bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a new spectral disentangling approach to ascertain whether the massive binary HDE 228766 contains a Wolf–Rayet star
Authors: Quintero Edwin A , Eenens Philippe 
Published: July 2024

ABSTRACT
The massive binary HDE 228766 is composed of an O type primary and an evolved secondary. However, previous qualitative analyses of the composite spectrum have led to a wide discussion about whether the secondary is an Of or a Wolf–Rayet star. We use new observations and our novel QER20 package to disentangle for the first time the spectra of the two stellar components and obtain artefact$-$free reconstructed spectra, yielding the more accurate and reliable spectral classifications of O7.5 V((f))z for the primary and O6 Iaf for the secondary. The emission features of the P$-$Cygni profiles of the H $\beta$ and He i 5876 Å lines, present in the reconstructed spectrum of the secondary, show that this star is at an initial phase of its transition to the WN evolutionary stage. A previously unobserved variable emission, composed of at least four independent features, is seen since 2014 superposed to the H $\gamma$ absorption line. Our analysis reveals that these emission features originate from a physically extended region. This could be explained by an episode of enhanced mass-loss in the scenario of a non$-$conservative evolution of the binary.
Viscous circumbinary protoplanetary discs – I. Structure of the inner cavity
Authors: Penzlin Anna B T , Booth Richard A , Nelson Richard P , Schäfer Christoph M , Kley Wilhelm 
Published: July 2024

ABSTRACT
Many of the most intriguing features, including spirals and cavities, in the current disc observations are found in binary systems like GG Tau, HD 142527, or HD 100453. Such features are evidence of the dynamic interactions between binary stars and the viscous disc. Understanding these dynamic interactions and how they result in the structure and growth of asymmetric circumbinary discs is a difficult problem, for which there is no complete analytical solution, that predicts the shape of the observed disc accurately. We use numerical simulations to evolve circumbinary discs with varying disc viscosities and investigate the size and shape of the inner cavities in such protoplanetary discs. We have simulated over 140 locally isothermal 2D grid-based disc models for $\ge$3 × 104 binary orbits each and mapped out the parameter space relevant for protoplanetary discs. With this, it becomes possible to create parametrized profiles for individual discs to compare to observations and find limits to their binary eccentricity or internal viscosity from the simulation data. In the long-term simulations, larger cavity sizes than previously considered are possible within the parameter space ($\le$6 binary separations). As an example, we find that the eccentricity of the disc around HD 142527 suggests the impact of the binary dynamics on the disc. However, even considering the larger cavity sizes, the large size of the cavity in HD 142527 remains unexplained by the simulations considering the most recent orbital constraints.
Heart failure events in randomized controlled trials for adults receiving maintenance dialysis: a meta-epidemiologic study
Authors: Collister David , Pyne Lonnie , Bhasin Arrti A , Smyth Brendan , Herrington William , Jardine Meg , Mark Patrick B , Badve Sunil , Rossignol Patrick , Dember Laura M , Wanner Christoph , Ezekowitz Justin , Devereaux P J , Parfrey Patrick , Gansevoort Ron , Walsh Michael 
Published: July 2024

ABSTRACT

Background and hypothesis
Heart failure is characterized as cardiac dysfunction resulting in elevated cardiac filling pressures with symptoms and signs of congestion. Distinguishing heart failure from other causes of similar presentations in patients with kidney failure is challenging but necessary, and is needed in randomized controlled trials (RCTs) to accurately estimate treatment effects. The objective of this study was to review heart failure events, their diagnostic criteria, and adjudication in RCTs of patients with kidney failure treated with dialysis. We hypothesized that heart failure events, diagnostic criteria, and adjudication were infrequently reported in RCTs in dialysis.

Methods
We conducted a meta-epidemiologic systematic review of RCTs from high-impact medical, nephrology, and cardiology journals from 2000 to 2020. RCTs were eligible if they enrolled adults receiving maintenance dialysis for kidney failure and evaluated any intervention.

Results
Of 561 RCTs in patients receiving dialysis, 36 (6.4%) reported heart failure events as primary (10, 27.8%) or secondary (31, 86.1%) outcomes. Ten of the 36 (27.8%) RCTs provided heart failure event diagnostic criteria and five of these (50%) adjudicated heart failure events. These 10 RCTs included event diagnostic criteria for heart failure or heart failure hospitalizations, and their criteria included dyspnoea (5/10), oedema (2/10), rales/crackles (4/10), chest X-ray pulmonary oedema or vascular redistribution (4/10), treatment in an acute setting (6/10), and ultrafiltration or dialysis (4/10). No study explicitly distinguished heart failure from volume overload secondary to non-adherence or underdialysis.

Conclusion
Overall, we found that heart failure events are infrequently reported in RCTs in dialysis and are heterogeneously defined. Further research is required to develop standardized diagnostic criteria that are practical and meaningful to patients and clinicians.
Development of Tools to Detect and Identify Strains Belonging to the Pseudomonas syringae Species Complex Responsible for Vein Clearing of Zucchini
Authors: Lacault Caroline , Briand Martial , Jacques Marie-Agnès , Darrasse Armelle 
Published: July 2024

Vein clearing of zucchini (VCZ) is a disease caused by seedborne bacteria that affects young plants of Cucurbita pepo subsp. pepo. VCZ agents are distributed into four phylogenetic clusters within clades 2a and 2ba of phylogroup 2 of the Pseudomonas syringae species complex. All these strains are pathogenic to squash, but only certain strains can also attack melon and cucumber. Strains belonging to clades 2b and 2d are sometimes isolated from zucchini seeds but have not been associated with VCZ epidemics. Identification tools for VCZ agents are required to improve disease control. Primers were designed to implement a seven-gene multilocus sequence analysis (MLSA) scheme for a collection of 60 strains isolated from zucchini seeds. The MLSA showed a clear predominance of strains of cluster 2ba-A and the presence of VCZ strains in a fifth cluster (2ba-C). PCR tests were designed to characterize strains in the VCZ clusters, and a multiplex qPCR test was proposed to distinguish strains with a cucurbit host range extended to melon and cucumber, harboring hopZ5 and sylC, from other strains harboring avrRpt2 and sylC. Additional qPCR tests were also designed to gain insights into clade-2b and -2d strains that can be isolated from cucurbits. These tools evaluated in silico with the NCBI database and experimentally with a collection of 112 strains detected all target strains, except for the test dedicated to clade-2b strains, and excluded 96.7 to 100% of nontarget strains. These tools are intended to serve phylogenetic studies, epidemiological monitoring, and seed testing. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Exclusive Human Milk Diets and the Reduction of Necrotizing Enterocolitis
Authors: Harris Lydia , Lewis Stephanie , Vardaman Shellye 
Published: July 2024

Background:
Necrotizing enterocolitis (NEC) is common in preterm infants, especially infants less than 32 weeks gestation. Mortality from NEC is 7% and occurs in 1 out of 1000 preterm infants. Studies have shown the efficacy of an exclusive milk from mother diet in decreasing rates of NEC and associated mortality.

Purpose:
To evaluate the effectiveness of an existing exclusive human milk diet (EHMD) protocol on the incidence of NEC in extremely premature infants. EHMD, for the purposes of this project is defined as breast milk of mother, with or without human milk-based fortifier.

Methods:
A single-center retrospective quasi-experimental study. The sample included 201 infants born less than 32 weeks gestation, weighing less than 1250 grams, small for gestational age (SGA) and with low Apgar scores. Outcomes measured included incidences of NEC, mortality, and co-morbidities in infants pre- and postinitiation of an EHMD protocol.

Results:
Just 4.8% of the EHMD group had a NEC diagnosis compared to 10.5% of the bovine-based (BOV) group. There was a 1% mortality rate of the EHMD group as compared to 6% in the BOV group. The EHMD group had a statistically significant greater weight gain during hospitalization as compared to infants fed BOV (P = < .05).

Implications for Practice and Research:
Neonatal intensive care units should consider EHMDs for use in this infant population. Future research is needed to support dissemination of the use of EHMD as standard of practice.
Design and Content Validity of Health Games for Children With Atopic Dermatitis
Authors: Muzzolon Mariana , Morgan Mariana A. P. , Imoto Renata R. , Carvalho Vânia Oliveira 
Published: July 2024

Objective:
The success of managing atopic dermatitis (AD) largely depends on patient adherence to treatment. Achieving adherence requires more than knowledge transfer; it also requires a change in patients’ health behavior. Therefore, we conducted this study to develop and validate the content of health games for the pediatric population with AD.

Methods:
The study was conducted from August 2019 to February 2024 in the Hospital Complex of the Federal University of Paraná, Curitiba, Paraná, Brazil. The content of health games about AD were the book Oli e o Grande Desafio da Coceira™ (“Oli and the Great Itching Challenge”) and the games Dermatrilha™ (“Dermatrail”) and Caixinha Surpresa da Dermatite™ (“Dermatitis Surprise Box”). The instrument development process consisted of 5 stages: planning of the instruments, development of the instruments, development of content validation questionnaires, evaluation by an expert committee comprising 5 pediatric dermatologists, 5 hospital psychologists, 5 illustrators/designers, and 5 early childhood education teachers, and a pre-test with the target audience comprising 25 children with AD aged 5 to 12 years. The content validity index was used to assess content validity.

Results:
The content validity index was 0.94 in the evaluation by the expert committee and 0.95 in the evaluation by the target audience. Among the games, the general content validity index was 0.95 among the members of the expert committee and 0.92 among the target audience, being higher than 0.80 for all items.

Conclusion:
The health games evaluated in this study are useful psychoeducational tools with high content validity for use in the therapeutic education of children with AD.
Trends in Common Ownership among Insurers in Medicare Part D
Authors: Chatterji Pinka , Ho Chun-Yu , Kamara Alyssa , Lee Jaehak 
Published: July 2024

Background:
Recent studies document the rising prevalence of common ownership by institutional investors in specific industries. Those investors offer products, such as mutual and index funds, to trade securities on behalf of others and often own shares of multiple firms in the same industry to diversify portfolios. However, at present, few studies focus on common ownership trends in health care.

Objectives:
This paper examines institutional investors’ common ownership in the major insurers offering plans in the Medicare Part D stand-alone prescription drug plan (PDP) market between 2013 and 2020.

Research Design:
Using data from the Securities and Exchange Commission (SEC) database and the Center for Research in Securities Prices, we compute the percentages of outstanding shares of each insurer owned by institutional investors. Data visualization and network analysis are employed to assess the trends in common ownership among major insurers.

Results:
We document a high prevalence of and substantial increase in shared institutional investors in the PDP market. From 2013 to 2020, the degree of common ownership increased by 7% on average, and the common ownership network became more connected. Common ownership also varies across the 34 PDP regions depending on their reliance on listed insurers, that are traded in the stock exchange, offering stand-alone PDPs.

Conclusions:
High and rising common ownership in the Medicare Part D PDP market raises policy questions about potential effects on plan offerings, premiums, and quality for consumers.
Nerve Transfers in the Management of Femoral Nerve Palsy
Authors: Lee Alyssa , Robinson Larry , Baltzer Heather , Farag Jordan 
Published: July 2024

Abstract
The primary objective of this systematic review is to describe the effectiveness of nerve transfers for restoring quadriceps motor function in patients with femoral nerve palsy. MEDLINE, Embase, and CENTRAL were searched from their inception to June 2023 for any English language, primary literature investigating nerve transfers for femoral nerve palsy. Data were extracted for study and intervention characteristics, as well as clinical outcomes, including preoperative and postoperative knee extension strength, electrodiagnostic studies, functional outcomes, adverse events, and donor site morbidity. The primary outcome was defined as return of knee extension equivalent to or greater than a grade 4-on the Medical Research Council scale. Eighteen studies with a total of 40 patients were included. The most common nerve donor was the obturator nerve in 17 studies with 37 patients, followed by the nerve to sartorius in two studies (10 patients). Significant variations in procedures and outcomes reported were observed. There were no studies that reported an effect on ambulation due to donor weakness. Based on the available literature, nerve transfer appears to be an effective treatment for restoring quadriceps function in this population, with 79% of patients in our study achieving at minimum 4-/5 Medical Research Council grade power.
Improving Interpreter Access in the Pediatric Emergency Department: A Quality Improvement Initiative
Authors: Douglas Katherine E. , Fox Miriam T. , Cheston Christine C. , Behara M. Laxmi , Schoppel Kyle A. 
Published: July 2024

Background:
An increasing proportion of the population in the United States have limited English proficiency (LEP). Hospitals that receive federal funding must offer interpreter services. However, access is often lacking for patients. Patients with LEP are at higher risk for adverse events, and the Emergency Department is a particularly high-risk environment for these events.

Methods:
This quality improvement initiative took place from April 2021 to August 2022 in an urban, tertiary care Pediatric Emergency Department. A driver diagram informed four Plan-Do-Study-Act cycles, and data were collected through medical record review, patient surveys, and staff surveys. We tracked outcomes using run and control chart data.

Results:
During the study period, the proportion of patients with LEP reporting “always” having an interpreter was unchanged (no centerline shift—control chart rules). Documentation of interpreter use for encounters with patients with LEP improved. Preferred language documentation and documentation of the need for an interpreter in the electronic medical record showed no change. Process measure data for staff-reported use of professional interpreters significantly increased, and the use of ad hoc interpreters decreased significantly. Length of stay did not change for English or LEP patients.

Conclusions:
This quality improvement initiative improved appropriate documentation of LEP and decreased use of nonqualified interpreters, although no change occurred in the proportion of patients who reported always having an interpreter. Patient satisfaction was unaffected.
Medical Student Exposure to Plastic Surgery and the Impact of a Home Training Program
Authors: Ford Aubree , Granger Peter , Vargo James D. 
Published: July 2024

Background
Contemporary medical education devotes little time to plastic surgery topics. This deficiency is potentially greater at institutions without a dedicated plastic surgery training program. Lack of exposure to plastic surgery results in many medical students developing limited awareness to the full scope of the field. As a result, these future physicians may be unaware of many conditions treated by the plastic surgeon, resulting in referrals being diverted to alternative specialist and furthering scope of practice creep. This study aims to assess medical students' exposure to plastic surgery and evaluate institutional-based differences in plastic surgery education by comparing medical schools with and without a plastic surgery training program.

Methods
Surveys were distributed to medical students at 2 institutions in the same United States city: 1 with a plastic surgery training program (TP) and 1 with no training program (NTP). Surveys assessed students' clinical experiences, exposure to plastic surgery, and understanding of the scope of plastic surgery.

Results
The response rate was 24.3% (306 of 1261). Many students reported having “little” or “no” exposure to plastic surgery during preclinical (93.5%) and clinical (77.7%) phases. NTP students were more likely to report “no” exposure to plastic surgery during both the preclinical (P = 0.0145) and clinical (P = 0.045) years. Consequently, approximately half of all students felt uncomfortable knowing when to refer a patient (46.1%) or place an inpatient consult (51.1%) to a plastic surgeon.
When presented with clinical scenarios, plastic surgery was selected by only 53.4% of students. Performance between institutions was similar (53.0% TP vs 53.5% NTP, P = 0.936), with greater accuracy on cosmetic vignettes compared with hand and peripheral nerve vignettes. There was a statistically significant difference in 4 subspecialty domains between students who had prior exposure to plastic surgery and those who did not (hand/peripheral nerve, P < 0.0001; craniofacial, P = 0.007; breast/cosmetic, P = 0.001; and reconstruction/burn, P < 0.0001).

Conclusions
These findings add to the growing body of literature demonstrating that medical students have limited exposure to plastic surgery. Although limited in its scope, this study suggests that home TP status does not appear to overtly impact students' understanding. Increased exposure and overall surgical experience correlated with an increased understanding of the scope of plastic surgery.
Electroconvulsive Therapy in Forensic Psychiatry
Authors: Besse Matthias , Gather Jakov , Schiffer Boris , Zilles-Wegner David 
Published: July 2024

Abstract
Patients with schizophrenia are the largest population in forensic hospitals, and treatment-resistant psychosis is associated with length of stay. For patients with severe and treatment-resistant psychotic disorders, electroconvulsive therapy (ECT) is a potentially effective treatment. Data regarding the use of ECT in forensic psychiatry are scarce. This systematic review aims to provide an overview of the use of ECT in forensic psychiatry. Three databases (PubMed, Web of Science, and PsycINFO) were searched for publications since 1980. Peer-reviewed articles describing patients who underwent ECT treatment in the context of forensic psychiatry were included when a treatment outcome was reported. We identified 5 case reports and 1 case series comprising 13 patients treated with ECT in forensic settings. The quality of evidence was poor accompanied by a considerable risk of bias. Patients were diagnosed with schizophrenia spectrum disorders (n = 10) or depression with psychotic features (n = 3). Eleven patients (84.6%) were described as responders in terms of symptom improvement associated with a reduction of aggressive behavior and improved functioning. At least 3 patients were able to return to community settings. Despite the very limited evidence base, our review suggests that patients in forensic hospitals may benefit from ECT, but more systematic and higher-quality evidence is urgently needed. In addition to prospective, controlled observational studies, a qualitative view focusing on patients' perspectives in this specific setting is of particular importance.
A study on viruses and bacteria with particular interest on Mycoplasma pneumoniae in children with exacerbation of asthma from a tertiary care hospital in Sri Lanka
Authors: Wijesooriya Lakmini Inoka , Chalker Victoria , Perera Priyantha , Sunil-Chandra N.P. 
Published: July 2024

Asthma is a significant public health concern, particularly in children with severe symptoms. Exacerbation of asthma (EOA) is life-threatening and respiratory infections (RIs) play a crucial role. Though viruses play a significant role in EOA, patients are empirically treated with antibiotics which contribute to the development of antibiotic resistance. Although there are widely reported association of EOA with viral or M. pneumoniae infections, there are no published data in Sri Lanka. The present study aimed to identify the association of common respiratory viruses, typical respiratory bacterial pathogens, and M. pneumoniae in children with EOA and relate them with the compatibility of antimicrobial use.
A case-control study was conducted in the pediatric unit of North Colombo Teaching Hospital, Sri Lanka, involving two groups of children between 5-15 years of age. Group-1: children with EOA, Group-2: children with stable asthma (SA). Each group consisted of 100 children. Sputum/throat swabs were tested for common respiratory viruses using virus specific FITC-labelled monoclonal antibodies (MAbs), bacteria by routine culture and M. pneumoniae by RT-PCR. Macrolide-resistance in M. pneumoniae was detected using conventional PCR and sequencing specific genetic mutations in the 23S rRNA gene. M. pneumoniae was genotyped using nested multilocus sequence typing (MLST), which targeted eight housekeeping genes (ppa, pgm, gyrB, gmk, glyA, atpA, arcC, adk).
There was no significant difference in age, gender, demographic or geographical locations between the two groups. In children with EOA, antibiotics were used in 66% (66/100) and macrolides in 42% (42/100) in children with EOA. Samples consisted of 78% (78/100) sputum and 22% (22/100) throat swabs. Adenovirus was the most common virus identified, and it was significantly higher in children with EOA compared to those with SA, but no significant difference in typical bacteria findings between the two groups. M. pneumoniae was detected in one patient with EOA, with none detected in the SA group. The M. pneumoniae was macrolide sensitive, and it was ST14 by Multi Locus Sequence Typing. This study showed that the empiric use of antibiotics in children with asthma may be better targeted with prior pathogen screening to inform appropriate treatment to minimize antibiotic resistance.
FlowPacker: Protein side-chain packing with torsional flow matching
Authors: Lee Jin Sub , Kim Philip M. 
Published: July 2024

AbstractAccurate prediction of protein side-chain conformations is necessary to understand protein folding, proteinprotein interactions and facilitate de novo protein design. Here we apply torsional flow matching and equivariant graph attention to develop FlowPacker, a fast and performant model to predict protein sidechain conformations conditioned on the protein sequence and backbone. We show that FlowPacker outperforms previous state-of-the-art baselines across most metrics with improved runtime. We further show that FlowPacker can be used to inpaint missing side-chain coordinates and also for multimeric targets, and exhibits strong performance on a test set of antibody-antigen complexes. Code is available athttps://gitlab.com/mjslee0921/flowpacker.