supporting the choice of setting alignment boundaries in TKA when surgeons are interested in reproducing the constitutional knee anatomy of the patient within a safe range.
The First Observational Study of Acute Medical Unit in Qatar
Authors: Elzouki Abdel-Naser , Iqbal Phool , Zahid Mohammed , Kamal Ijaz , Kartha Anand , Al-Tekreti Mustafa , Al-Muhanadi Dabia , Al-Mohamed Ahmed 
Published: August 2024

Abstract
Background Acute medical unit (AMU) is a dedicated facility to treat patients with acute medical conditions requiring a short hospital stay (< 72 hours) with the support of a multidisciplinary team led by a medical consultant. We aim to present a study of the AMU model of care from Qatar to provide insight into its effects on patient care and management.
Methods Retrospective data from AMU facility at Hamad General Hospital (HGH), Doha, Qatar, was collected from January 2019 to December 2020 from the electronic patient record. The data were analyzed for demographic characteristics of the patients, length of stay (LOS), readmission rate, and postdischarge follow-up. The effectiveness of the AMU system was studied closely from this data. An extensive literature search was also performed for comparative results analysis in other AMU facilities outside Qatar.
Results Total admissions under the AMU facility were 8,371 from january2019 to December 2020. The 28 days readmission rate was 10.25 and 9.9% in 2019 and 2020, respectively. The average LOS was approximately 3.2 days. Around 88.7% of the patients were discharged home, 7.8% were admitted to medical wards due to longer stays, and 0.5% left against medical advice. Most of the patients admitted under AMU were 18 to 60 years old. The top primary diagnoses of admissions were minor stroke, transient ischemic attack, chest infection, urinary tract infections, and gastrointestinal and liver diseases. The most common comorbidities were hypertension, diabetes, acute kidney injury, and chronic kidney disease. A total of 2,858 patients were booked for a follow-up visit in the postdischarge clinic on discharge from the AMU for the year 2019 and 2020. The analysis of these followed up patients showed 73% of patients were discharged from clinic after first visit while the readmission from clinic was on only 1% (28 patients for year 2019 and 2020).
Conclusion Attentive patient care under AMU with a designated multidisciplinary medical team led by an internal medicine consultant is the cornerstone for the success of the AMU unit. This unit has proven very helpful for the smooth disposition of patients from the emergency department with reduced LOS, readmission rate, and overall mortality.
Complications and Long-Term Outcome in 30 Canine Total Hip Arthroplasties Using a Second-Generation Selective Laser Melted Screw Cup
Authors: Huels Nikolaus , Dautzenberg Philipp , Keim Dana , Harms Oliver , Siedenburg Johannes 
Published: August 2024

Abstract
Objective The aim of this study was to report complications and outcomes of a cementless total hip arthroplasty (THA) system with a second-generation selective laser-melted screw cup (SCSL).
Study Design All THA using the SCSL performed at a single institution between January 2017 and November 2022 were retrospectively evaluated. Patients with a minimum follow-up period of 12 months and complete medical records were included and analyzed for radiographic and clinical outcomes.
Results Thirty THA with SCSL in 23 dogs were included in this study. Complications were observed in seven hips, comprising two minor and five major complications, with two hips experiencing two major complications. Among these seven major complications, six were associated with the femoral implant and one involved cup luxation. Of the 30 THA, 4 were explanted, while 26 remained in place for a median follow-up of 17.5 months (range, 12–38 months).
Conclusion No cases of late aseptic loosening were observed with SCSL. THA using SCSL helps reduce cup-associated complications and is appropriate for THA surgery, and the overall complication rate is comparable with that of other single-implant systems. Nevertheless, four hips were explanted.
Bandwidth modulation and pulse characterization of passively Q-switched erbium-doped fiber laser
Authors: Muhammad Farah Diana , Hamdan Khalilah Zatiliman 
Published: August 2024

Abstract
We demonstrate the modulation of laser bandwidth by utilizing an ultranarrow tunable bandpass filter (UNTBF) in a passively Q-switched erbium-doped fiber laser. The passive Q-switch mechanism is enabled by using carbon nanotubes as saturable absorber at a Q-switched threshold of 35.5 mW. Based on spectral filtering effect introduced by the UNTBF, the 3 dB laser bandwidth can be tuned from 0.016 nm to 0.478 nm at a fixed pump power of 75.9 mW. The corresponding pulse behavior for each different bandwidth is characterized, and the results reveals that the pulse width can be as well tuned from 7.8 to 2.6 μs against the laser bandwidth, which agrees with the rule of time-bandwidth product. Correspondingly, the pulse repetition rate and the pulse energy vary from 16.23 kHz to 26.16 kHz and from 0.67 to 1.03 μJ respectively across the laser bandwidth. Further investigation of the pulse performance is performed against the pump power increment up to 107.2 mW. To the best of our knowledge, this is the first demonstration of spectrum bandwidth modulation in a passively Q-switched fiber laser, which can be useful for fully exploiting the possibilities of Q-switched pulse applications.