bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid-Related Trends in Active Duty Service Members During the Coronavirus Disease 2019 Pandemic
Authors: Sorensen Ian S , Susi Apryl , Andreason Paul , Hisle-Gorman Elizabeth , Jannace Kalyn C , Krishnamurthy Jayasree , Chokshi Binny , Dorr Madeline , Wolfgang Aaron S , Nylund Cade M 
Published: November 2023

ABSTRACT

Introduction
The USA is experiencing an opioid epidemic. Active duty service members (ADSMs) are at risk for opioid use disorder (OUD). The Coronavirus disease 2019 (COVID-19) pandemic has disrupted health care and introduced additional stressors.

Methods
The Military Healthcare System Data Repository was used to evaluate changes in diagnosis of OUD, medications for OUD (MOUD), opioid overdose (OD), and opioid rescue medication. ADSMs ages 18-45 years enrolled in the Military Healthcare System between February 2019 and April 2022 were included. Joinpoint Trend Analysis Software calculated the average monthly percent change over the study period, whereas Poisson regression compared outcomes over three COVID-19 periods: Pre-lockdown (pre-COVID-19 period 0) (February 2019-February 2020), early pandemic until ADSM vaccination initiation (COVID-19 period 1 [CP1]) (March 2020-November 2020), and late pandemic post-vaccination initiation (COVID-19 period 2 [CP2]) (December 2020-April 2022).

Results
A total of 1.86 million eligible ADSMs received care over the study period. Diagnoses of OUD decreased 1.4% monthly, MOUD decreased 0.6% monthly, diagnoses of opioid OD did not change, and opioid rescue medication increased 8.5% monthly.
Diagnoses of OUD decreased in both COVID-19 time periods: CP1 and CP2: Rate ratio (RR) = 0.74 (95% CI, 0.68-0.79) and RR = 0.72 (95% CI, 0.67-0.76), respectively. MOUD decreased in both CP1 and CP2: RR = 0.77 (95% CI, 0.68-0.88) and RR = 0.86 (95% CI, 0.78-0.96), respectively. Adjusted rates for diagnoses of opioid OD did not vary in either COVID-19 time period. Opioid rescue medication prescriptions increased in CP1 and CP2: RR = 1.09 (95% CI, 1.02-1.15) and RR = 6.02 (95% CI, 5.77-6.28), respectively.

Conclusions
Rates of OUD and MOUD decreased, whereas rates of opioid rescue medication increased during the study period. Opioid OD rates did not significantly change in this study. Changes in the DoD policy may be affecting rates with greater effect than COVID-19 pandemic effects.
Cohesion Assessment Team: A Multidisciplinary Unit Assessment Grounded in Army Doctrine
Authors: Crouch Coleen L , Teegarden Lisa A , Davis Jason , Adrian Amanda L , Knust Susannah K 
Published: November 2023

ABSTRACT

Introduction
The Cohesion Assessment Team (CAT) provides battalion and brigade command teams with actionable insight into the climate of their unit and the presence of certain harmful behaviors. This assessment, initiated by the Vice Chief of Staff of the Army and initially managed by the Headquarters Department of the Army’s People First Task Force, employs a framework from the Center for Army Professional Leadership to structure data and findings.

Materials and Methods
This manuscript describes how to conduct a CAT assessment. To start, two battalions within the same brigade are selected or volunteer for observation based on various metrics. Data are collected from multiple sources including (1) army metrics, such as promotion rates and Uniformed Code of Military Justice actions, (2) subject matter expert in-person observations and interactions, (3) discussions with battalion and brigade staff, (4) survey data from approximately 90% of the soldiers in participating units, and (5) targeted interviews, focus groups, and listening sessions. Onsite data are collected and synthesized with the survey results within a week. Results are presented to battalion and brigade command teams. Briefs highlight key elements of the unit climate that should be maintained or improved. In addition, summarized results are presented to progressively higher echelons of leadership, culminating with the Vice Chief of Staff of the Army for consideration of army-wide changes.

Results and Conclusions
The CAT focuses on providing leaders at brigade and below with relevant and actionable information to help inform their internal decision-making to improve their unit’s climate. This capability is distinct in many ways, including its non-attributional systems focus and its methodical approach to quickly collecting and triangulating multiple data points. Additionally, the CAT helps leaders identify areas under their control that will impact unit climate, similar to the feedback that training events provide on unit readiness. Army leadership deemed the CAT pilot a success, and responsibility for future CATs was transferred to the Training and Doctrine Command (TRADOC) in October 2022.
Prompt gamma-ray burst emission from internal shocks – new insights
Authors: Rahaman S k Minhajur , Granot Jonathan , Beniamini Paz 
Published: November 2023

ABSTRACT
Internal shocks are a leading candidate for the dissipation mechanism that powers the prompt γ-ray emission in gamma-ray bursts (GRBs). In this scenario a compact central source produces an ultra-relativistic outflow with varying speeds, causing faster parts or shells to collide with slower ones. Each collision produces a pair of shocks – a forward shock (FS) propagating into the slower leading shell and a reverse shock (RS) propagating into the faster trailing shell. The RS’s lab-frame speed is always smaller, while the RS is typically stronger than the FS, leading to different conditions in the two shocked regions that both contribute to the observed emission. We show that optically thin synchrotron emission from both (weaker FS + stronger RS) can naturally explain key features of prompt GRB emission such as the pulse shapes, time evolution of the νFν peak flux and photon energy, and the spectrum. Particularly, it can account for two features commonly observed in GRB spectra: (i) a sub-dominant low-energy spectral component (often interpreted as ‘photospheric’-like), or (ii) a doubly broken power-law spectrum with the low-energy spectral slope approaching the slow-cooling limit. Both features can be obtained while maintaining high-overall radiative efficiency without any fine tuning of the physical conditions.
SnapKin: a snapshot deep learning ensemble for kinase-substrate prediction from phosphoproteomics data
Authors: Xiao Di , Lin Michael , Liu Chunlei , Geddes Thomas A , Burchfield James G , Parker Benjamin L , Humphrey Sean J , Yang Pengyi 
Published: November 2023

Abstract
A major challenge in mass spectrometry-based phosphoproteomics lies in identifying the substrates of kinases, as currently only a small fraction of substrates identified can be confidently linked with a known kinase. Machine learning techniques are promising approaches for leveraging large-scale phosphoproteomics data to computationally predict substrates of kinases. However, the small number of experimentally validated kinase substrates (true positive) and the high data noise in many phosphoproteomics datasets together limit their applicability and utility. Here, we aim to develop advanced kinase-substrate prediction methods to address these challenges. Using a collection of seven large phosphoproteomics datasets, and both traditional and deep learning models, we first demonstrate that a ‘pseudo-positive’ learning strategy for alleviating small sample size is effective at improving model predictive performance. We next show that a data resampling-based ensemble learning strategy is useful for improving model stability while further enhancing prediction. Lastly, we introduce an ensemble deep learning model (‘SnapKin’) by incorporating the above two learning strategies into a ‘snapshot’ ensemble learning algorithm. We propose SnapKin, an ensemble deep learning method, for predicting substrates of kinases from large-scale phosphoproteomics data. We demonstrate that SnapKin consistently outperforms existing methods in kinase-substrate prediction. SnapKin is freely available at https://github.com/PYangLab/SnapKin.
Four decades of full-scale nitrous oxide emission inventory in China
Authors: Liang Minqi , Zhou Zheyan , Ren Peiyang , Xiao Han , Xu-Ri  , Hu Zhongmin , Piao Shilong , Tian Hanqin , Tong Qing , Zhou Feng , Wei Jing , Yuan Wenping 
Published: November 2023

ABSTRACT
China is among the top nitrous oxide (N2O)-emitting countries, but existing national inventories do not provide full-scale emissions including both natural and anthropogenic sources. We conducted a four-decade (1980–2020) of comprehensive quantification of Chinese N2O inventory using empirical emission factor method for anthropogenic sources and two up-to-date process-based models for natural sources. Total N2O emissions peaked at 2287.4 (1774.8–2799.9) Gg N2O yr−1 in 2018, and agriculture-developed regions, like the East, Northeast, and Central, were the top N2O-emitting regions. Agricultural N2O emissions have started to decrease after 2016 due to the decline of nitrogen fertilization applications, while, industrial and energetic sources have been dramatically increasing after 2005. N2O emissions from agriculture, industry, energy, and waste represented 49.3%, 26.4%, 17.5%, and 6.7% of the anthropogenic emissions in 2020, respectively, which revealed that it is imperative to prioritize N2O emission mitigation in agriculture, industry, and energy. Natural N2O sources, dominated by forests, have been steadily growing from 317.3 (290.3–344.1) Gg N2O yr−1 in 1980 to 376.2 (335.5–407.2) Gg N2O yr−1 in 2020. Our study produces a Full-scale Annual N2O dataset in China (FAN2020), providing emergent counting to refine the current national N2O inventories.
Stewardship-Guided T2Candida Testing Shortens Time to Antifungal Treatment and Reduces Antifungal Usage Among Medical Intensive Care Unit Patients With Septic Shock
Authors: O’Donnell Matthew , Shields Ryan K , Marini Rachel V , Groetzinger Lara M , Potoski Brian A , Falcione Bonnie A , Shah Sunish , McCreary Erin K , Clarke Lloyd , Brant Emily , McVerry Bryan J , Liegey Susan , Pasculle A William , Clancy Cornelius J , Nguyen M Hong 
Published: November 2023

Abstract

Background
Diagnosis of invasive candidiasis (IC) is limited by insensitivity and slow turnaround of cultures. Our objectives were to define the performance of T2Candida, a nonculture test, under guidance of a diagnostic stewardship program, and evaluate impact on time to antifungal initiation and antifungal utilization.

Methods
This was a retrospective study of adult medical intensive care unit (MICU) patients with septic shock for whom T2Candida testing was performed from March 2017 to March 2020. Patients with positive T2Candida results during this period were compared to MICU patients who did not undergo T2Candida testing but had septic shock and blood cultures positive for Candida from January 2016 through March 2020.

Results
Overall, 155 T2Candida tests from 143 patients were included. Nine percent of T2Candida tests were positive compared to 4.5% of blood cultures. Sensitivity, specificity, positive predictive value, and negative predictive value of T2Candida for proven and probable IC were 78%, 95%, 50%, and 99%, respectively. Patients who tested positive for T2Candida (n = 14) were diagnosed earlier and initiated on antifungal therapy sooner than patients with IC (n = 14) diagnosed by blood culture alone (median, 5.6 vs 60 hours; P &lt; .0001). Median antifungal days of therapy/1000 patient-days were 23.3/month preimplementation and 15/month postimplementation (P = .007). Following a negative T2Candida result, empiric antifungals were either not administered in 58% or discontinued within 72 hours in 96% of patients.

Conclusions
Diagnostic stewardship guided T2Candida testing resulted in reduced time to IC diagnosis, faster initiation of antifungal therapy, and lower antifungal usage among MICU patients with septic shock.
Central Nervous System Tuberculosis: Risk Factors for Mortality in a Propensity Score–Matched Case-Control Study
Authors: Asare-Baah Michael , Johnston Lori , Ramirez-Hiller Tatiana , Séraphin Marie Nancy , Lauzardo Michael 
Published: November 2023

Abstract

Background
Despite advancements in tuberculosis (TB) control and treatment in the United States (US), patients with central nervous system TB (CNS-TB) continue to experience significantly higher mortality rates than those without CNS-TB. This raises concerns regarding clinical management and the need for a deeper understanding of the risk factors contributing to these deaths. This study aimed to determine the predictors of mortality in patients with CNS-TB.

Methods
We conducted a retrospective 1:2 propensity score–matched case-control study. Cases were TB patients diagnosed with TB of the meninges, brain, spinal cord, or peripheral nerves, as documented in the Florida Department of Health (FDOH) TB registry, between 2009 and 2021. Controls were TB patients without CNS-TB, also reported in the FDOH TB registry during the same timeframe. We employed conditional logistic regression models to investigate the factors contributing to mortality in cases compared with controls.

Results
We analyzed data from 116 cases and 232 matched controls. Patients with CNS-TB had a 5.69-fold higher risk of death than those without CNS-TB (adjusted odds ratio [aOR], 5.69 [95% confidence interval {CI}, 2.91–11.6]). Increased risk of death was associated with human immunodeficiency virus (HIV) coinfection (aOR, 1.93 [95% CI, .82–4.37]) and diabetes (aOR, 3.13 [95% CI, 1.28–7.47]). Miliary TB and non-HIV immunosuppression were significantly associated with being a case, while cavitary TB was less likely to be associated with being a case.

Conclusions
Clinical management should prioritize screening and close monitoring of patients with HIV coinfection and diabetes to improve patient outcomes.
Evaluating the Goals of Personal Injury Law: Some Empirical Evidence
Authors: Harris Donald 
Published: November 2023

Abstract
A major justification put forward today for retaining tort liability for personal injuries is that the fear of incurring liability will lead potential defendants to take care to avoid causing accidents. Much of this paper will be devoted to examining, in the light of recent empirical data, both this goal, and that of compensating injured people. But something should be said about the view that tort law is a mode of corrective justice,2 which requires restoration of the previous balance between the wrongdoer and the victim. This goal is that the wrongdoer should be compelled to restore the victim’s previous position: he enjoys individual rights, and if they are violated the wrongdoer is required to reverse the wrong. In the case of unintended harm, corrective justice would require that losses caused by careless action should be shifted from the innocent victim to the careless person.
Emerging clinical relevance of microbiome in cancer: promising biomarkers and therapeutic targets
Authors: Dai Jia-Hao , Tan Xi-Rong , Qiao Han , Liu Na 
Published: November 2023

Abstract
The profound influence of microbiota in cancer initiation and progression has been under the spotlight for years, leading to numerous researches on cancer microbiome entering clinical evaluation. As promising biomarkers and therapeutic targets, the critical involvement of microbiota in cancer clinical practice has been increasingly appreciated. Here, recent progress in this field is reviewed. We describe the potential of tumor-associated microbiota as effective diagnostic and prognostic biomarkers, respectively. In addition, we highlight the relationship between microbiota and the therapeutic efficacy, toxicity, or side effects of commonly utilized treatments for cancer, including chemotherapy, radiotherapy, and immunotherapy. Given that microbial factors influence the cancer treatment outcome, we further summarize some dominating microbial interventions and discuss the hidden risks of these strategies. This review aims to provide an overview of the applications and advancements of microbes in cancer clinical relevance.
Lepton universality violation in the minimal flipped 331 model
Authors: Thu P N , Duy N T , Hernández A E Cárcamo , Huong D T 
Published: November 2023

Abstract
We perform a detailed study of the b → cτν and b → sl+l− processes in a minimal flipped 331 model based on the SU(3)C × SU(3)L × U(1)X gauge symmetry. The non-universal SU(3)L × U(1)X symmetry in the lepton sector gives rise to non-universal neutral and charged currents involving heavy non-SM gauge bosons and SM leptons that yield radiative contributions to the b → s, b → c, s → u, and d → u transitions arising from one-loop-level penguin and box diagrams. We find that the observables related to these transitions agree with their experimental values in a region of parameter space that includes TeV-scale exotic up-type quarks, within the reach of the Large Hadron Collider.
Development of a low-background HPGe detector at Kamioka Observatory
Authors: Ichimura K , Ikeda H , Kishimoto Y , Kurasawa M , Suzuki A A , Gando Y , Ikeda M , Hosokawa K , Sekiya H , Ito H , Minamino A , Suzuki S 
Published: November 2023

Abstract
A new ultra-low background high-purity germanium (HPGe) detector has been installed at the Kamioka underground experimental site. The background count rate in the energy range from 40 keV to 2700 keV is about 25% lower than that of the first HPGe detector installed in 2016, which has the same detector specification and similar shielding geometry. This paper describes the shielding configuration, including the cleaning of the material surface, the comparison of calibration data and simulation, the time variation of the background spectra, the sample measurement procedure, and some results of the radioactivity in the selected samples.
Full-Thickness Macular Hole Closure with Topical Medical Therapy
Authors: Wang Jessie , Rodriguez Sarah H , Xiao Jason , Luo Wendy , Gonnah Reem , Shaw Lincoln , Dao David , Schechet Sidney A , Mackin Anna G , Komati Rahul , Skondra Dimitra 
Published: November 2023

Abstract

Purpose:
To examine the efficacy and clinical characteristics of successful full-thickness macular hole (FTMH) closure with topical therapy.

Methods:
Retrospective case series of FTMHs managed by a single retinal physician (DS) diagnosed and treated from 2017-22.

Results:
Of 168 patients with FTMHs, 71 patients were started on steroid, carbonic anhydrase inhibitor (CAI), and non-steroidal anti-inflammatory (NSAID) drops. 49 patients (mean 67yrs, 59% women) were included in the analysis; 22 were excluded for poor follow-up. 7/49 were secondary post-PPV holes and 42/49 were idiopathic. 18/49 eyes (36.7%) achieved closure on topical therapy, of which 13 were idiopathic. Hole size was directly correlated with odds of closure: for every 10-micron decrease in size, odds of closure increased by 1.2x (p=0.001, CI 1.1-1.4). Average time to closure was 107.2 days (range 20-512 days), and was not correlated to hole size (p=0.217, CI -0.478–+1.938). The presence of VMT was found to be inversely related to successful closure (OR 6.1, p=0.029, CI 1.2-31.3). There was no significant difference in final BCVA for eyes undergoing primary PPV versus those trialing drops before undergoing PPV (p=0.318, CI -0.094–+0.112).

Conclusion:
In the first study to-date to report the overall efficacy and clinical characteristics of successful macular hole closure with topical therapy, drops achieved an overall closure rate of 36.7%, with higher efficacy in smaller holes and those without VMT. Rates of MH narrowing and reduction in CFT acted as predictors of effectiveness of drop therapy.
Assessing the impact of COVID-19 on outpatient and inpatient revenues: A comparative analysis of large and small hospitals in Taiwan
Authors: Yan Yu-Hua , Ho Sam Yu-Chieh , Chien Tsair-Wei , Chou Willy 
Published: November 2023

Background:
The COVID-19 pandemic has had profound effects on healthcare systems worldwide, not only by straining medical resources but also by significantly impacting hospital revenues. These economic repercussions have varied across different hospital departments and facility sizes. This study posits that outpatient (OPD) revenues experienced greater reductions than inpatient (IPD) revenues and that the financial impact was more profound in larger hospitals than in smaller hospitals.

Methods:
We collected data on patient case numbers and associated revenues for 468 hospitals from the Taiwan government-run National Health Insurance Administration website. We then employed Microsoft Excel to construct scatter plots using the trigonometric function (=DEGREES (Atan (growth rate))) for each hospital. Our analysis scrutinized 4 areas: the case numbers and the revenues (represented by medical fees) submitted to the Taiwan government-run National Health Insurance Administration in both March and April of 2019 and 2020 for OPD and IPD departments. The validity of our hypotheses was established through correlation coefficients (CCs) and chi-square tests. Moreover, to visualize and substantiate the hypothesis under study, we utilized the Kano diagram. A higher CC indicates consistent counts and revenues between 2019 and 2020.

Results:
Our findings indicated a higher impact on OPDs, with CCs of 0.79 and 0.83, than on IPDs, which had CCs of 0.40 and 0.18. Across all hospital types, there was a consistent impact on OPDs (P = .14 and 0.46). However, a significant variance was observed in the impact on IPDs (P < .001), demonstrating that larger hospitals faced greater revenue losses than smaller facilities, especially in their inpatient departments.

Conclusion:
The two hypotheses confirmed that the COVID-19 pandemic impacted outpatient departments more than inpatient departments. Larger hospitals in Taiwan faced greater financial challenges, especially in inpatient sectors, underscoring the pandemic’s varied economic effects. The COVID-19 pandemic disproportionately affected outpatient departments and larger hospitals in Taiwan. Policymakers must prioritize support for these areas to ensure healthcare resilience in future epidemics. The research approach used in this study can be utilized as a model for similar research in other countries affected by COVID-19.