bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subword Representations Successfully Decode Brain Responses to Morphologically Complex Written Words
Authors: Hakala Tero , Lindh-Knuutila Tiina , Hultén Annika , Lehtonen Minna , Salmelin Riitta 
Published: June 2024

Abstract
This study extends the idea of decoding word-evoked brain activations using a corpus-semantic vector space to multimorphemic words in the agglutinative Finnish language. The corpus-semantic models are trained on word segments, and decoding is carried out with word vectors that are composed of these segments. We tested several alternative vector-space models using different segmentations: no segmentation (whole word), linguistic morphemes, statistical morphemes, random segmentation, and character-level 1-, 2- and 3-grams, and paired them with recorded MEG responses to multimorphemic words in a visual word recognition task. For all variants, the decoding accuracy exceeded the standard word-label permutation-based significance thresholds at 350–500 ms after stimulus onset. However, the critical segment-label permutation test revealed that only those segmentations that were morphologically aware reached significance in the brain decoding task. The results suggest that both whole-word forms and morphemes are represented in the brain and show that neural decoding using corpus-semantic word representations derived from compositional subword segments is applicable also for multimorphemic word forms. This is especially relevant for languages with complex morphology, because a large proportion of word forms are rare and it can be difficult to find statistically reliable surface representations for them in any large corpus.
On the Relation between Thermohaline Anomalies and Water Mass Transformation in the Eastern Subpolar North Atlantic
Authors: Passos Leilane , Langehaug Helene R. , Årthun Marius , Straneo Fiammetta 
Published: June 2024

Abstract
Decadal thermohaline anomalies carried northward by the North Atlantic Current are an important source of predictability in the North Atlantic region. Here, we investigate whether these thermohaline anomalies influence surface-forced water mass transformation (SFWMT) in the eastern subpolar gyre using the reanalyses EN4.2.2 for the ocean and the ERA5 for the atmosphere. In addition, we follow the propagation of thermohaline anomalies along two paths: in the subpolar North Atlantic and the Norwegian Sea. We use observation-based datasets (HadISST, EN4.2.2, and Ishii) between 1947 and 2021 and apply complex empirical orthogonal functions. Our results show that when a warm anomaly enters the eastern subpolar gyre, more SFWMT occurs in light-density classes (27.0–27.2 kg m−3). In contrast, when a cold anomaly enters the eastern subpolar gyre, more SFWMT occurs in denser classes (27.4–27.5 kg m−3). Following the thermohaline anomalies in both paths, we find alternating warm–salty and cold–fresh subsurface anomalies, repeating throughout the 74-yr-long record with four warm–salty and cold–fresh periods after the 1950s. The cold–fresh anomaly periods happen simultaneously with the Great Salinity Anomaly events. Moreover, the propagation of thermohaline anomalies is faster in the subpolar North Atlantic (SPNA) than in the Norwegian Sea, especially for temperature anomalies. These findings might have implications for our understanding of the decadal variability of the lower limb of the Atlantic meridional overturning circulation and predictability in the North Atlantic region.

Significance Statement
Anomalously warm–salty or cold–fresh water, carried by the North Atlantic Current toward the Arctic, is a source of climate predictability. In this study, we investigate 1) how these ocean anomalies influence the transformation of water masses in the eastern subpolar gyre and 2) their subsequent propagation poleward and northwestward. The key findings reveal that anomalously warm waters entering the eastern subpolar gyre lead to increased transformation in lighter water masses, while cold anomalies affect denser water masses. These anomalies propagate more than 2 times faster toward the Greenland coast (northwestward) than toward the Arctic (poleward). Our findings contribute to enhancing the understanding of decadal predictability in the northern North Atlantic, including its influence on the Atlantic meridional overturning circulation.
Hard to Soft Tissue Profile Changes in Skeletal Class III Dentofacial Deformities After Maxillary Advancement and Mandibular Setback Orthognathic Surgery
Authors: Sharma Rupesh , Verma Sanjeev , Kumar Vinay , Verma Raj Kumar , Singh Satinder Pal , Rattan Vidya 
Published: June 2024

Objective To correlate the sagittal hard tissue movement and soft tissue changes among patients with skeletal class III malocclusion following bimaxillary orthognathic surgery. Material and Methods Fifty-nine subjects with skeletal class III malocclusion treated consecutively with maxillary advancement and mandibular setback were assessed for skeletal and soft tissue linear changes using presurgical (T1) and post-treatment (T2) lateral cephalograms. Pearson’s correlation coefficient test was used to correlate hard and soft tissue parameters. Results The sagittal hard tissue movement and soft tissue changes for all the parameters assessed in maxilla and mandible showed statistically significant correlations. The ratios of changes for the maxillary protrusion [N-A (HP)] to horizontal subnasale (Sn), superior labial sulcus (Sls), and labrale superioris (Ls) were 0.574:1, 0.703:1, and 0.721:1 respectively. The ratio of horizontal labrale inferioris (Li), mentolabial fold (Mlf), and soft tissue (Pg′) to mandibular protrusion [N-B (HP)] were 0.992:1, 0.970:1, and 0.590:1 respectively and to chin protrusion [N-Pg (HP)] were 1.293:1, 1.252:1, and 1.001:1, respectively. The ratios were different for males and females in maxilla and mandible. Conclusion Sagittal hard tissue movement and soft tissue changes are significantly correlated. The soft tissue movement in the mandible were more proportionate compared to the maxilla. The sagittal hard tissue to soft tissues movement ratios were greater in maxilla and lesser at pogonion and mentolabial sulcus in females compared to males. The ratios obtained can be used for predicting postsurgical soft tissue changes.
Short-term Outcomes After Hip Arthroscopic Surgery in Patients Participating in Formal Physical Therapy Versus a Home Exercise Program: A Prospectively Enrolled Cohort Analysis
Authors: Hobson Taylor E. , Metz Allan K. , Bellendir Trina R. , Froerer Devin L. , Rosenthal Reece M. , Hunter Collin D.R. , Featherall Joseph , Maak Travis G. , Aoki Stephen K. 
Published: June 2024

Background: Physical therapy is frequently utilized in the postoperative care of femoroacetabular impingement syndrome (FAIS). There has been limited research into the efficacy of a structured home exercise program (HEP) compared with formal physical therapy (FPT) in this patient population. Purpose/Hypothesis: The purpose was to evaluate the short-term outcomes of patients utilizing FPT versus an HEP after hip arthroscopic surgery for FAIS. It was hypothesized that both groups would show similar improvements regarding outcome scores, which would improve significantly compared with their preoperative scores. Study Design: Cohort study; Level of evidence, 2. Methods: Patients undergoing hip arthroscopic surgery for FAIS at a single center between October 2020 and October 2021 were prospectively enrolled. Patients were allowed to self-select FPT or an HEP and were administered a survey preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. The survey included the Single Assessment Numeric Evaluation, visual analog scale for pain, 12-item International Hip Outcome Tool, Patient-Reported Outcomes Measurement Information System Physical Function, and patient satisfaction with physical therapy and overall care. Statistical analysis was conducted between the 2 groups and within groups to compare preoperative and postoperative scores. Results: The patients’ mean age was 32.6 ± 10.4 years, with 47.2% being female and 57.4% choosing the HEP. At 12 months postoperatively, no significant differences were reported between the FPT and HEP groups regarding the Single Assessment Numeric Evaluation score ( P = .795), visual analog scale for pain score ( P > .05), Patient-Reported Outcomes Measurement Information System Physical Function T-score ( P = .699), 12-item International Hip Outcome Tool score ( P = .582), and patient satisfaction ( P > .05). Outcome scores at 12 months postoperatively were significantly improved from the preoperative scores across all measures in both groups ( P < .001). Conclusion: There were no significant differences regarding patient outcomes between FPT and the HEP at 1-year follow-up after hip arthroscopic surgery for FAIS when patients selected their own treatment, with both groups demonstrating significant improvements in their outcome scores from their preoperative values. These findings suggest that a structured HEP may be a viable alternative to FPT after hip arthroscopic surgery in patients who prefer a self-directed rehabilitation program.
Conceptualizing the Commercialization of Human Milk: A Concept Analysis
Authors: Rusi Heather Christine , Grummer-Strawn Laurence , Perrin Maryanne Tigchelaar , Risling Tracie , Brockway Meredith Lee 
Published: June 2024

Background: Donor human milk is recommended when infants are unable to be fed their mother’s own milk or require supplementation. For-profit companies use technologies to create human milk products for infants in the neonatal intensive care setting without consistent guidelines and regulatory frameworks in place. This commercialization of human milk is inadequately conceptualized and ill-defined. Research Aims: The aim of this study is to conceptualize and define the commercialization of human milk and discuss the need for policy guidelines and regulations. Method: Using a concept analysis framework, we reviewed the literature on the commercialization of human milk, analyzed the antecedents and potential consequences of the industry, and developed a conceptual definition. The literature review resulted in 13 relevant articles. Results: There has been a surge in the development and availability of human milk products for vulnerable infants developed by for-profit companies. Commercialized human milk can be defined as the packaging and sale of human milk and human milk components for financial gain. Factors contributing to the commercialization of human milk include an increased demand for human milk, and consequences include potential undermining of breastfeeding. The lack of guidelines and regulations raises concerns of equity, ethics, and safety. Conclusion: The industry is rapidly growing, resulting in an urgent need for consistent guidelines and regulatory frameworks. If left unaddressed, there could be potential risks for donor milk banking, the future of breastfeeding, and infant and maternal health.
The sleep problems in individuals with Rett syndrome and their caregivers
Authors: Huang Cheng-Hsien , Wong Lee-Chin , Chu Yen-Ju , Hsu Chia-Jui , Wang Hsin-Pei , Tsai Wen-Che , Lee Wang-Tso 
Published: June 2024

Sleep problems are prevalent among individuals with Rett syndrome. We aimed to investigate sleep problems in individuals with Rett syndrome and their caregivers. A total of 29 participants diagnosed with Rett syndrome and their respective 29 caregivers were included. The Children Sleep Habits Questionnaire (CSHQ), the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the actigraphy data collected from Actiwatch 2 were used to investigate the change of sleep pattern. Based on the CSHQ questionnaire, 75.9% (22/29) of the patients reported sleep disturbances. The younger patients exhibited higher CSHQ scores. Actigraphy data revealed that both young and older patients had short total sleep duration, low sleep efficiency, long sleep-onset latency, long awaking duration, and fragmented sleep. The caregivers reported significantly higher PSQI scores, mildly declined sleep efficiency, and shorter total sleep duration in the actigraphy study. Associations were identified between smaller head circumference and shorter total sleep duration, more severe motor dysfunction and longer wake after sleep onset, worsen scoliosis and more awakenings per night. Sleep efficiency was inversely associated with epilepsy and positively associated with somatic growth. Sleep disturbances are common and should be investigated in individuals with Rett syndrome and their caregivers. Lay abstract Sleep problems are common and impactful among individuals with Rett syndrome (RTT) and their caregivers. We examined the sleep patterns of 29 RTT patients and their primary caregivers using various assessment tools. The study found that a majority of the patients experienced sleep disturbances, with younger patients showing more sleep difficulties. Caregivers also reported poor sleep quality. The findings emphasize the need to address sleep problems in RTT management, as improving sleep quality can positively impact the well-being of individuals with RTT and their caregivers.
Remineralization Rate of Lytic Lesions of the Spine in Multiple Myeloma Patients Undergoing Radiation Therapy
Authors: Zijlstra Hester , te Velde Jens P. , Striano Brendan M. , Groot Olivier Q. , de Groot Tom M. , Raje Noopur , Patel Chirayu , Husseini Jad , Delawi Diyar , Kempen Diederik H. R. , Verlaan Jorrit-Jan , Schwab Joseph H. 
Published: June 2024

Study Design Retrospective cohort study. Objective In general, Multiple Myeloma (MM) patients are treated with systemic therapy including chemotherapy. Radiation therapy can have an important supportive role in the palliative management of MM-related osteolytic lesions. Our study aims to investigate the degree of radiation-induced remineralization in MM patients to gain a better understanding of its potential impact on bone mineral density and, consequently, fracture prevention. Our primary outcome measure was percent change in bone mineral density measured in Hounsfield Units (Δ% HU) between pre- and post-radiation measurements, compared to non-targeted vertebrae. Methods We included 119 patients with MM who underwent radiotherapy of the spine between January 2010 and June 2021 and who had a CT scan of the spine at baseline and between 3-24 months after radiation. A linear mixed effect model tested any differences in remineralization rate per month (βdifference) between targeted and non-targeted vertebrae. Results Analyses of CT scans yielded 565 unique vertebrae (366 targeted and 199 non-targeted vertebrae). In both targeted and non-targeted vertebrae, there was an increase in bone density per month (βoverall = .04; P = .002) with the largest effect being between 9-18 months post-radiation. Radiation did not cause a greater increase in bone density per month compared to non-targeted vertebrae (βdifference = .67; P = .118). Conclusion Our results demonstrate that following radiation, bone density increased over time for both targeted and non-targeted vertebrae. However, no conclusive evidence was found that targeted vertebrae have a higher remineralization rate than non-targeted vertebrae in patients with MM.
Measuring treatment burden in people with Type 2 Diabetes Mellitus (T2DM): a mixed-methods systematic review
Authors: Lin Kai , Yao Mi , Ji Xinxin , Li Rouyan , Andrew Lesley , Oosthuizen Jacques , Sim Moira , Chen Yongsong 
Published: June 2024

Abstract
Background
Measuring treatment burden is important for the effective management of Type 2 Diabetes Mellitus (T2DM) care. The purpose of this systematic review was to identify the most robust approach for measuring treatment burden in people with T2DM based on existing evidence.

Methods
Articles from seven databases were retrieved. Qualitative, quantitative, and mixed-methods studies examining treatment burden in adults with T2DM and/or reporting relevant experiences were included. A convergent segregated approach with a mixed-methods design of systematic review was employed, creating a measurement framework in a narrative review for consistent critical appraisal. The quality of included studies was assessed using the Joanna Briggs Institute tool. The measurement properties of the instruments were evaluated using the Consensus based Standards for selection of Health Measurement Instruments (COSMIN) checklist.

Results
A total of 21,584 records were screened, and 26 articles were included, comprising 11 quantitative, 11 qualitative, and 4 mixed-methods studies. A thematic analysis of qualitative data extracted from the included articles summarised a measurement framework encompassing seven core and six associated measurements. The core measurements, including financial, medication, administrative, lifestyle, healthcare, time/travel, and medical information burdens, directly reflect the constructs pertinent to the treatment burden of T2DM. In contrast, the associated measurement themes do not directly reflect the burdens or are less substantiated by current evidence. The results of the COSMIN checklist evaluation demonstrated that the Patient Experience with Treatment and Self-management (PETS), Treatment Burden Questionnaire (TBQ), and Multimorbidity Treatment Burden Questionnaire (MTBQ) have robust instrument development processes. These three instruments, with the highest total counts combining the number of themes covered and "positive" ratings in COSMIN evaluation, were in the top tertile stratification, demonstrating superior applicability for measuring T2DM treatment burden.

Conclusions
This systematic review provides evidence for the currently superior option of measuring treatment burden in people with T2DM. It also revealed that most current research was conducted in well-resourced institutions, potentially overlooking variability in under-resourced settings.
Preliminary study on AI-assisted diagnosis of bone remodeling in chronic maxillary sinusitis
Authors: Zou Caiyun , Ji Hongbo , Cui Jie , Qian Bo , Chen Yu-Chen , Zhang Qingxiang , He Shuangba , Sui Yang , Bai Yang , Zhong Yeming , Zhang Xu , Ni Ting , Che Zigang 
Published: June 2024

Abstract
Objective
To construct the deep learning convolution neural network (CNN) model and machine learning support vector machine (SVM) model of bone remodeling of chronic maxillary sinusitis (CMS) based on CT image data to improve the accuracy of image diagnosis.

Methods
Maxillary sinus CT data of 1000 samples in 500 patients from January 2018 to December 2021 in our hospital was collected. The first part is the establishment and testing of chronic maxillary sinusitis detection model by 461 images. The second part is the establishment and testing of the detection model of chronic maxillary sinusitis with bone remodeling by 802 images. The sensitivity, specificity and accuracy and area under the curve (AUC) value of the test set were recorded, respectively.

Results
Preliminary application results of CT based AI in the diagnosis of chronic maxillary sinusitis and bone remodeling. The sensitivity, specificity and accuracy of the test set of 93 samples of CMS, were 0.9796, 0.8636 and 0.9247, respectively. Simultaneously, the value of AUC was 0.94. And the sensitivity, specificity and accuracy of the test set of 161 samples of CMS with bone remodeling were 0.7353, 0.9685 and 0.9193, respectively. Simultaneously, the value of AUC was 0.89.

Conclusion
It is feasible to use artificial intelligence research methods such as deep learning and machine learning to automatically identify CMS and bone remodeling in MSCT images of paranasal sinuses, which is helpful to standardize imaging diagnosis and meet the needs of clinical application.
Psychiatrists’ perceptions of conditions and consequences associated with the implementation of open notes: qualitative investigation
Authors: Schwarz Julian , Hoetger Cosima , Pluschke Lena-Sophie , Muehlensiepen Felix , Schneider Michael , Thoma Samuel , Esch Tobias 
Published: June 2024

AbstractObjectiveIn a growing list of countries, patients are granted access to their clinical notes (“open notes”) as part of their online record access. Especially in the field of mental health, open notes remain controversial with some clinicians perceiving open notes as a tool for improving therapeutic outcomes by increasing patient involvement, while others fear that patients might experience psychological distress and perceived stigmatization, particularly when reading clinicians’ notes. More research is needed to optimize the benefits and mitigate the risks.MethodsUsing a qualitative research design, we conducted semi-structured interviews with psychiatrists practicing in Germany, to explore what conditions they believe need to be in place to ensure successful implementation of open notes in psychiatric practice as well as expected subsequent changes to their workload and treatment outcomes. Data were analyzed using thematic analysis.ResultsWe interviewed 18 psychiatrists; interviewees believed four key conditions needed to be in place prior to implementation of open notes including careful consideration of (1) diagnoses and symptom severity, (2) the availability of additional time for writing clinical notes and discussing them with patients, (3) available resources and system compatibility, and (4) legal and data protection aspects. As a result of introducing open notes, interviewees expected changes in documentation, treatment processes, and doctor-physician interaction. While open notes were expected to improve transparency and trust, participants anticipated negative unintended consequences including the risk of deteriorating therapeutic relationships due to note access-related misunderstandings and conflicts.ConclusionPsychiatrists practiced in Germany where open notes have not yet been established as part of the healthcare data infrastructure. Interviewees were supportive of open notes but had some reservations. They found open notes to be generally beneficial but anticipated effects to vary depending on patient characteristics. Clear guidelines for managing access, time constraints, usability, and privacy are crucial. Open notes were perceived to increase transparency and patient involvement but were also believed to raise issues of stigmatization and conflicts.