bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of clinical response criteria and disease activity levels with axial spondyloarthritis core domains: results from two phase 3 randomised studies, BE MOBILE 1 and 2
Authors: Navarro-Compán Victoria , Ramiro Sofia , Deodhar Atul , Mease Philip J , Rudwaleit Martin , de la Loge Christine , Fleurinck Carmen , Taieb Vanessa , Mørup Michael F , Massow Ute , Kay Jonathan , Magrey Marina 
Published: April 2024

ObjectiveTo assess how achievement of increasingly stringent clinical response criteria and disease activity states at week 52 translate into changes in core domains in patients with non-radiographic (nr-) and radiographic (r-) axial spondyloarthritis (axSpA).MethodsPatients in BE MOBILE 1 and 2 achieving different levels of response or disease activity (Assessment of SpondyloArthritis International Society (ASAS) and Ankylosing Spondylitis Disease Activity Score (ASDAS) response criteria, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50)) at week 52 were pooled, regardless of treatment arm. Associations between achievement of these endpoints and change from baseline (CfB) in patient-reported outcomes (PROs) measuring core axSpA domains, including pain, fatigue, physical function, overall functioning and health, and work and employment, were assessed.ResultsAchievement of increasingly stringent clinical efficacy endpoints at week 52 was generally associated with sequentially greater improvements from baseline in all PROs. Patients with nr-axSpA achieving ASAS40 demonstrated greater improvements (CfB) than patients who did not achieve ASAS40 but did achieve ASAS20, in total spinal pain (−5.3 vs −2.8, respectively), Functional Assessment of Chronic Illness-Fatigue subscale (12.7 vs 6.7), Bath Ankylosing Spondylitis Function Index (−3.9 vs −1.8), European Quality of Life 5-Dimension 3-Level Version (0.30 vs 0.16), Work Productivity and Activity Impairment-axSpA presenteeism (−35.4 vs −15.9), overall work impairment (−36.5 vs −12.9), activity impairment (−39.0 vs −21.0) and sleep (9.0 vs 3.9). Results were similar for ASDAS and BASDAI50. Similar amplitudes of improvement were observed between patients with nr-axSpA and r-axSpA.ConclusionsPatients treated with bimekizumab across the full axSpA disease spectrum, who achieved increasingly stringent clinical response criteria and lower disease activity at week 52, reported larger improvements in core axSpA domains.
Milling characteristics of SiCp/2024Al composites thin-walled part based on movable auxiliary support
Authors: Gao Zhijie , Zhu Peng , Yang Shu , Wei Zuoshan , Wang Qitong , Zhou Li 
Published: April 2024

Due to milling force and milling heat, thin-walled parts are highly susceptible to deformation and even scrap. In this paper, a method of milling thin-walled part based on the movable auxiliary support was proposed. The ABAQUS software was employed to simulate the milling of thin-walled SiCp/2024Al composite part, while the movement of the auxiliary support was simulated using the secondary development subroutine VDLOAD. The influences of the magnitude and area of the movable auxiliary support on the surface temperature, deformation, and residual stress of the workpiece were investigated by single factor method. The results showed that, with the increasing of the magnitude and area of the movable auxiliary support, both surface temperature and deformation of the thin-walled part decrease. The tensile residual stress decreases and gradually changes to compressive residual stress. Interestingly, when the magnitude exceeds 20 MPa or the area exceeds 100 mm2, the deformation of the thin-walled part continues to decrease, but the middle of the thin-walled part is concave toward the milling cutter. It is worth noting that the effect of area on the residual stress does not show a clear regularity. Thus, the reasonable auxiliary support can reduce deformation and stability in the milling of thin-walled parts and the results of the study can provide a theoretical basis for optimizing the milling process of thin-walled parts.
Orphan GPCR GPRC5C Facilitates Angiotensin II-Induced Smooth Muscle Contraction
Authors: Wang Tianpeng , Shao Jingchen , Kumar Shamit , Alnouri Mohammad Wessam , Carvalho Jorge , Günther Stefan , Krasel Cornelius , Murphy Kate T. , Bünemann Moritz , Offermanns Stefan , Wettschureck Nina 
Published: April 2024

BACKGROUND:
GPCRs (G-protein-coupled receptors) play a central role in the regulation of smooth muscle cell (SMC) contractility, but the function of SMC-expressed orphan GPCR class C group 5 member C (GPRC5C) is unclear. The aim of this project is to define the role of GPRC5C in SMC in vitro and in vivo.

METHODS:
We studied the role of GPRC5C in the regulation of SMC contractility and differentiation in human and murine SMC in vitro, as well as in tamoxifen-inducible, SMC-specific GPRC5C knockout mice under basal conditions and in vascular disease in vivo.

RESULTS:
Mesenteric arteries from tamoxifen-inducible, SMC-specific GPRC5C knockout mice showed ex vivo significantly reduced angiotensin II (Ang II)–dependent calcium mobilization and contraction, whereas responses to other relaxant or contractile factors were normal. In vitro, the knockdown of GPRC5C in human aortic SMC resulted in diminished Ang II-dependent inositol phosphate production and lower myosin light chain phosphorylation. In line with this, tamoxifen-inducible, SMC-specific GPRC5C knockout mice showed reduced Ang II–induced arterial hypertension, and acute inactivation of GPRC5C was able to ameliorate established arterial hypertension. Mechanistically, we show that GPRC5C and the Ang II receptor AT1 dimerize, and knockdown of GPRC5C resulted in reduced binding of Ang II to AT1 receptors in HEK293 cells, human and murine SMC, and arteries from tamoxifen-inducible, SMC-specific GPRC5C knockout mice.

CONCLUSIONS:
Our data show that GPRC5C regulates Ang II-dependent vascular contraction by facilitating AT1 receptor-ligand binding and signaling.
Impacts of Stochastic Coalescence Variability on Warm Rain Initiation Using Lagrangian Microphysics in Box and Large-Eddy Simulations
Authors: Morrison Hugh , Chandrakar Kamal Kant , Shima Shin-Ichiro , Dziekan Piotr , Grabowski Wojciech W. 
Published: April 2024

Abstract
Various coalescence methods for Lagrangian microphysics schemes are tested in box and large-eddy simulation (LES) models, including the stochastic all-or-nothing (AON) superdroplet method (SDM) and a deterministic version of SDM (dSDM) that applies a fractional approach similar to the average impact method. In LES, variabilities driven by microphysics and by flow realizations are separated using the “piggybacking” technique. Rain initiation averaged over many realizations of the box model is delayed, and rain variability increases as the number of superdrops per collision volume NSD is decreased using SDM. In contrast, rain initiation time using SDM in LES is insensitive to NSD for 32 ≤ NSD ≤ 512. This is explained through the interaction between LES grid boxes, each acting as a separate collision volume. Variability across the ensemble of LES collision volumes using SDM results in rain quickly initiating in some of the LES grid cells at low NSD and leading to a similar overall timing of rain initiation from the cloud compared to simulations with high NSD. There is a ∼20% decrease in the total rain mass and mean rain flux as NSD is increased from 32 to 256, with little additional change as NSD is increased from 256 to 512. The fractional coalescence approach in dSDM leads to reduced microphysical variability and a 15–18-min delay in rain initiation compared to SDM. An additional LES ensemble with microphysical variability feeding back to the dynamics shows that flow variability dominates the impact of microphysical variability on rain properties. Thus, flow variability must be constrained to isolate impacts of microphysical variability.

Significance Statement
An emerging tool in cloud microphysics modeling represents drops by computational particles called “superdroplets” that evolve in the modeled flow. Recent studies have documented that different superdroplet models produce widely varying predictions of rain. Understanding these differences is an important step in the wider adoption of these models by the community. Here, we examine different methods for representing droplet collision-coalescence in a superdroplet model and sensitivity to the number of superdroplets employed. The timing of rain initiation is insensitive to the superdroplet number in 3D cloud simulations, but rain is substantially delayed using a coalescence method that limits random variability in droplet collisions. We also show that flow variability must be constrained to isolate impacts of microphysical variability on rain properties.
Improving the Representation of Moisture and Convective Instability in Baroclinic-Wave Channel Simulations
Authors: Lloveras Daniel J. , Durran Dale R. 
Published: April 2024

Abstract
We present an improved approach to generating moist baroclinically unstable background states for f-plane-channel simulations via potential vorticity (PV) inversion. Previous studies specified PV distributions with constant values in the troposphere and the stratosphere, but this produces unrealistic static-stability profiles that decrease sharply with height in the troposphere. Adding moisture to such environments can yield unrealistically large values of convective available potential energy (CAPE) even for reasonable relative humidity (RH) distributions. In our modified approach, we specify a PV distribution that increases with height in the troposphere and the stratosphere, yielding background states with more realistic values of static stability and CAPE. This modification produces environments that are better suited for representing moist processes, namely, deep convection, in idealized extratropical-cyclone simulations. Also, we present a method for introducing moisture that preserves a specified RH distribution while maintaining hydrostatic balance. Our approach allows for a large degree of control over the initial conditions, as background states with different jet strengths and shapes, average temperatures, moisture contents, or horizontal shears can easily be obtained without changing the underlying PV formula and inadvertently producing unreasonable values of static stability or CAPE. We demonstrate the characteristics of idealized extratropical cyclones developing in our background states by adding localized perturbations that represent an upper-level trough passing over a low-level frontal zone. In particular, we illustrate the impacts of horizontal shear, moisture, and grid spacing on baroclinic-wave development.
Safety and Efficacy of Inpatient Infliximab Rescue Therapy for Acute Crohn’s Disease Flares
Authors: Whitlock Ashlyn E. , Arndt Kevin R. , Zakopoulos Iordanis , Wong Daniel J. , Kaul Sumedh , Feuerstein Joseph , Crowell Kristen T. , Messaris Evangelos 
Published: April 2024

Purpose Describe the safety, complications, and need for urgent surgery in patients requiring inpatient rescue infliximab for acute Crohn’s disease (CD) flare. Background Infliximab is increasingly used for patients hospitalized with acute severe ulcerative colitis as rescue therapy; however, optimal management for patients hospitalized for CD flares remains unclear. Methods A single-institution retrospective study of patients aged 18+ admitted from 2008 to 2020 with acute Crohn’s flare requiring induction of rescue infliximab therapy. Outcomes included postoperative and medication-related complications and need for urgent surgery. Results 52 patients were included in analysis; 8% required surgery on index admission, and 19% required surgery within 90 days of infliximab. Postoperative complications included 1 anastomotic leak, 3 superficial wound infections, 3 prolonged ileus, and 1 urinary infection. There were no adverse reactions to infliximab infusion, and medical complication rates were low. Patients with penetrating disease were more likely to undergo surgery within 90 days of infliximab (43% vs 8%; P = .01). Mean LOS was longer for patients undergoing surgery within 90 days of therapy compared to those who did not (13.4 vs 8.3 days, P = .04). Conclusion Inpatient rescue infliximab is safe for treating acute Crohn’s disease flare in addition to standard steroid therapy. The majority of patients hospitalized with Crohn’s flare requiring rescue infliximab avoided surgery with low postoperative and medication-related complications. More research is needed to clarify the optimal rescue infliximab therapy dosage.
Findings from the Promoting Independence in Dementia App (PRIDE-app) Study a Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework Discussion
Authors: Lee Abigail Rebecca , McDermott Orii , Orrell Martin 
Published: April 2024

Introduction Self-management is pivotal in helping people with their independence and in managing their health conditions more effectively. The PRIDE-app is a novel online intervention, providing support and information for people living with dementia and their families, aimed at increasing self-management and improving quality of life. Knowledge generated will help inform future developments to the app, with the aim of improving its uptake and implementation in services. Methods A mixed-methods approach incorporating the RE-AIM framework. Recruited 25 people living with dementia, of which 17completed the PRIDE-app intervention over 8 weeks with support from a dementia adviser facilitator. Measures exploring mood, physical well-being, and quality of life were collected at baseline, 3 and 6 months and analysed through modelled analysis. Post-intervention interviews were conducted with participants and facilitators and analysed through thematic analysis. Results Quantitative results did not show significant improvements in participants’ scores. Qualitative data showed that the PRIDE-app motivated people to reconnect socially and set individual goals for activities. Participants and facilitators identified areas for improvements to the app interface and delivery format. Conclusions This study evaluated the PRIDE-app’s reach, effectiveness and adoptability in the independence and quality of life of people living with dementia, as well as how it could be implemented and maintained within services. Pre- and post-intervention scores were inconclusive. Interviews provided positive feedback of the app’s influence on peoples’ activities and mood.
Cardiac Troponin I as an Early Prognostic Indicator in Asphyxiated Neonates
Authors: Gupta Rahul , Kumar Neeraj , Sharma Ram Kshitij , Dayal Rajeshwar , Yadav Poonam , Goyal Anamika 
Published: April 2024

Background Myocardial damage, estimated to occur in 28%–73% of asphyxiated neonates, 1 is a major cause of mortality in perinatal asphyxia, and survivors can show significant myocardial morbidity as well. 2 Study Setting and Design This study is a hospital-based prospective cohort study, done at the pediatrics department of a tertiary care hospital in northern India, from December 2020 to June 2022. Materials and Methods 40 asphyxiated neonates with an APGAR score of <7 at 1 minute of life, as per the WHO–Neonatal Perinatal Database, were included in the study. They were graded as hypoxic ischemic encephalopathy (HIE) I (mild), II (moderate), and III (severe) based on Sarnat and Sarnat staging. The blood samples at 0 and 6 hours of life were taken for studying successive changes in the values of high-sensitivity cardiac troponin I (hs-cTnI) and creatinine phospho-kinase-myocardium-bound (CPK-MB). These were compared with various parameters such as electrocardiograph (ECG) findings, 2D-ECHO abnormalities, HIE severity, and outcome. Results Among the two biomarkers that were assessed, hs-cTnI had the highest diagnostic value for detecting myocardial injury and was corelated with the severity of HIE and higher chances of death. Conclusion The troponin I levels, in contrast to CPK-MB levels, were significantly associated with the outcome of the patient, implying that asphyxiated babies with elevated troponin I levels have a poorer prognosis and a higher mortality rate.
The impact of educational and medical systems on autistic children from multilingual American homes: A systematic review
Authors: Kim Hyejung , Baker Diana , Kim Sunyoung , Liu Cong , Cook Kelley 
Published: April 2024

Research has demonstrated that multilingual exposure does not inherently impede language development or academic achievement in autistic children. Nevertheless, autistic students who are multilingual learners may experience unique challenges in the United States, where systemic barriers constrain both the diagnosis and the delivery of education. This review synthesizes 46 US-based studies to assess how educational and, to a lesser extent, medical systems are (or are not) prepared to offer adequate support to autistic individuals from multilingual families. Results reveal varied patterns of systemic inequity faced by multilingual children on the autism spectrum, elucidating the issues of disproportionality as well as unequal access to educational and medical resources. While the majority of studies emphasize the benefits of multilingual environments for autistic students, a persistent trend in favor of monolingual instructional strategies remains. Despite this, emerging publications present experimental evidence that drawing on students’ first languages can bolster academic and behavioral performance and strengthen executive functioning. Lay Abstract Research has found that autistic children can navigate multilingual schools and communities without harming their language skills or school success. However, they may encounter specific challenges within the United States, where educational and healthcare systems are insufficiently equipped to meet their needs. This review examined 46 US-based studies on the topic and findings reveal persistent deficit-based ideas about multilingualism and autism (e.g., professionals recommending that autistic students only speak and learn in English) accompanied by patterns of unequal identification of autism among multilingual children. These findings highlight issues of disproportionality and inadequate access to educational and healthcare resources. However, recent studies indicate that incorporating a child’s native language in education not only enhances learning and behavioral outcomes but also boosts cognitive functions like problem-solving and planning. Taken as a whole, current research suggests that intentionally addressing linguistic diversity will allow educational and medical systems to better serve autistic children.
Complications and Efficacies of Surgical Versus Transcatheter Closure for Pediatric Ostium Secundum Atrial Septal Defect: A Meta-Analysis
Authors: de Liyis Bryan Gervais , Kosasih Anastasya Maria , Jagannatha Gusti Ngurah Prana , Dewangga Made Satria Yudha 
Published: April 2024

Introduction: The optimal approach for pediatric ostium secundum atrial septal defect (ASD) closure remains uncertain. This study aims to assess complications and efficacies of surgical and transcatheter closures. Methods: Systematic search in Medline, Cochrane, and EMBASE databases identified cohort studies until July 2023. Complications, length of hospital stay, and efficacy outcomes were evaluated. Subgroup analyses considered ethnicity, ASD size, age, and rim deficiency involvement. Results: Fourteen cohort studies involving 9695 patients were comprehensively analyzed. Regarding complications, the pediatric patients in the surgery group exhibited higher occurrences of cardiac arrhythmia (odds ratio [OR]: 1.87, 95% confidence interval [CI]: 1.22–2.87, p=0.004), pericardial effusion (OR: 14.80, 95% CI: 6.97–31.43, p<0.00001), and pulmonary complications (OR: 2.58, 95% CI: 1.73–3.85, p<0.00001) compared with those in the transcatheter group. However, no significant difference in fever incidence was observed (OR: 2.57, 95% CI: 0.90–7.34, p=0.08). Furthermore, length of hospital stay was notably shorter in the pediatric transcatheter group (mean difference [MD]: 4.00, 95% CI: 1.71–6.29, p=0.0006). Regarding efficacies, both groups demonstrated similar rates of successful closure (OR: 1.97, 95% CI: 0.56–6.92, p=0.29) and residual shunting (OR: 0.55, 95% CI: 0.17–1.77, p=0.31) in the pediatric cohort. Subgroup analyses revealed that surgical residual shunting was notably lower in the European pediatric population (OR: 0.18, 95% CI: 0.07–0.45, p=0.0002), in cases with ASD size exceeding 15 mm (OR: 0.19, 95% CI: 0.08–0.49, p=0.0006), and in pediatric patients younger than 8 years (OR: 0.33, 95% CI: 0.12–0.92, p=0.03). Interestingly, residual shunting involving complex ASD with rim deficiency was more pronounced in the surgery group (OR: 2.66, 95% CI: 1.33–5.32, p=0.006). Conclusions: Both surgical and transcatheter closures are equally effective, with transcatheter closure showing significantly fewer complications. Clinical Impact This meta-analysis offers pivotal insights for clinicians grappling with the optimal approach to pediatric ostium secundum ASD closure. The observed higher incidence of cardiac arrhythmias, pericardial effusions, and pulmonary complications in surgical closures underscores the challenges associated with this modality. In contrast, transcatheter closure, with its comparable efficacy and shorter hospital stays, emerges as an appealing and less invasive alternative. These findings equip clinicians with evidence to make informed decisions, optimizing patient outcomes. Subgroup analyses further refine recommendations, emphasizing tailored considerations for European pediatric patients, larger ASDs, and those under 8 years old, ultimately fostering personalized and improved care strategies.
The Moderating Role of HIV Stigma on the Relationship between Perceived Social Support and Antiretroviral Therapy Adherence Self-Efficacy among Adult PLHIV in South Africa
Authors: Luthuli Muziwandile Qiniso , John-Langba Johannes 
Published: April 2024

Background People living with human immune deficiency virus (PLHIV) grapple with distinct challenges, including HIV stigma which affects their antiretroviral therapy (ART) adherence self-efficacy. This study investigates the interaction of HIV stigma and perceived social support on ART adherence self-efficacy among adult PLHIV in South Africa. Methods This study utilized a cross-sectional design that involved 201 participants selected using time location sampling at a tertiary health facility in Durban. Results HIV stigma was significantly and negatively associated with self-efficacy (β = −7.860, t = −4.654, p = .001), with variations across different stigma levels (β = −5.844, t = −4.003, p = .001). Social support was significantly and positively associated with self-efficacy at lower HIV stigma levels (β = 7.440, t = 3.887, p = .001), in contrast to higher levels (β = −2.825, t = 1.400, p = .163). Conclusion Social support significantly influences ART adherence self-efficacy, particularly at lower levels of HIV stigma, but the effect of support weakens as stigma intensifies.