bluuebunny/crossref_metadata_2025_split huggingface dataset:
Wildfire Management Strategy and Its Relation to Operational Risk
Authors: Noonan-Wright Erin , Seielstad Carl 
Published: May 2024

Abstract
Changes to US wildfire policy in 2009 blurred the distinction between fires managed for resource benefits and fires with primarily suppression objectives, making management strategies difficult to track. Here, qualitative text is coded from a sample of 282 Wildland Fire Decision Support System Relative Risk Assessments completed on wildfires between 2010 and 2017 to examine the prevalence of different strategies and their associations with risk. Suppression is used most, associated with high risk. Managers discuss intent to suppress even when it is untenable. Monitoring, confine, or point protection are used much less commonly and when risk is low. The Southwest region discusses a diversity of strategies, leveraging landscape barriers from past management to support them; the Northwest discusses suppression or monitoring and rarely links strategy selection to barriers. Based on associations between physical barriers to fire spread, risk, and strategy, creating more barriers may provide a path forward to better implement fire policy.
Study Implications: Systematic analysis of text data in wildfire decision documents provides insights into how fires are managed. Most wildfires are still aggressively suppressed despite federal fire policy promoting the use of fire to enhance resources. When managers discuss risk during wildfires, it is evident that physical barriers to fire spread (e.g., rivers, roads, trails, rocky scree), including mechanical fuel treatments, prescribed fires, and previous wildfires, are important factors in operational fire planning. However, management strategies promoting the use of wildfire to enhance ecological resiliency or reduce transmission of future fires to values are used sparingly. Southwest fire managers are relying on past wildfires, fuel treatments, and prescribed fires more so than the Northwest to engage in a full spectrum of fire management strategies. This finding suggests that, at least in some geographies, ongoing investments in fuels management will pay dividends in reducing risk and broadening opportunities to meet federal policy goals.
Constraints on Mechanical Fuel Reduction Treatments in United States Forest Service Wildfire Crisis Strategy Priority Landscapes
Authors: Woolsey George A , Tinkham Wade T , Battaglia Mike A , Hoffman Chad M 
Published: May 2024

Abstract
The USDA Forest Service recently launched a Wildfire Crisis Strategy outlining objectives to safeguard communities and other values at risk by substantially increasing the pace and scale of fuel reduction treatment. This analysis quantified layered operational constraints to mechanical fuel reduction treatments, including existing vegetation, protected areas, steep slopes, and administrative boundaries in twenty-one prioritized landscapes. Results suggest that achieving the objective to treat 20%–40% of high-risk area is unlikely in most landscapes under a business-as-usual approach to mechanical fuel reduction treatments. Increased investment in steep-slope systems and expanded road access opens sufficient acreage to meet treatment objectives in eighteen of twenty-one priority landscapes. Achieving treatment objectives in the remaining three landscapes will require both increased investment to overcome physical constraints and navigating administrative complexities within reserved land allocations to implement fuels treatments at the pace and scale needed to moderate fire risk to communities.
Study Implications: Legal, operational, and administrative factors have hindered the implementation of proposed wildland fire risk reduction management actions. Investing in steep-slope systems, expanding use of temporary roads, and revising administrative rules to allow for appropriately tailored mechanical thinning in special conservation areas are possible ways to meet fuel reduction treatment objectives of the USDA Forest Service Wildfire Crisis Strategy in twenty-one landscapes across the western United States. Broadening the land base available for mechanical treatment allows for flexibility to develop treatment plans that optimize across the multiple dimensions of effective landscape-scale fuel treatment design and restore fire as a key ecosystem process.
Risk Analysis of Respiratory Syncytial Virus Among Infants in the United States by Birth Month
Authors: Gantenberg Jason R , van Aalst Robertus , Bhuma Monika Reddy , Limone Brendan , Diakun David , Smith David M , Nelson Christopher B , Bengtson Angela M , Chaves Sandra S , La Via William V , Rizzo Christopher , Savitz David A , Zullo Andrew R 
Published: May 2024

Abstract

Background
Respiratory syncytial virus (RSV) is a major cause of morbidity and mortality among US infants. A child’s calendar birth month determines their age at first exposure(s) to RSV. We estimated birth month-specific risk of medically attended (MA) RSV lower respiratory tract infection (LRTI) among infants during their first RSV season and first year of life (FYOL).

Methods
We analyzed infants born in the USA between July 2016 and February 2020 using three insurance claims databases (two commercial, one Medicaid). We classified infants’ first MA RSV LRTI episode by the highest level of care incurred (outpatient, emergency department, or inpatient), employing specific and sensitive diagnostic coding algorithms to define index RSV diagnoses. In our main analysis, we focused on infants’ first RSV season. In our secondary analysis, we compared the risk of MA RSV LRTI during infants’ first RSV season to that of their FYOL.

Results
Infants born from May through September generally had the highest risk of first-season MA RSV LRTI—approximately 6–10% under the specific RSV index diagnosis definition and 16–26% under the sensitive. Infants born between October and December had the highest risk of RSV-related hospitalization during their first season. The proportion of MA RSV LRTI events classified as inpatient ranged from 9% to 54% (specific) and 5% to 33% (sensitive) across birth month and comorbidity group. Through the FYOL, the overall risk of MA RSV LRTI is comparable across birth months within each claims database (6–11% under the specific definition, 17–30% under the sensitive), with additional cases progressing to care at outpatient or ED settings.

Conclusions
Our data support recent national recommendations for the use of nirsevimab in the USA. For infants born at the tail end of an RSV season who do not receive nirsevimab, a dose administered prior to the onset of their second RSV season could reduce the incidence of outpatient- and ED-related events.
Moderately hypofractionated proton beam therapy for localized prostate cancer: 5-year outcomes of a phase II trial
Authors: Murakami Motohiro , Ishikawa Hitoshi , Sekino Yuta , Nishiyama Hiroyuki , Suzuki Hiroyoshi , Sugahara Shinji , Iizumi Takashi , Mizumoto Masashi , Okumura Toshiyuki , Keino Naoto , Iizumi Yuichi , Hashimoto Koichi , Gosho Masahiko , Sakurai Hideyuki 
Published: May 2024

Abstract
The usefulness of moderately hypofractionated radiotherapy for localized prostate cancer has been extensively reported, but there are limited studies on proton beam therapy (PBT) using similar hypofractionation schedules. The aim of this prospective phase II study is to confirm the safety of a shortened PBT course using 70 Gy relative biological effectiveness (RBE) in 28 fractions. From May 2013 to June 2015, 102 men with localized prostate cancer were enrolled. Androgen deprivation therapy was administered according to risk classification. Toxicity was assessed using Common Terminology Criteria for Adverse Events version 4.0. Of the 100 patients ultimately evaluated, 15 were classified as low risk, 43 as intermediate risk, and 42 as high risk. The median follow-up time of the surviving patients was 96 months (range: 60–119 months). The 5-year cumulative incidences of grade 2 gastrointestinal/genitourinary adverse events were 1% (95% CI: 0.1–6.9) and 4% (95% CI: 1.5–10.3), respectively; no grade ≥ 3 gastrointestinal/genitourinary adverse events were observed. The current study revealed a low incidence of late adverse events in prostate cancer patients treated with moderately hypofractionated PBT of 70 Gy (RBE) in 28 fractions, indicating the safety of this schedule.
Hemostatic Evaluation of Refrigerated Whole Blood Stored 7 Days Post-Expiration
Authors: Greene Nicholas A , McIntosh Colby S , Meledeo Michael A , Reddoch-Cardenas Kristin M 
Published: May 2024

ABSTRACT

Introduction
The United States Army has shifted doctrine to focus on large-scale combat operations against peer to near-peer adversaries. Future conflicts could result in a limited supply chain, leaving medical providers with only expired blood products for treatment of hemorrhagic shock. This study evaluated quality, function, and safety metrics of whole blood stored for 1 week past regulated expiration (i.e., 35 days, in CPDA-1).

Materials and Methods
Whole blood units (n = 6) were collected in citrate phosphate dextrose adenine-1 (CPDA-1) anticoagulant and stored refrigerated for up to 42 days. Units were sampled on days 35, 37, 39, and 42 of storage and evaluated for the following: complete blood count, blood metabolism and chemistries, clotting dynamics, and presence of bacteria.

Results
The majority of evaluated parameters fell outside of normal clinical ranges beginning at day 35 of storage. At 42 days, blood pH was 6.58 ± 0.038, hemolysis was significantly increased (P = .037 vs day 35), and bacterial contamination was not evident. Glucose levels continuously dropped during extended storage. K+ was significantly increased at day 42 compared to day 35 (P = .010). A significant reduction in clot strength, factor V activity, and factor VIII activity was evident beginning at day 39 of storage.

Conclusions
Storage of whole blood out to 42 days results in a continuous decline in function, but further in vivo safety studies should be performed to determine if the benefits of expired blood outweigh the risks. Other methods to safely extend storage of whole blood that maintain hemostatic function and preserve safety should be investigated, with emphasis placed on methods that reduce potassium leak and/or hemolysis.
Pilot Study: Developing Curriculum to Prepare Fourth-Year Medical Students Applying for OBGYN Residency Within the Defense Health Agency
Authors: Wright Danielle , Boedeker David , Ulfers Alexander , Peterson Logan 
Published: May 2024

ABSTRACT

Background
Obstetrics and gynecology (OBGYN) is becoming increasingly competitive among medical specialties. As a result, many medical schools have frameworks to help their students increase their competitiveness to maximize chances of a successful match. However, “boot camps” have traditionally been geared toward the transition to intern year and not to sub-internships during the fourth year of medical school. We aimed to develop a boot camp for rising fourth-year medical students planning to apply into OBGYN before the initiation of their sub-internships and interview season.

Methods
Sixteen students enrolled in this course led by faculty OBGYNs at our institution. We utilized a combination of mentorship, coaching, and education to achieve applicant success. The curriculum included formal lectures, surgical skills training, and focused feedback from our applicant development committee.

Results
Our response rate was 100% and 94% for the pre-intervention and post-intervention survey, respectively. Before the intervention, the majority of participants felt either neutral (47.4%) or unprepared (21.1%) regarding their knowledge before their sub-internships. However, after the intervention, all reported feeling more prepared for their rotations. All respondents either agreed (60%) or strongly agreed (40%) that the course increased their confidence in performing well on audition rotations. Our match rate increased from 62% for the class of 2022 (before this intervention) to 75% for the class of 2023.

Discussion
In light of the increasing residency match competitiveness, it is crucial to investigate programs that can assist students in developing stronger applications. This reproducible intervention utilizes few resources and can be implemented at most medical schools to better support their OBGYN applicants.
The Association Between Grip Strength, Upper Body Power, and Limb Dominance in a Military Population
Authors: Silder Amy , Zifchock Rebecca , Brown Luke , Sessoms Pinata , Jones Douglas 
Published: May 2024

ABSTRACT

Introduction
Military service members rely on upper body strength and power to accomplish tasks such as carrying heavy weapons and gear, rappelling, combat grappling, and marksmanship. Early identification of the factors that lead to reduced upper body strength and power would enable leadership to predict and mitigate aspects that decrease military operational readiness and increase injury risk. The purpose of this study was to investigate the relationship between grip strength and upper body power in U.S. Infantry Marines. We hypothesized that dominant arm grip strength would show a strong positive correlation with upper body power and that the dominant arm would be more powerful than the non-dominant arm.

Materials and Methods
A total of 120 U.S. Marines completed 3 maximum effort isometric grip strength trials with their dominant hand and 3 maximum effort ballistic pushups on a ForceDecks force plate system. Force plate data were used to estimate pushup height and peak power. Maximum grip strength, pushup height, and peak power across the 3 trials were used for analysis. Pearson’s correlation was used to test for associations between peak power, pushup height, and grip strength. Paired t-tests were used to test for differences in peak power between the dominant and non-dominant arms.

Results
A very weak correlation was found between grip strength and upper body power, but there was no relationship between grip strength and pushup height. Additionally, there were no significant differences in upper body power between the dominant and non-dominant arms.

Conclusions
The results of this study suggest that grip strength is not predictive of upper body power and cannot be used as a stand-alone measure of physical readiness in a military unit. These findings do not, however, degrade the potential of both measures to predict and inform health status and physical readiness. Future prospective research should be conducted to determine if either of these measures can be used as indicators of performance and/or injury susceptibility and if limb dominance plays a role in injury incidence within the upper extremity.
Eccentric orbits in disc-embedded EMRIs : orbital evolution and observability trend in LISA
Authors: Basu Prasad , Chatterjee Sangita , Mondal Soumen 
Published: May 2024

ABSTRACT
The purpose of this work is to study the orbital evolution under the combined effect of disc-drag and GW-emission for E/IMRIs endowed with accretion disc. We study the dependence of disc-torque and GW-torque on the orbital-parameters of compact companions. We employ a semirelativistic technique to study E/IMRI-dynamics evolving under most general elliptical-orbits in the equatorial plane and assume natural transonic-disc in the Kerr space–time around a supermassive black hole (SMBH). To conduct an accurate investigation, we fix the disc attributes and alter orbital-parameters, mass-ratio of E/IMRIs and spin of SMBH. We notice that high-eccentric orbits with smaller semimajor axis exhibit a more prominent impact of accretion-drag on the companion-dynamics. The magnitude of disc-torque is greater and almost one order higher in retrograde-spins than prograde-spins. We identify the best fitted orbital parameters, which can potentially enhance detectability of accretion-disc effect on the observed GW-signal. Prioritizing such orbital-configuration, we obtain substantial impact on the dephasing for maximum disc-torque and high signal-to-noise-ratio (SNR) in emitted signals. Employing a threshold-SNR (&gt;8), we finally identify the detectability trend of those systems in LISA-band. A key aspect of our findings is the ability to constrain the orbital parameters by GW-detection and estimate orbital-ellipticity or other orbital-characteristics by comparing two SNRs. Hence, the study will be important in understanding the orbital-evolution, predicting orbital-configuration, and finding detectability for such gas-rich E/IMRIs. The predictions of E/IMRI formation pathways from ground and more certainly from future space-borne detectors, would also be possible from the likelihood of such eccentric-E/IMRIs in the sky.
Characteristics and Outcome of Vascular Graft Infections: A Risk Factor and Survival Analysis
Authors: Stockschläder Leonie , Margaryan Donara , Omran Safwan , Schomaker Martin , Greiner Andreas , Trampuz Andrej 
Published: May 2024

Abstract

Background
Vascular graft infection (VGI) is a serious complication after implantation of arterial vascular grafts. Optimal surgical and pathogen-specific antimicrobial treatment regimens for VGI are largely unknown. We evaluated patients with arterial VGI according to onset, location, microbiological and imaging characteristics, and surgical and antimicrobial treatment and performed an outcome evaluation.

Methods
Consecutive patients with VGI treated in 2 hospitals from 2010 through 2020 were retrospectively analyzed. Uniform definition criteria and standardized outcome evaluation were applied. Logistic regression was used for multiple analysis; survival analysis was performed with Kaplan-Meier analysis and a log-rank test.

Results
Seventy-eight patients with VGI were included: 30 early-onset cases (&lt;8 weeks after graft implantation) and 48 late-onset cases, involving 49 aortic and 29 peripheral grafts. The median time from initial implantation to diagnosis of VGI was significantly longer in aortic than peripheral VGIs (363 vs 56 days, P = .018). Late-onset VGI (odds ratio [OR], 7.3; P = .005) and the presence of surgical site infection/complication (OR, 8.21; P = .006) were independent risk factors for treatment failure. Surgical site infection/complication was associated with a higher risk for early-onset VGI (OR, 3.13; P = .040). Longer infection-free survival was observed in cases where the infected graft was surgically removed (P = .037).

Conclusions
This study underlines the importance of timely diagnosis of VGI and preventing surgical site infections/complications at graft implantation. It highlights the complexity of infection eradication, especially for late-onset infections, and the importance of adequate antimicrobial and surgical treatment.
In-home TB Testing Using GeneXpert Edge is Acceptable, Feasible, and Improves the Proportion of Symptomatic Household Contacts Tested for TB: A Proof-of-Concept Study
Authors: Medina-Marino Andrew , Bezuidenhout Dana , Bezuidenhout Charl , Facente Shelley N , Fourie Bernard , Shin Sanghyuk S , Penn-Nicholson Adam , Theron Grant 
Published: May 2024

Abstract

Background
Household contact investigations are effective for finding tuberculosis (TB) cases but are hindered by low referral uptake for clinic-based evaluation and testing. We assessed the acceptability and feasibility of in-home testing of household contacts (HHC) using the GeneXpert Edge platform.

Methods
We conducted a 2-arm, randomized study in Eastern Cape, South Africa. HHCs were verbally assessed using the World Health Organization-recommended 4-symptom screen. Households with ≥1 eligible symptomatic contact were randomized. Intervention households received in-home GeneXpert MTB/RIF molecular testing. GeneXpert-positive HHCs were referred for clinic-based treatment. Standard-of-care households were referred for clinic-based sputum collection and testing. We defined acceptability as agreeing to in-home testing and feasibility as generation of valid Xpert MTB/RIF results. The proportion and timeliness of test results received was compared between groups.

Results
Eighty-four households were randomized (n = 42 per arm). Of 100 eligible HHCs identified, 98/100 (98%) provided consent. Of 51 HHCs allocated to the intervention arm, all accepted in-home testing; of those, 24/51 (47%) were sputum productive and 23/24 (96%) received their test results. Of 47 HCCs allocated to standard-of-care, 7 (15%) presented for clinic-based TB evaluation, 6/47 (13%) were tested, and 4/6 (67%) returned for their results. The median (interquartile range) number of days from screening to receiving test results was 0 (0) and 16.5 (11-15) in the intervention and standard-of-care arms, respectively.

Conclusions
In-home testing for TB was acceptable, feasible, and increased HHCs with a molecular test result. In-home testing mitigates a major limitation of household contact investigations (dependency on clinic-based referral), revealing new strategies for enhancing early case detection.
Oncology drug pricing: potential Medicare savings on cancer-directed and supportive care medications through the Mark Cuban cost plus drug model
Authors: Bouvette Max J , Lam Anh B , Bouvette Christopher , Ayanambakkam Adanma , Nipp Ryan D 
Published: May 2024

Abstract
Prescription drug costs within oncology remain a challenge for many patients with cancer. The Mark Cuban Cost Plus Drug Company (MCCPDC) launched in 2022, aiming to provide transparently priced medications at reduced costs. In this study, we sought to describe the potential impact of MCCPDC on Medicare Part-D oncology spending related to cancer-directed (n = 7) and supportive care (n = 26) drugs. We extracted data for drug-specific Part-D claims and spending for 2021. Using 90-count purchases from MCCPDC, we found potential Part-D savings of $857.8 million (91% savings) across the 7 cancer-directed drugs and $28.7 million (67% savings) across 21/26 (5/26 did not demonstrate savings) supportive care drugs. Collectively, our findings support that alternative purchasing models like MCCPDC may promote substantial health care savings.
Speaking of ‘violence’: Figleaf use in sexualized violence contexts
Authors: Kenyon Madeleine 
Published: May 2024

Abstract
In this project, I develop the concept of a sexualized violence figleaf, a speech mechanism often used in sexualized violence discourse to dismiss or characterize assault as some other kind of thing: a misunderstanding, a change of heart by the victim, a mischaracterization of the perpetrator, or any other number of things which are not rape, or violence. Sexualized violence figleaves are an extension of Jennifer Saul's work on racial and gender figleaves, as the underlying mechanics of the utterance track those of Saul's figleaves. In other words, I am developing a figleaf variant, showing that this conceptual tool is useful for analysing utterances beyond racist, sexist, and conspiracist speech, upon which Saul focuses. Rather, bringing figleaves into the realm of sexualized violence discourse illuminates features of the discourse which are often obscured by the prevalence of strong social intuitions about rapists and their corresponding character.